1505 W 25 St; 18-3801; ROOFSSEP052018
e °a CITY OF
y ' ` - ......... PERMIT' APPLICATION
frY,;s
7;-BUILDING DIVISION
f Application No:
i ocumenied Construction value: $
0
Job Address: 1. QS• wez—r Sf f'' ; l[, 3Zq4i Historic District:- Yes No
Parcel ID: 02.- 70-30 • Sbk - 04w - Drzp Residential Commercial
Type ofWork: New Addition Alteration Repair Demo[] Change of Use Mdove
Description of Work: P-G O-O F
Plan Review Contact Person:
Phone: Fag: Email:
Title:
Property Owner InformationRPSroan.t G t oi tt
Name Stir, t r.,l Ro ,4 --6 UC - Phone: Street:
3i3z.A- lZov-,46 SI Sri joz ; Resident of property?: City,
State Zip: 109 -K z- Contractor
Information Name !
Q (f Phone: ?2ZJ03 Street: _
l o 6 ra, c-P,Mcr Fax: City,
State Zip: GO LC. 3,f 3-Igr, State License No.: ACC. B Z Gi 4 06 Name:
Street:
City,
St, Zip: Bonding
Company: Address:
Architeaffingineer
information Phone:
Fax:
E-
mail: Mortgage
Lender: _ Address.
WARNING
TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEAU NT MAY RESULT IN YOURPAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED
ON THE JOB SITE BEFORE THE FIRST INSPECTIOM IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOURNOTICE 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 tins jurisdiction. I understand that
a separate permit must be secured for electrical work, plumbing, signs, *yells, 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 ofthat date:6`s Edition (2017) Florida Building Code
NOTICE: Inaddition to the requirements of this permit, there may be additional restrictions applicable to this property that maybe 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 ofpermit is verification that I will notifythe owner of the property of the requirements ofFlorida Lien Law, FS 713.
The City ofSanford requires payment of a plan review fee at the time of permit sub,-nittal. 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 ofsubmittal. The actual construction value
willbe figured based on thecurrent ICC Valuation Table in effect at the time the permit is issued, inaccordance withlocal ordinance. Shouldcalculated
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 rn Hance with all applicable laws regulating con:slru n zoning.
t (?5 -I s
fOwncr/Agent Date Signatareot ontmctor/Agent Date
L.PCf Qt l ' S
PrintOwner/Agent'sName Print Con aor/Age is Na
Signature ofNotaty-State of Florida %1jTARYPUBIIC Signature ofA ary-State
MARCELLA SOARESOFFLORIDA
ommisston N FF 189633FF9T5f315y Pc My Commission Expires
E{xpt r s 3/28/2020 %?
Owner/Agent is Personally Known o 1 e or Contractor/Agent i VnlA,9@ b4
Produced ID - Type of ID &- 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- Etectric - # of Amps Plumbing - 'of Fixtures
Fire Sprinkler Permit Yes No # of Heats Fire Alarm Permit:- Yes No -
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING: f
COMMENTS: