HomeMy WebLinkAbout1026 W 12 St 11-441 (demo)RECEIVED
DEU ® 7 Hilo
CITY OF SANFORD
BUILDING $ FIRE PREVENTION
PERMIT APPLICATION
Application No: I/— q Documented Construction Value: 5 _ t/5,P1.0o
Job Address: /0,2
6 W l ,Z f sf Historic District: Yes ❑ Vu ❑
P.trccl ID: 2-5-1 a- 30- 5AH - OW6- 0370 Zunin•j
btscription of Work: Demol+oyl
Plan Review Contact Person: ����°�� �f4fi' Title: Qres oy�
Phone: qo�- qgi q - �,byq Fax: tj0'7-,9Yw- 3-511 E-mail: MWa� � C�euhS tf@S e��i'Gf S .Corte
Name kct, ie jafksgn
St1'eet:
City, State Zips:
Property Owner Information
Phone:
Resident of properly:' .
Contractor Information
Name t;C Ea�V e✓SiFI`e.� Phone: `16-7-fff-It? 9
Street: �O�i21 Pu�-�� e Ln Fax.•
City"state Zip: or 306 State Lirense No.: CGC, i51 yggq
ArchitectlEngineer Information
Name: Phone:
Street:
City, St, Zip:
%ndinl; Company:
Address:
Fax:
E-mail:
Mort-;aue Lender:
Adtiness:
PERMIT INFORMATION
Building Permit ❑
Square Footage: `l(05i Construction Type: W (Me No. ofStoiies:
No. of Dwritinb Units: ( Flood Zone:
Electrical ❑
New Service — No. of _MPS:
Nfeclianical ❑ (Dui:t layout r:quiriA for systwns)
Plumbing ❑
New Construction - No. of Fixtures:
Fire SprinklerlAlarin 0 No. of herds:
# J/0.0(-)
� , 1
Application i; hLrehy made to obtain a permit to do the work and Installation.; a, itidic;at, ; . Tcertif that tit)
work or irlstaltatlon has cot muncud p6ol to the isjwuicc of it pci-mit mid that all work will be pi:r otnicd to
meet s-taiidards of all laws regulatinLl c:uustructiutl ill this jurisdictiun. I undr:rstand that a sCparatc permit
must be secured for electrical work, plumbing, signs, wells, pools, furnaces, builers, heaters, tanks, and
air conditioners, etc.
OWNER'S AFFIDAVIT: 1 certify that all of the foregoing information is accurate and that all work will
be dune in complianct with all applicablt laws regulating construction and zoning.
WARNING TO OW—NER., YOUR FAILURE TO RE CORD A NOTICE OF COMNIENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE
OF CON•IMF.NCF.MFNT MUST RE RECORDED ANiD POSTE D ON THE JOB SITE BEFORE `i'HE
FIRST iN SPECTIUN. 1F YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE, In iaditiLlori to the ccquircmLi .ts of lliis p, rout, lhLrL may be atiditional iesirictions applicable to this
property that may be found In tht; public. rocords of this county, and thi;rc may be additional permits rcquired
li'orn ttth r at�vUt7tttl ntal erttilie such 3s w �tur tnarlagelt)iNiL &,Ldtcts, slate- arin, lest or izderat a;;ertcle',
Auceptant;e of litrmit IN vLriticatinn that I will iintity tht ctwiitr cif tht proptity of the requirenitlit, of Flnrida
Lien L.lw, FS 713,
Tht City of Sanford rqulrt, payrint nt of a plaii rtwlcw fee. A cttpy of tht cxcruttd conttact is requirLd ill order
to ialt-ulatt a plan teview chatgc. if lhi txecuwd contruct to not submitted, we reative tht right ti] calculAc the
plan review fix basi;il on past pernut activity levels. Should calculated charges ekcced the docunic-atcd
i onstiiuut�wi value wht to the CXeLuttd ctYntract is N-uhnlitttd. cridit Wilt be Applied tip your permit tet, whtti the
permit is rcicase(t.
`tgual►u.: Of i]wu-.m _Awnt D:iLc
Print.OwtierlNantc
Sijuantcanrlrertrl- tatrufFkuida ban
i�Wuci .A=cot is PCISUu;illy Kiiown to N-lu or
Produced [D Typt of [D
APPROVALS: 70NING: UTiLiTTES:
EN61NEERINO:
COMMENTS.
FIRE:
Sh4ialur:: ai'Cun taclui! 2a1L Dal.:
Cyrt
F�
Print iii l.r) I rili�atl's Nai is
ZJ7/,v
Sienatur:: of lntat}' Stag. of Flnrida Uat
E h!.
O S�,
••• ..
