HomeMy WebLinkAbout360 Lake Mary BlvdCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: Documented Construction Value: $
Job Address: Historic District: Yes No
Parcel ID: Zoning:
Description of Work: 5117_
41
Plan. Review r./ w Contact Person: A J v C,o -
Phone: 7b 1_2"9S 79a d Fax: 7- 9S7 E-mail:
Property Owner Information `
Q
Name J<,J a-_Ze 04qU Phone:
Street: 6A Resident of property?
City, State Zip: .S7, -+,d 2/ 3R 223
Contractor Information
Name &% fiyG x—'Q/' 4L. Phone: %`"
Street: 115;'_ 25z_ lWe_ Fax:
City, State Zip: State License No.:
Title: — 5
Y
4A) ei2,
Name:
Street:
City, St, Zip:
Bonding Company: _
Address:
Building Permit
Square Footage:
No. of Dwelling Units:
Electrical
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type: No. of Stories:
Flood Zone:
Plumbing
New Service —/No. of AMPS: New Construction - No. of Fixtures: _
Mechanical , (Duct layout required for new systems) Fire Sprinkler/Alarm No. of heads:
P,
9
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.
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.
WARNING TO OWNER: YOUR FAILURE TORECORD 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.
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. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should' calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.08
UTILITIES:
Signature of Contractor/Agent
Print Contractor/Agent's Name
Date
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
All Temp Air Conditioning And Refrigeration LLC
1998 setter Ave
Saint Cloud FI 34771
Office 407-857-7800
Fax 407-957-0829
CAC1814398
Sanford Citgo
360 Ik mary rd
sanford fl 32773
Date Estimate No. Project
05/03/11 3569-B
Estimate
50TC08A21350A Carrier 7.5 ton Straight cool, R -410-A,208/230-3 1 0.00 0.00
OAO IRoof Top Package unit
CRMANDPRO02 Manual Outdoor Air Damper Package 1 0.00 0.00
A03
Micro Metal Micro Metal Hurracane Rated Hold down Clips 1 0.00 0.00
Curb Adapter Curb Adapter 1 0.00 0.00
crain Craine Rental 1 0.00
INSTALL INSTALL LABOR 1 0.00
LABOR
Permits Permits, Building Department 1 0.00
Duct Work Cut in 2- 12"x12',Stamped Supply Grills and 1- 1 0.00 0.00
12'x12' Return Air Grill, in existing Ducting
total job bid Total Job Bid 1 8,000.00 8,000.00
Terms: 1000.00 Deposit upon Acceptance of
contract,
Curb Adapter will then be ordered Fabracated , and
should be shipped within 5 days of order,
Balance of contract will be due upon Completion of
equipment Installation.
Work can not start untill We Receive The notice of
Commencment back from the property owner