HomeMy WebLinkAbout623 Wilner CirCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value:
yy
Job Address: .2-3IIam/ 3 ln -r 6 C Historic District: Yes No
Parcel ID: Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of .Use Move
Description of Work:
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Name Phone:
Street: Resident of property?
City, StaterZip
Contractor Information
r
1____-_____-_ --Phone:-7%- tfo_
1 Street: r i7 j Z'V\4e_e1 t9'-1 f/+fv
City, State Zip:--
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Fax:
State License No.: Ctrl C 0C-6 <q`
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: 5ni 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 it
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.
Signature of Owner/Agent Date Signature of ontractor/Agent Date
Print Owner/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of Florida Date Signature of Notary- tatbrida DEBBIE BUR !
MY COMMISSION # FF 178648
o EXPIRES: February 25, 2019
Bonded Thru Notary Pubrrc Undenrrdters
Owner/Agent is_—____P_ersonally Known_to_Me_or_.__________._ ContractorlAgent_is_ Personally_ Known to Me or
Produced ID Type of ID Produced ID Type of ID L
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:
COMMENTS:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
of Heads Fire Alarm Permit: Yes No
UTILITIES: WASTE WATER:
FIRE: BUILDING:
Revised: June 30, 2015 Permit Application
Randy Boyd, Sr.
Mechanical Contractor
PROPOSAL SUBMITTED TO:
Greystone Properties
Attn: Brenda Boyd
SCOPE OF WORK AS DESCRIBED BELOW:
DATE OF PROPOSAL: 7/21/16
Lic# CMC056971
PROJECT LOCATION:
Overlook at Monroe
Apartments 623 to be upgraded with new HVAC Systems.
Site will provide condenser, air handier, thermostats (if applicable), front flush panels (if applicable).
Site will repair all drywall, paint, etc. as required.
PROPOSAL COST:
875.00 total contract cost .
Cost includes permitting fees. Site will schedule and manage inspections in coordination with
Mechanical Contractor.
Contractor will schedule and manage inspections for an additional $50.00 per unit.
PROPOSAL EXCLUSIONS AND CLARAFICATIONS:
Includes 90 day labor warranty from startup date. Equipment warranty by manufacturer.
Does not include any new high voltage electric. Does not include any new low voltage electric.
0-P, P;
ill*,nature . Acceptance Date of Acceptance
STATE OF FL RIDA
COUNTY
The f e oing instrument was ac owledged before me this W day o V l, 2016, by
16 who is ersonally known to me or o who has produced
as identification and who did (did not) take an oath.
Si j ature __..
Notary Seal) QrAnria Rnv: BRENDAJ.BOYD
Print or type name ,
MYCOMMISSIDN4FF131347
Notar Public - State of 4"1
EXPIRES: June
NorySo18
Notary E)ondedThNBedgetNWaryServices
Commission No. F
My Commission Expires:
1778 Imperial Palm Dr., Apopka, Florida 32712
Phone 407-780-1547 Page 1