HomeMy WebLinkAbout124 Quail Ridge Ct 17-1333; RE-PIPECITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ ( 0 D
f
Job Address: u toA ( 614/ Historic District: Yes No
Parcel ID: Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work:
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
0V E ` / ,, Name J V N' l iG . /l/ ! C Phone: 3
Street: 1
f
Resident of property?
City, State Zip:
ntractor Information
Name e S /Q /Liil Phone:
Street: 9&qFax: 35 a - 3F 3- l City,
State Zip: 50 kti 39177 State License No.: G' l C D5 3 33l 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: 5' Edition (2014) Florida Building Code Revised:
June 30, 2015 h /1 C T _ J 1
Perm it
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 info
be done in compliance with all applicable laws regulating-ean ii
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
and zoning.
of Contractor/Agent Date
Print Contractor/Agent's Name
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ignatur Q Nor StatE€J,lC
ebruary 25, 201 Date+; e c o?,•o II
6ondad Thru Notary Pu9,c Unuerwr'ters
work will
Contractor/Agent is Personall Known to Me or
Produced ID Type of ID L..
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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:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application