HomeMy WebLinkAbout1851 WP Ball Blvd; 11-18888; SLAB ADDITIONCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
i l ) 'o -o S/ids
Application No: Documented Construction Value: $
Job Address: / P-r-1 c3,432L0/ Q6j fj
L lid Historic District: Yes No Parcel
ID: aZ- J 9 -2e; -.SD3 - d 0 0 0 - 60S—CX Zoning: Description
of Work: WODi 770,0 d ` .lTAa1,0U 66:J ZGi9TS Plan
Review Contact Person: 604Vi,d e=1j:V Title: AULI-cE 1A4Xj'4r' ,t Phone:
J7v/ GJ0l --r'iS1 Fax:,"/- o! if 9- `-J-`i 9 E-mail: 6-3*,6 r cG e-c;,Uc Property
Owner Information Name
A/C- 2r6-hJ/L Phone: _PD3 5'g x!y Street:
d-yj— ) 9-)'t't4 s7Resident of property? : City, State
Zip: G,%PI-51. fZ • Y.7 VD f Contractor Information
Name % / a
d4-5 . Phone: Street: O-
0 ZLG/ Fax: 0SK) 7 3 L - -2 0 City, State
Zip: (3ZC—VAJ k 000 Z 'Z . 0Z %
Zz- State License No.: Architect/Engineer
Information Name: Phone:
Street: City,
St,
Zip: Bonding Company:
Address: Building
Permit
Square Footage:
No. of
Dwelling Units: Electrical New
Service -
No. of AMPS: Fax: 1
E-mail:
Mortgage Lender:
Address: PERMIT
INFORMATION
Construction Type:
Flood Zone:
Mechanical (Duct
layout required for new systems) No. of
Stories: Plumbing New
Construction -
No. of Fixtures: Fire Sprinkler/
Alarm 0 No. of heads:
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.
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.
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.
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. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
ignature "'wrier/Agent Date
Print Owner/Agent's Name
A)) 2---- <- e-17-1
Sign re of . ntracto /A nt Date
DA,VID R. 14IM-1 847-il
Print Contractor/Agent's Name
u
Signature of Not ry-State JYFlorida Date
NOTARY PUBLIC -STATE OF FLO A
Douglas J. Dorsey
Commission # DD725572
Expires: DEC. 14, 2011
BONDED THRU ATLANTIC BONDING CO., INC.
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Signature of
otvsn aue^ Notary Public State of Florida
Norma J Reilly
c My Commission DD910449
9?oF Id Expires 08/26/2013
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID F '11Z`
WASTE WATER:
BUILDING:
Rev 11.08
V
r •
e.
1 CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
pp ica ion o: I Documented Construction Value: $_ !D, Q G O
If
Job Address: I d'.71 W r K A I] N I Vdi
Parcel ID: 32- I5 - 3C -5/o,?- p000 - ooSo
Description of Work: her,v.r ivi)4• fdg b
Plan Review Contact Person: „1 c/{
Phone: C 3 -Z PV Fax: _
Name
Street
Historic District: Yes No
Zoning:
Title:
E-mail:
1
Property Owner Information
Fed,,41 fAvi )-r 9a4.4 Phone:
R2 o VA N E A 1/ 0 Resident of property? :
City, State Zip: „}.a G k 3 o 3 o5L,
D
Street:
City, State Zip:
2
Contractor Information
Phone:
Fax:
State License No.:
I- II
Architect/Engineer Information
Name:— Ar lli...; ,t Street:
22 - Z IV City,
St, Zip: Bonding
Company: Address:
Building
Permit Square
Footage: No.
of Dwelling Units: Electrical
New
Service - No. of AMPS: Phone:
7 % 5 -//u o Fax:
1 7 - o y o E-
mail: Mortgage
Lender: Address:
PERMIT
INFORMATION Construction
Type: No. of Stories: Flood
Zone: Mecha
ical (Duct layout required for new systems) V-
Plumbing
New
Construction - No. of Fixtures: Fire
Sprinkler/Alarm No. of heads:
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.
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.
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.
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. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when thepermitisreleased.
7. Signature of Owner/Agent Date Si nat e of Contracto Agent Date //
4(
Print Owner/Agent's Name Print C=
1=2
Signature of Notary -State of Florida Date Signat e of Notary-Sdofida Date
NOTARYPUP !,_.-STATEOF
ran Dolb
Cc,. zion #DD
b EX;Ii , : FEB. 18,2014
BONDED THRU ATL.kNTIC BONDING CO., INC. /
Owner/Agent is Personally Known to Me or Contractor/Agent is i' Personally Known to Me orProducedIDTypeofIDProducedIDTypeofID
APPROVALS: ZONING: UTILITIES: A I'E WATER:
ENGINEERING: FIRE: - BUILDING:
COMMENTS: 77 n /J . /
in,
Rev 11.08
Application No: i
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Documented Construction Value: $ y0, Q G o
Job Address: I 057 we g 411 did Historic District: Yes No
Parcel ID• 3 2 - I J - 30 - 50.3 - 0 00 0 - 0 0S0 Zoning:
Description of Work: _ 6ene144vr iv;r- f/,g y
Plan Review Contact Person: N it,
Phone: 1/3- 3 ( 3 - Z.,? l Fax: 12G 3711 E-mail:
II
Property Owner Information
Name - !8 S,,r Fed ri 4 l fqyi A/ f 9A Nk Phone: s
3 P- inN E f Title: '
1_)"" / Ac,
S,lJ t%GP•,6ir Oi//'y r!-/ treet.
2 0 , ro N-o } -} 710 Resident of property? : City,
State Zip: 44k,0C k 3030! D Street:
Contractor
Information
Phone: Fax:
RE
D
City, State
Zip: State License No.: I- II
ArchitectlEngineer Information
Name: / Street:
22
O Z IV j,,). j r„ J'k City, St,
Zip: tg m- yo , h 3 G 0 Bonding Company: Address:
Building Permit
Square
Footage: Phone: )
12 - 7 % -'/
A a Fax: , 75 - e
y o E-mail: Mortgage
Lender: Address:
PERMIT INFORMATION
Construction
Type: No.
of Stories: No. of Dwelling
Units: Flood Zone: Electrical New Service —
No.
of AMPS: Mechanical (Duct layout
required for new systems) Plumbing New Construction -
No.
of Fixtures: Fire Sprinkler/Alarm
No. of heads: IF
Application is hereby made to obtain a permit, to do the work and installations as indicated. I certify that noworkorinstallationhascommencedpriortotheissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate permitmustbesecuredforelectricalwork, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, andairconditioners, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work willbedoneincompliancewithallapplicablelawsregulatingconstructionandzoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAYRESULTINYOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICEOFCOMMENCEMENTMUSTBERECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOURLENDERORANATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT.
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 requiredfromothergovernmentalentitiessuchaswatermanagementdistricts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of FloridaLienLaw,,FS 713.
The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate theplanreviewfeebasedonpastpermitactivitylevels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when thepermitisreleased.
Signature of Owner/Agent Date
Print Owner/Agent's Name
7 /ii
Si nat e of Contracto Agent Date
Print Contractor/Aara a P
Signature of Notary -State of Florida Date Signat e of Notary -State of F rida Date
NOTAP.Y PGP .U.:;:TATE OF FL A
n Dolb
Ex r:: F EB.18, 2014
BONDED THRC ATL:v*: `]C EONDINGCO., INC.. /'
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me orProducedIDTypeofIDProducedIDTypeofID
APPROVALS: ZONING: UTILITIE %3 //WASTE WATER:
COMMENTS:
Rev 11.08
ENGINEERING: FIRE: BUILDING:
JUL 19 aft
of ("/
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: i Documented Construction Value: $ 0, (/ G O
11
Job Address: ID I JA)f Y1411 d r Historic District: Yes No
Parcel ID• Z-15 - 30 -50 7- 0 0o 0 - OOSO Zoning:
Description of Work:
Plan Review Contact Person: \ f
Phone: J-1-7- 3 ( 3 - Z,P / Fax: _
it, J/,# b
Title: e A
E-mail:
Property Owner Information
Name Fedef4l fgyiAlf 9A
Street: 3 2 0 e 0 A N E A Yip
City, State Zip: G Ci 30305'
60
Street:
City, State Zip:
2
Phone:
Resident of property? :
Contractor Information
Phone:
Fax:
State License No.:
Architect/Engineer Information
Street: 22 . Z IV (,J'47tr,r . ed
City, St, Zip: (a nx ro . f2. VOD Bonding
Company: Address:
Building
Permit Square
Footage: Phone:
a Fax:
75 - e Y o E-
mail: Mortgage
Lender: Address:
PERMIT
INFORMATION Construction
Type: No. of Stories: No.
