1703 W 16 St - BR18-002655 - Stucco4W
CITY OF
SANFoRn
FIRE DEPARTMENT
JUN 1 A 2018
i4L-- uihling & Fire Prevention Division
PERMIT APPLICATION
Application No: 19 _'; 655,
Documented Construction Value: S Irey.
Job Address: l 703 / 10 '4-' Y7L text! JG 72771 Historic District: Yes No
Parcel ID: ' S 9 v ..S`3- o - a>bo Residentialommercial
Type of Work: New[] Addition[] Alteration Repair Demo[] Change of Use Move
Description of Work:
Plan Review Contact Person: Title:
Phone(Za71)Z(o2 -63W& Fax: Email: ec"'_
01
Property Owner Information
Name Phone:
Street: / Gt1 Resident of property? : 105
City, State Zip: 4. P,
Contractor Information /
l
Name /7CU47,^ /C`C/ Phone: C 0/ .26 7 -5:1f6
Street: 'G%y Suminw I t n At. Fax:
City, State Zip: g%- ?9-77t State License No.:
Architect/Engineer Information
Name: Phone:
Street:
City, St, Zip:
Fax:
E-mail:
Bonding Company: 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 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: 61D Edition (2017) Florida Building Code
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 ofpermit is verification that I will notify the owner of the property ofthe 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 totcalculate 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 compl• ce with all applicable laws regulating construction an oning.
4
lure of er/ Date %ure ofCon ctor/Agent Date
TI!-A
Print
um
Print Contractor/Agedt's
L.a. 12. (9
o s; SHANJERICA JOHNSON ; i4; ANNETTE BLAND
Notary Public -State of Florida Notr.y Public •State of FloridamissionpGG0298680.: Commissionon G 060623CommissionsslG
My Comm. Expires Sep 13. 2020 °f MY Comm. Expires Jan 16.'2018o : ,..
Owner/Agent is e o Con a o i?;p to Me or
Produced ID Type of ID Produced ID Type of 1D
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plui-nbing 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 Fire Alarm Permit: Yes No
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE:
COMMENTS:
BUILDING:
This agreement is made between Rickard Construction LLC and the owner
6f&k PkednP, 4 on this 291h day of May 2018. This contract is for the sum of
for the installation of stucco at the residence of 1703 W. 16`h St. Sanford, FL 32771.
The owner is responsible for all permitting fees.
re date
41, V-s y s'
Untractor Signature date