HomeMy WebLinkAbout113 S Palmetto AveCITY OF
NFORD
FIRE DEPARTMENT
1 AR Z Building & Fire Prevention Division
PERMIT APPLICATION
Application No: 1 9~ N q q
Documented Construction Value: $
Job Address: z� �� ]�r`� Historic District: Yes�No❑
Parcel ID: Residential❑ Commercial
Type of Work: New[] Addition❑ Alteration❑ Repair❑ Demo❑ Change of Use[] Move❑
Description of Work:
Plan Review Contact Person: Title:
Phone:
Fax:
Email:
Property Owner Information
Name Phone: 1Jo`q
Street:
City, State Zip:
Resident of property? :
Contractor Information
Name /� �6 `Ry : /_�.
Street: /JD Y S ��L✓h � �a �J�
City, State Zip: 32271
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone: y1� 1f�l
Fax:
State License No.:'��3®/�z
Architect/Engineer Information
Phone:
Fax:
E-mail:
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. 1 certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed 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: 6'h Edition (2017) Florida Building Code
Revised: January 1, 2018 Permit Application
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 I 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 submittal.
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 Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Signature of Contractor/Agent Date
//Zf voAA �
Print Contractor/Agent's Name
Signature of Notary -State of Florida D to
ANNETTE M BLAND
:Notary Public— State of Florida
`.
Commission # GG 170900
• _ pt Comm. Expires Jan 16. 2022
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e,�,• ',rCeC TTr_gr Na,cra
Contrac nown to Me or
Produced ID. : Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing[] Gas[-] Roof ❑
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
# of Heads Fire Alarm Permit: Yes ❑ No ❑
UTILITIES: WASTE WATER:
FIRE:
BUILDING:
Revised: January 1, 2018 Permit Application
Florida Star Electric, LLC
404 S. Palmetto Avenue
Sanford, FL 32771
Phone: (407) 416-8001
License # ER 13013250
E-mail: service .floridastarelectric.com
Job Estimate
FOR: Mike Yebba
113 S. Palmetto Avenue
Sanford, FL 32771
Date: March 26, 2018
SCOPE OF WORK
Install 100 Amp temporary service
GENERAL PROVISIONS
• The job will be permitted and inspected
• All work shall be completed in a professional manner and in compliance with all
applicable building codes.
• Contractor will provide all materials and all labor necessary to complete job.
PROPOSAL DETAILS
• The job will take one day
TOTAL COST
• $500.00
• Balance due upon completion of work
• Quote valid for 30 days from date of estimate.
Thank you for the opportunity to bid on the service repair for this business. If you have
any questions, please feel free to contact me. I look forward to working with you soon.
Thanks — Bob Hearn
Contract Agreement
IN WITNESS WHEREOF, the parties agree to the scope of the service provided and the
terms of payment and duly affix their signatures under hand and seal.
(customer)
l a f date
(contractor)
Florida Star Electric, LLC
- - --'ar date