HomeMy WebLinkAbout2406 Oregon Ave; 18-4100; WATER HEATERtiton t' •
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BUILDINGD •
Job Address: 9' y 0 t 0( e
Parcel ID:
PERMIT APPLICATION
Application No: W—z-4)00
Documented Construction Value: $ g 0. 0
0 lr` / $ Historic District: Yes N.
Residential Commercial
Type of Work: New [Addition Alteration Repair Demo Change of Use Move
Description of Work: K:* 14 c-e- L,-" A— t -er K C `Z + . V- Plan
Review Contact Person: Phone:
Fax: Email: Property
Owner Information Name
4 Cr^ r e'er Phone: Street: '
0' u r-1 tq J ' Resident of property?: Y f S City,
State Zip: Contractor
Information P-,
Name `i r -('y q JD U M, / e- v- Phone: 2 7 7 7 Street:
Z Z S' U-r, , Y^^ I; eN e I -P- 3 C-yp cF c 7 Fax: City,
State Zip: N Z ? 7 1 State License No.: Name:
Street:
City,
St, Zip: Bonding
Company: Address:
Architect/
Engineer Information Phone:
Fax:
E-
mail: Mortgage
Lender: Address:
C
Fc-o 1f 9 s o -t-- 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 ofapplication and the code in effect as of that date: 6`t' Edition (2017) Florida Building Code
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that maybe 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.
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
C----- /
a l0 Z 4:p
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary-J to,51. ida DEBBIE MiTOIN x
MY COMMISSION # FF 178846
EXPIRES: February 25, 2019
Bonded Thru Notary Public Undery rters
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: Occupancy Use:
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:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING: