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HomeMy WebLinkAbout402 Maple AveCITY OF SANFORD BUILDING & FIRE PREVENTION ` PM-IT=AP ICA71ON Application No: iy--�� Documented +Construction Value: $ Job Address: b p. Parcel D: historic District Yes Q No Q - r Residential ElCommercial Q Type of Work: New Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑ Description of Work:,n Plan Review Contact Person: Title: Phone:--, Pax: Emailc_ i � -t Property Owner In ration Name �--- -.�.. Phone: Street:__�_1 Resident of proper#y? : city' State zip �--1� 1 1 Contractor Information Name p - Street. t)av-� 47-7 "A-_ } - -- ...._ Fax: City, State Zip: C'X A..� rr�r h '3 State License Arehitect/Engineer information Name: Phone: Street: - Fax: City, St, Zip: F mail: Bonding Company: Mortgage Lender. - Address: 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. [F YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT, Application is hereby trade 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 performed to meet standards of all taws regulating construction in this jurisdiction. I underntand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners, etc. F$C 105.3 $ball be inscribed with the date of application and the code in effect as of that date: $t° Edition (2014) Florida Building Code Revised; June 30.2015 Pamit App&cation t l 1 Q 1 O 0 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 omaler/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Date 6 —�-4 nInacl /Agent Date Pnnt Contractor/Agent's Name Notary Public State of Florida Lynn M Blerd d 6 My Commission FF 049333 of Expires 01/11/2020 Owner/Agent is Personally Known to Me or Contractor/Agent is Personall mown to a or Produced ID Type of 1I) Produced ID Type of ID -= BELOW IS FOR OFFICE USE ONLY Permits Required: Building 0 Electrical ❑ Mechanical n Plumbing[ Construction Type: Occupancy Use: Gas Roof [] Flood Zone: Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes ❑ Non # of Heads No [] Fire Alarm Permit: . Yes [] APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: COMMENTS: FIRE: BUILDING: Revised: June 30, 2015 Permit Application THIS INSTRUMENT PREPARED.SY; Name: Michael S, West Ac',ir9ss: 108 Grvstal Vleev East Sanford. F 77 NOTICE OF COMMENCEMENT State of Florida County of Seminole i 3 � � a 3F5 �xf;� NIlf s�fi� fig ii:l �-�: }tIfs; I Permit Number: 1 p 0CQW —n nparcel ID Number: 25-19-30-5AG-0610-0010 The undersigned hereby gives notice that imorcvement will be mace to certain real property, and in accordance lath Chapter 713, F'crda Statutes, the follotivina ,n.orma* on s movided ir: his Notice of Commencement. DESCRIPTION OF PROPERTY: (Legal description of Vie p ocerty and street address if available) I nT 1 PV F TO -1n Tntneni fr n � r. -tecoras -'iemmole CountyF( se known as: 402 Maple Ave FL 32771 GENERAL DESCRIPTION OF IMPROVEMENT: Construct a new one story sin le family residence OWNER INFORMATION: Name: Katrina Southward Address: 7311 Lake Drive Sanford, FL 32771 Fee Simple Title Holder ,;f ot;,er th::n o v:ner) Name: CONTRACTOR: Name: M. S. West, Inc. Y' Address: 108 Crystal View East Sanford, FL 32773 Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section 713.13(1)(b), Florida Statutes. Name: Address: In ad&ion to himself, Owner Designates of To receive a copy of the Lienors Notice as Provided in Section 713.13(1)(b), Florida Statutes. Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a different date is specified) 11VARNING TO OWNER ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYItTENTS UNDER CHAPTER 713, PART 1, SECTIO-,N 713. 13, FLORIDA STATUTES, AND CAN 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 FINAtiC04NG CONSULT WITH YOUR LENDER OR A% ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOjR 1NO T;CE OF COMMENCEMENT. Under penalties f pe jury, I declare that I have read the foregoing and that the facts stated in it are true to he St of my n ledge d belie .�. t7 rrers Signature t + Owner s Pmnted Narne Honda Statute 713.13(1)(g) The w.-ner must sign the notice c.` cc..—a-c , and no one else maybe Pere: ez to ::, "n his or her stead. State of Countyof S01 j f 16 f ) The foregoing instrument was acknowledged before me this f day of a�� 20 e by �(i-G�f(Lx, Who is personally known to me ❑ Name of person making <-tatenno-li— r OR who has produced identificatiokFeKtype of identification produced: �� t�{' f S !!' t VICYOl4fA CAMPM $ Notary Pubk Slat of P itiill Camttdss Vj FF W9WW My Damn. eogtires May M Mee KEN LAWSON, SECRETARY RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT CONS RUCT O BUSINESS INDUSTRY LICENSING BOARD ULATiON CFC057227 The PLUMBING CONTRACTOR f "- Named below IS CERTIFIED Under the provisions of Chapter 489 FS. 'r Expiration date: AUG 31, 2018 TURNER, JASON SCO'TT EXACT PLUMBING INC*4. 306 E 4TH ST, UNIUCLA SANFORD ISSUED: 07/2512016 REQUIREDYwsPLAYAS SEQ # L16O725000097i FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 ---------------------------------------------------------------------------- Application Number . . . . . 18-00001476 Date 6/OS/18 Application pin number . . . 766448 Property Address . . . . . . 402 MAPLE AVE Parcel Number . . . . . . . . 25.19.30.SAG-0610-0010 Application type description NEW SINGLE FAMILY HOME - DETACHED Subdivision Name . . . . . . Property Zoning . . . . . . . RESTRICTED COMM Application valuation . . . . 182392 ---------------------------------------------------------------------------- Application desc noc on file ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SOUTHWARD, KATRINA M.S. WEST INC 108 CRYSTAL VIEW EAST SANFORD FL 32773 (407) 718-7355 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . VB Occupancy Type . . . . . . RESIDENTIAL USE GROUP Flood Zone . . . . . . . . NONE Other struct info . . . . . ELEC - # AMPS 200.00 PLUMBING FIXTURES 15.00 NUMBER OF STORIES 1.00 SQUARE FOOTAGE 1745.00 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT -NEW RESIDENC. Additional desc . . Phone Access Code 1055144 Permit pin number 1055144 Sub Contractor EXACT PLUMBING INC Permit Fee . . . . 90.00 Issue Date . . . . 6/05/18 Valuation . . . . 6000 Expiration Date . . 12/02/18 Qty Unit Charge Per Extension 15.00 6.0000 EA FIXTURES,WATERHEATR,DRAIN,TRAP 90.00 ---------------------------------------------------------------------------- Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do every type inspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov Water impact fee $1343.00 Sewer impact fee $3025.00 -------------------------------------------------------------------------- Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00 01-APPLCTN FEE -PLUMBING 25.00 01-BLDG PLAN REVIEW 77400 01-FIRE IMP-RS 9-2017 383..81 01-LIBRARY IMPACT FEE 54.00 01-PARKS IMP-RS SINGLE 17 1103.95 -------------------------------------------------------------------------- FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. CITY OF SANFORD ## CUSTOMER RECEIPT +�** apex: BLANDA Type: OC Drawer: 1 Date: 6/05/18 01 Receipt no: 135484 Year Number Amount 2018 1476 40R MAPLE AVE SANFORD, FL 32771 BP BUILDING PERMIT RECEIPTS $119.00 AC 009390 Tender detail CC CREDIT CARD $119.00 Total tendered $119.00 Total payment $119.00 T•ran5 date: 6/05/18 Time: 8:48:31 FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 ---------------------------------------------------------------------------- Page 2 Application Number . . . . . 18-00001476 Date 6/05/18 Application pin number . . . 766448 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . 01-POLICE IMP-RS 09.1.17 384.82 O1-SEM CNTY RD IMPACT FEE 705.00 O1-SCHOOL IMPACT FEE 9000.00 WD IMPACT:SINGLE FAMILY 1343.00 SD IMPACT:SINGLE FAMILY 3025.00 O1-BLDG DCA SURCHARGE 23.20 O1-BLDG DBPR SURCHARGE 33.80 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 90.00 .00 .00 90.00 Other Fee Total 16880.58 16851.58 .00 29.00 Grand Total 16970.58 16851.58 .00 119.00 -------------------=-------------------------------------------------------- FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & F'IRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 ---------------------------------------------------------------------------- Page 3 Application Number . . . . . 18-00001476 Date 6/05/18 Property Address . . . . . . 402 MAPLE AVE Parcel Number . . . . . . . . 25.19.30.5AG-0610-0010 Application description . . . NEW SINGLE FAMILY HOME - DETACHED Subdivision Name . . . . . . Property Zoning . . . . . . . RESTRICTED COMM Permit . . . . . . PLUMBING PERMIT -NEW RESIDENC. Additional desc . . Phone Access Code 1055144 Permit pin number 1055144 ---------------------------------------------------------------------------- Required Inspections Phone Insp Seq Insp# Code Description Initials Date ---------------------------------------------------------------------------- 10 322 UNPB PLUMBING UNDERGROUND 10-1000 311 PL03 SEWER 20 312 PL04 TUB SET 1000 313 PL05 PLUMBING FINAL / / FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 ---------------------------------------------------------------------------- Page 3 Application Number . . . . . 18-00001476 Date 6/05/18 Property Address . . . . . . 402 MAPLE AVE Parcel Number . . . . . . . . 25.19.30.SAG-0610-0010 Application description . . . NEW SINGLE FAMILY HOME - DETACHED Subdivision Name . . . . . . Property Zoning . . . . . . . RESTRICTED COMM Permit . . . . . . PLUMBING PERMIT -NEW RESIDENC. Additional desc . . Phone Access Code 1055144 Permit pin number lOSS144 ---------------------------------------------------------------------------- Required Inspections Phone Insp Seq Insp# Code Description Initials Date ---------------------------------------------------------------------------- 10 322 UNPB PLUMBING UNDERGROUND 10-1000 311 PL03 SEWER 20 312 PL04 TUB SET 1000 313 PLOS PLUMBING FINAL / / N BOUNDARY AND IFO MBOARD SURVEY j (p PROPERTY DESCRIPTION: LOT _IER 10, FLORIDA LAND AND COLONIZATION COMPANY LIMITED E.R. TRAFFORD'S MAP OF THE TOWN OF SANFORD, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 1, PAGES 56 THROUGH 64, OF THE PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA. W E qi�iS (� 1"=30' GRAPHIC SCALE 0 15 30 4TH STREET 66' R/W EDP ':CO16.- APRON >CONc. IN INLET CHU CHU — 0.5' CONC CURB CHU CHU CHU CHU CHU CHU CHU CHU CHU N89'49'05"E 117.00'(P&M) DRI uriLl Y0 B°X `T 1� ��i N FOUND LOT 1 1/2- I.R.& CAP 0 5UL BIBLE, BLOCK 6 DO 01 EL=2D.B5 TIER 10 CO 00 o sz0' p C) 9 m cc t 1 0 0 Z m ao o FORMBOARD Q \ A O ENVELOPE m `7 y FF ELEV = 23.17' v � O r- ^ m < 67.0' R. o 25.0' 25.0' °—O— OUND FOUND S89'40'42"W NAIL AND DISK 1/2" I.R.& CAP ILLEGIBLE u ;, - 41.00'(P&M) LB#3282 SITE BM q2 EL=20.81' I N89'49'05"E 117.00'(P&M) LECE'ND.- 0 = DELTA/CENTRAL ANGLE A/C = AIR CONDITIONER BB = BEARING BASIS(ASSUMED) C = CALCULATED CH = CHORD CB = CHORD BEARING CBW = CONCRETE BLOCK WALL C.M. = CONCRETE MONUMENT CNA = CORNER NOT ACCESSIBLE CONC. = CONCRETE COV. = COVERED = ASPHALT = BRICK = CONCRETE = PAVERS = LINE BREAK CENTERLINE RIGHT-OF-WAY LINE BUILDING SETBACK LINE —x—x—x—x—x—x—x— = PVC -VINYL FENCE/VF —❑—❑—❑—o—o—❑—o— = WOOD FENCE/WF —0-0-001 IO-0-0— = CHAIN LINK FENCE/CLF �H VV = OVERHEAD UTILITY LINES IFLOOD ZONE INFORMATION• MAP NUMBER: 12095C 11 F DATE: 09 28 07 ZONE: X I CORNELIUS DAVIS D = DESCRIBED d/b/a = DOING BUSINESS AS D.E. = DRAINAGE EASEMENT D.U.E. = DRAINAGE & UTILITY EASEMENT EOP EDGE OF PAVEMENT COW = EDGE OF WATER F = FIELD FB = FORMBOARD FF ELEV FINISHED FLOOR ELEVATION I.D. = IDENTIFICATION I.R. = IRON ROD I.P. = IRON PIPE L = ARC LENGTH LS = LAND SURVEYOR LB = LAND SURVEYING BUSINESS M = MEASURED NR = NON -RADIAL O.R. = OFFICIAL RECORDS P = PLAT PC = POINT OF CURVATURE PCC = POINT OF COMPOUND CURVATURE PCP = PERMANENT CONTROL POINT PI = POINT OF INTERSECTION -Q) = UTILITY POLE O = SET 1/2" I.R. & CAP LB #7020 O = FOUND PROPERTY CORNER El = FOUND CONCRETE MONUMENT ® = WELL 0 O = UTILITY RISER © = GAS METER =LIGHT POLE } = GUYWIRE yW = FIRE HYDRANT ® = WATER METER Y Bradley Cox & Associates ADDRESS: 402 S. MAPLE AVENUE SANFORD, FLORIDA 32771 L' Land Surveying C A 405 W. 25th Street Sanford, Florida 32771 Phone (407) 323-9202 Fax (407) 324-9661 WWW.BRADLEYCOXSURVEYING.COM POB = POINT OF BEGINNING POC = POINT OF COMMENCEMENT POL = POINT ON LINE PRC = POINT OF REVERSE CURVATURE PRM = PERMANENT REFERENCE MONUMENT PSM = PROFESSIONAL SURVEYOR & MAPPER PT = POINT OF TANGENT R = RADIUS RAD = RADIAL RP = RADIUS POINT R/W = RIGHT OF WAY S/W = SIDEWALK TBD = TO BE DETERMINED TOB = TOP OF BANK (TYP) = TYPICAL U.R. = UTILITY ROOM U.E. = UTILITY EASEMENT WM = WATER METER WPP = WOOD POWER POLE JOB # BCA20570FB DRAWN BY: RO CHECKED BY: BC FIELD BY: GC (FIELD DATE:) 02/22/18 REVISIONS: FB 05/21/18R NOTES: 1: THIS SURVEY IS BASED ON THE LEGAL DESCRIPTION AS PROVIDED BY THE CLIENT. 2: THIS SURVEYOR HAS NOT ABSTRACTED THE LAND SHOWN HEREON FOR EASEMENTS, RIGHTS OF WAY OR RESTRICTIONS OF RECORD WHICH MAY AFFECT THE TITLE OR USE OF THE LAND. 3: DO NOT RECONSTRUCT PROPERTY LINES FROM INTERIOR IMPROVEMENTS. (BUILDINGS, FENCES ETC...) 4: NO FOOTINGS OR OVERHANGS HAVE BEEN LOCATED EXCEPT AS SHOWN. 5: NO UNDERGROUND IMPROVEMENTS OR UTILITIES HAVE BEEN LOCATED EXCEPT AS SHOWN. 6. NO WETLANDS AND/OR OTHER NATURAL FEATURES HAVE BEEN LOCATED EXCEPT AS SHOWN. 7. THIS SURVEY SHALL NOT BE USED FOR DESIGN OR CONSTRUCTION WITH OUT PRIOR WRITTEN AUTHORIZATION FROM THE SIGNING SURVEYOR. 8: THIS SURVEY IS NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 9: ELEVATIONS BASED ON NORTH AMERICAN VERTICAL DATUM OF 1985. (NAVD88). I HEREBY CERTIFY THAT THE SURVEY OF THE HEREON DESCRIBED PROPERTY WAS PREPARED UNDER MY DIRECT SUPERVISION AND MEETS THE STANDARDS OF PRACTICE SET FCRTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 5J-17, FLORIDA ADMINISTRATIVE CODE, PURSUANT TO CHAPTER 472, FLORIDA STATUTES. BRADLEY G. CnX, iPSM -V567 CERTIFICATE OF AUJIHORIZATION LB 05/21 /18 NAWCertificate`of,(,'orAp1iance for Termite Protection (as required by Florida Building Code Section 1816) This property was treated by Massey Services, Inc 800-432-1820 Address of tre ted property Lot # Treatment Date Product Name Concentration % The building has received a complete treatment for the prevention of subterranean termites. Treatment is in accordance with rules and laws established by the Florida Department of Agriculture and Consumer Services. /11 MS-153 Authorized Signature Rev. 03/15 CITY Cif Building & Fire Prevention Division SkNFORD �p a JU�� 1 � �,��� PERMIT APPLICATION FIRE DEPARTMENT �/ BY D Application No: 1 y 7 (a Documented Construction Value: S fWa Job Address:=a-f Historic District: Yes ❑ No Parcel ID: ResidentialaCommercial ❑ Type of Work: New Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑ Description of Work: 17leC f-rtedl.1 2 Plan Review Contact Person: Title: Phone: Fax: Email: Property Owner Information Name a vtitvla S0&AU_A;'G/f Phone: Street: [.(01Ma0el Ai t_ Resident of property? : A/4 City, State Zip: 5Q41 d u Contractor Information Name � � Tr a't �'�C F erg Phone: S- yoo Street: ���� I�%�� S� Fax: City, State Zip: ' r� l 32-77/ State License No.: �F_t2 f 3@l `1 !-L50 Architect/Engineer Information Name: Phone: Street: Fax: City, St, Zip: E-mail: Bonding Company: Mortgage Lender: Address: 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 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" Edition (2017) Florida Building Code Revised: August 1, 2017 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 Print Owner/Agent's Name Date Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID Sifnature of Con for/Age Date Print Contractor/Agent's Name C(a /(711-1" / �, Signature of _tgp;6,t e o lorlda Date DEES:r / _ MYM MISS F`l�,+iG1Ir, 4? s E X P 1 F S Fei)ri,rini c %,19 Bonded i hru N t. ry P _ zhc t, ,acnariiBrs Contractor/Agent is Personally Known 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: # of Heads UTILITIES: FIRE: Flood Zone: # of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes ❑ No ❑ WASTE WATER: BUILDING: Revised: August 1, 2017 Permit Application -, 7 ja OCT 0 4 2018 i_ I' iw REQUEST .FOR TUG & PREPOWER AGREEMENT ALL RESIDENTIAL PROPERTIES Altamonte Springs, Casselberry, Longwood, Oviedo, Sanford, j Seminole County, Winter Springs: Date:. 1 � " ' Project.Name:. Wa Project Address:' �tJ .Tf -u `7! Building Permit #:`' Electrical Permit # In consideration for authorizing the appropriate utility company to energize the facility, we agree with and understand the following: l This T49 'e power application is valid only for one -and two-family dwellings. 2. The facility will not be occupied until a certificate of occupancy has been issued. 3. If the jurisdiction hereafter finds that the facility"has been occupied before a certificate of occupancy has been issued, the jurisdiction will have the unilateral right to direct the utility to terminate electrical service without. notice. Furthermore, we understand and agree that should the jurisdiction exercise such right, the jurisdiction will not be responsible for any damages or costs which may result from the exercise of such right Also, in the event any third party claims damages from the exercise of such right, we agree to jointly and individually indemnify and hold harmless the jurisdiction from all such, damages and costs, including attorney's fees. 4. Prior to pre power, the building or structure shall be weather tight and secure. The electrical wiring in the area designated for pre -power shall be complete and in safe order. All electrical services associated with the area will be 1001/4 complete unless specifically approved by the electrical inspector. 5. Interior electrical rooms shall be lockable, if electrical. panels ;are in an:area-that cannot be locked by doors, the panels shall be equipped with a locking mechanism (approved by the AHJ). The licensed. electrical contractor or his licensed representative shall hold the keys(s) for such access to electrical panels to prevent energizing circuits other than. those that are safe. 5. This TUG/Pre-power approval is valid for a maximum of 180 days from date of approval. 7. If provided, the fire sprinkler system must be operational with water on the system prior to pre -power: S. TUG approval is for service and outside GFCl outlets only.. 9. Check with the local jurisdiction for fees associated with tags. NaMda C ontractor Signature of Gen. Contractor CGCat; R 10 Gen, Contractor License #' JURISDICTION EWL.OYEE NAKE JURISDICTION: Print Name of El. Contractor Signature of Ei. Contractor El. Contractor License # CALLED INTO: c Progress Energy ri Florida Power and Eight an 1 1 (Rev_ 02110115)