HomeMy WebLinkAbout477 Carriage Cove WayCITY OF
,,ORD
DEPARTMENT FIRE
Building & Fire Prevention Division
PERMIT APPLICATION
Application No:�—
Documented Construction Value: $ 10. iq 0'
Job Address: L4111 CCTV, r1 04 (,CNr Historic District: Yes❑No�
Parcel ID: I Z - •- `-D — Res identialE�`Commercial❑
Type of Work: NewV
�rAddition[] Alteration ❑ Repair ❑ Demo ❑ ❑ Change of Use❑ Move
Description of Work: ge;k) mob Le "OMe
Plan Review Contact Person: LA V\6 -4e Title: "I e1L �,{��`
Phone:3,Q \4� Fax:t'(tLaI Email: t (Ca ADC d f 1 is''PViC
UProperty Owner Information
Name'SLAV\ i�/li� N (� Phone:
Street �1� rQLVk G1n QCQ gt 2BO Resident of property? : �L
City, State Zip , (d 4034
jL, ,, Contractor Information rr�
Name "IlitiQ 1T Phone: - Y�� " (_P3S5
Street:�P. a. 6-3x 1 (()1 Fax: (�5W Ke Ce — I SS
City, State Zip: NG� , State License No.:.��1
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'h Edition (2017) Florida Building Code
Revised: January 1, 2018 Permit Application
40TICE: 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.
1;ZZ--1 -:� 1 17 6AaJ,-(—P (Z 6a---4�4
Signatur o O r/A ent Pate Signature of Contractor/Agent Date
F Charles
Prir Owner/Agent's Name WPrint Contractor/Agent's Name
( � A7 4--D V Q3I 31-22-1 ►g
S atureo Signature ���y HALL AMY HALL .+ v. "�..�
MY COMMISSION # GG 0=64 i� � i MY COMMISSION # GG 020864
EXPIRES: August 14, 2020 '� br EXPIRES: August 14, 2020
ad Thm Notary Public Un*WftM ' r7' Bonded Notary Public Undarwrltots
Owner/Agent is V Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Type of ID Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing[] Gas[] Roof ❑
Construction Type: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads Fire Alarm Permit: Yes ❑ No ❑
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Revised: January 1, 2018 Permit Application