110 Keyes Ct - 97-000949 (1997) (INTERIOR OFFICE REMODEL) DOCUMENTSSUBDIVISION:
ZONE I DATE oZ
CONTRACTOR (It CAC& &) X- A• ACft YYL)
PERMIT* # `1 /-`'l 7` LOT NO.
j I JOB
BLOCK:
ADDRESS - `
SECTION:
PHONE # 03'- COST
S6SQUAREFEET:
LOCATION 2L0
FEES MODEL:
OWNEK*'.L
STATE NO. OCCUPANCY CLASS:
ADDRESS
PHONE #
9 l -'i5 7 PLUMBING CONTRACTOR k U-
ADDRESS
PHONE #
f - -( 6oLELECTRICAL CONTRACTOR
ADDRESS
PHONE #
ECHANICAL CONTRACTOR
v
AOD RESS
PHONE #
MISCELLANEOUS CONTRACTOR
ADDRESS
SEPTIC TANK PERMIT NO.
SOIL TEST REQUIREMENTS
FINISHED FLOOR
ELEVATION REQUIREMENTS
ARCHITECTURAL APPROVAL DATE
FEE S31 FEE
S FEE
S ` INSPECTIONS
I TYPEDATEOKREJECTBYa-
11
a
FEES
ENERGY SECT. EPI: I
C
CERTIFICATE
OF O CUP NCY $I ISSUED #
DATE: _ FINAL
DATE
k
DAT+TARTED: <: {
CITY O SANFORD. FLORIDA
Request for Final Inspection fo":
Certlf ea .-at-Vtcupancy
OR
The Building department has prepared a certificate of occupancy fortheabovelocationandisrequestingafinalinspectionbyyourdepartment.
After your inspection, please come to the Building Department to
sign -off on the Certificate of occupancy, or submit a certificateofoccupancyaddendumifithasbeendenied.
Your prompt attention will be appreciated. Thank you.
DISTRIBUTION: Engineering Department Ll_
Fire
Public Works
Utilities/Cross Connection
Zoning
v'
glq
DATE STARTED:
CITY 00 SANFORD. FLORIDA
Requo'st for Final Inspection for:
Cerffflcalq,f= ccupancy
ADDRESS . D
12-- ZO - 30 -.510 -- 0000 - 0//0
The Building Department has prepared a certificate of occupancy fortheabovelocationandisrequestingafinalinspectionbyyourdepartment.
After your inspection, please come to the Building Department to
sign -off on the certificate of Occupancy, or submit a certificateofoccupancyaddendumifithasbeendenied.
Your prompt attention will be appreciated. