HomeMy WebLinkAbout2846 Empire Pl (2)7,
9
Application No:
RECEIVED
FEB 13 2012
BY:
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
/ (:� � d Documented Construction Value: $
95D
Job Address: E".1e ►-c Place historic District: Yes ❑ No ❑
Parcel ID• * iib -ac, - 31- 505-0)� - Oa/)O Zoning:
Description of Work: Ay,?`^" 0"ib'k M��
-
Plan Review Contact Person: 0k'rA4+' .' Title:
Phone: �1.�"'� i" 59 X.Il -q Fax: E-mail: �Pup{u .b/y�K �Celecf�•C�-+
Property Owner Information
Name RR 9 V-4. I Phone:
Street: D Resident of property?: y eS
City, State Zip:
Contractor Information
Name -C.4 y Ckc+rt Cr- ( Cj. 40"ic orf T .-
Street:1I 30 Ute f Pf VC,
City, State Zip:g, syr FI .3.1% Ll
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit O
Square Footage:
No. of Dwelling Units:
Electrical 0
Nc,vti, Service - No. of AMPS:
Phone: Hol -1$$-3.500 X ( 16q
Fax: Vl0q -'1008- a.o017
State License No.: F-C00OOV
Architect/Engineer Information
Phone:
Fax:
E-mail: _
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type:
Flood Zone:
Plumbing O
No. of Stories:
New Construction - No. of Fixtures:
Mechanical 0 (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. 1 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. l 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: l 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 l 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 oc mented
construction value when the executed contract is submitted, credit will be applied to your permit ees hen 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
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.08
UTILITIES:
FIRE:
Signature of Contractor/Agent Date
K(4nCe gOd&,GK,
Print Contractor/Agent's Na ne
Signature o otary-Stale of flori Date'
WOLYN MORM
** MY COMMISSION I EE 037195
EXPIRES: December 13, 2014
114f or A. Bonded TAN Budge) Notary SWm
Contractor/Agent is �rsonally Known to Me or
Produced 1D Type of ID
WASTE '\A/ATER:
BUILDING:
7rFC W Oft-b1cal Conftfta, Inc.
40
430 West D=xr1116 H •Admnle Sp
dg, FL
32714� Phoe407.788-3500
Fax: 407-788.2007
Stele Uc.11ECA0009B1
TO: Raquel Vidal Proposal No.: 003
2846 Empire Place
Sanford, FL. Date: 2/1.0/2_0.12
RE: FPE panel Replacement
We hereby propose to furnish all labor and material necessary to provide the Elec&fcal Installation
in the above -referenced project in accordance with the following specifications:
1. Replace existing FPE exterior main disconnect
-2. Fumish 8 install 1-Sq.D 150amp main disconnect
3. Furnish & install'5-15amp breakers
4. Furnish & install 4-20amp breakers
5. Fumish & install 1-2pole 30amp breaker
6 Furnish & install 1 2pole 50amp breaker
7
8
9 Permit Fee included
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Price for the work described above will be:
Payable on the following terns:
TOTAL LABOR & MATERIAL: $750.00
$750
This proposal is void if not accepted in writing within 30 days after this date.
Accepted by:
FORM NO. C -1555/8-99/5000-A
TRI=CITY ELECTRICAL CONTRACTORS, INC.
ifbo lbm/
Ron Hovel, Estimator