111 Lee Ave 101 - M17-003258 - HVACAW ti .1%
tiov 6 20V
CITY OF SANFORD
BUILDING & FIRE PREVENTION
IM PERMIT APPLICATION
Application No: J -- J 2)
Documented Construction Value: S
Job Address: Q '41 D I Historic District: Yes No
Parcel ID: — L - 7j 50 (_ D A00 _ Residential 9 Commercial
Type of Work: New Addition Alteration Repair Z' Demo Change of Use MoveET Description
of Work: ar o n Ct i Plan
Review Contact Person: ( Title: Phone:
Fax: Email: Property
Owner Information Name
iA}(t IC`P' t
1
lr'L Phone: Street:
Iwo 6 Pt_ Resident of property? rtyCity,
State Zip:Q({}C( Contractor
Information Name ]
ro T-C' C h k Phone: _ _ - -'D-7- _1 9 --I e Street: (
1I Fax: City,
State Zip:(or Q , o( State License No.: 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 PAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION. 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 commencedpriortotheissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, beaters, 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
a
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that noworkorinstallationhascommencedpriortotheissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate permitmustbesecuredforelectricalwork, 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 all 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
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.
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 documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Signattue ofContractor/Agent Date /D /may
Print ContraetprdAgent's Name
t_
Date
LORI LOCKHART
MY COMMISSION # GG 008697
1!*A:: EXPIRES: July 5, 2020
ffoP Bonded Thru Notary Public Underwriters
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER.
BUILDING:
Rev 11.08
Building & Fire Prevention Division
Residential Permit Card
PERMIT NO. ' • 3 4259 ISSUE DATE: 114 71, 11
CONTRACTOR:
JOB ADDRESS: I % t L
TYPE OF WORK: A IC. G1 0
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
N TYPE APPROVED REJECTED INSPECTORFELECTRICFOOTERINSPECTIONUNDERGROUND
STEMWALL 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
DRYWALL/SHEETROCK 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
INSPECTION TYPE APPROVED REJECTED INSPECTORROOF
INSPECTION TYPE APPROVED REJECTED INSPF_C'T'OR GAS UNDERGROUND PIPE
ROOF DRY -IN GAS ROUGH -IN
FINAL ROOF GAS FINAL
MISCELLANEOUS / FINAL INSPECTIONS
INSPECTION TYPE APPROVED REJECTED INSPEC'T'OR INSPECTION TYPE APPROVED REJECTED INSPECTOR
FINAL DEMO FINAL DOOR
FINAL SOLAR PANELS FINAL WINDOW
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 FBC105.3.3
REVISED: 4-17 Inspection Line: 407.792.6069 or 855.541.2112