of Dwelling Units: Flood Zone: Electrical
New
Service - No. of AMPS: Plumbing
New
Construction - No. of Fixtures: Mechanical
13 (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that noworkorinstallationhascommencedpriortotheissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate permitmustbesecuredforelectricalwork, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, andairconditioners, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work willbedoneincompliancewithallapplicablelawsregulatingconstructionandzoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAYRESULTINYOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE
OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOURLENDERORANATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT.
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 requiredfromothergovernmentalentitiessuchaswatermanagementdistricts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of FloridaLienLaw, FS 713.
The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when thepermitisreleased.
Signature of Owner/Agent
r' mL vwner/Agenrs Name
Date Si hat e of Contraccto/Agent Date
Print Contractor/Aurlat a „P
olguaLuic ui iwrary-Mate of Horida Date Signat e of Notary -State
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.08
NOTARY PG11j-tt`-;?TATE OF FLPiCDA
an Dolb
Ex rr-.:. FEB. 18, 2014
BONDED TPIRC fiii,a: 1C BONDING CO.. INC.
UTILITIES:
FIRE:
Contractor/Agent is
Produced ID
Date
s' Personally Known to Me or
Type of ID
WASTEWATER: Ll -1l 3_ BUILDING:
n
l JUL I CITY OF SANFORD
gY. BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: C lee Documented Construction Value: $ 0, Q G O
Job Address: (S57 We 9A 11 91 V) Historic District: Yes No
Parcel ID: 3 2 -1 J- o- o 3- o oo o- o o S o Zoning:
Description of Work: e et v.r fvi, Ilq
Plan Review Contact Person:
Phone: 3 C 3 -Z eel Fax: d
Title:
E-mail: f"-5u%r Oi/
Property Owner Information
Name F47 41 Jr, ,- ! 9A-k Phone:
Street: R2 0 VA k 1E f+ I / o Resident of property? :
City, State Zip: G k 3Cj30!r
D
Street:
City, State Zip:
2ZL -
Contractor Information
Phone:
Fax:
State License No.:
Architect/Engineer Information
Name: o t ;,..;
Street: 22 - Z M Li ifitt,,, orkl
City, St, Zip: to nxo , o Bonding
Company: Address:
Building
Permit Phone: )
13 - M -W u o Fax:
e'13 - ? 72 E-
mail: Mortgage
Lender: Address:
PERMIT
INFORMATION Square
Footage: Construction Type: No. of Stories: No.
of Dwelling Units: Flood Zone: Electrical
New
Service — No. of AMPS: Mechanical (
Duct layout required for new systems) Plumbing
New
Construction - No. of Fixtures: Fire
Sprinkler/Alarm 13 No. of heads:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that noworkorinstallationhascommencedpriortotheissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate permitmustbesecuredforelectricalwork, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, andairconditioners, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work willbedoneincompliancewithallapplicablelawsregulatingconstructionandzoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAYRESULTINYOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE
OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOURLENDERORANATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT.
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 requiredfromothergovernmentalentitiessuchaswatermanagementdistricts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of FloridaLienLaw, FS 713.
The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate theplanreviewfeebasedonpastpermitactivitylevels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when thepermitisreleased.
Signature of Owner/Agent Date Si nat e of Contracto Agent Date /
l
Print Owner/Agent's Name 14,( " /'/-1
Print Contradtor/Anr
Signature of Notary -State of Flonda Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
of Notary -State of
NOTARY PGFQ U.::-STA PE OF FLADA
in Dolb
DD
Exrrr..,: FEB. 18, 2014
unN-nPD iN Br' AT[ -L;T'1C BOVDING CO INC
APPROVALS: ZONING: 1 13'1 UTILITIES:
ENGINEERING:
COMMENTS:
Rev 11.08
FIRE:
Date
Contractor/Agent is Y Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
CRY oo SCMT Ord
snnri(mc FFire? Plartl R-evk)
Tel: 407,688,5050
Fax'., 407.688,6051
BUsiness Proicad Neanio--. . ..... V—,
Address
G , 0 T, ta ef I\f a m e:
C/O [J hive Alarm 11 Fire; Sprlrlkier [-_-I 1 anl< F-I Pains Booth
7,S--- o al Fe'es T
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint:
an agent of:
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):
All permits and applications submitted by this contractor.
he specific permit and application for work located at:
i'P c-/ Aj'4 A*-tv_ ,Q "tj .
Street Address)
Expiration Date for This Limited Power of Attorney: / -- pA9i-;v-
License Holder Name: i -) " i 6 %\ / 2 9
State License Number:
Signature of License H
STATE OF FLORIDA
COUNTY OF
The foregoing instruinent was acknowled ed before me this day of ,
20% by who is ? personally known
to me or ?who has produced tk to Z+ 14 2q,z o as identification
and who di (did not) take an oath. Signature
Notary
Seal) Print
or type name F
e4Notary Public State of Floridallorma J Reillyo`My CommissionDD910449NotaryPublic - State of o Q i oc,. o°' Expires
08/26/2013 Commission No-"
1VD k' cA My Commission
Expires: 2tA Rev. 3/
27/07)
Application No:
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Documented Construction Value: $
Job Address: 1PS"1 4J/4
4 H-iL dt- i- 9, Historic District: Yes No
Parcel ID: 3Z / 9'--70 -_"3 - 0OyC - CJOsb Zoning:
Description of Work: Ti ved d F S' o B y Gb. ,s- „r,- S' s .,l',gn
Plan Review Contact Person:
Phone: Fax: E-mail:
Property Owner Information
Name %/IrG 04Py A_' 414
Street: _SOT 2)9-7- 41'toO F7-7
City, State Zip: 3S VO I
Title:
Phone: FV 3- 59 V Y
Resident of property? :
Contractor Information
Name oi?;A ZEG7 ZiC vKC . Phone: TZ
Street: -C G Fax: J7lSd-SS City,
State Zip: 4-0P . FZ. 33 VC? State License No.: EGO 00 iaJj!2 Architect/
Engineer Information Name:
4/C 6Z16 Phone: Street:
City,
St, Zip: Bonding
Company: Address:
Building
Permit Square
Footage: No.
of Dwelling Units: Electrical
E' New
Service - No. of AMPS: Fax:
E-
mail: Mortgage
Lender: Address:
PERMIT
INFORMATION Construction
Type: Flood
Zone: No.
of Stories: Plumbing
New
Construction - No. of Fixtures: Mechanical
0 (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads:
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.
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.
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.
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. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
Signature of Owner/Agent Date
Ax.o,c kr - . 4c.,v r
Print Owner/Agent's Name
1 v 0
Signature of tary-Stat0of Florida Date
NOTARY PUBLIC -STATE OF FLORIDA
Douglas J. Dorsey
Commission # DD725572
Expires: DEC. 14, 2011
BONDED THRU ATLNTIC BONDING CO., INC.
Owner/Agent is / Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Signature of Contractor,%Agent Date
64wl?6Nc.e W_ ReiHEM
Print Contractor/Agent's Name
A"
Signature o otary-St of Florida Date
NOTARY PUBLIC -STATE OF FLORIDA
Douglas J. Dorsey
Commission # DD725572
Expires: DEC.14, 2011
BONDED THRU ATLANTIC BONDING CO., INC.
Contractor/Agent is V1 Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
Rev 11.08
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: / b /2,v I
I hereby name and appoint: )41Z , jQ ,q?„
an agent of: 3'e, 1-1- eL,E G 7)4_/ C
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):
permits and applications submitted by this contractor.
