HomeMy WebLinkAbout414 Pine Ave1„
0 C 1 6 2011
CITY OF SANFORD
-70UILDING S FIRE PREVENTION
PERMIT APPLICATION
Applilttibd N& Documented Construction Value: $ .F it
Job Address: Xbj2. Sc s\Rux . Historic District: Yes ❑ No ❑ y v S
Parcel ID: '5',5- -- QxrL\L Zoning:
Description of Work: "Zo c'<ob&e- A(AZ ,r
Plan Review Contact Person: Title: C-k-�`KQ \ rA ,
Phone: "'��,� - y�-�- Fax: E-mail: ye
Property Owner Information
Name MC c�-,e N-A.e Phone:'�u
Street-. Resident of property?:
City, State
Contractor Information .
Name_��e
Street: P(-.) Fax: -7)�b-4 -A,`4 - Yj,y P_;
City, State Zip: 1?ul-,, �c,cx��, L. 3\3`� State License No.:
Archibect(Engineer information
Name: Phone:
Street:
City, St, Zip:
Bonding Company:
Address:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Building Permit Go*"
Square Footage:
Construction Type: No. of Stories:
No. of Dwelling Units: Flood Zone:
Electrical 0 Pluinbing,�
New Service - No. of AMPS: 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. 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
most 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 EWPROVEMENTS 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.
C�
Sipdm of Owner/Agent Dan Signature ofCar&sctWAgem Dan
Print OwnedAsm's Name
signatum ofNotary-State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
pmt CmURe .(Agent's No=
l�
'SCOTT RAYMOND
MY COMMISSION it DD 794345
EXPIRES: June 3, 2012
8-ded TAN NoWy PuW UndeN OM
Contractor/Agent is '--1 Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING: s_si ib- S• ii UTILITIES: WASTE WATER:
ENGINEERING: Z N /O -C -U FIRE: BUILDING:
COMMENTS:
Rev 11.08
Kehle Plumbing, Inc.
PO Box 353511
Palm Coast, Fl 32135
(386) 447-4249 Office
(386) 437-8488 Fax
Date: September 30, 2011
Proposal Submitted To: Worked to be performed at:
Kehle Construction, Inc 414 Pine Ave
PO Box 353511 Sanford, FL 32771
Palm Coast, FL 32135
WE HEREBY PROPOSE TO FURNISH MATERIALS AND PERFORM THE LABOR
NECESSARY FOR THE COMPLETION OF: PLUMBING AT THE ABOVE ADDRESS,
FIXTURES TO CONSIST OF:
TO FURNISH AND INSTALL (1) 40 GALLON ELECTRIC WATER HEATER AS NEEDED.
All materials is guaranteed to be as specified, and the above work to be performed in accordance with the
drawings and specifications submitted for above work and completed in a substantial workmanlike manner
for the sum of:
SEVEN HUNDRED SEVENTY FIVE DOLLARS ($775.00) WITH PAYMENT TO BE AS
FOLLOWS: $775.00 DUE UPON COMPLETION OF JOB.
RESPECTFULLY SUBMITTED:
PER KEHLE PLUMBING, INC.
Any alteration or deviation from above specifications involving extra costs will be executed on upon written order, and
will become an extra charge over and above the estimated. All agreements contingent upon strikes, accidents, or delays
beyond our control
ACCEPTANCE OF PROPOSAL
THE ABOVE PRICES, SPECIFICATIONS, AND CONDITIONS ARE SATISFACTORY AND ARE
HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED. PAYMENTS
WILL BE MADE AS OUTLINED ABOVE.
SIGNATURE: �.�,'/ DATE: t.\
SIGNATURE: DATE: