3430 Windleshore Way - P18-004607 - WATER HEATERR asCITY OF
SkNFORD Buildhig & Fire Preventioit Division
PERMIT APPLICATION
Application No: I 0 ' w p ()
Documented Construction Value: $ 1139
Job Address: 3430 WINDLESHORE WAY Historic District: Yes NoF]
Parcel ID: 12-20-30-514-0000-1440 Residential Commercial
Type of Work: Nerv Addition Alteration Repair Demo Change of Use Move
Description of Work: 40 GAL ELEC WATER HEATER REPLACEMENT
Plan Review Contact Person: SHANNON BYRNE
Phone: 866-219-0880 Fax:866-219-0729
Title: PERMITTING
Email: FLPERMITS@DELTAMECHANICAL.COM
Property Owner Information
Name RUBINO FAMILY LP
Street: 3430 WINDLESHORE WAY
City, State Zip: SANFORD,FL 32773
Ilona,-buk` 6- e,. -
Name DIMITRE BOBEV
Phone: 407-970-9315
Resident of property? :
Contractor Information
Street: 8402 LAUREL FAIR CIR SUITE 111
City, State Zip:
Name:
Street:
City, St, Zip: _
TAMPA, FL 33610
Bonding Company:
Address:
Phone: 866-219-0880
Fax: 866-219-0729
State License No.: CFC1425917
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
PAYING TRICE 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 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.
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 611 Edition (2017) Florida Building Code
Revised: January 1, 2018 Permit Application
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 ofthis 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 ofpermit 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 ofthe 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 c nstruction and zoning.
r
1" I "7-6-7-OU9
signature of OKiier/Agent Date Signature of Conlmctor/Agent Date
Print Owner/Agent's Name
Signature ofNotary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
06, fte, & ben
Print Contractor/Agent's Name
t /_ ZG— ZOE-
EMILY H. MEDINA
MYCOMMISSION # GO 227056
EXPIRES: June 11, 2022
Bmdw Matt Rotary Public thu0et>t bm
Contractor/Agent is _-Z Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbingo 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 Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Revised: January 1, 2018 Permit Application