109 Oak View Pl - M18-003027 - HVACCITY OF
M""'~'
t
L 0 200kNFORD
BUILDING DIVISION
PERMIT APPLICATION
Application No: 1 $-3Qq
Documented Construction Value: $ ., 50 - O " Job
Address: 1 U g O A e I A- t Q S0 Historic District: Yes No Parcel
ID: Residential [Commercial Type
of Work: New Addition Alteration Repair Demo Change of Use Move Description
of Work: rif 5z: fk $, Plan
Review Contact Person: R vo t_ /299 tAe- i I cā 2 Title: Phone:
kO 7 e6 Fax: Email: 5 /) V, 4 Property
Owner Information Name
f-f " c- t d e- f! S h I J S Phone: Street:
0 k l/ 1 C Ah c Resident of property?: City,
State Zip: i4 P-' 3 ;Z 7 7 -7 Contractor
Information Name
44 4 LA_< ā.A e- Street:
S' 7 3 ^Sy City, State
Zip: Li' f O -,e "g7 e 3 a 7,9 Name: Street:
City,
St,
Zip: Bonding Company:
Address: Phone:
Fax:
State
License
No.: CAC_ ) 8 / z-s e 3 3 Architect/Engineer
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 permitand that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 understand that a
separate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners, etc. Revised:
June,
2018 Permil Application
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 6" Edition (2017) Florida Building Code
NOTICE: In addition to the requirements ofthis permit, there maybe 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.
Signature ofOwner/Agent
Print Owner/Agent's Name
Date
kz/ all B'
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID' Type of ID 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: 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:
Revised: June, 2018 Permit Application