115 W 1 St - E17-000211 - New Outlet, lightingJob Address: Historic District: Yes El No El
Parcel ID: ResidentialEl CommercialEl
Type of Work: NewEl Addition El AlterationM Repair[] I)cmol:l Change ofUse E] MoveEl Description
of Work: Plan
Review Contact Person: Title: am=
IM OR= Property
Owner Information Name
Phone: Resident
of property? : _,I&Id T
City,
State Zip, P
Cbntractor Information Name
Ptb ivs, At L Q 3 ALA±_vL, Y, Phone: 1 34 Street:
vIl--, Fax: ;Ie e 4, ut, City,
State Zip: I
State
License No.: 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 Shan be inscribed with the date of application and the code in effect as of that date- 5t" Edition (2014) Florida Building Code Revised:
Jane 30, 2015 Pernift Applicatiori
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 sitch as w-,Aer
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 ol'subtruffal.
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 with all applicable laws regulating construction and zoning.
Signature of'owner/Agent
Print Owner/Agent's Name
Signature ot'Notary-State of Florida
Signat wfo A eContractor/Ag Date
Print "hac or/Agent's e
F)et-e Signature of Nota t-State F
AWTTEKMO
flotuy Pubk - 100 Of FWI"
com""Sionorscmycomm. Expires Jan 16,2014
Owner/Agent is - Personally Known to Me or Co n to Me cat -
Produced ID - `Fype of ID Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building E] Electrical [] Mechanical [] Plumbing[] Gas [:] Roof`E]
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: in. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: YesEl NoEl of Heads Fire Alarm Permit: Yes E] NoE]
APPROVALS: ZONING: UHLITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING: —
COMMENTS:
Revised: June 30, 2015 Permit Application
PromagEnergy Group Electric, Inc. wwVw Pr0ma9e"er9Ygr0#"om Invoice
3300 37th St - Orlando,,FL 32839 00*910 +* httPe-1/ptus-googittcom/"`+Pi*magotwergy@Statewide: 1-844-PROMAGNOW Twittor: https:Btwttter-com/Profiftooriand*AC 1651
FLORIDA SFATE LIC. # ER 13015111 E."y facebook: http$Vtwww.facebook.cory"CR*pairOrlando
OW—YCxwts
DA-TE INSTALLEC
EMAIL
WORK PERFORMED
ITOM OR" PART
Upoft tompLeTION
IT CARD It
collection, including a reasonable amount as attomey's fees. Interest at t a rate AUTHORIZATION #
of 18% per annum will be added to all delinquent balances,
AUTHOJ LiPARTS _9EV SIGNATURE J NEEDED
I certify that I 4ave p9dormed services indicated and installed parts listed,
LjPARTSORDERED -
OUR TRAINED PERSON;K' THE FOLLOWING IMPROVEMENTS: LiRETURNDATE
LIPAw LIC.0,D,
Lj
C.O.D.
iDBY LICASH LJCHECk#_,-.
QUOTE ACCTS. REC, OX'D BY
Authorized to start work
CITY OF SANFORD
Contractor Registration Application
P. OBox 1788, Sanr0rd, FL 32772-1788 Phone:
407.088.5150 Fax 407M8.5152 Email:
building@,saafordfl.gov Date:
Business
Mailing Address, 2` City- _
0_vAa state-. —V Zip: State
Liucnsc Number: A
registration fee is not required. We do not mail confirmation of registration. 0
State license from Department of Business and Profeisional Regulation. Certificate
of workers compensation insurance AND general liability with the City of Sanford Hiled as certificatc
holder, If faxed ore-mailcd it MUST come ftom the insurance agcnt/company. Cartificates fr contractor',
s- offices are not acccptcd, 0
Copy of valid business tax receipt I State
license from Department of Busincsi and professional Regulation, Current
Seminole County Comp, Card Ccrtificate
of workers compensation insurance AND general liability with the City of Sanford listed as the certificate
holder, If faxed or e=ilcd it MUST come from the insurance as Certificates from contractor'
s offices arc not accepted, Copy
of valid business tax receipt Mmmzz
Certificate
of workers compensation insurance AND gcncial liability with the City of Sanford listed as the cortificatc
holder, If faxcd or entailed it M`USTcome from the insurance agent/company. Certificates from contractor'
s office.% are not accepted. Copy
of valid business tax receipt Control
11 City Rcgistrition, # _, _