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HomeMy WebLinkAbout200 S Myrtle Ave (6)Permit # : 0? —� l ` Job Address: m S V` Nlr cz Description of Work: �t�,re�►a�Se y Historic District: Zoning: CITY OF SANFORD PERMIT APPLICATION KCm OOfC / Total Square Footage Value of Work: S oZ©i 000 Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical: New Service — # of AMPS ''0 Addition/Alteration Change of Service ✓ATemporary Pole Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required) Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial Occupancy Type: Residential Commercial Industrial Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required ) Owners Name & Address: Phone: Bonding Company: Address: Mortgage Lender: . Address: Architect/Engineer: Address: Phone: Fax: 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 a water management districts, state a encs s, or federal agencies Acceptance of permit is verification that I will notify the owner of the property of the requi ins of Florida, Lien/aw, ?y7 SignatureofOwner/Agent Date Sign tune C ntractor/Agentaate Print Owner/Agent's Name Print Contractor/Agent's ame Signature ofNotary'State of Florida to Signatures da ate � ri IIIY else ODW11d81 a E)PM� � 20.2004 Owner/Agent isersonally Known to Me or Contractor/Agent is _ Personally Known to Me or Produced ID _ Produced ID APPROVALS: ZONING: UTIL: FD: ENG: BLDG: Special Conditions: 1 Rev 03/2006 Krish K. FM DIY Corte pp0011091 a Fxpirea AprM 20. 2W6 r ABRAMS TOWN & COUNTRY 200 S. MYRTLE AVE, SUITE 204 SANFORD, FL 32772 JOSEPH ABRAMS, P.E. EC 0000148 407/947-8482 City of Sanford: PLEASE ACCEPT THIS LETTER AS AUTHORIZATION. FOR CHARLES BOMBALIER OF ABRAMS TOWN & COUNTRY TO PULL A PERMIT ON MY BEHALF FOR ELECTRICAL WORK LOCATED AT: 200 S MYRTLE AVE SANFORD, FL 32771 SIGNATURE JOSEPH L. ABRAMS STATE CERTIFICATION #EC00001 48 SWORN AND SUBSCRIBED BEFORE ME THIS 1 DAY OF -MONTH YEAR IN` JOSEPH ABRAMS IS PERSONALLY KNOWN TO ME. WITNESS WITNESS SIGNATURE/NOTARY PUBLIUSTATE OF FLORIDA " # Krista K Fay * Commtlen DDWt1881 ka E*Wft AM 20.2= CORD CERTIFICATE OF LIABILITY INSURANCE 06/26/2M/DD 09/2000606 CER (407)&86-3301 FAX (407)886-9530 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION FRY INSURANCE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR East Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Box 2046 PKA, FL 32704-2046 INSURERS AFFORDING COVERAGE NAIC # :D Abrams Town & Country Electric INSURERA: Hartford Cas Ins Co 29424 DBA: dba Allstate Security Alarms Co. INSURERB: AequiCap Insurance Co P.O. BOX 2014 INSURER C:, Apopka, FL 32704 INSURER D: . :RAGES POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 'REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR 'PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH .ICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ) SR TYPE OF INSURANCE POLICY NUMBERPOLICY EFFECTIV DATE MM/DD I DATE MM/DD/YY LIMITS GENERAL LIABILITY 21SBPQD4930 01/30/2006 01/30/2007 EACH OCCURRENCE $ 1,000,000 E TO RENTED $ PREMISES Ea occurence 300, OO X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR MED EXP (Any one person) $, 10,000 PERSONAL & ADV INJURY $ 1,000,000 _ GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY PROECT LOC J PRODUCTS - COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ YORKERS COMPENSATION AND EMPLOYERS' LIABILITY \NY PROPRIETOR/PARTNER/EXECUTIVE WC07063086 01/30/2006 01/30/2007 X TORY LIMITS 1131H - ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE . EA EMPLOYEd $ 100,000 )FFICER/MEMBER EXCLUDED? f yes, describe under WECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ S00,000 )THER 3PTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS a License #EC0000148 I•IFICATE HOLDER City of Sanford Building Department Attn: Contractor Licensing PO Box 1788 Sanford, FL 32772-1788 RD 25 (2001/08) FAX: (407)328-3859 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Kathleen Baylis/DAWN ©ACORD CORPORATION 1988