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Home My WebLink About124 Gleason AveU ! `D' NOV X011 CITY OF SANFORD Bx': BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: � �g'3 Documented Construction Value: $ Job Address:GV blnla _7V Historic District: Yes ❑ No ❑ Parcel ID: UC(- OI 1. Description of Work: Plan R Phone: Name Street: Contact Person: City, State Zip Name Street: City, S1 Title: Fax: (WLQ n(wl • U /"'1 E-mail: Property Owner Information I �/ c� Grp, Phone• j ` 0-7 - -(Od &2-� Resident of property? : �0_ S t 'c >rmation O (o ai�iogb Phon, -7 Fax:KI• U /D A State License No.: Architect/Engineer Information Name: Phone: Street: City, St, Zip: Bonding Company: Address: Fax: E-mail: Mortgage Lender: Address: PERMIT INFORMATION , Building Permit Square Footage: Construction Type lmh No. of Stories: ; No. of Dwelling Units: Flood Zone: Electrical ❑ Plumbing* r New Service — No. of AMPS: New Construction - No. of Fixtures: Mechanical ❑ (Duct layout required for new systems) Fire Sprinkler/Alarm ❑ No. of heads: !. it At, 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. 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. n 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: Date rac oungem s Name AM& 111 // of Notary -State of Florida Date WASTE WATER: FIRE: BUILDING: '�^'•'ix . DECEMBER BALL MY COMMISSION d DD 875799 ?z o EXPIRES: July 31, 2013 Bonded Thru Notary Public Underwriters mmm Contractor/Agent is nall Known:to or Produced ID Type of ID WASTE WATER: FIRE: BUILDING: Service Information- --- - _ - - - - -- - -� jesse kline 124 gleason cove sanford fl 32773 Contact: jesse kline Phone: (407) 902-5163 Fax: Alt Contact: Aft Phone I E -Mail: Print Order - - - Job Name- - - -- - - - []• Call Ahead - -0 Confirmed •I 58567 Job Type - - - - - - - - - I PO # 1� _--- Home Depot:SFNI I 64467908 Item- - - •- - - - -- - - - -- - - - - WH:EL:487-876 HD - 50 Elec T GE12 4500W(487-876)HD 5719 S F81:Basic Install WH - S F81 Water Heater Basic Install We Also Instell:W/H:Expansion Device - Expansion Device HD003 - Permit and Jurisdiction administrative assesment Sanford SFNI We Also Install:W/H:Shut off valve - Shut off valve Quantity , Additional Items) - - - - - Florida Delta Mechanical Inc. #CFC1425917 2716 Broadway Center Blvd Brandon FL 33510 Phone: (813) 425-0020 Fax: (813) 425-0027 flo-OdaCD_deltamechancial.com www.deftamechancial.com Invoice Total Due: $944.82 - - - - - - - - - - - - I Rate Amount Scheduled Job Subtotal: I Additional Items: Additional Tax: FI Total Due: ----- - -- -- - Job Notes and Instn�rh...�g - - - - - - - - - - - - - - - - - - 64467908 PAID _ _ iBilling Information ------•-------------- - - -- - -- •- - - - - - ---- Home Depot - 264 j 4600 W. Lake Mary Blvd j 407-333-9650 Lake Mary FL 32746 - - - - - - Marketing Campaign- - Sales Rep I Terns I- - - - Class -Type - - I - --i Home Depot r RJute Scheduled Stant End - - Quantity T- - Rate Amount l 1 $562.8200 $562.82 1 $197.0000 $197.00 1 $65.0000 $65.00 1 $90.0000 $90.00 1 $30.0000 $30.00 Job Subtotal: $944.82 $0.00 Total Due: $944.82 - - - - - - - - - - - - I Rate Amount Scheduled Job Subtotal: I Additional Items: Additional Tax: FI Total Due: ----- - -- -- - Job Notes and Instn�rh...�g - - - - - - - - - - - - - - - - - -