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1135 E 7 St - E18-004571 - UPGRADE HEATING & AC CIRCUITSron BUILDING DIVISION 4FS Ia PERMIT APPLICATION qs `7_ Application No: ` ' 09z*_ k f7GI. Documented Construction Value: $ Job Address: Historic District: Yes iqoFL Parcel ID: > " `s L7- () - ©( Residential Commercial Type ofWork: New Addition Alteration Repair Demo Change of Use Move Description of Work: LIP 6Q- ct-- A-e Cl P(y; r-5- Plan Review Contact Person: Title: Phone: Fax: Email: Property Owner Information Name Phone: Street: Resident ofproperty? City, State Zip: Y-\,; n Contractor Information Name %'t'I`S F-c'1,/ L Phone: _ 6 ' C)t%3 Street: ' ,... /'c fi c c / / i Fax: ... _ . City, State Zip: State License No.: Architect/Engineer Information Name: Phone: Street: Fax: City, St, Zip: E-mail. Bonding Company: Mortgage Lender: Address: _ Address: WARNING TO OWNER: YOUR FAILURE TO RECORD ANOTICE 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 heieby made to obtain a permit to do the workand installations is 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. L Z' Ir FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 601 Edition (2017) Florida Buildint Code—, NOTICE: In addition to the requirements ofthis 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 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 I alculate a plan review charge andwillbe considered the estimated construction value of the job atthe -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 ofOwner/Agent Date Signature of Contractor/Agent Date Print Owner/Agents Name Print Contractor/Agents Name Signature ofNotary -State ofFlorida Date Signature ofNotary -State of Florida Date Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced ID Type ofID 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 Sprinlder Permit: Yes No # ofHeads APPROVALS: ZONING: COMMENTS: UTILITIES: ENGINEERING: FIRE: Fire Alarm Permit: Yes No WASTEWATER: BUILDING: l FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 6" Edition (2017) Florida Building Code 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. ofOwner/Agent UC)- V I f Print Owner/Agent's Name Signature of Notary -State of Owner/Agent is Produced ID 46 Signature ofContractor/A ent Date Date Personally Known to Me or Type of ID Print Contractor/Agent's Name Signature ts..ye, DEBBIEBLANTON MY OOh4MISSION t FF 178648 EXPIRES: February 25, 2019 ondoGed Th. Notary Public Under++dters Contrac ersoni Produced ID Type of ID Known to Me or SY Po Notary Public state of Florida Anita C Witherspoon BELOW IS FOR OFFICE USE ONLY y p My Commission FF 236656 Rd' Expires 0610312019 ermits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Total Sq Ft of Bldg: 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: Co(C( c,C-) Fire Alarm Permit: Yes []No WASTE WATER: BUILDING: