307 Live Oak Blvd; 17-2320; AC DISCONNECTi
11
t 1, AUG 01 2017 CITY OF SANFORD
BUILDING & FIRE PREVENTIONii
BY. --- PERMIT APPLICATION
Application No: Y
Documented Construction Value: $ /g DD
Job Address: __
1_01 1. w__ DCQIL B104 • Historic District: Yes No
Parcel ID: 1— 20 " 330 •565 - MW - DoZfl Residential Commercial
Type of Work: New
t,
A,,
X.tddition
ElAlteration Repair ElDemo Change of Use Move
Description of Work: C11 ra,Q
Plan Review Contact Person: ULI
Phone — Fax:
j.Vam,,
Property Owner Information
Name ehisc, Phone: 4—)— 3,14— (P &A-
101
Street: 6AIy_ Cwj Resident of property?
City, State Zip:._k l\'tWc L 2-DI
F_t
j Contractor Information
1 r , Name l 1 1-t cmjf 1Z_
t
k DYI,CtG Phone:32 1 — 22-R- 2S 32
Street: w bo CAn i 1 Pd `L.O-y Fax: b—j — I 22.Z
City, State Zip: !)t' Of)& '[ (,.. -3,State License No. Tz C 1 Jad `-fm
Architect/Engineer Information
Nance: Phone:
Street
City, St, Zip:
Bonding Company:
Address:
Fax;
E-mail: _
Mortgage Lender:
Address:
WARNING TO ON't'NER: YOUR FAILURE TO RECORD A NOTICE OF CON—IMENCEIVIEN'r MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMA IVIENCEINIENT 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
CONEMENCENIENT.
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: 5111 Edition (2014) Florida Building Code
Revised: June 31).2015 Permit Application
a
a
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 fl•om 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 I=lorida 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: 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 zoning.
Signatureol'OwneriAgent Date S na" -ot + for/Agent Date
Print Omier/Agent's Name
Signature otNotary-State ol'Plorida pate
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
M,\SNEL Coo"62
Print Contractor/Agent's Name
Signature of'Notary-State oP lor` a Date
DIANA RODRIGUEZ
MY COMMISSION # GG041266
w EXPIRES October 24, 2020
P-
mmially Known to Me or
Produced ID
1
ype of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas[] Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30. 2015 Permit Application
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
12Date: 61Al
I hereby name and appoint:
an agent of. _'9_V'Vk CjC- UYV_ MY
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all thingsC,
necessary to this appointment for (check only one option):
The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney: 2-(-t Z01 j
License Holder Name: M'Sac( C—Vu -7
State License Number:
Signature of License Holder:
STATE OF FLORIDA
COUNTY OFaMIMV
The foregoing instrument was cknowleclued before me this 2q day of Alff-
200 V-z personally knownbyMj,')0 who, is
to me or o who has produced
identification and who did (did not) take art ath.
Signature
Notary Seal) LICA za-<k W __s
Print or type nameDANIELEZASOWSKI
4My COMMISSION # FF95121 1
EXPIRES February 27. 202011 Notary Public - State of Aolrljp_
Commission No. k4-45 -11
My Commission Expires: ZI 21120
Rev. 08.
as
v
ALCOh
2016-2017
LEE COUNTY LOCAL BUSINESS TAX RECEIPT
Account Number: 0003596 Account Expires: September 30, 2017
Location:
10271 DEER RUN FARMS RD STE 1
FT MYERS FL 33966
PLAYMORE RECREATIONAL PRODUCTS & SERVICE
PLAYMORE WEST INC
10271 DEER RUN FARMS RD STE I
FT MYERS FL 33966
OUSHICSS clusrlu
May engage in the business of-.
DISTRIBUTOR/ MOBILE SALES
Selling on roadsides is prohibited
THIS LOCAL BUSINESS TAX RECEIPT IS NON REGULATORY
Payment Information:
PAID 423138-186-1 09119/2016 1237 PM
50.00
City of Sanford
Building & Fire Prevention Division
Residential Permit Card
PERMIT NO. I I a 31X0 ISSUE DATE: %-I am I I
CONTRACTOR:
JOB ADDRESS:
TYPE OF WORK:
Post this permit in a conspicuous location outside
Approved plans must be posted with permit for inspection
Leave all work uncovered until inspected and approved
Permit expires 6 months from date of issue or last approved inspection
PROTECT FROM WEATHER
BUILDING
INSPECTION TYPE APPROVED REJECTED INSPECTOR
ELECTRICAL
INSPECTION TYPE APPROVED REJECTED INSPECTOR
FOOTER INSPECTION ELECTRIC UNDERGROUND
STEMWALL FOOTER/SLAB STEEL BOND
FORMBOARD SURVEY T.U.G. / PRE POWER
SLAB / MONO -SLAB ELECTRIC ROUGH
LINTEL / TIE BEAM ELECTRIC FINAL
SHEATHING - ROOF MECHANICAL
INSPECTION TYPE APPROVED REJECTED INSPECTORSHEATHING - WALLS
FRAME MECHANICAL ROUGH
INSULATION ROUGH IN MECHANICAL FINAL
DRYWALL/S HEETROCK PLUMBING
INSPECTION TYPE APPROVED REJECTED INSPECTORLATHINSPECTION
FINAL STUCCO/SIDING UNDERGROUND ROUGH
FIREWALL SCREW TUB SET
FIREWALL FINAL SEWER
INSULATION FINAL PLUMBING FINAL
FINAL SFR GAS INSPECTIONS
INSPEC'77ON TYPE APPROVED REJECTED INSPECTORROOF
INSPECTION TYPE APPROVED RFJECTED INSPECTOR GAS UNDERGROUND PIPE
ROOF DRY -IN GAS ROUGH -IN
FINAL ROOF GAS FINAL
MISCELLANEOUS / FINAL INSPECTIONS
INSPECTION TYPE APPROVED REJECTED INSPECTOR INSPECTION TYPE APPROVED REJECTED INSPECTOR
PRE -DEMO FINAL DOOR
FINAL DEMO FINAL WINDOW
FINAL SOLAR PANELS IRRIGATION FINAL
FINAL POOL SCREEN FINAL SCREEN ROOM
FINAL UTILITY BUILDING FINAL BUILDING (OTHER)
MOBILE HOME TIE -DOWN MOBILE HOME FINAL
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 FBC105.3.3
REVISED: 4-17 Inspection Line: 407.792.6069 or 855.541.2112