HomeMy WebLinkAbout103 Pamala Ct P17-000205 - RepipeC E1, 01 CITY OF SANFORD
JAN 19 2011 BUILDING & FIRE PREVENTION
PERMIT APPLICATION
1z, . .. ......... .
Application No: / j7
Documented Construction Value: $
Job Address: Historic District: Yes El No Q
Parcel ID: Residential L4 Commercial E]
Type of Work: New El Addition E] Alteration El Repair El Demo El Change of Use El Move El
Description of Work:
Plan Review Contact Person:
Phone: Fax:
Property Owner Information
Name 1 Phone: 5 t
Street: 10 2:> V, Resident of property?
City, State Zip:
Name Phone:
Street: Ilk 3 Fax:
City, State Zip•w. State License No.:
Arch itect/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'EDE ion SITE BEFORE THE FIRSTINSPE(,.TION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULTWITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Application
is hereby made to obtain a pernut 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. FIIC
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 Pernut Application
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that natty be
found in the public records ofthis 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 ofthe 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 ofthe 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 [CC 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 dancewithallapplicablelawsregulatingconstructionanzoning. to
ere
Signature
of Owner/Agent Date Sign ureof(tnaractor/
Agen
Date Print
Owner/Agent's Narne Signature
to'Notary-State ofFlorida Date Owner/
Agent is Personally Known to Me or Produced
117 W "Type of IL) Print
Contractor/Agent's Name Z-
Signature
ot'Notary-State of Florida Date q
DBBIE BLAND MY
COMIMISSION * rF 178,64*8EXPIRES:
February 25, 2019 Niqded
Thru Nowy flubk Undpmrreess Contractor/
Agent is Persona Known to Me or Produced
ID ---- Type of I., 9
BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building[] Electrical[] Mechanical[] Plumbingo Gas[] Roof [:] Construction '
Type: Occupancy Use: Total
Sq Ft of Bldg: — in. Occupancy Load: — 9 of Stories: New
Construction: Electric - # of Amps Plumbing - # of Fixtures_ Fire
Sprinkler Permit: Yes[] No ofl-leads Fire Alarm Permit: Yes E] NoE] APPROVALS:
ZONING: UTU'rIES: WASTE WATER: ENGINEERING:
FIRE: BtJILDIN(.'Y:— COMMENTS:
Revised
June 30, 2015 Permit Application
a
Po Box 952993
Lake Mary F1 32795
Phone: (407) 393-0717
Estimate #
Date
Business / Tax #
Jerry Destine
103 Pamela Ct
Sanford, H 32771
Description Total
Scope of work $2,115.00
Re -pipe entire house with pex piping. Replacing all pipe and all new water system which also
includes valves under sink to water heater, hose bibs and main water shut off. epipe payment is
due at time of
Subtotal $2,115.00
Total $2,115.00
ACCEPTANCE OFJOB PROPOSAL
You are hereby authorized to return a formal contract between us to accomplish the work
described in the above proposal, for which the undersigned agrees to pay the amount stated in
said proposal and according to the terms thereof:
Signed on: 0 1 /2017
Date of test: 01/23/2017
Affidavit of Plumbing Testing
State Plumbing Contractor, John Bodrato
CFC Number: CFC1428022
Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04 (1)(m)].
Type of project (check one) -
New plumbing installation Remodel or addition 0 Repair El Other
If other, explain:
iry Building Sewer or Private Interceptor
Sewer:
Water Service or Private Water Main-,
Dram & Vent System
Iater Distribution
it Admittance Valves
Water test (10' for 15
Air test (3 psig for 15 minutes)
Air test not recommended for plastic
Water test (Working pressure)
Air test (Working pressure)
Water test (10' for 15 minutes)
Air test (5 psig for 15 nurmte<
Water test (Working pressure)
State umbing Contractor - signature Witness (not required) - signature