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HomeMy WebLinkAbout1305 Travertine TerJUL I8 2011 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: _ I— `1( Documented Construction Value: $ ) X-1 g.0V Job Address: -L20`J TIQ I 'Telr Parcel ID: '? • q • '3d 5 • QC1Q • I l an Description of Work: Plan Review Contact Person: Phone: Fax: Historic District: Yes No Zoning: Title: Property Owner Information Name n I 1 Phone: _q0-3• PQ-1 • CM-7 Street: l asjm: Ya w 41 ry" T r Resident of property? LALIL_ city, State Zip: N.n-CQvr! FL sQ m Contractor Information Q Name L . .1,1 1 Phone: l o • 5 l, f • Street ' F Faz• O G a' City, State Zip: G% State License No.:` 13 C)U Name: Street: City, St, Zip: Bonding Company: Address: Building Permit Square Footage: Architect/ Engineer Information Phone: Fax: E- mail: Mortgage Lender: Address: PERMIT INFORMATION Construction Type: No. of Dwelling Units: Flood Zone: Electrical &- New Service — No. of AMPS: Mechanical ( Duct layout rewired for new systems) No. of Stories: Plumbing New Construction - No. of Fixtures: 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 noworl' or installation has commenced prior to the issuance of a permit and that all work will be performed tomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate permitmustbesecuredforelectricalwork, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, andairconditioners, etc. OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work willbedoneincompliancewithallapplicablelawsregulatingconstructionandzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAYRESULTINYOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOURLENDERORANATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT. 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 requiredfromothergovernmentalentitiessuchaswatermanagementdistricts, state agencies, or federal agencies. Acceptance of permit is verification that I will notify the owner of the property of the requirements of FloridaLienLaw, 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 ees when thepermitisreleased. I, A/ 4 J):1 - S of Agent Date Signature of Conuactor/Agent Dato Print U J&_NIPER A. I AI 1SFIELD""r' NOTARY PUBLIC STATE OF FLORIDA Comm# EE09n98 Expires 2/8/2014 Owner/Agent is VPersonally Known to Me -or Produced ID Type of ID Print 'tractor/ gent's I/- Sipaur of Notary -State o Florida _ Dft v TABITHA VANDEe 'r NOTARY r3UBLIC J STATE OF FLORI®A' y Cornm# DDS60489 Contractor/Agent isKnown to Me or Produced IDType of M Lll APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: Fes: COMMENTS: BUILDING: 1,46T', ,• ALARM SERVICES CONTRACT Mnnitnrinn Armunt Number Section-• of • - • PREWIRE Yes © No Wireless Apartment ACCOUNT TYPE: 0 Install Takeover System Move PRODUCT CODE QUANTITY DESCRIPTION OFFICE USE ONLY CostIssueInstallReturnAdd 01 ElSee additional equipment listed in attached Schedule of Protection nConfirmationCodeO ` 2C- Cross Street 9\-AQN-- J J Subtotal, Map PageEquipmentType • V; k _ .. You acknowledge that: (a) We have explained the full range of protection, equipment, and services available to Rate _% Tax: You, (b) additional protection over and above that provided herein is available and may be obtained from Us at Purchaseanadditionalcosttoyou (c) You desire and have contracted for only the equipment and services itemized on Amount Total: this Contract and (d) the equipment will become your property upon payment of the Purchase Amount Total including Sales Tax in full. We are not a security consultant.; Less Deposit '...'._.. Estimated Start Date q Balance Due,.-'_."llJ...._"_: Estimated Completion Date Section• be Provided i I Optional Electronic Monitoring Services (Cont.) Monthly Rate . Affinity Name _,:: _1, l...l. _i_ _ Cellular Backup: Basic Monthly Service, Burglary Service includes: Customer Monitoring Center Signal Investigator Response, i Receiving and Notification Service for Burglary, Manual MPF (Monthly Processing Fee) Fire, and Manual Police Emergency. Basic Monthly Service, Burglary Monthly Recurring Municipal Fee (Subject to change based on local law) with Extended Limited Warranty _ Customer to obtain and pay for municipal alarm use permit T -- Other - Residential Customer Only) Service includes: Customer Monitoring Center Signal Receiving and Notification Service for Burglary, Manual. Fire, and Manual Police Emergency along with Extended Other 1 Limited Warranty during which you will be billed $25. for each trip made to the Monitored Location after the- Limited Warranty period. Other Optional Electronic Monitoring Services • Monthly Rate Total Monthly Service Charge Remote Access/Keyfob ' Initial/Annual Recurring Municipal Fee -billed separately Subject to change based on local law) Customer to obtain'and pay, for initial/annual municipdalarm use permit. Fire Alarm/Smoke Detection Your failure to obtain and provide Us with your municipal alarm use permit registration number could result in no municipal firelpolice response to an alarm from your premises and/or a fine. Two Way Voice Municipal Construction Permit Fee Customer to obtain construction permit, Carbon Monoxide Other 2 of 6 02010 ADT Security Services, Inc. f 5 1 L4-U / UL (09/10)