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HomeMy WebLinkAbout400 Red Rose LnCITY OF SANFORD 4 p h BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: Documented Construction Value: $ Q Job Address: _ r IA alr1 Parcel ID: Type of Work: New Description of Work: Historic District: Yes Nog Residentiac Commercial Addition Alteration Repair Demo Change of Use Move Plan Review Contact Person: i_ Title: Phone: `tU J` CJ4 Fax:4-1- - .3 Email: kyc&&1 Y, &)Jr Property Owner Information / y Name Phone: Street: Resident of property? rh? G City, State Zip: ;,P'774 I Contractor Information Name Phone:11 Street: :Z),t5 f t s,co U LA - Fax: go -7- 6JJ City, State Zip:ear yyCV 6J 1- Z_ r-7_1 State License No.: CACo3 p o 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 atwork will be done in compliance with all applicable laws regulating. construction and zo g.. Signature of Owner/Agent Date Sig re of Contractor/Agent bme Print Owner/Agent's Name Pr' t Contractor/A ent's Name nk I Ac L Signature.of Notary -State of Florida Date Signature of No cy-State of Florida Date F-P, CHERYL it AF(ERS MY COMMISSION # FF998962 EXPIRES June 05, 2020 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 Electrical Mechanical Plumbing Gas Roof F] Construction Type: Occupancy Use: - Flood Zone: Total Sq Ft of Bldg: Min. Occupancy Load: New-- Construction: Electric - # of Amps Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: _ UTILITIES: ENGINEERING: FIRE: COMMENTS: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: YesE] No WASTE_WA_T_ER:----- -- ----- _ - BUILDING: Revised: June 30, 2015 Permit Application P1M3ears1 `^Msaesta>3 a;`Bn't3; ry lsslr,S/131 P2od516Ko)T.s d.MNiP} IN. 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