The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney: kc
License Holder Name: 9w lL rvC E A
State License Number:
Signature of License Holder:
STATE OF FLOPjlDA
COUNTY OFpj ,
C_ C
The foregoing instrument was acknowledged before me this Way of 60/ 5
20 L_, by [4 W 96n/6E R . AD-rH ELL who is ?_yers_oT1allv known
to me g ? who has produced as
identification and who did (did not) take an oath.
Notary Seal)
NOTARY PUBLIC -STATE OF FLORIDA
Douglas J. Dorsey
Commission #DD725572
Expires: DEC. 14, 2011
BONDED THRU ATLANTIC BONDING CO., INC.
Rev. 3/27/07)
ZOJ,-(AS .S': [)W?S6!/
Print or type name
Notary Public - State of fio
Commission No. J D 7z s -r2,
My Commission Expires: /z
AUG-18-2011 09:19 ROTHELL ELECTRIC INC. 561 6B9 5299 P.005
July 22,203 1
ROTHELL ELECTRIC,"INC. .
3428-C West 45" Street
West Palm Bcach, Flom '334,07
Voice (561) 689-5151 - Fax (561) ft9-5299
State License BC0001 S89 '
Yicit our Web -site @ www.rachelleleo.ie.eo;n
PNC Realty alamces
205 Darns Street
West Palm Bcwk F1
Attrr- Mr Andy Hoyt
Re: PNC Bank Standby Crcnerator — RMnlwt Road, SaeoA
Base: Bid as per drawings dated 7n/l l by Diamondback. JEaa;,ineering........ $30,50e.00
Price Includes:
Estimated permk f= of $1,400.00. Additional perikt fccs if incurred wi11 be
bMed on atimc and mate%W-basis.
Mcctrical wiring of owner provided 80kw gcnerazoX=nd 400 amp automatic
transfer switch (Gsacrator to be delivered and set il'a placc by ownc;rrs Rigging
Co. w per the drawings) ,
Supply and inostallation of new breakglass stop stad4n and wp G,fi receptacle as
per the drawings
Supply and install whbg for Battery Ck arge r and Jsckct Water Heater provided
with generator
Form, Place and Finish new concrete Saaerator slabisnd Unnsfer switch slab
Replace conmctc sidewalk Arid repair sod as ncac ssgy for newly installed
conduits
Relocation of existing A/C discouncet if necessary o , per the drawings
City of Sanford fees for after hams electrical inspe n ($200,00)
FPL fix for after hours discom,eadola of electrical saviee ($825.00)
Price Exctndes• .
Form Board Survcy .
Maz=W Ttsiing (Soil CompaMon/Der4ity Teas, and Concrete Cylinders) for
Ocnerator Pad
Fema Flood Certificate
coding, lam ox concrete bollards arotmd sen ator and transfer switch
Provision of fuel for new generator
Sincerely,
Rothcll Electlid; Inc.
A"70-4-0 C A wv.
Douglas I Dorsey
Vice Presidcnt
AUG-18-2011 09:19 ROTHELL ELECTRIC INC. 561 689 5299 P.006
EXMBTT B
FACILITY LOCATIONS
d's w
AUG-18-2011 09:19 ROTHELL ELECTRIC INC. 561 689 5299 P.007
FIXMITC PRICING
AUG-18-2011 09:19 ROTHELL ELECTRIC INC. 561 689 5299 P.008
FNC: OPTIONAL STANDBY GENEItAT(* PROJECT
BID -FORM
PNCBANK — Rciahart Road Branch — Optional S"ran& Cronemtor Project
DATE:
SUBM3TTED BY. Bidder Company Name: A,r,....+rrBidderCompanyAddress:gz
Bidder City, Statc, Zip'
Contact Name:
Conu5 telephdER -
TO: PNC Corporation
620 LibertyAvemuc
Piftburgh, PA 15222
Attention: MY Justin McCobmick Jsn.tttcoormiek@pnC.cotn
AUentIon: Mr. Aady'Hoyt ar rcw.hoyt@pnc.coni
Bid= Having wmmziaed the: Contract doomne is dated -,2011.,, r)s prepared by the CustomCr for
cOMttuetion of the Projoct, the undersigned 13 idder hereby propo=o uo furnish materials,
coordination and do&cry required to.properly complete the work iittludcd is the Contract
Docuaimt for t6 hump sum of.
