HomeMy WebLinkAbout2451 Mccracker RdV--
NOV 2 9 2015 I CITY OF SANFORD
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BUILDING & FIRE PREVENTION
D oy:..i 6 _ _ _ _ PERMIT APPLICATION
Application No: to- 3 S y
Documented Construction Value: SAzuo'r `T
Job Address: arqTy /�'� ����� l Historic District: Yes ❑ No ❑
Parcel ID: Residential [<ommercial ❑
Type of Work: New ❑ Addition-❑ Alterajti�on Repa'r Demo ❑ C ange of Use ❑ Move ❑
Description of Work- � { !?�
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Plan Review Contact Person: -L
Phone: y'_j IT3 f -) t Fax:
Title:
Email: g<jt;yt/M//hr l�tr/¢i�t �c�i►
Property Owner Information
Name fe=d 26� --d?wC Phone:
Street: 1-72- 0 U Cz Resident of property?: 0
City, State Zip:
c Contractor Information
Name ` �� �'t r- Phone:
Street: 0 `( .,1 hl -Fax: ) FS - 0 (/(f
City, State Zip: Or el G '37 State License No.: GFC,'0,'5-?&
Architect/Engineer Information
Name: Phone:
Street:
City, St, Zip.-
Bonding
ip:Bonding Company:
Address:
Fax:
E-mail-.--
Mortgage
-mail:Mortgage Lender:
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
;PAYING ;TWICE FOR IIVLPROVEME ..NTS TO 'YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED �ON THE JOB SITE BE.F.ORE.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. 1 understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools,
furnaces, boilers, heaters, taeks� and air conditioners, etc.
FBC 105.3 Shall be inscribed with, the date of appli'catforr and: the code in effect as of•that date: V' Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
4
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 entitics such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that 1 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. tune of permit subming. A• copy of the executed,coatract is required
in order tot 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 ICE Valtration Table irr 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.
Print Owner/Agent's Name
Date Silmature of Contractor/Agent Date
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Print Contractor/Agent's Name
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Date
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Owner/Agent is Personally Kh ��t *,tlJ�`' Contractor/Agent is Personally KnowHY8 a or
Produced 1D Type of 1D Produced 1D 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: Flood Zone:
Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No Q• # of Head's
APPROVALS: ZONING:
ENGINEERING:
,COMMENTS-.
UTILITIES:
FIRE:
Plumbing - # of Fixtures.
Fire Alarm Permit: Yes ❑ No[] -
WASTE WATER:
BUILDING:
Revised: June 30, 2015• Ptnnit Application
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: ��
I hereby name and appoint: fC - r kz.1562 /--
an agent of:
(Tame of Company)
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 f eb-eck •only onvoprion):
CY The specific hermit and aunlicationAgr work
(street
Expiration Date for This Limited Power of Attorney:
License Holder Name: ':�* 4014h dd_
State License Number:
Signature of License Holder:
STATE OF FLORIDA
COU-NTy'Of 1/7D
The qDregoing i e t wa ac wledged before me this �a*er&son!ally
`/
2VE, by r7� (B who is known
to me or o who has produced as
identification and who did (did not) take an oath.
SON EYpS 'moi
(Nota '�'j�'�aa�'�s •, ';
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0%0740 e: `0 o
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:y Public V� • ��t ���
(Rev. 08.12)
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Print or fype name
Notary Public - State of
Commission No. " (70 ?
My Commission Expires: / 2�
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— (F'`Irtl Name,
1 The rpprorun.i! Labor $
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above descnbecf work which has been deme tom com late settsf' ���
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