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Home My WebLink About2025 S Summerlin Ave (4)C ITV OF SANFORD PERMIT APPLICATION Permit N : 0 YJ — 2. qEq Date: 0 l— 2 6 — 0Ip Job Address: — 20ZS 'S S(J/!'!!iiLc i,N i41/0, Description of Work: Total Square Footage Historic District: Zoning: Value of Work: S Permit Type: Building Electrical t/ Mechanical Plumbing Fire Sprinkler/Alarm fool Electrical: New Service — N of AMPS Addition/Alteration Change of Service 'femporary Pole Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required) Plumbing/ New Commercial: N of Fixtures N of Water & Sewer Lines N of Gas Lines Plumbing/New Residential. N of Water Closets Plumbing Repair — Residential or Commercial Dccupancy Type: Residential Commercial Industrial Construction Type: I q of Stories: N of Dwelling Units: Flood "Lone: (FEMA form required owners Name & Address: 7ontractor Name & Address: hone & Fax: 300ding Company: ddress: Mortgage lender: ddress: rchilectfFrigineer: ddress: Guo I''Al d,= r- 0 Lb Phone: Slate License Number: Contact Person: Phone: Phone: Fax: pplication 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 ssuanee of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 understand that a separate mmit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOIS, FURNACES, BOILERS, HEATERS, TANKS, and UR CONDITIONERS, etc. WNER'S AFFIDAVIT: 1 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 inning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. MC : 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 his county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. cceptance of is verification 1 will notify the owner of the p;erty of the requirements of Florida Lien Law, FS 713. g Z Sign ure of Owner Agent Date Signature of Contractor/Agent Date Pri, f c4ge s amen Print Contractor/Agent's Name Signature of NotarytMrida DEBBIE BLANTb* MY COMMISSION # DD ISMI EXPIRES: February 25. 2007 1- 800-4 0 TARY FL Notary Dw.9m A =. Co. Owner/ Agent is _ Personally Known to Me or Produced ID PPROVALS: ZONING: UTIL: FD: pecial Conditions: ev 03/2006 Signature of Notary -State of Florida Date Contractor/ Agent is _ Personally Known to Me or Produced ID ENG: BLDG: CITY OF SANFORD BUILDING DIVISION OWNER/BUILDER AFFIDAVIT ELECTRICAL & FIRE ALARM SYSTEMS An owner of property making application for permit, supervising, and doing the work in connection with the construction, maintenance, repair, and alteration of and addition to a single-family or duplex residence for his or her own use and occupancy and not intended for sale or an owner of property when acting as his or her own electrical contractor and providing all material supervision himself or herself, when building or improving a farm outbuilding or a single-family or duplex residence on such property for the occupancy or use of such owner and not offered for sale or lease, or building or improving a commercial building with aggregate construction costs of under $25,000 on such property for the occupancy or use of such owner and not offered for sale or lease. In an action brought under this subsection. proof of the sale or lease, or offering for sale or lease. of more than one such structure by the owner -builder within 1 year after completion of same is prima facie evidence that the construction was undertaken for purposes of sale or lease. This subsection does not exempt any person who is employed by such owner and who acts in the capacity of a contractor. For the purpose of this subsection, the term "owner of property" includes the owner of a mobile home situated on a leased lot. To qualify for exemption under this subsection, an owner shall personally appear and sign the building permit application. State law requires electrical contracting to be done by licensed electrical contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owher of your property, to act as your own electrical contractor even though you do not have a license. You may install electrical wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under $25,000. The home or building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourself within I year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your electrical contractor. Your construction shall be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. 1, , do hereby state that I am qualified and capable of performing the requested construction involved with the permit application filed. I will assume full responsibility as an Ovrner/Builder Contractor, and will personally supervise all work allowed by law on the permitted structure. 0-,vneVBuilder Signature at ilk -Pok, O Print caner/Builder Name Signature of MY COMMISSION A DD 166491 D(PIAES: Fetrruery 25, 20W ooanar:aY - No rnMaoe.Co. Owner is Persol . o«-te.A oi, Produced ID ll CITY OF SANFORD PERMIT APPLICATION Permit #:. d . Dale: O /O % /O l Job Address: Z J S+ Sit n^ IV e r I / a Azxe— Description of Work: R/K `t I N Dl Total Square Footage Historic District: Zoning: Value of Work: S Y S 0 V r J J Permit Type: Building [electrical Electrical: New Service - # of AMPS Mechanical: Residential Non -Residential Plumbing/ New Commercial. # of Fixtures Plumbing/New Residential: # of Water Closets _ Occupancy Type: Residential Commercial Mechanical Plumbing Fire Sprinkler/Alarm Pool Addition/AIteration Change of Service 'Temporary Pole Replacement New (Duct Layout & Energy Calc. Required) of Water & Sewer Lines # of Gas lines Industrial Plumbing Repair - Residential or Commercial Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required) Owners Name & Address: V_ Phone: ' 6— 7%— Z I e 7 Contractor Name & Address: ' •v-'e- #-/ s' C e>2.P i: Phone & Fax: Beading Company: Address: Mortgage Leader. Address: Archilect/Engineer: Address: Contact Person: State License Number: Phone: Fax: 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. 1 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. 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 FI ida Lien Law,713 Signature of Owner/Agent Date Signature of Contractor/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Date OwnedAgent is _ Personally Known to Me or Produced ID APPROVALS: ZONING: Special Conditions: Rev 03/2006 UTIL: FD: ge nt' Name DEBBIE BLANTON MY COMMISSION # DD 188491 EXPIRES: February 25, 2007 Produced ID ENG: BLDG: