HomeMy WebLinkAbout2537 Georgia AveRECEIVED JUL 0
JUL 14 2011 ITY FORD
yam
BUIL PREVENTION
PERMIT APPLICATION
Application No: / l os Documented Construction Value:
Job Address: -Z-5 37 - iia eF2 Historic District: Yes No
Parcel ID: Zoning:
Description of Work:
Plan Review Contact Person: /4'e `YI E'+ S Title: eO/,121--
Phone: Fax: E-mail: - a
Property Owner Information
Name
SGN S I • LCL . Phone: 4T-- 7 3 2
Street: ' f iU Jy y, Resident of property?
City, State Zip: Ge)
Contractor Information
Name !
n
Y'!u t'qc ole S Phone: 3 5tL 25-5- S9t 3
Street: t' Q 'b' '
I
Fax:
Y
City, State Zip: U'1 +
Ir/
l . 8¢ State License No.: fl!?3615VZ4
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: \' E-mail
Bonding Company: Mortgage Lender: `
Address: ` - a.> - r Address:
3 a +. • rte— f raaSvaomsr.:ss.c Jr lbrc+*crBv-max a-a:isf
00 1 V01281M.M03 1A
PERMIT INFO TO
Building Permit. - `'' `;""` """>tt„F'm;"" Lam -
Square Footage: 'a '.1
Construction Type: No. of Stories:
No. of Dwelling Units: Flood Zone:
i
Electrical D - - Plumbing _
New Service — No. of AMPS: New Construction - No. of Fixtures:
r
Mechanical 0 (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads:
4
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 WIT -H• 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.
N \ ' ,
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.
7 f
Signature of Owner/Agent Date
aSes - l 2"
Signature of C tactor/Agent Date
42L-> -3-, l AOF-A
Print Contractor/Agent's Name N
A
a re oPN - onda Si ature of Notary -State of Florida\
YJEREMY J. WILLIAMS k • ,
r46MYCOMMISSION # DD 755831 a-
s EXPIRES: June 6, 2012a Vs Vo ;
Pgdy eo1ded R. Notary Public U d.,, i..,/,Ea
18 I1U y, e
Y ' 9
Owner/Agent is Personally Known to Me or Contractor/Agent is Pei/?( .%vri1to Me orIi
Produced ID f `7L Type of ID C yCa-a1 Produced ID Type of ID
exp. 2-,?--Zo1y
APPROVALS: ZONING: : UTILITIES: WASTE WATER:
ENGINEERING:
COMMENTS:
Rev 11.08
BUILDING:
f.
4;, AaCCURATE ART'S
PLUMBING& TILE- Inc.
P. O. BOX 574 • UMATILLA, FL 32784
352) 551-3455 • (352) 255-8937
Fax (352) 669-3880 • Lic. #RF0064426
FHOFOOG°QL
FD O.
teNo.
Proposal Submitted To: Work To Be Performed At:
Name 5,q IQ C/q oN
Street
city L G
State 3Z -7-7 Y
Phone
Street, 7 7 eo
city S
Date of Plans
Architect
We hereby propose to furnish the materials and perform the labor necessary for the completion of
w A
All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and
specification submitted for above work and completed in a substantial workmanlike manner for the sum of
i_ Q % Dollalis ($ a O O• d d ). with payments to be made as follows:
Invoices are due and payable upon receipt. It is expressly intended and understood that title and ownership of all goods, parts and materials described on the face hereof is and shall remain vested in Accu- rate Art's Plumbing & Tile, Inc. notwithstanding delivery of possession, until the entire purchase price is paid. In the event the amount shown on the face hereof is not paid when due, Accurate Art's Plumb. Ing & Tile, Inc., its agents or any officer of the law may take immediate possession of such goods, parts and materials and for this purpose may enter upon premises where they may be located. In the eventlegalproceedingsbecomenecessary, the customer agrees to pay all court costs and reasonable attorney's fees. If not paid within 30 days from the date of invoice, a service charge of 1.5% per month (18% per year) will be added to unpaid balance.
Any alterations or deviation from the above specifications involving extra costs, will be executed only upon written orders, and will become extra charge over and above estimate. All agreements contingentuponstrikes, accidents or days beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work. Worker's Compensation and Public Liability Insurance on above work to betakenoutby
Respectfully submitted. Accurate Art's Plumbing & Tile, Inc.
Note—This proposal may be withdrawn by us if not accepted within days.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work asspecified. Payment will be made as outlined above. If not paid within 30 days from date of invoice, a s rvice charge of 1.5% permonth (18% per year) will be added to unpaid balance.
Signature
Date 1 Signature