278 Venetian Bay Cir 12-2444 (water htr)Application No: 1 � a � 7
Job Address:
Parcel ZD:
Description of Work, �(,,.
Plan Review Contact Person:
Phone:
Fax:
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Documented Construction. Value:
�� Cl Historic District: Yes ❑ No
/t✓ Zoning:
E-mail:
Title:
Property Owner Information
Name �� S ao k.. Phone: U b`l ' 3� I— � 33b
Street: � f'l �,{j2 , - Resident of property?
City, State zip: _.✓� 7 Dre . �7
� (�' Contractor Information z/0
Name l J �L i� �{ I'1 Phone: �7�a �fd
Street: Pf /
�✓ Fax: 471) ~
City, State zip: 324-Y" State License No.: �le /Vo? ?1,61
Name:
Street:
City, St, Zip: _
Architect/Engineer Information
Phone-
hone=
Fax-
Fax:
E-mail:
E-mail:
Bonding Company: Mortgage Lender:
Address: Address:
PERMIT INFORMATION
Building Permit ❑
Square Footage: Construction Type: No. of Stories:
No. of Dwelling Units: Flood Zone:
Electrical ❑
New Service — No. of AMPS:
Mechanical 171 (Duct layout requixed for new systems)
Plwmbin&A—
New Construction - No. of Fixtures:
Fire Spriuld,ear/AJarm 13 No. of beads:
,�O
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,
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with aliapplicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTI.CE 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.
J�TOTICE: 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. A, copy of the executed contract is required in. order
to calculate a plan review change. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels_ Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released. „
Signature o.' Dwner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.43
Print n ctor/Agcttt's'Name
� aha
Signatu f o - tatcofFlorida Date
a
,y Ci,tFFDRt) t • �NT£CCHIO
61r C15iA ISSkH � #M4604
EXMM: AV, 13, 2016
�Bonded ittrou9A Tsi 9tafe Inautt�t:9
Contractor Agent is - ersona.uy Known to Me, or
Produced ID Type of ID
UTILITIES: WASTE 'WATER:
FIRE:
]BUILDING,
RECEIVED 09/12/2012 09:49
09/12/2012 WED H750 FAX 407 677 3027 SearaCSG CUStamerSerViCe M001/002
Page: 1 Document Name: untitled
NPOS714 Item Detail Display 09/12/12 09:33:18
SC# 015552469565
Name: VANFRANK, PHYLLIS H: 407-321-8330 W: 407-321-8330
Salec Date : 06/1./12 Sale Amount: 859.97 Total ,Amount: 866.27
Time of Sale: 16:49:11 Reductions .00 Tax Amount . 6.30
Transfer to Store: Balance Due : .00
Type aa x by the Division number. Then press the desired Fkey.
4;aD
F3=Exit P4=Comments F5 -Customer F6=Itemhst F7-Skwd F8=Fwd F9=Payhst
F12=Cancel.
Date: 9/12/2012 Time: 9:35:01 AM
Item
Sel Gft Rec Dt Div
Item/Sku
Description
Quantity
Amount
042
32956000
WHIR, 55GL P
0001
419.99
_
070
42574292
5Y HOMEMPA,
0001
104.99
-_ 010
42339187
MI WIC ELE.
0001
299.99
010
42469187
AI WH HAUL
0001
10.00
_
010
99888187
BLDG PERMITS
0001
35.00
4;aD
F3=Exit P4=Comments F5 -Customer F6=Itemhst F7-Skwd F8=Fwd F9=Payhst
F12=Cancel.
Date: 9/12/2012 Time: 9:35:01 AM