416 Elliott Ave 17-347 T-poleCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
n
Application No:/ -7- 3 7
Documented Construction Value: S
Job Address: 14kG El W 1A K\AE • , Y11i1 (P P1 _ ci;QTl I Historic District: Yes No Parcel
ID: Residential,® Commercial Type
of Rlork: new Addition Alteration Repair Demo Change of Use Move Description
of Work: Plan
Re ew Contact Person: t wcmt \\ Title:Qrmt SflhSOPCiIorlS. Phone:
91-1 gOln .1l13 Fax: L4071 fRt IMQ Email:(_IQC. 0., lrcm&,eIeCiY1C.(nm 1
1Property Owner Information Name
F0 15k1 IZe51c1e+e Phone: Street:
41In E11104 KV E Resident of property? : L City,
State Et _1-1 1
Contractor
Information Name
Soya&\ C,\eCi1 1C'. c (r Arl-11t • Phone: Street:
skc Fax: LjQ7 `&5 tpua City,
State Zip: &&rclState License No.:L['h'11`J Architect/
Engineer Information Name:
Phone: Street:
City,
St, Zip: Bonding
Company: Address:
Fax:
E-
mail Mortgage
Lender: Address:
K46RNTNG
TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYWG
TWICE FOR IMPRONTMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED
AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. ff YOU INTEND TO OBTAIN FINANCING,
CONSULT RTT9 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, tams, and air conditioners, etc. FBC
1053 Shall be inscribed with the date of application and the code In effect as of that date: 511 Edition (2014) Florida Building Code Revised:
June 30, 2015 Permit Application
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 %rill 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 urill 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 Hill
be done in compliance with all applicable laws regulating construction an oning.
la 1
Signature of owner/Agent Date Signa of Conawtor/Ageot Date
s e Ph iS--ado.
Print Owner/Agent's Name Print Contractor/A ent's Name
Srgnaare of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
AA 4uywd a )to l-o 17
Signature of Notary -State of
MELLISA ANN HUBBARD
Commission # FF 14344:: t
s ;,= Expires July 20. 2018
Contractor/Agent is IV Personally Known to Me or
a
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas[] Roof
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Alin. Occupancy Load:
Flood Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONTING: UTILITIES: WASTE WATER:
ENGINEERING:
COAIN11ENTS:
FIRE: BUILDING:
Revised: lure 30.2015 Permit Application
City of Sanford
Building & Fire Prevention Division
T-Pole Permit Card
PERMIT NO. / 70- -7 ISSUE DATE: Odso7o , 7
OF
CONTRACTOR:
JOB ADDRESS:
TYPE OF WORK:
iv
Post this permit in a conspicuous location outside Leave all work uncovered until inspected and approved
Approved plans must be posted with permit for inspection Permit expires 6 months from date of issue or last approved inspection
PROTECT FROM WEATHER
All T-Poles limited to 60 amps MAX (unless authorized by the Building Official)
ELECTRIC
APPROVED
IT -POLE 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 FBC103.3.3
REVISED: OCTOBER 2014 Inspection Line: $55.541.2112
TO SCHEDULE AN INSPECTION:
Dial855.541.2112
Provide the items requested during the message
The type of inspection requested must be scheduled under the appropriate permit type
Follow the prompts
PLEASE NOTE: Inspections scheduled by 3:30 p.m. will be conducted the next business day.
If you experience difficulty, please call 407.688.5150 Monday - Thursday 7:30 am - 5:30 pm for
assistance.
AUTOMATED INSPECTION SYSTEM CODES
ELECTRIC
T-POLE FINAL 215
Miscellaneous Notes:
REVISED: OCTOBER 2014 Inspection Line: 85S.S41.2112
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . . . . 17-00000347 Date 2/06/17
Property Address . . . . . . 416 ELLI07T AVE
Parcel Number . . . . . . . . 30.19.31.525-0000-024A
Application description . . . ELECTRIC PERMIT APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . SINGLE FAMILY
Permit . . . . . . ELECTRIC PERMIT-ALTER/ADD/FIX
Additional desc T POLE
Phone Access Code 971879
Permit pin number 971879
Required Inspections
Phone insp
Seq Insp# Code Description Initials Date
1000 215 EL04 TEMPORARY POLE _/_/_