�V�MISSION�.��•i''
>�' OatV 16? A ••
ir-
{ s]I1tl'2leii)r'rA4iijC�la t�lt<3 irolowti to Nit: Or
PioducrftID lt'IVQo�L
SUILDiN63:
Rtv 11.08
Date: December 7, 2010
Contractor: Seminole County
Project: 1026 W12t St
Attn: Becky Heckters
Sanford, FL 32771 i
Ph: 407.665.2388
Fax: 407.665.2399
Email: bheckters@seminolecounty.gov
Clean Site Services Inc, hereby proposes and agrees to furnish all necessary labor, materials, equipment;
machinery, safety gear, environmental protection, liability insurance and workers compensation to perform
the following scope of work in accordance with the specifications supplied and reviewed. No hazardous
waste, toxic chemicals or asbestos abatement included.
SCOPE OF WORD- Estimate
Demolition of 1792 sgft wood frame structure @ $1.171sgft. $1497.60
Demolition of 70 sgft block shed structure @ $1.20fsgft $84.00
Additional items not included: asbestos abatement and tipping fees not able to estimate at this
time.
Iota I Pro posa I Price $ 1581.00
Respectively Submitted by: Mike Craft
6827 Partridge Lane
Orlando, Fl 32807
Ph:407.999.2699 Fax:407.849.3515
Acceptance of Proposal
The above prices, specifications and conditions are satisfactory and accepted, hereby authorizing Clean Site Services
Inc. to proceed with above -mentioned project. All salvage rights reserved by Clean Site Services, Inc. at
commencement of project. Please sign and mail or fax to our office for scheduling. No hazardous waste, toxic
chemicals or asbestos abatement included. Payment terms are net 30 days from completion unless otherwise agreed to
prior to the commencement of said proposed scope of work. A deposit may be required.
Signature: Date:
Printed Name:
6827 Partridge Lane
Orlando, Fl 32807
Ph:407.999.2699 Fax:407.849.3515
Demolition Perimit Application
Certification of Service Disctiilmect
Date:, �D.C!11-zolo
Applicant: Contractor orOwaer "T[—; C QW iA i al
Address: W1.1 PU.r-�%'l of t* LVV--, Q rtaAt�o �r'� 3Sf�QZ---
stmet city State Zip Code
Building/Structure to be: ` DEMOLISHED XResidentlal ❑Commercial ❑other
Site Address i, n ti� 1'I.t-
Legal Description
Owner on Record....,,i
�. Electric Utt It+r I � A �
Certfifled By ���c.-rc
as r1 �yI/o 2 �ed r1�11a
2 a Company
Certifled By�
09te,
3, Canny
Caffi led By
n
4. D1ePh2DC Corn a1]�
C,ertffled By
Dau -
c� LA
I /T 'zDdd STSE08LOr s9ovizgS 9gTS LreaTO D'1bi SS:OT OIOZ'SZ'AoN
Florida Power & Light Company, MG Spruce Creek Rd., port Orange. FI- 32129
November 24"', 2010
TEC Diversified
6827 Partridge Ln
Orlando, FL 32807
Re: Service Removal
This letter confirms that the service was removed from 1026 W 12TH St, Sanford, FI on November
20" 2010.
if you need any further information, please contact me at 800-741-1424.
Thank you,
Susan Zellers
Power Systems
1111812010 13:40 TECO PEOPLES GAS ENG DEPT
RX Date/11me 1111712010 14:04 4078493515
Nov.17.2010 01:50 PM Cl®an Site Services 4078493515
#:AH}407M768 P.0011001
P.Wz
PAGE. 2/ 2
Demolition Permit Application
Certification of Service Disconnect
Date:. 00-1l01 D
Applicant: Contractor or Owner ..r V-, C t->\jml-Re al
Address: k? 9_1 Pa-r 4-nAQ<, Uy.,. Q rt&A�o A,► &M r
Street aty State Zip Code
Building/Stmeturo to be: X DEMOLISHED [Residential QCommerclal DOther
51te Address ienU W 1 Z rh 5
Legal Description- 30 59 N_ 00 O 0 3 110
_
Owner on Record Kab e, do c*--SM
1, Electric Utility
c4rtifled
Dare
2. !Sao COMPAny
CoMfled gy iA) tel G'
Dabe„ PIAi 11* J
3. Cable Comoanv
Certified By
Doi7e�
4. Telephone Company
Certlf l ed By
-
Da
� A
,A f° s
Mu5f
,&sA P' j -3E�
tip V.' "'`.
Nov.l$, 2010 2:04PM Florida Public Utilities
No, 3759 P. 1
Nov,17.2010 01:54 PM Clean Site Services 4078493515 PAGE. 2/ 2
Demolition Permit Application
Certification of SeMoe Discomect
eau Alo411,20)o _
Applicant: Contractor or Owner IT i iye sl t al �.
