HomeMy WebLinkAbout1218 Pine Ridge CirCITY OF SANFORD PERMIT APPLICATION
Permit # : 1 �(( c�/ S 14 � /� `
Job Address: I a 171 PlIn e- U �_ I A__C, D
Date:
. 7,"__ 1 �
Description of Work: }U ,Q t PF
Historic District: Zoning: Value of Work: $ . lid
Permit Type: Building Electrical Mechanical Plumbing _X__ Fire Sprinkler/Alarm Pool
Electrical: New Service -AMPS
Mechanical: Residential Non -Residential _
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential X Commercial
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial
Construction Type: # of Stories: # of Dwelling Units:
Total Square Footage:
Flood Zone: (FEMA form required for other than X)
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
Fax:
166
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 TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. 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 require mept of Florida Lien Law, *FS 713.
(/
Signature of Owner/Agent Date Signature of Contractor Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to
_ Produced ID
APPLICATION APPROVED BY: Bld4l4_6_) Zoning:
([nit
Special Conditions:
Paul &)ox.l ,
Print Contracto�ent' Name
,0_v5
Signature of Notary -State of Florida Date
••9•n.a...• c.. w:.., neAu ru�:3i1
•l ,Ir1�c's"Jg
Contractor/Agent is Personall n to Me`or
Produced ID G ; z r -c3.
1.Rk
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Date)
Date
POWER OF ATTORNEY
I hereby name and point /j(, �(�`) UGC( ru(y—
of �y► to be my lawful attorney in fact
to act for me and 6pply to the Building Department for
a building permit for work to be perf med at a I ation described as:
Section Township Range Lot Block
Subdivision Plo n f2.- 6" - 2h — 30 —,( l 5 —0M6 —DNI -
Iii PJA�v
r
U (Address O7 JOD) U
(Owner of Property and Address)
and to sign my name and do things necessary to this appointment.
I U C', jr
Type or rint name of Registered Contractor
Signature
gistered Contractor
3-2:7,-�3
ThWwhproducEM
oing instrume as ackn wledged before me this /day
of200 by I ( o who is personally known to
mas identification and who did not take an oath.
State of Florida County of t,�LnILM
Commission # N n P r.PAM PAPWQ
y Commission expires: MY comm exp. Aug,0,
Camm b\3®u CID
.
Ica ,,
07/H/2005 .110N 9;1'7 FAX ; X002/002
�..
ltamnaldv
Plumbing
SINCE611 t Old Cheney I t.ighway i-
t 974 qc 'relepltone (407) 282-2900
Ort �ttda, rl, 32807 State Certified Plutxtbitt8 Catltractar Cr C1426�r31 Facsirtiile (407) 380-7790
mto vmAr, SUBM=0 To p}rtlN6 4nrn
Wamer,Quinlan _[ )uly 7, ?005
91_Rr_RT .Ina Naar,
3216 Corrine Drive Rosemary Caimon,
CITY, STATr, ANYI Y,IP Crit)r,
Orlando, FL 32803
nn<;NYraCT DATR Un m,AN5
IUB LOCATION
121.8 Riueddge Circle (South. Sanford., FL 32772
JOB PNONIE
We PrepOSO IV:rcby to RIMIS11 mnterial and labor complete in accordance with the nhovc t;Preific,vcions, for the slam of
Two Thousand One Hundred Twl n.ty C{ivc Ind. 00/100 $2,125.00
(,nyrAcn((0 00 made na Rttinwa;
In full, upon completion of job.
All MNarid h gunrnnlr,td la t>e N npe:tifimi, AI) work It; OG omplrtcd in n workmnn lo-odf U01'(111lp to mhinrd pmetiena, Any
o11,rn8on (it teMation ftm IbO tltJMy AprlggAtjQrS involving cztrn CodIA wlll VO a'tMRW only upon wriftcn nrdcm, and will IIU OInC On
C-tih cFargc -41 Pod hh00 011 ,d m All nor,c onta Lomingetit upon mrIUO, hCetdM`t< OY 401AYA UoyOrd our capfrnl, UymM to enrry
flr0, tnrngUO Anrl ctl;tt nCi:h9a�1N IdvurmlCt. Our wprm[a n¢ n�liy tOVfNY) i}y Wotkmc^,i nCnmp:neatton lntnrgncQ
HT;. I'112MBV 9IJAMIT,4PCCrFCAT1ONS AND ITP,17MATIS9 f OR:
signhlur0_ GL
RMPn0 Ct 1(ICr011
VOTE: Thif DIPlmSnl cony M rvitlld—
byueirnotngcrpkd•vilhln Jn Ohys.
SCOPE OF WORK
F2�>pi,pa hot/cold w,tt- . J_inef3 throu!,311out usi,.ng Cross;i,iirtked Pclyeth.•Ilt:ne ()pJ_pe,
'`Connect new water. liars to exist,i,rlg pl,v.rnbing f I xturce in Ici.tci.-ienr l,.�I,, dry & bathroomf,,
including new _Citure stor�sl & .;t�l)f)ly Lines, whG,r:: ,,pp_1.a.ca.le_
'Replace OUtoide hose bibs .1.nelatGd on e,ctr-r.i.r.>1: wl.l,l.s .adjacent to o_d lines.
'R.ePai'- t.1Te clrywc)).1/conr,;,rrzt,:e holes made by the repipe.
(2 rR"xth/1 story)
"WARRANTY ON GuORIfMANStlXP - Ten yerJr. from the dato o:f,, <:onlpJ.eti.
"(,t,V,TIFICATF, OE 'WARRA-NTY — silvgj:` P1.,
PLEASE NOTE: >)uo to the installation of ncNi, water ones In the attic Customer may briefly experienro hol water comfng out of cold lines during warmer
weather,
THIS PRIQF p01_S NOT INCLUDE REPLACEMENT OF THE FOLWWING, tJNt1_E39 3PECIFIED ACJOVE;
1) AIR CONDITIONER WATER LIN:=S 2) SHOWER RISER WATER LINE 3) FIXTURE PARTS OR FAUCE=TS 4)
SPRINKLER OR IRRIGATION WATIFR LINES 5) NO PATCHING OF TILL, WALLPAPER RC`PL.ACEMENT OR PAINTING
OF ANY KIND 0) GROUNDING OF ANY KIND 7) REPLACEMENT OF MAIN WATER SERVICE FROM METER TO HOUSE.
3)SOD OR SHRUBBERY,
Reinnldi F1 CQN011ALED CONDITION CLAUSG
vrnnng, lra will rngi)lre a changa urdne In writing should candltfono Pylat In Ilio Br 4nd or In an existing elrucfurn wvhjell (4'1 unusual In nslui a rx,Irn dlffnront korn tortdl6on, ordinarily encounfamd.
Thoro wolltd bd tan axtra che!ge on n e;utnpi Order which wand he over and nhoyo 11113 Quoted estimmm. fn Iho avont an Apk)C(Y!athi can not hq rgRch ad thl0 SPntrpdt will l>fl considnrad cvmplgted as of ihnt dnttf.
All mplmlpl!i UP What dal. and tlrne \vilf bo duo and pRyabib
595
Ar_cupranca ofPmpalill -THE ABOVE PRICES, SPECIFIrICARM AND CONDITIONS AFF, SATI$1'ACTORY AND AFF
HCRPBY ACCEPTCO, YOU ARE AUTHORIZED TO DO Tl{I! WORK AS SPECIFIED. PAYMENT Will. 8' MADE AS
OUTLINED ASOVL'.
.DATE OF A,Cf_"PTANCC 7