HomeMy WebLinkAbout341 Placid Lake Dr (2)RECEI TE • .
JUL 2 7 2011
CITY. OF SANFORD .
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: '' Y Documented Construction Value: $ ` C:Z 01
Job Address: Historic District: Yes ' No
Parcel ID: C9 a ^ aCi JO JraC Cao —O'-1 C Zoning:
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Description of Work: (1Z h :!o Ei e_5 e Lc a i -F aot T-1,4 es ]_ 5-/GVG4Z_
Plan Review Contact Person: Title:
Phone: Fax: E-mail:
n n ^ Property Owner Information
Name Phone: ' ' ' — as -4 P — h 6 i
Street:/ &ej 1, Resident of property? : VYS
City, State Zip:
Contractor Information
Name T g I C < <. /JebSe zr L Phone:
Street: Y(C3 /12 5f 5,rtf Oc? Fax: 407'` -3y- 5 70
City, State Zip: LAA< td&OX %s i State License No.: 1 C.w -)4 71 S
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
Building Permit
Square Footage:
No. of Dwelling Units:
Electrical I/
New Service —No. of AMPS:
Mortgage,Lender:
Address:
PERMIT INFORMATION
Construction Type:
Flood Zone:
No. of Stories:
Plumbing
New Construction - No. of Fixtures:
iviecnamcai u (i)uct layout requtrea for new systems) r ire 3priuiuerifuarm u rNu. ui ueaus:
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: --501 -V a 9, 2 a l l
I hereby name and appoint: 'jai 1u\,,o,oj& Ind'C'-- e—cc,u X
an agent of: C o ry-' e.1 co
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:
f ( fl -di -IJ L.a 'Dc- i ve_
Street Address)
l
Expiration Date for This Limited Power of Attorney:
License Hol
State Licens
Signature of
STATE OF
COUNTY C
The foregoing ins ument wa
200_J_L by e
to me or who has produced
identification and who did (did
NOTARY PUBLIC -STATE OF FLORIDA
Felicia Gonzalez
Commission#DD823708
Nm=
OCT. 31, 2012
caormura co, INc
Rev. 3/27/07)
ale ged before this o-1Iday of
I P who is personown
as
e an oath.
i
ure
Print or type name
Notary Public - State of
Commission No. r237L g
My Commission Expires:
275 Hunt Park Cove, Longwood, FL 32750"
407-331-9077,'40.7-331-0305 FAX
www. s u p e r i o r s a I a r: c o m Florida's Premier SOLAR ENERGY Systems Provider
LIC #CVC056636
t NAME ,-. - - PHONE _ DATE., .
t lic r,o1 sGik lt 00 ik
STREET - - ALTERNATE PHONE _ ; DESIRED INSTALLATION DATE -
c LA 39tCITY, STATE, ZIP CODESOURCE - - • „ - SUPERI\\OR//SOLAR REPRESENTATIVE
LEGAL DESCRIPTION ; • ^- I E?BAIL ADCHESS • . GATE CODE , • •
f ;
ft31
SYSTEM SIZE
GRID -TI77EDRESIDENTIAL7. a.. _ t
STAND-ALONE COMMERCIAL
MODULE MAKEMODEL NO.OF MODULES s ,+ q •' -t - - n +- - -. __. _ __.._,
L! • il Cx" -t k.. .. - v _%tljr ,'1. tS! t •„Q`f•icx- INVERTER NO. OF INVERTERS t-'
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CIST.TO MVVERT=_R
t V'l' ••, t i.`_ i.", _
t r _ - VROOFTYPEPITCH .
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MOUNTINGfdETHOD •. U71LPROVIDER
ARRAY i " EXISTING BREAKER PANEL „ i • '.; -;: ': •i-•• . - . _ _ _ 5...
f . -*. ` . --+ --, . - _ _ " ,.„=j;7.1'- -' .
e i.^._ ARRAY 2 BATTERY BANKTYPE &LOCATION
t-4 i _ i
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ARRAY 3 MONFTORiNG
s_ ..,-' . ?'Iji i _ : . , ,• -
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ARRAY 4 — --" _ _ _ OTHEA
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ADDITIONAL,INFORMATION
a—'cL.s___C s1rC L..a.:f•- l. '.____is'S i2L,._.? ? isa._r./_,
t •r C2 AIS. r.ittr s.
C s 01CL P_c.ii
A ctPTANCE: The prices, specification &,conditions are satisfactory and are hereby accepted
tt is
System Cost: r
TERMS: _Deposit Amount' 's ! , Balance of
Balance due upon completion unless otherwise specified:
Buyer acknowledges receipt of a`copy of the Statement of Policies, Terms and Conditions on the
reverse side or attached, which are incorporated •ass part of this Contract.
Signature Cale
Sigma
ur Date •• IMPORTANT NOTICE: The buyer has the right
to cancel•this transaction at any time prior'to
midn`ighioftWtMH business'day offerthedate'
of this contract. -' -
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, heater's, 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-InradditionAo.".thexequirements-o£tlus_permit—there-ma"y-b-e_additionaLr_estric-tions•..applicable_to-this
property that may be found in the public records of this county, and there may be additional permits required
fiom 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 permitTees when the
permit is released.
0000
0061
S&Aweer/Agent Date Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Si ure of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
UTILITIES:
FIRE: -
WASTE WATER:
BUILDING:
Rev 11.08-