2907 S Park Ave - P18-002592 - RePipeisCITY
OF
SkNFORD
FIRE DEPARTMENT
Building & Fire Prevention Division
PERMIT APPLICATION
JUN 7 2018 Application No: Ik- d_!-Q)=
C3v
Do;4ented Construction Value: S ':Vlo
Job Address: D07 5,-, Historic District: Yes No EL Parcel
ID: 01 - ? - ,3 0- S/k- Q0oo 0 V ZD Residentialz Commercial Type
of Work: New Addition Alteration Repair Demo Change of Use Move Description
of Work: Le, - Plan
Review Contact Person: r L cal. Title: Phone:
Fax: Email: bl' / ^-t-i • • 04A
Property
Owner Information Name -
i l S I, Phone: 4?0 y- Yy9 Z S? 3 Street:
010 8&rk Ai Resident of property? City,
State Zip: ;-/• 3 Z 3 r / ®
Contractor
Information ' 4'— /
Name (; !
E,t Phone:'c - Street:
44 r' 401 Fax: lo Z City,
State Zip:Q L&_'rv77 State License No.: C `G 0 Y0 0 21 Architect/
Engineer Information Name:
Phone: Street:
Fax: City,
St, Zip: 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. 1 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. 1 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 Revised:
August I, 2017 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 1 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 ]CC 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 Date Si pWre of Coraractor/ ent Date
Print Owner/Agent's Name
Signature ofNotary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Print ntractor/Agent's
061aA,4,,_) 0
Signature Notarv-st
a DEDBIE EIANTON
MY COMMISSION 0 FF 178648c,r •:
EXPIRES: February 25, 2019
Bonded Tbru 14otary Public Undermters8„ h
Contractor/Agent is Personally 6_n0 n toe or
Produced ID Type of 1D
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas[] Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use: Flood Zone:
Min. Occupancy Load:
New Construction: Electric - # of Amps,
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads
UTILITIES:
FIRE:
of Stories:
Plumbing - # of Fixtures,
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: August I, 2017 Permit Application