Address: U011 Q r�Yl' aC. LtZ. r� rl�,nG�O A, 3SVO7
street City State zip Code
Building/Structure-to be: DEMOLISHED gResidential InCommerclal 0Other
slur Address
Legal Description
Owner on Record Ko_ .Ja ct5�M,.,... ,
1.
ElectriUtility
C+erMed By
Date
Certifted By
0Gt`a1 rc'Ss3.
bate /l Za --aQZQ
Cable Comoanv
CertMed 13
Date
4.
Telephone Company
Certified Ry
Dais
. i5 A R-sN I r o(�..R y
MU
G'v+�
Dec. 1. 2010 2:13PM Florida Public Utilities No-3940 P. 1/2
Demolition Permit Application
Certification of Servioe Diwonnect
-Date: r4o�
.Applicant: Contractor or Owner
Address;
Street city State Zip Code
: 'Building/Structure to be: DEMOLISHED �Residentlai []Commercial U Other
X
Site Address 102up W 12-th 5+!k I -.Atn:h!jA
:Legal Description
Owner on Record Kah e4j la (I=- 2M--
1. Electag UtIlIV
Certified 9 A P-US'
i P" P rw
Date
Gas Company- 3r— -,--�F7AADLA D
A/o o9c-4 ov0012. cerufled BY L) L-AE5,
Date
6 A-P P
oopol,,4reot 3. Cable- CQMRRBY 14—
(�o LAL.
CertMed By
4. Teleahane Company
Certified 6
Date
I A-13
1,: 4Z I I -I T§IM I
:-10 It IN
SODTAaBS UqTs UuaTO Wa LQ:10 010Z-10-z9a
11/17/2010 16:46 4075789451 BHN CENTRAL OFFICE
NOV.17.2010 01:52 PM Clean Site SOY.iriceS 4078493515
PAGE 04/04
PAGE . 2 / 2
Demolition Permit Apphe4on
Certification of Service Disconnect
Date.
Applicant: Contmotor or Owner T C I 1VPx5#-R { 671
Address, , UO �l Par-4ri A :_ LrZt'1<, O rtv,n,6Lo A, 3.,no7
street City state zfp Code
Building/Structure to be: X
DEMOLISHED gize-sidential nCommercial 00ther
Site Address
Legal Description
Owner on record
Certified by
Date
2. Gas Cornoany
Certified By _ T
Dote PkSA-P
3. OVIA (e r
Certi?1 J4 By
Date
4. Tleu one Com ap_ny
Certified Ry
Date
DEC-06-2010 16:17 From:425 580 9886
Page: P1
Demolition Permit Application
Certification of Service Disconnect
Date: �09 11120,0
Applicant Contractor or Owner
Address: - �ftl Pax+viAq - Uanc, 0 rleL'n�o R,. 32to 7
Street city State Zip Code
Building/Structure to be: X DEMOLISHED XResidential [3Comrnerclal 11 Other
Site Address. -.-.Io.2.(#
Legal Description ,
Owner on
3U-321-3q4q
1.
Electric- Utility.
Certffled By
Milk -
2.
Gag Camoai)y
CertMed By
Date
3.
(;able CornRany
cemma By
Do
-1 -
Teftbone Co1ppany I,-)
Certified 5
Dot iDA(d
T
A P-USA
. ��MDUS
A-P P
F /T aE)VCT STSEMLOV SBDTAIBS BITS UP913 Wd ZV:Z0 OTOZ-To-Dea
Special Power of Attorney
I Shannon Ethridge (Name of License Holder), license # CGC 1514499 , hereinafter referred to as the "License
Holder," the President (title), of TEC Diversified Inc (Name of Company), hereinafter referred to as the
"Company", hereby appoint the following persons as Attorney -in -Fact of the License Holder/Company, in
order to (a) sign and submit building permit applications, (b) obtain building permits, and (c) obtain the
certificate of occupancy City of Sanford on behalf of the License Holder/Company:
Mike Craft
LICENSE HOLDER WITNESSES:
Sign: " n CQ.2_. Sign:
Print Name: Shannon Ethridge Print Name: ames
Title: President
Company Name: TEC Diversified Inc
Mailing Address: PO Box 616922
Orlando, Florida 32861-6922
Telephone No.: 407-298-4217
Sign:
Print Name:�i fC
Fax No.: 407-445-1980 E-mail Address: TEC Diversified 0-) a ol. com
State of or-0-0-
County of
The foregoing instrument was acknowledged before me this day of _V= 2O 10, by
(7
V►Qfjy1 i_-ArlyG the Pres(Ven of TEC L')IJe/61'4,ed a
FjQrl l c. corporation, on behalf of the corporation. He/she is personally known to me or has produced
as identification.
A
Not PubQiTEr.1NE GNT
IV.Y�:'OMNLISSION#k�:gg33
f'�'oxr,a
LBC0.1NOTARY Pl. Na4 Bimunt Aaum. Co.
Commission Expires: