HomeMy WebLinkAbout221 Clydesdale Cir - BR17-000248 - FenceCITY OF SANFORD
BUILDING & FIRE PREVENTIONA—Z
PERMIT APPLICATIONNilJAN242017
1"E"
Application No:
Documented Construction Value:
iJobAddress: Historic District: Yes D No 0
Parcel ID: 00 0 CXX_)'- Residential H CommercialEl
Type of Work: New El Addition Alteration 1:1 RepairEl DemoEl Change of Use MoveEl
Description of Work:
Plan Review Contact Person: Title:
Phone: i96. Gl:Y:> Fax: Email:
Property Owner Information
Name C, Phone:
Street: Resident of property? 2_221'
City, State Zip:
Contractor Information
Name C Phone -
Street: Fax:
City, State Zip: StatL-License No.: L 0CX --,: 2
Arch itect/Eng! neer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
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 constructioninthisjurisdiction. 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: 511 Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
Q I_CE: In addition •to the requirements of thi AilW." AW 011- W"
pcauiiib ICA-1111cl 11"101 entities such as watermanagementdistricts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner ofthe property ofthe requirements ofFlorida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of vermit submittal. I coJ% *f J40 e;4r11ff0 nt ic r,-
vilivillereu Me estimatea construction value of the job at the time of submitt 1. 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 AEFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be one in compliance with all applicable laws regulating construction and zoning®
x. L
Signature of Owner/Agent Date 6naWurie Contra ant Date
F1in_t0,vner/Agem`s Na.-,,
Signature ofNotary -State of Florida Date
Print Contractor/Agent's Name
Signature .rNota,y-Stat,..'fFlorida Date
MOE BLAW'M
7 4NAyCC)MWSSION
EXPIRES: Februw
Owner/Agent is — Personally Known to Me or Contractor/Agent "'W Svd(,,d INU NOWY PUIU L!
Produced Type of IDProducedID — Type of ID ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: BuildingF] Electrical El Mechanicalo Plumbing[] Gas[] RoofE]
Construction Type: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: in. Occupancy Load: N of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes El No D # of Heads
APPROVALS: ZONING: UTILITIES:
RM
COMMENTS:
Fire Alarm Permit: Yes [] No a
Ll_'11
WASTE WATER:
BUILDING:
Revised: June 30,2015 Permit Application
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Public Records of Serninol 6DL'a Plut.,Irwereor osrecordedin jt bco* 4Pages 97 through 99, tY, Flo do, BOUNDARY
SURVEY FOR / CERTIFIED TO: Armando Ernesto Ramirez; Fanny Romirez; MOTin L. 600man, Jr., P.A.; Old Republic National Title Insurance Company, Fairwinds Credit Union isAOA MACY
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Lockhart, Florida
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Email: iayt m ail.CO Direct: 7-397-59 5
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ADDRESS: e Cl c C" PHONE:
STATE: ZIP: 2
ti PERMrr ISSUED BY:
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OF SPECIAL INSTRUCTIONS: UNDERGROUNDDIEScrnUnES
Power Company
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Style;R l 'Disposal o Existin Fe e: FT. CalaisEFEaMOAplRequired; YesNo
l Style. ce Open P 1: Yes No CablerPhone
Gate size i;i Cate size 2. O Gate size 3:
I- Total taRe Gas Line
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