HomeMy WebLinkAbout2770 Depot Ave - E18-004385 - INSTALL SECURITY LIGHTS4t1 ORD _
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FST.,18 1
Y OF
SXNFORD
BUILDING DIVISION
Job Address:O1 0
Parcel ID: 00 Type
of Work: Description
of Work: OCT
3 0 2018 PERMIT APPLICATION Application
No: mented
Construction Value: $ Historic
District- Yes [INo Residential
commercial Addition
Alteration Repair Demo Change of Use Move emcr/
or ll hts Plan Review Contact
Person: 1 f U n cis Co De (-CA--TGlrC-Q Title: OWn Phone: 3 s43 -
U JT4ax: Email: tf 1 t WS 2b6+15 ProrppertyOwnne'
r InformationName
C90 p r _ 1 lh , v ' Phone: Q, Street: 3-1
f 0 City, State Resident
of property?
Contractor InformationName
CC) D
CL 16 Ml Phone: ` I I/ Street: cU I
n Vc Fax: )VIA A City, StateZip:
Ix- Kind , B 0 0 State License No.: Name: Street: City,
S.
Bonding
Company: Address:
Architect/Engineer
Information
Phone: Fax: E-
mail:
Z
v Mortgage Lender: Address:
rT 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 andthat 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. CC)
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 6'h Edition (2017) Florida Building Code 4%
NOTICE: In addition to the requirements ofthis permit, there maybe 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 ofthe 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 Date Signature of Contractor/Agent Date
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
Print Contractor/Agent's Name
Signature of Notary -State ofFlorida Date
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:
Flood Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: -Yes No # of Heads Fire Alarm Permit: Yes [-]No
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING:
COMMENTS:
FIRE: BUILDING:
e
FBC 1053 Shall be inscribed with the date ofapplication and the code in effect as of that date: 61' .Edition (2017) Florida Building Code
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 thatI 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 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.
g
g'" 1 Date
P ' t OwnerlA ent's Name
S gnature of Notary -State of Florida Date
Signature ofContrac gent Date
Lru no-, —0 D, LCC76 r Pr'
ontracioijAgentshame l'o/
a9/ 1 Signature of
Notary -State of Florida Date Owner/Agent
is Personally Known to Me or Contractor/Agent is Personally Known to Me or Pr V
jki ID DL— Produced ID Type i CHAVARRI F•• i MY
ki SSION 0GG005870 MY COMMISSIONpGG005870 -•; EXPIRES June
27, 2020 €)(Pint§ June 27, 2020 407)398-
0t53 FWW&NotarySerrice.com BELOW IS FOR OFFICE USE ONLY ,a; , Permits Required:
Building Electrical Mechanical Plumbing Gas Roof Construction Type:
Occupancy Use: Total Sq
Ft of Bldg: Min. Occupancy Load: Flood Zone:
of Stories:
New Construction:
Electric - # of Amps Plumbing - # of Fixtures. Fire Sprinkler
Permit: Yes No # of Heads APPROVALS: ZONING:
UTILITIES: ENGINEERING: COMMENTS:
FIRE:
Fire
Alarm
Permit: Yes No WASTE WATER:
BUILDING:
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 10 15 2-(0) 0
I hereby name and appoint: J•eS6 Ca N4. C h G UG rri
an agent of: FWr 1 El -eCfn co 1 Co r t rocto r s Inc.
Name of Company)
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney: /
1
i 10()
License Holder Name: Fro l%CIV CCU D-e LcL Tc) rrf,
State License Number: Ec 13 UU (0W0
Signature of License Holder: _
STATE OF FLORIDA
COUNTY OF La
The foregoing instrument was acknowledged before me this b day of -to kc !
20016:, by gran isC0 La U 1'r:C who is ersonally known
to me or o who has produced as
identification and who did (did not take an oath.
ignature
Notary Seal)
JESSICA 1W CHAVARRI
407)
MY COMMISSION# GG005870
EXPIRES June 27, 2020
398-0163 Florida NotarySarv{rs.com
Rev. 08.12)
Jess Ica M cknu Lor r l Print
or type name Notary
Public - State of R 6 r i da Commission
No.POC9,770- r
My
Commission Expires: aa
Path Eloctrical.Contractors, Inc.
43927 looter Pond Rd.
Deland, FL 32720
386-848-8596
admin@pathec.com
Mr. Paul
XRC Roofing and Construction, LLC.
4019 W State Road 46
p Sanfl, 1 32771 US_
ad--F
INVOICE # DATE
m
TOTAL DUE
14300 10/15/2018 $365.00
Invoice
Mr. Paul
XRC Roofing and Construction, LLC.
4019 W State Road 46
Sanford, FI 32771 USA
DUE DATE TERMS ENCLOSED
11/01/2018 Due on receipt
ACTIVITY CITY RATE' AMOUNT!
Location 1 0.00 j 0.00
Warehouse: 2760 Depot Ave Sanford, FL
Building Permit fee 1 365.00 365.00
Buildin _ Permit fee for clerical cost
Thank you for choosing Path Electrical Contractors Inc. We truly value your BALANCE DUE $365.00
patronage!
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