HomeMy WebLinkAbout1240 Retreat View CirA(JG 3 CITY OF SANFORD
BUILDING & FIRE PREVENTION
4: PERMIT APPLICATION
Application No • / /
Documented Construction Value: $ 5,428.00
Job Address: 1240 Retreat View Circle Historic District: Yes No X
Parcel ID: 32-19-30-5SP-0000-1140 Residential ® Commercial
Type of Work: New ElAddition ElnnAlterationlI Repair Demo Change of Use Move
Description of Work: Remove existing A/C equipment and replace with new 3 Ton heat pump with
5 KW heat strip.
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Name Wibker, Cynthia L Phone:
Street: 1240 Retreat View Circle
City, State Zip: Sanford, FL 32771
407-321-8747
Resident of property? :
Contractor Information
Name Pro -Tech Air Conditioning & Plumbing Svcs, Inc. Phone: (407) 291-1644
Street: 2425 Silver Star Road Fax: (407) 522-0445
Yes
City, State Zip: Orlando, FL 32804 State License No.: CACO29393
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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 Pennit 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.
J 30 8/30/16
Si ture of Owner/Agent Date ignature of ontractor/Agent Date
C 0141iA 2 wN jI(Z Thomas T Nixon PrAsident
Print xvner/Agent's Name Print Contractor/Agent's Name
0" ),x-,4 '. 8/30/16
Signa ure of Notary -State of JayRRi •s Sig ture of Notary-S e of Florida Date
MY COMMISSION # FF907271
EXPIRES August 05, 2019 i'1 till;: MELISSA J ANDERSON
a071398 53 Fb.idxNo« 5«vic..cam •2 ••: MY COMMISSION # FF928786
EXPIRES OClobW 19. 2019
Api gll.ptbt RIarMMNartiewka.wm Owner/
Agent is Personally Known to Me or Contracto Personally Known to Me or Produced
ID Type of ID 7—tL. Produced ID Type of ID BELOW IS
FOR OFFICE USE ONLY Permits Required:
Building Electrical Mechanical Plumbing Gas[] Roof Construction Type:
Occupancy Use: Flood Zone: Total Sq
Ft of Bldg: Min. Occupancy Load: # 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, 2015 Permit Application