HomeMy WebLinkAbout186 Magnolia Park TrlCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:) 0 ")/
Documented Construction Value: $ `(X-) (n 1 1)
Job Address: o V Y I Ca QA v
A AL J Historic District: Yes No.[]-----'
Parcel ID: Residential DCommercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: ` , yea , ..=P,c
Plan Review Contact Person: 0 lu Title: P
Phone: - - - I . Fax• - Email: Y L2CS 4 i')?h ,
C'Q rli1
Name
Street:
City, State Zip:
Property Owner Information
Phone:
Resident of property? :
Contractor Information
Name Phone: , 4h-7- 3,;/., /- 11
Street: Fax:
City, State Zip: 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-her-eby-made-to-obtain-a-permit to-do-the-wor-k-and-installations-as-indicated.—I certify -that -no -work or-instwllation-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: 5th 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 constriction 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.
Signature of O%vner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
4 J/D ID p
Ngnature of Contra /Agen Date
P 4 )/JV
PrintContractor/.
J:))
s Name
16
iatugnreofNota &florid 1Y COMMISSION 6786 8
25, 2019EXPIRES'• February
OF F.C. Bonded 7hru Notary Public UndenxnteFrs
Owner/
Agent is Personally Known to Me or Contractor/Agent is Personal own to Me or Produced
ID Type of ID Produced ID Type of ID . i. BELOW
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: New
Construction: Electric - # of Amps Fire
Sprinkler Permit: Yes No APPROVALS:
ZONING: ENGINEERING:
of
Heads UTILITIES:
Flood
Zone: of
Stories: Plumbing - #
of Fixtures, C-
OMMIINT-S: Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
Revised:
June 30, 2015 Pemrit Application