HomeMy WebLinkAbout1101 Historic Goldsboro BlvdCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: IR, -
C 2�1
........ ........ ..... .
Documented Construction Value: $ 2,000.00
Jot) Address: 1101 HISTORIC GOLDSBORO BLVD SANFQBD, EL 3277I Historic District: YesO NoEl
Parcel ID: 35-19-30-5AJ-OBOO-0290 I — Residential [Z Commercial [I
Type of Work: NeNvEl AdditionEl AlterationD RepairEl Demo Z Change of UseF] Move F
Description ol'Work: Demo existi
Plan Review Contact Person- _mark _QrMan__ — Title: Contractor
Phone: 321-945-2500 Fax: 4n7-?n9_,j560 Email: markormanj C�gmajl,com
Property Owner Information
Name Jh2LFug LD2AiYran ����__C Phone: 321-228-8477
Street: 1405 ROCK LAKE DR Resident of property?
City, State Zip: Dd �ndo FL 32�05
Contractor Information
Name Mark Orman Phone: 321-945-2_500
Street: 117 Geoirgetown Dr. Suite A Fax: 417-2Q9-3560
City, State Zip: Casselberry, FL 32707
State License No,: CCC1327051
Architect/Engineer Information
Name:
Street:
Citv, St, Zip:
Bonding Company:
Address:
Phone:
11
, ax:
E-mail:
Mortgage Lender:
Address:
WARNING TO OWNrR: YOUR FAILURE TO RECORD A NOTICE or RLSULTIN YOUR
PAYING TWICE FOR UNIPROVEIWEXI'S 'to )OUR PROPI"RTY. A NOTICL OF C'OMMENCEMENT INICAT IIE
RECORDED AND POS'IFD ONT11L,11013 SITE 1IFFORL''I'll-ff' FIRST INSPECTION. IF YOU'INTEND To OBTAIN
FINANCING, CONSUILT WITH YOUR LENDER OR AN ATTORNEY BEFORE 111"CORDING YOUR NOTICE OF
COJNIMEINCF°NIENT,
Application iherchy 111ado to oblainl IM-Plit 10 (10 L11C work and instattations'-Is irldicatat. I certify that 110 Work oi- ijlsuM4uiofl has
comnienced prior io ih,,;ssuance 01'a pzriiiit and that all work Will be performed to riiect _standards o I all laws I-Coulad Ila colistructiol)
in thisjurisdiction, I understand that a separate permit.nitist be secured for cicctj�jcal 4voj-k-, plujjjbijjg��sigjjs,�wells, pools,
furnaces, boiler-s, fietitel,s. tjokys, a11(1 III- conditioners, etc.
FI;C 1053 Shall be inscribed with tIIv elate of application and the code in effect as ()I'that date: Stb Edition (2014,) Florida Buildi fig Code
It itwual Jjne 30, 20, 5 Permit kpphcwio�l
I
N—OFICE: in addition to the requirements of th" crinlit, there may be additional restrictions applicable to this property that rtlay be
found in the pnbhc reow& of'',111's county, and there may be additional permits requirecl from other governmental entities,stich as water
rnaria geniew district�, Iate or ledoral ageticics.
Accel)LUCC Dfpernijt Is \,Cl-ificaion that I wJ1 notify the tanner OfthO Propertyoftlic recluirc3xterrts of' Florida Lien Lau, FS 711
The Ci(Y of Sanford requires Payment of a plan review fee at the time of'permit St.lbrnit!id. A copy Ofthe executed contract is required
in order, to (:,flcL1J,,1te it plan review charge and will Lie considered the estirn"Ited consti-tiction value of the job at the time Of,"Mbinntal
The actual construction valUC Will he fif , Mired based Of! the current ICC ValLration Table in effect at the tirrie the permit is issued. I'll
accoldani!e kvlt�, local orJinarrcc, Should calculated C)MP-IeS HgUrCd off file executed contract exceed the actual constifictJon value,
Credit will be applied to votir permit 1ecs when the pert -nit ' is issliccl.
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.
Si�'MAUIV' (A-0-wneriAg,,n)[
PITH OSvfle!,;Agcnt's 'ojm��
Si�VIAVre of Notary -State of Florida
Dite
Daic
Owner/Agent is Personally Known to Me or
Produced ID — Type of f.D
s=malurc of Contraetor,Aeejjt Date
Pri1t Conrra;toriAgem's %ame
Signaaire of Notan-State ofHorida
Date,
Conti actor/Aiz ' ent is — Personally Known to Me or
Produced ID -- - Type of [D __
BEL"'M IS FOR dOWFICE USE ONLY
Permits Required: Bllildillg 'I
I n 1-`Jectrica[E] klechanical F] PIL)MbingE] GasF] Roof ❑
Construction Type:_Occupancy Use: Flood Zone:
Total Sy Ft of Bldg:
New Construction: Electric - # of Am
Min. Occupancy Load:
Fire Sprinkler Permit: YesEl No 0 # of Heads
APPROVALS: ZO'\ING: UTILITLE'S:
f "ING UN EF-`,R ING: V I R E:
CO.N"IMENTS:
R �,,, i �;ed: J ii n c� 30, 20 i5
# of Stories;
Plumbing - # of Fixtures
Fire Alarm Permit: Yes 0 No D
WASTE WATER:
B U- I I-D IN G:
Permit Applicimcn,