105 Kaywood Dr - P18-003655 - WATER HEATERCITY OF AUG 2 7 2018
t ;,` '• Skl FORD _ D PERMIT APPLICATION
BUILDING DIVISION /8_ 2 5
Application No: / //
Docume ted Construction Value: $ /ADD
Job Address: J /l Gr,lzyaew j/ l Historic District: Yes NoO—'
Parcel ID: < -2-L. -( 5-17c Type
of Work: New Addition Alteration Description
of W, Plan
Review Contact Person: Phone:
Fax: ezY
Residential Q .ommercial Demo
Email:
Property
Owner Information Name
Phone: Street:
J ti-- ® % City,
State Zip: _S lt•l it " i 3 2 q—L-/ Title:
Resident
of property?: Contra
or Information Name
U' c
tf Phone:oe
Street:
a t C C`blil Fax: City,
State Zip: .tXO J State License No.: j Name:
Street:
City,
St, Zip: Architect/
Engineer Information Phone:
Fax:
E-
mail: Z--
BondingCompany: Mortgage Lender: Address:
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 apermit 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: 61 Edition (2017) Florida Building Code
NOTICE: In addition to the requirements ofthis 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 ofpermit is verification that I will notify the owner ofthe property of the requirements ofFlorida 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 reviewcharge and will be considered the estimated construction value ofthejob at the time ofsubmittal. 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.
AtreOwner/Agent Date
Print Ommer/A¢enes Name
Signature of Notary -State of
Owner/Agent
Produced ID
ANNE1RMLAND
Notary Public - State 01 Florida
Commission # GG 060623
Av Comm. Expires Jan 16, 2018
Type of ID
I
fi, 7 //,: P -
Signature of Cont or/Agent Date-
1ed//// fc*r
Print o tractor/Agent's Name
4 - -C-"-
Signature of Not&f4 vFof,FIori
ANNETTE BLAND
r • ;¢ = Notary Public State of Florida
Commission # GG 060623
My Ptfi'1 1" OWnto a or
eo
BELOW IS FOR -OFFICE -USE ONLY- -
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
Flood Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:'. '
AUG 21 2010
A
This Agreement ("Contract") is made this _1?2 day of G(GL ,, 20
between "'i zd;,2 - &./,,Contractor") and
L lC- ("Owner") at 4 "Y
z,/-t°(Z-/ o- c _?2-+
SECTION 1. SCOPE The Contractor agrees to furnish all labor, materials,
SECTION 2. PRICE AND PAYMENT The Owner agrees to pay the Contractor for
the strict perform vf the work, the sum of $
subject to adjustments for changes in the work
as may be agreed to by the Owner and the Contractor, as may be required under this
Contract.
Payments will be due and payable within thirty days of invoice.
SECTION 3. ENTIRE AGREEMENT. This agreement represents the entire
agreement between the Contractor and the Owner regarding the work described in
Section 1, and supersedes any prior written or oral agreements or representations as to
that work.
Dated: Dated:4-/,,-27,//,,P-
OWNER: CONTRACTOR: _1*es
By:
Name)
Title)
By: cY
Name)
Title)