HomeMy WebLinkAbout429 Summerlin Aver
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
11 ("
o - ate
Documented Construction Value: $ 1 1 c7O . 00
Job Address: HzPt Summ-e I n A-,i e_ Historic District: Yes No
Parcel ID: 3D -1' -3 1 -S_Z 5 _000- ON 0 Residential P -Commercial
Type of Work: New U' Addition Alteration Repair Demo Change of Use Move
Description of Work: m- 1 n (DOAC, +p Vit cr r–
hecA--e r
Plan Review Contact Person: N 1 cc) e Title: ().' d a- imon—ae,r
Phone: H 01- 37-Z - 513Fax: L4 0 '.32Z -L4'3H Email: W C( -)J 4R_Tnet- Q,10!L'i-e..
Property Owner Information
q
C()M
Name f) elind(? rTOpl ./ Phone: n_ (p L3S_ 002 O
Street: 14ZCI 3(s'l i1 1 ed tin ,-l Resident of property?
City, State Zip: tC1d 1U
r1U
r
PL ?JZ
Contractor Information -
7 j
NameCi err-tci e Prronae Phone: q 0-1, 3(-' F'—I
Street: q -Lb 3+ Fax: y(n - 3zZ 1 LA'9 3H
City, State Zip: Salo t-
nn(
t
5, R -TA) State License No.: I- PCS ()0.3C)'T
Name:
Street:
City, St, Zip:
Architect/Engineer Information
Phone:
Fax:__( J'A
E-mail:
Bonding Company: Mortgage Lender:
Address: KFfA 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: 5"' Edition (2014) Florida Building Code
OD
Revised: June 30, 2015 Permit Application Im 119L
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 zo ing.
Signature of Owner/Arent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
C z H. oberfwnJ r.
Print Cotractor/Agent's Name
ignature of Not ar tate of Florida Date
r N.RY P&e N. FLANAGM
MY COMMISSION # FF 057576
s, EXPIRES: September 25, 2017
r: Bonded ThruBudget Services
Contractor/Agent is V Personally Known 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:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
of Heads Fire Alarm Permit: Yes No
UTILITIES: WASTE WATER:
FIRE: BUILDING:
COMMENTS: IW W&,T aAt S AfN' /O - 6'fSy/L 26Roc.I
0M - E43
Revised: June 30; 2015 Permit Application
Altamonte Springs, Casselberry, bake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint: Lauren M oo r e -
an agent of:
Name of
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:
L q-5uml1)erlir Ag -e.. Can FL 3Z -TT
Street Addr ss)
I
Expiration Date for This Limited Power of Attorney: 12 5 ( Z o
License Holder Name: C l j d -e H. R o h c riS :n r.
State License Number:
Signature of License Fl
STATE OF FLORIDA
COUNTY OF I n UI 2
4
The foregoing instrument was acknowledged before me this Z5 ly of Au C t".
20Q_(,p, by C,d,Qy VA. Ru b-er--i :2n who is,,P11personaK known
to me or who has produced I') CA as
identification and who did (did not) take an oath.
Notary Seal)
o,p0.Y PUBI c
N. FLANAGAN
MY COMMISSION t FF 057576
EXPIRES: September 25,2D17
Oe Bonded Thru Budge N*ry BMW
Rev. 08.12)
Signature
011r -01-e- tl cl IMC)
Print or type name
Notary Public - State of Pb7i CSG
Commission No. rj: D S:a 5 4(p
My Commission Expires: q. 2 S • J_q
ESTIMATE Permit Y ! N Permit 01
City 1 County
Name: 1' Gate Code:
Address: JU9t t t 1mrin City: (U f Zip;
Phone:(
Dolly In Full R Upright
13 V ty G-euty= ink-
D-kaydown D-Hek-is42ug
Inst I EXT - 24 - 28 - 6)O 120 - 150 - ,250 - 500 - 1000 - '
IJG: i'
Tank Size /-. Location
FP I CK i W / Fur I /Spa I Grill{}/ Gen
r
Off-ce: t J 3U7 Run i UJ
h 00A
Service:
Future Stub Out For: 1-1
Parts Form Completed
Employees Needed: Hours:
Email 1 lfO06 i5 P
SERVICE CALL 71)
GAS- 75 .—
YEARLY TANK RENTAL 8Ze
ec4
1 M 3 H LABOR 0
PARTS Z
r
TAX az.2
TOTAL? 9G
DEPOSIT PAID ON
BALANCE OWED
FINAL PAYMENT
CUSTOMER PAID IN FULL Y.1 N
AUTO PAY Y / N
I would like to pay the 50% deposit and schedule the above job. I understand the office will contact me to schedule.
1 would like to have someone from the office call me to discuss this estimate.
X I understand this Estimate and would like to review it further before
making a decision..
Total Price $
C996
Customer Signature• ate:
15i,
12_e1J,6
Estimator: n%I fc- Date: z
FOR OFFICE USE ONLY
Date Emailed
Estimate #
Date Re -Called #1
Date Re -Called 92'
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414 W 9" St - Sanford, FL 32771 P.O. Box 635 - Sanford, FL 32772 407.322.5854 Sales@thermotane.com
a CA,,lRECORD COPY
I
At
REVIEWED FOR CODE COMPLIANCEG
f°D
PLANS INER
rr - ZS' ! L
DATE
Sp, -i ORDBUIL DING DIVISION
A PERMIT ISSUED SHALL BE CONSTRUED TO BE A
LICENSE TO PROCEED WITH THE WORK AND NOT AS
AUTHORITY TO VIOLATE, CANCEL, ALTER OR SET
ASIDE ANY OF THE PROVISIONS OF THE TECHNICAL
CODES, NOR SHALL ISSUANCE OF A PERMIT PREVENT
THE BUILDING OFFICIAL FROM THEREAFTER
REQUIRING A CORRECTION OF ERRORS IN PLANS,
CONSTRUCTION OR VIOLATIONS OF THIS CODE
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