522 Liberia Ct; 18-3847; AC CHANGE OUTCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: i5 3 R4j_
Documented Construction Value: $
Job Address: , ,',, r> C-: Historic District: Yes No
Parcel ID: 3 - ip Residential 9--Commercial
Type of Work: New Addition Alteration Repair Demo Change of ,AUse Move
Description of Work: At VrLdrlao ax - _( p _nc-& 1,5 rFnn A0_ -:5)
Plan Review Contact Person: ..WL 0
Title:
Phone: } o'I -- t a Fax: Email • 6K.t •
Property Owner Information
Name IIP.Lu I f t kZ2b in% St•oCa Phone: ? W -SLP' j- Lp l'>4
Street: I OQD S. I S 'ST Resident of property?
City, State Zip:d'flr
Contractor Information
Name ':v - e' A, ' Phone: I u,44
Street: -1 " C\,k'O t- _ Fax:
City, State Zip: ,rl ,p 4'" 1 1)4 State License No.:
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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: 5th Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that ne
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 permitmustbesecuredforelectricalwork, plumbing, signs, wells, pools, furnaces, boilers, beaters, 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.
Signature of Owner/Agent Date
Print owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Signature CW..t.,/Ag..t Date
7 AJ I tOA-
int Con r/Agent's Name
Stgnature f Notary -State of lorida Date
LORI LOCKHART
it; w
MY COMMISSION 0 GG OW97
EXPIRES: July 5, 2020
t„d„ f`t'' Bonded Thru Notary Putdt Undm witera
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
Rev 11.08
ISystem Description:
Thermostat.
Pull All Permits/Fees:
Preventative Maintenance: Comfort Club
Attic Installation,
System Price:
Comfort Club Rebate Applied.
Pro Tech Rebate:
Pro -Tech Cash Discount:
Manufacturer Rebate:
I Thermostat Upgrade
U
p 'Air Purification System
Customer's Name: Lk) -I -r t 4 () fw
Today's Date:-__ Valid until:
XR14
lncludeci Included
Included Included
4 "J,CJ9. M4 ,
g !Zone Systems
r ;Duct System/Grills
I
Comfort Club (2nd yr)
d
i Electrical Upgrades
Plumbing Additional items
s
Approved Upgrades:
44TotalDuetoPro-T'ech:
Power Company Rebate: TA
Welts Fargo finance:
anufacturer, Pro -Tech Rebates, Pro -Tech cash Micount cannot be combined with Wells '-Fargo -financing and/or any Promotions.
Install Date:
llay')Z6ni a10 I er rn S
eCheck- I Cash/Credit Card Discount: Ll Financing: $
i have authority to order the work outlined above. in the event that payment is not made promptly in accordance with agreed terms, it shall be the seller's option to charge a
service charge not exceeding 1.5% a month, the first service charge becoming due 15 days from the date of installation Of our amount due on the job. In the event of collection byattorney, at, attorney costs, Mod cost and other legal fees shall be borne by the buyer. In the event of nonpayment, purchaser agrees to allow seller on premises to removeequipmentinstalled. This inves t prgpgSil Ah!Ll be binding upon the heirs, successor, or assigns of the parties hereto. It is understood that the title to all products andequipment
dc%
efbf"e contract remains solely in he entire purchase price has beer, paid in full and the manner of installation and/or attachment to any 77
Fid ,
or any portion of the building in which the P"'sanon is equade
shall not in any manner jeopardize the setter's title- 1,
1t. '1112-- Date: CusOner
Signature Date:
Customer
mate:
Pro -
Tech Comfort Specialist - Vem1m
MOP Page 3 Of 3 6125./
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