HomeMy WebLinkAbout936 Willner CirApplication No:
is -9a3
RECEIV �i
JAN 3 0 2012
BY:
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
of
Documented Construction Value: $
Job Address: qz!)(0 LXSX\ir _(^ C\ r
Parcel ID:
Description of Work:
Plan Review Contact Person:
Phone: Fax:
Historic District: Yes ❑ No
Zoning:
E-mail:
Title:
nn ww ,�.,ssProperty Owner Information
R
Name . Monmet . Phone: LW- J" 2Z.- 9(Dq W
Street: LM&& CT 1(-_ Resident of property?: 1J o
City, State Zip: �Snl 0 _Y59111
e I Contractor Information
Name I.- Phone: ��% 'R 2 S- %ZDV
Street: 1 Vy f i /\.& UM" �" 1 4)C)12 Fax: �—
--�
City, State Zip: k1L"_'4'—C yam( EL State License No.: CACI `y� �i �l e i
Architect/Engineer fn1? /Ration
Name:
Street:
City, St, Zip:
Bonding Company: _
Address:
Building Permit D
Square Footage:
No. of Dwelling Units:
Electrical D
New Service - No. of AMPS:
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type:
Flood Zone:
Mechanical ®'(Duct layout required for new systems)
eronIy
No. of Stories:
Plumbing O
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm D 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, 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.
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.08
UTILITIES:
FIRE:
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
-im,/V /
1 8 1 1
12
Signature of O ner Agent
I
ate
Print Owncr, gent's Name
Signature of Notary -State of Florida Date
,•;;a�a�s.
DEBBIEBLANTON
+°.
Notary Public - State of Florida
. •
My Comm. Expires Feb 25.2015
���"° ��"•�
Commission N EE 60162
Owner/
Bonded Thro Na nal N T or
Produced ID
Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.08
UTILITIES:
FIRE:
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
.V
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint:
an agent of:
to be my lawful attorney - in - fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
? All permits and applications submitted by this contractor.
The specific permit and application for work located at:
0I Nn- . tn,A4 /n„ a ).11rte- 0; r
At4 1S 9 IZ,l 3 1 101T ireet Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: S19- r M c Ga kky
State License Number
Signature of License H
STATE OF FLORIDA
COUNTY OF SCS flnookC,
The foregoing instrument was acknowledged before me this Lay of -�C�,
2081 v , by do! ncGahS,�,=j who is ? personally known
to me or ? who has produced
identification and who did (did not) take an oath.
1
Signature
WTMY!COMS�01
RCHE•CRU. Z �(-e r-18 aG
2 QZW?,
0wDDM307h1Print or hPa name
,00: 3.
14
NOOYNdrARY Fl, N.Wy DWPM Aum Co.
( Rev. 3/27/07)
Notary Public - State of 4L
Commission No. b(J00%LA30-7
My Commission Expires: -7 1-60114.
as
PATENAUDE
_NA
IATES 1S &ASSOCIATES, INC
A OC
10612 McCulloch Dr http://www.Patenaude.cc Phone: 407.740.0391
Orlando, FI 32817 Fax: 407.740.0791
License # CG 0057811 Email: mail@Patenaude.cc
J
HVAC System Repair
Proposal
Prepared For:
Town Center Apartments
Prepared by:
Patenaude & Associates, Inc.
Jacob Patenaude
Vice President
JacobCa)Patenaude.cc
(407)466-8206
December 30, 2011
Patenaude to Associates, Inc. has reviewed all buildings and amenities at Town Center Apartments. The following
Scope of Work is designed to address items and make improvements in the areas where specified.
The bidder agrees to provide all materials, labor, tools, equipment, and scaffolding required to complete the work
described. The proposal shall include all necessary permits, fees, taxes, cleanup, disposal, and all other costs necessary
to complete the work described unless otherwise noted.
Scope of Work
• Provide Labor to install 3 condensers
• Provide Labor to install 1 air handler
• Permitting to be done by other
Bid Proposal
Base bid for the above-mentioned scope of work is One thousand, six hundred fifty and
00/100 ($1,650.00).
Notes
■ All materials to be provided by property
• Permitting and inspections to be done by other
Acceptance of Proposal
Thehove price, specifcations and conditions are her by accepted.l'ou are authorized ro do the work
pc
'It
icd
Town Center Apartments Date
Authorized Signature
- 2 -Proposal for Town Center Apartment
12/30/2011