Loading...
HomeMy WebLinkAbout1105 E 20 St (3)W INI Nam! flfu ATl . Inl hlfY111 TGR10 rR 711111wIrf't11 11 h In1A IIF IJIt+I irYhR III IVY I 1PE8152016 CITY OF SANFORD BUILDING & FIRE PREVENTION BY- PERMIT APPLICATION Application No: Su-rMA 4n Documented Construction Value: $ _J, 0.00 00 Job Address: S +r^t2 t Historic District: Yes No E] Parcel ID: ; _ -- 1 - l T 1 0 010 0 ^ Residential [" I Commercial Type of Work: New Addition Alteration Repair Demo Change of Use Move Description of Work: rf pl Q Ge -R -fSt1 -es. Ccsrn vC''r L +_L%' b '_n 5- In n l ,a r. Plan Review Contact Person: Phone: Fax: Title: Email:.' —,Au ,Oca A P( (aw d - (oAA Property Owner Information Name 'R(.,m ma M C G:6 t t_r4n Street: ),1 --1 15 V G City, State Zip: ft` D0 ka , FL 3 a`11 a Phone: Resident of property?: Contractor Information Name MCIAOSA 3). MCC©W2Y1 Api U S I u4 1 Phone: A "7 27 7 — 6 3 h g Street: MaC 5\ D 0LY\S k4o& f'. Fax: 3' ' )Q y () s 1 LA City, State Zip: Gr X o6-4 1 and . L ?L9-136 State License No.: rGI4 aS% a3 Architect/Engineer Information Name: Phone: Street: City, St, Zip: Bonding Company: Address: Fax: E-mail: Mortgage Lender: Address: 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 OR 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. 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. FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5t° Edition (2014) Florida Building Code lRevised: June 30, 2015 Permit Application U 7 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 at the time of permit submittal. A copy of the executed contract is required in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal. The actual construction value will be figured Based on the current ICC 'Valuation Table in effect at the time the permit is issued, in accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value, credit will be applied to your permit'fees when the permit is issued. 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. Sigoatuue of Owner/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Date _ owner/.A.gent is Personally Known to Me or Produced ID Type of ID Sijmture of Contractor/Agent Date V i CL a-4 b, IffiC&-a W e4'1 Print Contractor/Agent's Name Q-zho/`c- of Notary -State of Florida bate KAUM.PINO QSeal r113LIC STATE OF FLORIDA Comm, FFOM37 E;(Plres 11/20/2017 Contractor/Anent is `f Personally Known to Me or Produced ID Type of ID BE, LOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads __ Fire Alarm, Permit: Yes No APPROVALS: ZONING: UTILITIES: WASTE WATER ENGINEERING: FIRE: BUILDING: COMMENTS: Revised: June 30, 201 5 Permit Application