1505 W 25 St; 18-3800; ROOFSEPG52018
b
CITY OF
y ?- ti-- KANFOPERMIT APPLICATION
BUILDING DIVISION
App catx® N®:
36 ocumented Construction value: $ q
Job Address: Itog WEI-r rN sr . , l[, 3z,?- i Historic District: Yes No
Parcel ID: 02-- 70-3e- Sbk - 04w - ecr-0 Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: a6 C-O F Sr( i.1G /C(•
Plan Review Contact Person:
Phone: Fax: Email:
pP Sroa: '7c1G Poi;q c' izx, Property Owner Im`ormation
Name V11 R? ;,A re Li C- Phone: —
Title:
Street: 3&,A- Resident of property?
City, State Zip: _%iie hr fr +yy' /0") SZ-
Contractor Info rmation
Name Phone: Zz o3
Street: 162fo PDbex4--1(_ Pax:
City, State Zip: (,t) W 3`f 3,3W State License No.: C!CG 13 Z4i4 (DO
Name:
Street: -
City, St, Zip:
Bonding Company:
Address:
Architectffingineer Information
Phone:
Iax -. -
E-mail:
Mortgage Lender: _
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COINDU NCMUNT MAYRESQLT 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 COM-MENCEMENT
Application is hereby made to obtain apermit 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 aII 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 woxr, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners,
etc
FBC 105.3 Shall be inscribed with the date ofapplication and the code in effect as of that date: Wh Edition (2017) Florida Building Code
NOTICE: In addition to the requirements ofthis permit, there maybe additional restrictions applicable to this property that maybe found in thepublic
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 ofpermit is verification that I will notify, the owner ofthe property ofthe requirements ofFlorida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permait submittal. A Copy of the executed Co:.<ioct is required in order to
calculate aplan review charge and will be considered the estimated construction value ofthe job atthe time ofsubmittal. 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 offthe executed contract exceed the actual construction value, credit will be applied to your permit fees when the permit is issued.
OWNER'S AFMAVIT: I certify that all of the foregoing information is accurate and that all work will be
done in mpliance with all applicable laws regulating con:siru ' n zoning.
fOwner/Agent Date Signatur . ontractor/Agent Date
17 i or: 1/9/I o)l? D 1 /7
Print Owner/Agent's Name Print
oho -ti3
Signature ofNotary -State ofFlorida Signature ofAwry -State rP
TARY PUBUC ,,,,,,,,
OF FLORIDA •... MARCELLA SOARES
ommisston # FF 189633vicnow, FF975815 =• •-
3/28/2020y, 4ocMy Commission Expires4?
OwnerlAgent is Personally o"'or Contractor/Agent init•I'I@ bf
Produced ID Type of ID Q— Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical 01 Plumbing Gas Roof
Construction Type: Occupancy Use:
Total Sq Ft ofBldg: Min. Occupancy Load:
Flood Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - `of Fixtures
Fire Sprinkler Permit: -Yes - No # ofHeads Fire Alarm Permit: Yes No - -
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES: . WASTE WATER: