439 Pecon Avenue 17-1178; HVACCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ 3 i00 . O D
Job Address: 1Q rpm , NPou Q r -Sab i A _ c" a 1 Historic District: Yes No Parcel
ID: - I
ResidentialO
Commercial Type
of Work: Newt.J Addition Alteration Repair Demo Change of Use Move Description
of Workl I cif fgjQ I
siYS Pal'_,A'^11T_j _ 0 c 1 Plan
Review Contact Person: Phone:
Fax: Name
Street:
City,
State Zip: Title:
Email:
Property
Owner Information Phone:
Resident
of property? : Contractor
Information Name`
an hQ Street:
Coof L (Ji lC i \) P_ City, State
Zip: i, an c7 FL ?,JWC Name: Street:
City,
St,
Zip: Bonding Company:
Address: Phone:
SM '
Qo Fax: State
License
No.: CAC 11.Q- 6 9LL Arch itect/
Eng I neer Information Phone: Fax:
E-
mail:
Mortgage Lender:
Address: 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. 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. FBC 105.
3 Shall be inscribed with the date of application and the code in effect as of that date: 51" Edition (2014) Florida Building Code Revised: June
30, 2015 Permit Application
00
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 at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
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.
IND A 1
Signature of Owner/Agent Date Signature of Contractor/Agent 6ate
R-%A—
Print Owner/Agent's Name P ' tractor/A ame
Signature of Notary -State of Florida Date Si be
pt JESSICA FAYE BACALLAO
NotaryPublic StateofFlordaW-0
Commission # FF 898671
Y My Comm. Expires Aug19,2019
Owner/Agent is Personally Known to Me or Contractor/Agent is PersonallyKnown to Me or
Produced ID Type of ID Produced ID _ Type of ID 0W I nSr
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Revised: June 30, 2015 Permit Application