HomeMy WebLinkAbout702 S French Ave4
SAN'
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JAN 11 2016
BY:
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $
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5D07
Job Address: Fr-er-A Ae Historic District: Yes No
Parcel ID:3D–
Type of Work: New l-! Addition Alteration !
Description of/Work: 21{x[
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Plan Review Contact
Phone: Fax:
Residential Commercial
Repair Demo Change of Use Move
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Email:
Title:
Property Owner Information
AbLb- Name hG Phone:
Street: F-yoe_4 Resident of property? : d
City, State Zip: ® r',r;.;L': 3;27j
L, ti;:,• ;.Contractor Information
Name %ice'er, sir atm v- Phone:
Street: /'o l clkl l'n i ?S Fax:
City, State Zip: L- k4e," L 30-709- State License No.:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Architect/Engineer Information
Phone:
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 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.
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: 51 Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
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 informatiQpi is ac cu ate and that all work will
be done in compliance with all applicable laws regulating constra tion d zo ing. '
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
d
of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
DEBBIE M ANTON
MY COMMISSION # FF 176648
r` EXPIRES: February 25, 2019
Bonded Thru Notary Public undeMters
Contractor/Agent is Personaljy KnoWn to Me or
Produced ID Type of ID, C,
Gam' ' /a/ I d
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
Flood Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads Fire Alarm Permit: Yes No
UTILITIES:
FIRE:
WASTE WATER:
BUILDING: /— I I- i A
Revised: June 30, 2015 Permit Application
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