HomeMy WebLinkAbout125 Pinecrest Dr (2)1 CITY OF SANFORD PERMIT APPLICATION
Application H: —,�� _I�5(e Submittal Date: O–S Q 1
I
Job Address: 125 Pinecrest dr Value of Work: $ 2480.00
Parcel ID: 01-20-30-517-01300-130 Zoning: Historic District:
Description of Work: Remove indoor obsolete breaker panel and replace with new
Square Footage:
Permit Type: Building ❑ Electrical ❑X
Electrical: New Service – # of AMPS
Mechanical: Residential ❑ Non -Residential ❑
Plumbing/ New Commercial: # of Fixtures _
Plumbing/New Residential: # of Water Closets
Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign
Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Replacement ❑ New ❑ (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair–Residential ❑ Commercial ❑
Occupancy Type: Residential ❑
Commercial ❑
Industrial ❑
Occupancy Use Group(s):
Construction Type:
.......................................................................................................................
# of Stories:
# of Dwelling Units:
Flood Zone: (FEMA form required)
Property Owner: Joann Bumbardner Contractor: Advanced energy Services Inc.
Address: 125 Pinecrest dr. Address: !78 Kenlake Dr. Deltona Fl 32738
Phone: E-mail: Phone: 386 804 085 State License Number: ER0015443
Bonding Company: Mortgage Lender:
Address: Address:
Architect/Engineer:
Address:
Phone:
Fax:
Plan Review Contact Person: Phone: Fax: E-mail:
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. 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 requireme is of Florida Lien aw, FS 713.
Signature of Owner/Agent Date gignature of ntractor/Agent
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 02/2007
UTIL: FD:
Print � trac�tor/Agent� � I�\\�c
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Signature of Notary -State of Florida - Z • r4e o -_
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Contractor/Agent is Personally Knd&epr' �✓ ` ?I'+yam
_Produced ID
R2_40 -2 -4A -4V
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ENG: BLtx�! (. F
Advanced Energy Services, Inc.
(407) 323-5575 178Xenlake Deltona, FL 32738 adv—energy_services@lycos.com
WE PROPOSE TO IURNISh THE MATERIALS ANd IAbOR TO COMPLETE THE INSTALLATION Of THE
FOLLOWING fOR JOANN BUMGARdNER IN HER HIONE AT 125 PINECREST DR.
• REMOVE EXISTING INdOOR OBSOLETE bREAkER PANEL.
• INSTALL NEW INdOOR bREAkER PANEL
• INSTALL THE WIRING TO PRESENT NEC
ALL Of THE WORk TO bE COMPLETEd IN A SUBSTANTIAL ANd WORkMANLIkE MANNER ACCORdING
TO STANdARd PRACTICES. THE TOTAL Of THIS CONTRACT TWO THOUSANd FOUR HUNdREd EIGHTy-
/� DOLLARS ($2,480.00)S TO bE PAid AS FOLLOWS: TWO HUNdREd dOLLARS AS dOWN PAYMENT.
! y' r - WEEkLY PAYMENTS OF�iZ�---TUNTR BALANCE IS PAld IN FULL.
ANY ALTERATION OR dEVIATION FROM THE ABOVE SPECIFICATIONS INVOLVING EXTRA COST Of
LABOR OR MATERIALS WILL bE EXECUTEd ON WRITTEN ORdERS Of SAME, ANd WILL BECOME AN
EXTRA CHARGE OVER THE SUM Of THIS CONTRACT. ALL AGREEMENTS MUST bE MAdE IN WRITING.
I HAVE REAd THIS CONTRACT ANd AGREE TO ITS TERMS.
SIGNE DATE, 1