1238 Pine Ridge Cir - E17-002911 - WATER HEATER9-0'ti C(
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I -' q 'I I Documented Construction Value: S I ,
Job Address: kQ51 sp f-\Q- RLC Cke— Historic District: Yes 0 No
Zoning:
Description of Work: ,30 90,,, .\ CV2-C
Plan Review Contact: Person: —\A-0, Q-0i
Phone: E&kULc-A\O E-mail: Fax:
Property Owner Information
r Itcklo-411 C-as fy-)
Name f*ksc\\`O' C-Kz'zr\o-c Phone: LAFTI - -i (Da - "5 \ 53
Street: rlZ '!P-QC- 0a y- Resident of property? City,
State Zip: Contractor
Information Name
T-5L 'DCAe-00'rllkca=Q Phone: a\q-()RRO Street: a-
w-e CA Fax: City, State
Zip: State License No.: Arch itect/
E n g ineer Information Name: Phone:
Street: City,
St,
Zip: Bonding Company:
Address: Building
Permit
Square Footage:
Fax: e-
mail:
MortgageLender:
Address: PERMIT
INFORMATION
Construction Type:
o-o. of Stories: No. ot'
Dwelling Units: - Flood Zone: Electrical 0
New Service -
No. of AMPS: Plumbing ( New
Construction -
No. of Fixtures: Mechanical 11 (
Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads:
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
rneet 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.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that al.1 work will
be done in compliance with all applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESU-LTI[N 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 RECORDINC YOUR NOTICE OF COMMENCEMENT.
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 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. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented1
construction value when the executed contract Is submitted, credit will be applied to your pen -nit fees when the
perr-nit is released.
Signature ofOwneriAl-ent Date
tit ONN'tter/AgenlI& Name
Signature of Notary -State of Florida Dale
Owner/Agent is _ Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
COMMENTS:
Rev 11.08
UTILITIES:
ENGINEERING: FIRE:
Signature of Co uric dditg Dale
T C_"
Print CortractoriAgent's Nlame
t21
Signature ofNotary-State of lorid3 Date
SHANNON E. BYRNEI
MY COMMISSION GG 132457
EXPIRES: August 7, 2021
Bonded Thru Notary Public UndeAfftrs
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
b7'
2
AMQuoteBuilder-__
Customer: PRISCILLA GROETZNER Customer#: 68276 Quote M 201644
Reference: Install Date:
Installation Address: Bill -to Address:
PRISCILLA GROETZNER PRISCILLA GROETZNER
1238 S PINE RIDGE CIR 23528 COMPANERO DR
Sanford, FL 32773 SORRENTO, FL 32776 US
407-702-5153
Item # Item Description Qty Price SubTotal Total
TK-049 SF I Installation Kit - Electric 1 206.00 206:00
TK-147 Service Fee 1 S36.00 36:00
TK-014 New Install 1 28828 S288,28
TK-058 Location fee - Third Floor 1 120.00 120.00
TK-123 Expansion Device 1 85,00 85,00
PERM-06 Permit for Electric Tank Water Heater 1 67:00 67,00
PERMA 1 Permit Processing Fee 1 50,00 W, 00
TK-004 Access Fee - Confined Location 1 11.00 OLO
TK-094 Reppe 1 75,00 75.00
1001300476 30 EEG SHORT 4500 W {XE30S06ST45U1 RHEEM 1 389.02 389,02
Non Taxable Total: S1,316,30
Taxable,item Total! S0,00
Sales Tax @ 6,000%: S0.00
Markup Anit 0,00
Total: 1,31630
IY
OF
SXNFORD
FIRE DEPARTM!!rNT
PERMIT NO. I Is 40L "I I L ISSUE DAT
CONTRACTORT-1—Q a1cx
JOB ADDRESS: -)L38 So
I4%
O
TYPE OF WORK:-----jw0m%w ena, ejc
Building & Fire Prevention Division
Residential Permit Card
kNitA
it
reclace neKE
Post this permit in a conspicuous location outside
Approved plans must be posted with permit for inspection
Leave all work uncovered until inspected and approved
Permit expires 6 months from date of issue or last approved inspection
PROTECT FROM WEATHER
BUILDING
INSPECTION TYPE APPROVED REJECTED INSPECTOR
ELECTRICAL
INSPECTION TYPE APPROVED REJECTED INSPECTOR
FOOTER INSPECTION ELECTRIC UNDERGROUND
STEMWALL FOOTER/SLAB STEEL BOND
FORMBOARD SURVEY T.U.G. / PRE POWER
SLAB / MONO -SLAB ELECTRIC ROUGH
LINTEL / TIE BEAM ELECTRIC FINAL
SHEATHING - ROOF MECHANICAL
INSPECTION TYPE APPROVED REJECTED INSPECTORSHEATHING - WALLS
FRAME MECHANICAL ROUGH
INSULATION ROUGH IN MECHANICAL FINAL
DRYWALUSHEETROCK PLUMBING
INSPEC77ON TYPE APPROVED REJECTED INSPECTORLATHINSPECTION
FINAL STUCCO/SIDING UNDERGROUND ROUGH
FIREWALL SCREW TUB SET
FIREWALL FINAL SEWER
INSULATION FINAL PLUMBING FINAL
FINAL SFR GAS INSPECTIONS
INSPEC77ON TIDE APPROVED REJECTED INSPECTORROOF
INSPEC77ON TYPE APPROVED REJECTED INSPECTOR GAS UNDERGROUND PIPE
ROOF DRY -IN GAS ROUGH -IN
FINAL ROOF GAS FINAL
MISCELLANEOUS FINAL INSPECTIONS
INSPEC77ON TYPE APPROVED REJECTED INSPECTOR INSPEC77ON TYPE APPROVED REJECTED INSPECTOR
PRE -DEMO FINAL DOOR
FINAL DEMO FINAL WINDOW
FINAL SOLAR PANELS IRRIGATION FINAL
FINAL POOL SCREEN FINAL SCREEN ROOM
FINAL UTILITY BUILDING FINAL BUILDING (OTHER)
MOBILE HOME TIE -DOWN MOBILE HOME FINAL
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.
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 FBCI05.3.3
REVISED: 4-17 Inspection Line: 407.792.6069 or 855.541.2112