HomeMy WebLinkAbout1215 S Oak AveApplication No:
FZECEIVE
JAN 10 2011
CITY OF SANFORD
BY: BUILDING & FIRE PREVENTION
PERMIT APPLICATION
I (PCB Documented Construction Value: $ 4_G C/
Job Address: S / v li Historic District: ves No
Parcel ID: _2 S (1-30 e, I-/ - G oy Zoning: Description
of Work: //C- /Z 2 512- R V(C /E Plan
Review Contact Person: Title: Phone:
Fax: E-mail: Property
Owner Information C(
Namel /- CO 6T (" Phone: Lt 0 7 4 `E 7 S' 3 c( cZ Street: _'
Resident of property? City,
State Zip: 51) 60A J fS 7 7 ( Contractor
Information Name
i w
r(
S% - Phone: L( o Street: (/ /
ter CG o,c_ i r c_)R Fax: !_f 6 City,
State Zip: o& i /A d-r- = C 7 2 20 State License No.: C /(-C I 5-6,2_ Architect/
Engineer Information Name:
Phone: Street:
City,
St, Zip: Bonding
Company: Address:
Building
Permit Square
Footage: Fax:
E-
mail: Mortgage
Lender: Address:
PERMIT
INFORMATION Construction
Type: No. of Stories: No.
of Dwelling Units: Flood Zone: Electrical
Plumbing New
Service - No. of AMPS: New Construction - No. of Fixtures: Mechanical (
Duct layout required for new systems) Fire Sprinkler/Alarm No. of heads:
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.
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.
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.
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 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. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
Signature of Owner/Agent Date nature 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
APPROVALS: ZONING: U l'1012-011 UTILITIES:
ENGINEERING:
COMMENTS:
FIRE:
C-K<_
Pri t Contractor/Agent's Name
dZ < - 6j,,4=!!
F t k -, I/,///
Signature of Notary -State ofFlorA Date
o1 aYP`s
r
Rotary Public State of Florida
Vickie l Clayton
A My Commission DD760637
ar,o' Expires 0312612012
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
Rev 11.08
r
WOP/CAL PLUMBING
4& SEPTIC, INC.
s
Tropical Plumbvig & Septic, Inc.
19468 East Colonial Drive
Orlando, FI 32820
P 407-568-0111 F 407-568-0119
CF'C1425621
Wendy Coletti
1215 S. Oak Ave
Sanford, F132771
For All Your Plumbing Needs
www.TropicalPiumbing.com
E) `,'I i January 10, 2011
EXPIRATION I [Date]
SALESPERSON . f JOB .. _ PAYMENT TERMS
Leo Replace water service ?Due upon receipt
Item Descm) on g LINE TOTAL
S SInstall 40' 50' of new water service in PVC. Wash under sidewalk and connect :
to meter and house. z i $ 400.00
i
1'
THANK YOU FOR YOUR BUSINESS!