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HomeMy WebLinkAbout120 Clearlake Cir.x rCITY OF S��F FIRE PEPARTMENT IV uilding & Fire Prevention Division PERMIT APPLICATION MAY 0 4 2018 A, lication No: BY• Documented Construction Value: $�` Job Address: 6� L,JK�. C(,PC!,4 Historic District: Yes[] No Parcel ID: Residential91 Commercial❑ Type of Work: New❑ Addition© Alteration❑ Repair❑ Demo❑ Change of Use❑ Move❑ Description of Work: ,A'G�� G i�2Gui�©,eiriC�O �'�T%c7 Plan Review Contact Person: Phone: Fax: Email: Title: Property Owner Information Name Z1 1gV—J'r� Phone: "'ki Street: /2-c2 CLF,+z 44-6 Ci/z Resident of property? : City, State Zip: 32773 Contractor Information Name 18��,417— h�lv Street: /7"OY �'�Gf'Y/>�" W City, State Zip: Sf1�/i' �� /-�- 3Z ?i/ Name: Street: City, St, Zip: Bonding Company: Address: Phone: Fax: State License No.: A95;el 30/ 32- S 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. 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: 6th Edition (2017) Florida Building Code Revised: January 1, 2018 Permit Application q 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 r '? • LISA ANTONINI Notary Public State of Florida My Comm. Expires May 21, 2018 Commission # FF 125242 Contractor/Agent is Personallown to Me or y n Produced ID i/ 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 ❑ # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: Flood Zone: # of Stories: Plumbing - # of Fixtures. Fire Alarm Permit: Yes ❑ No ❑ WASTE WATER: 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: serviced-floridastarelectric.com Job Estimate FOR: Daniel Dorn 120 Clear Lake Circle Sanford, FL 32773 Date: April 19, 2018 SCOPE OF WORK • Install circuit for addition 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 • $660.00 • 30% deposit due at start of job • Balance due upon completion of work • Quote valid for 30 days from date of estimate. Thank you for the opportunity to bid on the wiring repair for this home. 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. Daniel P. Dorn Jr. (customer) April 24, 2418 date (contractor) Florida Star Electric, LLC :5- 7 - date