DollarsTE%2•R/ Conbmt
T=Q: ' I.
Proposed n mabcr of calwdats days from Receipt of Signed Cormact to on: -silo mobiffication; 2.
Proposed Numbers of calendar days from Receipt of-Sipcdcontract Co 'bstaiQiaj Compleaan J
3.
Proposed Number of Calendar days froM Sabstaatial Compledon to Firal-omplc don Y4 The
undersigned Bidder aekmowle;dgcs receipt oftfie, following 4dAenda 2.
3.
SIGNATURES:
Date:_ Name
of Firm Atrestc& ,
PAGE -
1 i TOTAL
P.008
AUG-18-2011 09:18 ROTHELL ELECTRIC INC. 561 689 5299 P.002
PNC BANK, NATIONAL ASSOCALTION
SERVICE AGREEMENT
MAXTMTTM CONTRACT V-4,L JE NOT TO CXCEED $1007000
INSERT CLASSIFICATION OF SERVICE AND DEih.ETE THIS BRACKETED
LANGUAGE]
THIS AGREEMENT (this "Agreement") is made as ;f /v , 201 1 ,
between PNC Flank, National Association (the "riauk") aiatl
the "Contractor"). This Agreement shall
include the PNC Bank Service Agreement Geneml Tuns and Conditions which are uuached
hereto and any exhibits attached hereto (the "Terms and Conditions").
THE BANK has requested the Contractor to provide and Contractor agrees to provide
the work or services described on Exhibit A 'Statement of Work," attached hereto and made a
part hereof (the "Services").
THE LOCATION(S) where the Services will be performed under this Agreement is
described in Exhibit B "Facility Locations" attached hereto and made a part hereof.
THE SERVICES will be performed on or such
other date mutually acceptable'to the Bank and the Contractor.
THE PRICINC oontaincd in' Exhii it C "i'iicutg" represents (except for applicable state
tax) the all-inclusive price for the work covered by this Agreement and there shall be NO
adjUstment,to any stated puce, nor any surcharge, additional c-ost or add -on fees imposed by
Contractor unless the Bank has specifically authorized such in wt'iting. Any new or special work
or performance criteria shall be added to this Agreement at a pace mutually agreed upon by the
paucities, and shall become effective upon execution of a written addendum to this Agreement
signed by both parties.
THE CONTRACTOR shall issue an invoice for the Services performed to the Bank
Which invoice shall he in fnrm and substance =covtnbla to t1,e- Rr_r.
NOTICES relating to this Agreement shall be directed to the following parties at the
following addresses, and will be effective upon receipt if delivered personally to such party, or by
nationally Lcuv*LL4vd vycrutght courier service, or it sent by facsi4le transmission with
confirmation of delivery:
AUG-18-2011 09:18 ROTHELL ELECTRIC INC. 561 689 5299 P.003
W,
e2
Attcntion-
Fax No. 409 - S
The twm and conditions contained bet , toptha wfh the Tams and Condition and
the following attachments:
ExMbit A - Sulement of Work
F-Au it 8 - Facility Locations
Exhibit C - Dieing
Fxlubit D - b=mce Requit,e cm
constitute this entire Agreement
1N wffnsS WHMOF, the parries have caused this Agreement to be silted as of
the fast date written above.
mil''' -
AUG-18-2011 09:19 ROTHELL ELECTRIC INC. 561 689 5299 P.004
EX$IT A
STATEMENT OF WORK:
15?f7 G /7 f/P S f3 T j CtL./ ,1• p ! l
AUG-18-2011 09:18 ROTHELL ELECTRIC INC. 561 689 5299 P.001
3428•C West 45" Street - W. Palm Beach, Florida 33407
Electric, IncR"RothdW
Fax
To: Debby Blanton From: Rothel` Electric, Inc
Fax: 407-688-5152 Pages: 8
Phonec Date: August 18, 2011
Re: Service Agreement cc:
urgent For Review Please Comment Ple:se Reply please Recycle
If you did not receive all pages, please call back as soon as possible. The number
is: (561) 689-5151.
Comments:
INSTRUMENT#: 2011077743 OR BK 4063 PG 1863 PAGES:
NEIL KELLY; -P.IC COUNTY CLERK OF THE CIRCUIT COURT
REC FEES: $10.00
8/1'//2Ull J:jU:-nb L-M
Permit No.
Tax Folio No3Z-19- 30- 6'03-0000_OOS0
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
The undersigned hereby gives notice that improvement
will be made to certain real property, and in accordance
with Chapter 713, Florida Statutes, the following
information is provided in this Notice of Commencement.
NARY" KIRK, CURK CIF CIKUIT CONAT SEMWLE
CCMTV RK
07618 Pq W%; qpq) CLERRII
Sq RELCORDED
t IlVa"iil09.yt:57 gh RECI
RD I NG FEES 10.0 RUAR,
D BY T Sra lih 1.
Description of property: (legal description of the property, and street address if available) LO i S— 7W-6 Mi}1fraE i L' ,9Grc Pt—
n Lipi ,PrY -7o_,U S/ w!';43091-jam 'eLr.,3, S/=07t-6 7/ 2.
General description of improvement: /900,Toi o = S 3' ^%it f Ci G E'L rz' r C r•—t sr"• 3.
Owner information: Name: pNG 6±21,2 e rV f% Address:
jO S7z,&,-,q L..P3 T-/ 33449 b. Interest
in property: c. Name
9vd address of fee simple titleholder (if other than Owner) Name: Name: Phone
number: Ste' / - 6 Si- s-/S-) c. Address:
3 5 38 C w V 3- ram" • s.— t—i-fc9 /Z ' S' V 0 7 5. Surety
Name COP' Address:IV
TryQR
JE b. Amount
of bond: $ 1W ,y ANNE 6, Lender:
Name: CIRCUIT. ouFLOp Address: OE
I
IDA
b.
Lender'
s phone number: SEMI 7.a.
Persons within the State of Florida designated by Owner upon whom notices or other documents may be s provided by
Section 713.13(1)(a)7., Florida Statutes: Name: ®q Address: a
2 Ka. In
addition to himself or herself, Owner designates of to receive a copy of (he q i Lienor's
Notice as provided in Section 713.13(1)(b), Florida Statutes. b. Phone
number of person or entity designated by owner: - 9. Expiration
date of notice of commencement (the expiration date is t year from the date of recording unless a different date is
specified) WARNING TO
OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 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 FINANCING, CONSULT WITH YOUR LENDER(OAN
ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COM E
T -' VA-t {1/.f-- Sig re
of Owner or Owner's Authorized OtlicedDirector/Partner/Manager Signatory's Title/Office _ The foregoing
instrument was acknowledged before me this _1Q_ 1 clay of Ue , (y0fr) , by (narineo on)as'(type of authority.... e.
g. officer, trustee, attorney in fact) fbr (name of party on bell, f of whom instrument was executed) . NOTARY PUBLIC -STATE OF FLORIDA Douglas J.
Dorsey SEAL) : Commission #
DD72557725572 Expires: DEC.
14 2011 Signature of
Ndtary P lMic Personally Kuown
OR Produced Identification 1ON1RIRIW) °,t °t%lgif f'ovi'ced verificat' pu
suaut to Section 92.525, Florida Statutes: Under penalties of perjury, I declare that I have read the foregoing and that the t, t
n i re ue o the best of my knowledge and belief., l nature of
Natural
erson Signing Above Rev. date 3/
2008 I jll Ulr&
ep,
P
I certify that the foregoing is an accurate copy of the document bo as reflected '
n the Official Records. Portions may be redacted. NEIL CLE K
F CIRCUIT COU LAKE COUNTY c,e o4`
ov
By i puty Clerk 8/17/2011 3:30:56 PM roury rv,F