HomeMy WebLinkAbout2652 South Park Ave• •w
RECEIVED
OCT 2 5 20ii
CITY OF SANFORD
+, 13Y
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: Documented Construction Value: $ v?da
Job Address: d eS7, l i'A`,tX .4✓G Historic District: Yes ❑ NoX
Parcel ID:
Zoning:
Description of Work: RvA/ Mff/ A6 rJ5.)*WA4 ' A45W r e795,iL, 7V /-tVWX--
Plan Review Contact Person:
Title:
Phone: Fax:
E-mail:
Property Owner Information
Name
Phone: 162 74 I 63
Street: ����
-s� 1��9
V�
Resident of property? : �rS'
City, State Zip:
/i�
Contractor Information
Name f
41e22
//��
6,e &AC
TI A16 Ale.-
Phone: i% 7 AJ -3 7s/4;'
Street: A AX
/// -r
Fax: ye 7 3d--3
City, State Zip:
41/F1&1
/�` 3a 7-7,,1-
State License No.: C'/c
Architect/Engineer Information
Name: Phone:
Street:
Fax:
City, St, Zip: E-mail:
Bonding Company: Mortgage Lender:
Address: Address:
Building Permit O
Square Foy*age:
PERMIT INFORMATION
Construction Type:
No. of Dwelling Units: Flood Zone:
Electrical O
New Service — No. of AMPS:
Mechanical ❑ (Duct layout required for new systems)
Plumbing E3
No. of Stories:
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm O No. of heads:
Mt.
0
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no
work or irctallation 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.
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
zk
Signature I
Contractor/Agent Date
� 7loM,�s ���n�
Print Contractor/Agent's Name
Signature of Notary -State f °�� Notary 8eC11c . State of Florida
My Commission Expires Feb t, 2012
Commission 0 DD 710365
%°� ;• Bonded nrouph National Notary Assn.
Contractor/Agent is X Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING:
COMMENTS:
Rev 11.08
FIRE:
It,$ 1 kN1 rem
01/16/2011 21:50 4073238954
ADVANTAGE PLUMBING, INC.
PO Box 1117 .
Sanford, FL 32772.1117
407.323-7515
Fax: 407-323.8954
ADVANTAGE PLUMBING
PROPOSAL
PAGE 02
Page No.
Of Pages
PROPOSAL SUBMITTED TO: PHONE: DATE 10-25-11
NAME: Ann Otzelberger
2652 S. Park Avenue
Sanford, FL 32773
We hereby submit specifications and estimates for.
Run water line to house from new meter.
JOB NAME: Otzelberger Residence
We hereby propose to furnish labor and materials — complete in accordance with the above specifications, for the sum of:
Two hundred & 00/00 dollars 200.00 with payment to be made as follows:
100% upon completion of work
All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. This
proposal subject to acceptance within 30 days and is void thereafter at the option of the undersigned/!
Authorized Signature
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are hereby accepted. You are authorized to do the work as specified. Payment wig be
made as outlined above.
ACCEPTED: Signature
Date Signature