HomeMy WebLinkAbout356 Red Rose Ln Lot 9M,
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
T.
Application No:
Documented Construction Value: $ .
Job Address: Ln— Historic District: Yes No
Parcel ID: Residentiam Commercial L_
Type of Work: New.0 Addition Alteration Repair Demo Change of Use Move
Description of Work:l,S1911
Plan Review Contact Person: A,
Phone: -Q'W 5-31 1J Fa
Title:
Email: %VIC_"C ly, 6ary\
jj
Property Owner Information
Name
1
WY _ Phone: Wk
Street: ( - Resident ofroPe Y? !VQP
City, State Zip:1VL%
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P
Contractor Information
Name A i Phone: `-t - g t5 OJ
Street: 1 i se -0 (-Q)ct LA Fax: Ll0 a 1?53
City, State Zip: l'ttsrd PC= State License No.: 0 -40 n3 D 0
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company: Mortgage Lender:
Address: 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 1 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 at work will
be done in compliance with all applicable laws regulating- construction and
Signature of Owner/Agent Date
Print Owner/Agent's
Signature ,of Notary -State of Florida Date Signature of Not ry-State of Florida Date
Pa"• CHERYL D All ERS
MY COMMISSION # FF998962 '
EXPIRES June 0'.i, 2020
rn h)1'tOG_I115'i FlnriA oAlntaniCaniiro r
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known torte or
Produced ID Type of ID Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ElectricalEl Mechanical Plumbing GasO RoofF]
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 `W1ATER:— ---
ENGINEERING: FIRE: ` BUIL,DING:
COMMENTS:
Revised: June 30, 2015 Permit Application
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