105 W 18 St - E17-002996 - SERVICE UPGRADEOCT 201?
1_
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / 1") ' C9 q 9 l 2
Documented Construction Value: $ '3 fi Q - U
Job Address: ( 0 5 W . (S: b S$224— Ea ft- 3a7_7 ( Historic District: Yes No
Parcel ID: 31- j q --; b --5b(,, - Ck:;00 — t7q'`0 Residential 1 Commercial
Type of Work: New Addition Alteration 13 Repair Demo Q Change of Use Move
Description of Work:
t0]-3 3-&gSj2 Fax: Email: -LIC lf° P_+ac((1c,6
Property Owner Information
Name Phone:3L — fir%
Street: (b5 W. (-tb S f. Resident of property? : GS
City, State Zip:,
Contractor Information
Name 1'cC4%G inc . Phone: qD'1- 39 3 - to
Street: Jl' Fax
City, State Zip: f La % -7 3 State License No.: fE_ C 0U_-) 0 9_9
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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 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: 5"' Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
NOTICL: 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 verificatioJl 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 hermit 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 zonjft.
Signature of owner/Agent
Print Owner/Agent's Name .
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Producecl ID Type of ID
G / Z 1 7
S' ature of Contn to gent Date
Z-0
Print Contractor/Agent's Name
CAQ
n.ttt+pt otary- utt flt•t MAS I to
g4 = MY COMMISSION # GG 083925r,
o EXPIRES: June 28, 2021
p Bonded Thru Notary Pubtic Undenrtiters
Contractor/Agent is P onally Kno Me or
Produced ID Ty
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Gas Roof
Flood Zone:
of Stories:
Plumbing - # of Fixtures
of Heads Fire Alarm Permit: Yes No
UTILITIES: WASTE WATER:
FIRE: BUILDING:
Revised: June 30, 2015 Permit Application
407-323-6959
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9/26/2017 SCPA Parcel View: 36-19-30-506-0000-0770
THIS INSTJ,WM_NT N EPARED BY:
Name: i
Address: Cr
c 7,
NOTICE OF COMMENCEMENT
Permit Number:
Parcel ID Number:.3(n ) CA S -.SoCo be CbD G 7 Z v
The undersigned hereby gives notice that improvement will be made to certain real property, and in
following information is provided in this Notice of Commencement.
1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if availabit
a111,f01r_ (_OU.I
CLERK) 1 a:
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2. GENERAL DESCRIPTION OF PROVEMENT: n
eve. &4-s,le 4-,4 J Je-
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
I - Name and address: P P,i n C (Ge e/l 7VS (.(i I y 11, -)D-7 7 0
Interest in property:
Fee Simple Title Holder (if other than owner listed above) Name:
Address: /
r, 4. CONTRACTOR: Name: Q.
GG
C, Phone Number: 40 a
Address: 2 `! C % y r+G' / 3 Q % O]
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address: Amount of Bond:
6. LENDER: Name:_ Phone Number:
Address:
7. Persons within :he St, le of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7., F,urida Statutes.
Name: ._ _ Phone Number:
Address:
8. In addition, Owner der`orata.. of
to receive a copy of the'.ienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
9. expiration Date of Notice cf Com. "encement (The expiration is 1 year from date of recording unless a different date is specified)
WARA'NG TO OWNER: ANY DAY!W'NTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARECONSit`ERED IMPROPER PAYME141,'- UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE
JOB SITi BEFORE THE FIRST WSPECTION. IF YOU,INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTOPNEYBEFORE :OMMENCING WORK 011; RE sORDING YOUR NOTICE OF COMMENCEMENT.
1'
Snanatu wner or Lessee, or Owner's or Lossee's (Fri Name and Provide Signatory's Title/Office) twthorized Officer/Director/Partner/Manager, /
State of an ou County of._ " rn••C C•
The foregoing instrument was acknowledged before me this V c1! day of 20 l
bye r.- J3a' Who ' ersonaliy kno tome ORNameofersonmakingstaterrent
who has produced identification type of identification produced:
GA': ZtTHOMAS
MY COMMR-ION # GG 0839 5
EXPIRES'.:,ine28 20211j
Q• Bonded Tteu Nots, 'P•.tsiic uneer R r?
Notary Signature
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