1101 Pine Ave BR17-3161 - INTERIOR REPAIRS0)D
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: CC ,
Documented Construction Value: $ 375,000
Job Address: 1101 Pine Avenue Historic District: Yes No
Parcel ID: Residential Commercial
Type of Work: New Addition Alteration X Repair Demo Change of Use Move
Description of Work: Repair/Replace foundation columns, floor joists, wood siding.
Repair Electric and Plumbing per Plans
Plan Review Contact Person: Roderick Waller Title: CEO
Phone: 772-201-2850 Fax: 772-907-0420 Email:rodwallerl@gmail.com
Property Owner Information
Name Community Improvement Association Phone:
Street: 1101 Pine Avenue
City, State Zip: Sanford FL 32771
Name Sunrise City CHDO, Inc
Resident of property? : NO
Contractor Information
Street: 800 Virginia Ave Suite 61
City, State Zip: Fort Pierce FL 34982
Name: CPH, Inc
Street: 500 West Fulton Street
City, St, Zip: Sanford FL 32771
Bonding Company:
Address:
Phone: 772-201-2850
Fax: 772-907-0420
State License No.: CGC1515114
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. 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: 5ch Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
r
r
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 at the time ofpermit 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.
2e4___ 1 ho v• i-1SignatureofOwner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name Print Contrac /Agent's
r
Signature of Notary -State of Florida Date Signature &Notary-S e of St fl1A FtARRlSF" MY CONINI& 7,7003 I
3' EXPIRFGFF ••
407) 398-0153 Floridalloter jErvk, _o:;,
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Type of M Produced M T @ _ enouie HARRISp
MY COn14n.iSSn> FF99709:
I'
OFF EXPIRESA\4ay 30, 2020
407)398-0153 ritlallolarServ".com BELOW
IS FOR OFFICE USE ONL Flo
Permits
Required: Building Electrical Mechanical Plumbing Gas Roof Construction
Type: Occupancy Use: Flood Zone: Total
Sq Ft of Bldg: Min. Occupancy Load: # 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: BUILDING: COMMENTS:
Revised:
June 30, 2015 Permit Application
Job Address: 1101 Pine Avenue
CITY OF SANFORD
NOV 2 9 2017 BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: — (D
T
Documented Construction Value: S 1,800
Historic District: Yes No
Parcel ID: Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: Repair Plumbing Drain Line and Run Water Supply to New Bathroom
Plan Review Contact Person: Roderick Waller
Phone: 772-201-2850 Fax: 772-907-0420
Title: CEO
Email:rodwallerl@gmail.com
Property Owner Information
Name Community Improvement Association Phone:
Street: 1101 Pine Avenue
City, State Zip: Sanford FL 32771
Name Cavalier Plumbing Inc
Street: 2993 SE Orange Tree Place
City, State Zip: Stuart FL 34997
Name: CPH, Inc
Street: 500 West Fulton Street
City, St, Zip: Sanford FL 32771
Bonding Company:
Address:
Resident of property? : NO
Contractor Information
Phone: 954-934-4056
Fax: 772-907-0420
State License No.: CFC1426743
Arch itectlEngineer 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. 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: 5" Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
r
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 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 of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
I
t G 11 /21 /2017
Signature of ttractor/Agent Date
Eric Fos er
Print Contractor/Agent's Name
11 /21 /2017
Signature ofNotary St t"b ytortda SOPHIA INARRISr':
MY COMMISSION # FF997093
ri EXPIRES May 30.2020
401) 398-0153 F4wi6aNatarr5ervae.rom
Contractor/Agent is Iy ] Personally Known to Me or Produced
ID Type of ID BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building Electrical Mechanical Plumbing Gas Roof Construction
Type: Occupancy Use: Flood Zone: Total
Sq Ft of Bldg: Min. Occupancy Load: # 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 30, 2015 Permit Application
40 Sunrise City CHDO
PO Box 3582
Fort Pierce, FL 34948
Description
1101 Pine Avenue
Install Plumbing to ne\v bathroom
Misc Plumbing Repair,
AUTHORIZED SIGNATURE
RODERICK WALLER CEO
DATE 09-22-2015
f c (-') 'k-a"
ACCEPTANCE OF PROPOSAL
TIIE ABOVE PRICES, SPECIFICATIONS AND CONDITIONS
ARE HEREBY ACCEPTED.
CUSTOMER SIGNATURE
4 {
tpI
l_
Estimate
Date Estimate #
9/6/2016 5954
Project
OtY Rate Total
1 1,800.00
0.00 0.00
I
Total
t ,8woo
tr CITY OF SANFORDV03DECDIN"G & FIRE PREVENTION
PERMIT APPLICATION
I
x
Application No:
soDocumentedConstructionValue: $ I°
Job Address: l C) I 1 I K) T-CJG .'a- -Historic District: Yes N No
Parcel ID: Residential Commercial
Type of Work: NcwW Addition Alteration Repair Demo Change of Use Move
Description of Work: 1 N -'57I-
2 f G u ,i 5
Plan Review Contact Person: Title
Phone: Fax: Email:
Name
Street:
City', State Zip:
Property Owner Information
Phone:
Resident of property?
Contractor Information
Name t A] /1'7'1 4_/f"2z PK1 JJ Dr_'2 Phone: H CQ D S-E S
Street: 0 IA t i ! r e c[57 Fax:
City, State Zip: 1,' (_ ; State License No.:
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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 ANDPOSTEDON 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 commencedpriortotheissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructionin
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 he inscribed with the date of application and the code in effect as of that date: St" Edition (2014) Florida Building Code Revised:
June 30, 2015 Permit
Application
Bland, Annette
From: arnim@amhelectricaI.com
Sent: Tuesday, December 26, 2017 10:37 PM
To: Building
Subject: AMH Electrical Svcs Contractor Registration / permit form
Attachments: AMH BTR - LICENSE-2018.pdf; City of Sanford- COI.pdf; Sanford - 1101 Pine Ave
Apppication.pdf; Sunrise City- 1101 Pine Ave.docx
good morning attached are the documents for my registration
Is anything else needed
Regards
Arnim M Hernandez
President
AMH Electrical Services LLC
Maitland Fl
State Cert: EC-13006840
T- 407-790-5585
F- 321-972-5750