HomeMy WebLinkAbout2855 Empire Pl; 17-1851; ELECTRICALVE
JUN 2 0 2017
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: 1 112— 4 1
o
Documented Construction Value: $ & I S
Job Address: 2155 Cm p 1 P acc - sa o r Historic District: Yes No [
Parcel ID: E 0 0" 0 3 10 Residential [Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use El move
MDescriptionofWork: Ckgoq,_ old FcLraL load c E e Tr;z U tr oor ara Cifcuirt
Yco kcr ?,.,c 10 1/tcw J 6 a--t 5 ac cur- ,re,H1 Cirr.t,°c treaYGr puKcL
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Name LTJ.r. + U rs • UAy i dN,y c r-a Street:
2,f 5 s G M F % re. plocc City,
State Zip: Sao Ford F L 3 2 7 11 Phone: (
Yo 7 1 (v 9 0 -0 ? 4 S Resident
of property? Contractor
Information I
ZTa o4c s Name De
lya a 5-trrFled-. Co= LL C $ ke p he rJ Phone: (Yo7 l 2-77- - 37 5- y Street: l o `(
W" I to w Ayc . Fax: City, State Zip: Sao
Fo,A 32,771 Name: Street: City, St,
Zip:
Bonding
Company: Address: State
License No.:
E
R 0 0 0 6 Z S' Z 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: 5eh Edition (2014) Florida Building Code Revised: June 30, 2015
Permit Application
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.
Signa ure of Owner/Agent i Dhte
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
JL:!,P 2c 2-017
Sign lure ofContractor/Age // Date
TAf."es E• c{cn/tcr 1-,,
Print Contractor/Agent's Name
Signature of
06.,;,0.i-)
j.lsr DEBBIEBLANTON
t,fY COMb11SSI0N it F 178648
rN EXPIRES: February 25, 2019
Dondad Thru NcWy Public Undenvriters
Contractor/Agent is Personally Known to Me or
Produced ID 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:
Flood Zone:
of Stories:
Plumbing - # of Fixtures,
Fire Alarm Permit: Yes No
f.UJIMPM014 BUILDING:
Revised:
June 30, 2015 Permit Application
DELTA-STARR ELECTRIC COMPANY, LLC
ELECTRICAL CONTRACTORS
904 Willow Ave. Sanford, FL 32771-2169
State Reg. # ER0006252
Phone: (407) 272-3754
I' ll-WI 111
Job Address: 2855 Empire Place - Sanford, Florida 32773
Date: June 20, 2017
I, the undersigned Electrical Contractor, do hereby propose to perform the
following work for Mr. and Mrs. David Rivera for the sum stated below.
1. Change the existing 150 amp., "Federal Pacific Electric"
brand, outdoor, main circuit breaker panel to a new 150 amp,
Square D (HOMELINE)" brand, outdoor, main circuit breaker panel.
2. Provide all new branch circuit breakers for the existing circuits in
the new panel.
3. Inspect and upgrade any deficient clamps or connections of the
electrical service grounding system.
4. Correct any other deficiencies of outdoor electrical service equipment
to ensure safety compliance of the system.
TOTAL: ix Hundred and Seventy-five and 00/100 d
TERMS: Four Hundred and Twenty-five and 00/100 -dollars ($425.00)
in advance for materials and electrical permit. Balance: Two hundred and
fifty and 00/100 -dollars ($250.00) due after passing electrical inspection by,
City of Sanford.
Contractor: Date: fzj2Q 201- _ James
E. S&pherd Jr. ACCEPTANCE:
Owner/
General
Contractor: Date: This
proposal shall be good for 30 days. .