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HomeMy WebLinkAbout3706 Sanford Ave (2)Building & Fire Prevention Division PERMIT APPLICATION c' Application No: I a / q 9 _ 00 Documented Construction Value: $ 5 00 Job Address: 590 '1 )r ►1l(1" Historic District: Yes❑NoN Parcel ID: Residential❑ Commercial Type of Work: New© Addition❑ Alteration❑ Repair ❑ Demo ❑ Change of Use❑ Move ❑ Description of Work: JEJA P UA L- ( Q OI—E EDL Co tSSTR.Gc-Tl 0 tJ Plan Review Contact Person: Title: Phone: Fax: Email: Property Owner Information Name TE L' tJ CAALVEN G E Phone: Street: City, State Zip: Resident of property? : Contractor Information Name Et-E�T'�-�C CCTAf h►Z"-i b( '566VIV FLOP 4Phone: �0_7 961 al�� Street: &ffP-fc,S C-kfK 90 '}363 Fax: tts)A- City, State Zip: Ff 1. ODII-0hLf FL_ 3 33a 1 State License No.: L'� I30024-?% Name: Street: City, St, Zip: Bonding Company: Address: Arch itect/Eng1neer 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: 6te Edition (2017) Florida Building Code Revised: January 1, 2018 Permit Application C, NOTICE: In audition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found A 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 pen -nit 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 pen -nit 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 Signature of 66yror/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Date au;";-M 5b" A,--' Print Contractor/Agent's Name JOANNE CENTORE Notary Public - State of Florida •= My Comm. Expires Oct 1, 2018 Commission * FF 164738 �rE OF Fl��I Bonded through National Notary Assn. Owner/Agent is Personally Known to Me or Contra o Produced ID Type of ID Produced ID —Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building ❑ Construction Type: Total Sq Ft of Bldg: Me or Electrical Mechanical ❑ Plumbing[] Gas ❑ Roof ❑ Occupancy Use: Flood Zone: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes ❑ No ❑ APPROVALS: ZONING: ENGINEERING: COMMENTS: # of Stories: Plumbing - # of Fixtures # of Heads Fire Alarm Permit: Yes ❑ No ❑ UTILITIES: WASTE WATER: FIRE: BUILDING: Revised: January I, 2018 Permit Application LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 1� I hereby name and appoint:' G S Q^s�— an agent of: IELEtT�-kC C0rkf 1%-Kf`( of .30-OT4 1=LA (Name of Company) to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things necessary to this appointment for (check only one option): The specific permit and application for work to ated at: '- 310� 5XAspa �V 1 r SPt^fl -�s FL - (Street Address) j( j Expiration Date for This Limited Power of Attorney: lei 3(I 1$ License Holder Name: GLEE SULDMJ State License Number: Signature of License Holder: STATE OF FLORIDA COUNTY OF .i 1Lc 1'.M The foregoing instrument was acknowledged before me this 204R , by GtVJ -JOPNIQ to me or ❑ who has produced identification and who did (did not) tarn oath. JOANNE CENTORE Notary Public - State of Florida • My Comm. Expires Oct 1. 2018 Commission # FF 164738 Bonded through National Notary Assn. (Rev. 08.12) Print or type name day of ___1.; who isNepersonally known as Notary Public - State of Commission No. FF I 73$ My Commission Expires: 1010111B