HomeMy WebLinkAbout618 Palmetto Ave (2)jilm IAi111 1111 Al il '
1
2016 CITY OF SANFORD
JAN 2 BUILDING & FIRE PREVENTION
M `
PERMIT APPLICATION
Application No:
Documented Construction Value: $ 6,500.00
14is 3
Job Address: 618 Palmetto Avenue Historic District: Yes X No
Parcel ID: 25-19-30-5AG-0802-0050 Residential X Commercial
Type of Work: New Addition Alteration X Repair Demo Change of Use Move
Description of Work: Replace existing A/C system with new 3 Ton heat pump
Plan Review Contact Person: Title:
Phone:
Name Sara Nixon
Street: 618 Palmetto Avenue
Fax:
City, State Zip: Sanford, FL 32771
Email:
Property Owner Information
Phone: (407) 928-4716
Resident of property? :
Contractor Information
Name Pro -Tech A/C & Plumbing Services, Inc. Phone: (407) 291-1644
Yes
Street: 2425 Silver, Star Road Fax: (407) 522-0445
City, State Zip: Orlando, FL 32804 State License No.: CAG029393
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: 51h 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 information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
20 as I1A °z2
SigiiatureofOwner/Agent Date Signa re of Contractor/Age Date
A, . I . ---
nt
A /I", Melissa Anderson, POA
I
Signdwr6 of No
m S'e of Florida „ , Date 1
ANGELA L. ROR
MV COMMISSION V f
EXPIRES October
IIOII SBE 0137 F
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Print C tractor/Age Name
2OI C 7z, IZ01('e
Signature otary-Sta of Florid Date
ANGELA L. RODRIGUEZ
W COMMISSION # FF929774
EXPIRES Ocbbw 21, 2019
N07) • 757
Cont n to Me or
Produced ID Type of ID'-
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 # of Heads
APPROVALS: ZONING: Z,) 6 ,1,0 UTILITIES:
ENGINEERING:
COMMENTS:
FIRE:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
V87-
APPLICATION #
FOR A CERTIFICATE OF APPROPRIATENESS
Answer all the questions on this form and submit all required attachments. Incomplete applications will not
be reviewed. If you have questions about application requirements contact the Historic Preservation Officer
at 407.688.5145 to ensure your application is complete.
General Information
Downtown Commercial Historic District 0 Residential Historic District Is this a retroactive request? Yes J& No
Is this application filed in response to a Notice of Violation from the Code Enforcement Department? Yes RNo
Proposed improvements will affect the following elevations: JZ North South East West
Property Address: G / 8 Pa_ i' &1 L Ayen e
Property
Print Nai
Mailing
Phone:&U-f) `HI&Email:
Applicant/Agent Information
Print Name:
Signature:
Mailing Address: e t _!D l l V(X M. r )r lawn0 fw L ---5Zr-110
Phone: Email: Mtyl_I-ana, ai1 C2a6n2 i nature:
BY SIGNING BELOW YOU ACKNOWLEDGE THAT A BUILDING PERMIT MAY BE REQUIRED FOR THE
SCOPE OF WORK LISTED BELOW. YOU MUST CONTACT THE BUILDING DEPARTMENT TO
DETERMINE IF A BUILDING PERMIT IS REQUIRED. FAILURE TO OBTAIN A BUILDING PERMIT OR
DEVIATION FROM AN APPROVED CERTIFICATE OF APPROPRIATENESS WILL RESULT IN A STOP
WORK ORDER, DOUBLE PERMIT FEES, AND POTENTIAL FINES. BY SIGNING BELOW, YOU ALSO
ACKNOWLEDGE THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND
ACCURATE TO THE BEST OF YOUR KNOWLEDGE.
Signature: 51WA-Wk4E 6L Arrlf Mb BU/LD1k) FeP-14f-1- Date:
Yes, I would you like to receive emails regarding Historic Preservation and Community Planning within your community.
Description of proposed work
Completely describe the entire scope of work, including changes in material and color, and methods that will be used
to accomplish the proposed work. For large projects an itemized list is required. Use the reverse side if necessary.
HISTORIC PRESERVATION BOARD - 300 N. Park Avenue - Sanford, Florida 32771 -407.688.5145 - www.sanfordfl.gov/HP
CERi'IFI Ai'E ®F AP1 ' RaI i'EI E S S - •t` "-
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ISA BUI!_DING PERMIT REQUIRED FOR THE A IVITIf LISTED ABOVE? LL,,YES NO "
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