HomeMy WebLinkAbout1605 W 25 StCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Q o�
Application No: 1 J- 3-1 �7 Documented Construction Value: $ J qs
Job Address: /GDS` w ad' t% S 7 AGO/ Historic District: Yes ❑ No ❑
Parcel ID• Zoning:
Description of Work:
Plan Review Contact Person: Title:
Phone: Fax: E-mail:
Property Owner Information
Name T12OiJ;-C/-1 AJ1Q / Q T J Phone: 440 17 173o
Street: GU 27,* S 7 Resident of property?
City, State Zip: _S_Axo4e=i� 3 a 77/
Contractor Information
Name /Z • /C., (YG n -//G.4 L AZZ S zm, Phone: f10 7 99 S' SSG a
Street: /PO 03 o x Q n 9 Fax: 4/G7 G 79 79 o o
City, State Zip: Godot 0 ed_ -'i 1r -7-7C_ State License No.: EC /3oe ZG 3 0
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company: Mortgage Lender:
Address: Address:
tL. •. A r...�. _
.• t . ��. • ,; �'., ,;;� `�' :PEER T INFORMATION
Building Per t,;0_.`' '...' '"tr,�a, �� n�.,.:�e
Square Footage: Construction Type: No. of Stories:
No. of Dwelling Units:
Electrical 13
New Service — No. of AMPS:
Flood Zone:
Plumbing 13
New Construction - No. of Fixtures:
Mechanical 13 (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads:
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, beaters, 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, creditwi a applied to your permit fees when the
permit is released.
Signature of Owner/Agent Data
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
0-144 /LJ /4oat'i
Print Contractor/Agent's Name
Date
�^ DEBBIE BLANTON---
o �Y .
+ �� ; Notary Public State of Florida
My Comm. Expires Feb 25, 2015
s;►, Commission N EE 60182
'!�?,'„•„�` `` Bonded Through National Notary Assn.
Contractor/Agent is ' Personally Known to Me or
Produced ID Type of ID
UTILITIES: WASTE WATER:
19:9
BUILDING:
#1
j R*R
ELECTRICAL
=STAR
- - - 12pm - Spm
WORK OO G3DD IRG3
P.O. Box 2549 • Goldenrod, FL • 32733.2549
Phone 407-679-3200 or 407-295-9500
- -Mis-Nrit Or -Office C6py
DATE 11/28/2011 CALL TAKEN BY DV TIME
WORK ORDERED BY Tropicana Apartments PHONE NUMBER 407-322-7304
INVOICE TO -Tropicana artments JOB NUMBER 107542
ADDRESS 1505 W 25th St, Sanford, FL 32771 CITY ZIP
JOB NAME & LOCATION Tropicana Apartme... 1505 W 25th St, Sanford, FL 32771
407-322-7304 DATE REQUESTED—U/2-81201L—
DESCRIPTION
EQUESTED11/28 2011
DESCRIPTION OF WORK Reference Dispatch Number 107542
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/&O r 4�
lJ�7lfo �
PERMIT NONE POWER COMPANY
STARTING DATE-] 1/28/2011 SIGNATURE
ELECTRICIAN Gordon ESTIMATOR PRIci��)
HELPER OTHER
MATERIAL & LABOR RECORD
MATERIAL OTY PRICE AMT DATE EMPLOYEETOTAL
MATERIAL TOTAL S
DATE COMPLETED
AMT PAID $ CK CASH BILL
LABOR TOTAL S
I HEREBY ACKNOtVtLEDCE THE SATISFACTORY
COMPLETION OF THE ABOVE DESCRIBED WORK
FOR ADDITIONAL MAT,L / LABOR USE BACK OF FORM
Thank Youl
"TRUE 24 HOUR SAME DAY SERVICE"
'-Our price won't shock you!"