112 Hidden Arbur Ct - P18-004540 - INTERIOR REPIPEPERMIT APPLICATION
kBUILDING DIVISION
r')fis:718!l Application No: I 7 - q S '
Documented Construction Value: $ ( 00
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Job Address. I ` e N r La C rrSw [ a rd Historic District: Yes No ___
Parcel ID: Residential Commercial
Type of Work: New Addition Alteration Repair P Demo `` Change of Use Move
Description of Work: Kee t p[ mitrl"k 14J d Cola —1 rALI I( vJA,
Plan Review Contact Person: --3 N JJ "J N k Title: Pa rt J
Phone: 10 1416 104 Fa7.x• Email:
Property Owner Information
Name r t tk Phone:
Street: 1 ,`, N io i ti G ` Resident ofproperty?
City, State Zip: SkS14 L
Contractor Information -
Name
Street:-
City, State Zip: L
Phone:
Fax: ... _ .
State License No.: (-((- 0 S l Y11
Architect/Engineer Information
Name: `,U IL
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 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 ofa permit and that all workwill 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, fur aces, boilers, heaters, tanks, and air conditioners,
etc. An' 1 1 1 L
11-
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 6`h Edition (2017) Florida Building Code
IF
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NOTICE: In addition to the requirements of this permit, there maybe 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 isverification 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 ofpermit submittal. A copy ofthe executed contract is required in order to
calculate a plan reviewcharge and willbe considered the estimated construction valueofthe job at the time ofsubmittal. Theactual 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 a d that all work will be
done in compliance with all applicablelaws regulating construction and zoning.
Signature ofOwner/Agent Date Signature Contractor/Age , Date
Print Owner/Agent'sName
Signature ofNotary -State ofFlorida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Print Contractor/Agent's Name
522 11. • cs ,
Signature ofNotary' I rida Date
DEBBIE BLANTON -,
tAY COMMISSION # FF 178648aEXPIRES: February 25, 2019i' OF i P•
Contractor/A F° n t e or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical 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 # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE-,
Fire Alarm Permit: Yes No
WASTEWATER.
BUILDING: