HomeMy WebLinkAbout103 Academy AveJob Address:
Parcel ID: ,315-
Type of Work: New
Description of Work:
011 ECEIVE, CITY OF SANFORD
BUILDING & FIRE PREVENTION
DEC 2 O 2017 PERMIT APPLICATION
Application No: 11, 3 g
Documented Construction Value: $ d
Historic District: Yes No
ab Residential commercial ElAddition Alteration u Repair Demo Change of Use Move
I ,me z ,4r es.,zcr 74t s z5D
Plan Review Contact Person: eJ4
Phone:3g.Q. % fi Q Fax: Email:
Title:
Property Owner Information '
n C's i C y01 1 • 6116Namei
o v
Phone:
Street: Resident of property? 01—
City, State Zip: 2-771
Contractor Information
Name Phone: .
I tonStreet: M2 5 Fax:
i
City, State Zip: State License No.:
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: 51" 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 pen -nit 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.
1 Z lZo J4,4,17
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
Agent
ontractor/Agent's Name
ANNETTE BLAND
Notary Public - State of Florida
Commission # GG 060623
N.;?
171OFF o?°,my Comm. Expires Jan 16, 2018
C0MM-c1c `6rM-g`En-ris— — Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building
Construction Type:
Total Sq Ft of Bldg:
Electrical Mechanical
Occupancy Use: _
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler :Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Plumbing Gas Roof
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
50e
ATTIE INSULATION. SITEwSUILT-(SWS SECTIONW.,
a:.. f:N/A.
b I N/A N/A
Note:
C I N/A N/A 77! --- 777777*777-=
Note:
cal 1: N
Note:
I KICI I I A ti
6 1 N/A -N/A
Note:
V Ote
SCREEN/ WINDOW FILM ISWS 5.3202
I NIA -N/A
Note-,
Note:....
I N/A -N/A
Note:
b I NIA -N/A
Note:
a
Note:.
b I.N/A N/A"
Note:
a I N/A -NIA
Note:
b 1 N/A -NIA
MEASURES" NEAT/MHEA REQUIRED (Except Refrigerator can hemetered or NEAT MHEAI.':"' 8 .
1 Each ,. -AH C , on , d e n . s . er r ., eplace14 . Seer Heat pump k to . 1500 sq ft. (SWS 5.3xx) 2,600.00 . $ 1,500.00 $ 4,10b.00 Noteb
I N/A -N/A Note:
C
I N/A' -N/A Note:
Note:..
pe
1 Each -Permit: AH Condenser Building permit, If required, 85.00:1 215.90 V .120.0.0 Note:_ a
I Each -Programmable thumostat: With HOLD button. (Honeywell FocusPro 6000) 100,
00 65.00 165.00 Note: _r
7_77 b1NIA -N/A NCII)
FUTAL RFPAIRS IRMiflrol. WFATIMMrA with ritmelInflub MR el-fl -X nn mnmMan in ntF;nPrv%thAP;mirP1 -1 7 N/
A ,N/A Note:
b
I N/A _N/A Note:
Energ ':
MeasuresSuti Total 3,158.00 2 125.00 5,283.06' Disclaimers:
Vtrsloh 5.9 SWS #'
s are for Reference and may Include many other sections. T6*ALI 4,063,00 1 zw-CPT-$—Zx.-06: Contractor
to warrant work to pass bldg. codes & Wx Program. Contractor
verify lead test as needed. Contractor'
s Vgnature Date Meals on Wheels, EtC Date Ver3lon
GBD-5.9 August 2017 Page two for: Juanita Collins
EAST ENERGY AUDIT DATA ASSESSMENT & .TESTING FORMS- House.Sketch
Juanita Collins eP
103 Academy Ave. Sanford FL 32771
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