HomeMy WebLinkAbout1500 W 17 StCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: S O . (--,)d
Job Address: l 50C) `�+ �� T�i� Historic District: Yes ❑ No ❑
Parcel ID: �Jc 1 q— ��7�—rJ \3"" 0 \ CC-) — 0 1 Q^ Residential t Commercial ❑
Type of Work: New ❑ Addition Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work:
Plan Review Contact Person: Title: CLC'C'�.QL'V—
Phone:Z
Property Owner Information C_.., C�
Name�Wy-gL'ffICk_ �� Q
Street:
City, State Zip: -S Cx�11U1C
Phone:
Resident of property? :
Contractor Information 1 '
Name �� Phone:
Street: Fax: L--1c)
City, State Zip: �,�- - IhC1is State License No.: C_
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
Mortgage Lender:
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be perfornied to meet standards of all laws regulating construction
in this jurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools,
furnaces, boilers, heaters, tanks, and air conditioners, etc.
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5th Edition (2014) Florida Building Code
Revised: June 30. 2015 Permit Application
l
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of subinittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of F ' a �P e
Ir
W.,
Notaryy Public State of Florida
Lynn M BlerdMY CommlaalOn FF 9A9333
Mn�'' EXOMS01/11/2020
IVA
Print Contractor/Agent's Name I
ure o Notary- rate o orida Date
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Type of ID Produced 1D Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas ❑ Roof ❑
Construction Type: Occupancy Use:
Total Sq Ft of Bldg:
Min. Occupancy Load:
Flood Zone:
# of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes ❑ No ❑
APPROVALS: ZONING:
COMMENTS:
ENGINEERING:
# of Heads
UTILITIES:
FIRE:
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: June 30, 2015
Permit Application
305 E 4th St, Unit 101
Sanford Fl , 32771
(407) 688-2317
(407) 688-2397
CFC — 057227
February 7, 2018
Quote # 5862146
Willie Anderson
Replumb House
1500 W 171h St
Sanford, Florida 32771
Item # I Furnish all labor and materials to replumb house with pex piping and replace water service to the
House.
Total of Quote = $ 1,000.00
All work will be in accordance with state and local codes and will be quality workmanship. We look
forward to working with you on this project. If you have any questions or concerns, please do not hesitate
to contact us.
Sincerely,
Exact Plumbing
Jason Turner
President
Acceptance of Proposal
The above referenced, price, specifications and conditions are satisfactory and hereby accepted. You are
authorized to the work as specified.
Date of Acceptance (:A -` Signature
v
KEN IAWSON, SECRETARY
RICK SCOTT, GOVERNOR
STATE OF FLORIDA
DEPARTMENT CONS RUCTION.INDUS INDUSTRY LICENSING BOARDULATION
CFC057227
The PLUMBING CONTRACTORit y,=
Named below IS CERTIFIED
Under the pro islons of Chapter 489 FS.
Expiration date: AUG 31, 2018 J.
TURNER, JASON SCOTT
EXACT PLUMBING INCH'
305 E 4TH ST, UNIT.
SANFORD
SEO # L1607250000971
ISSUED: 07/25/2016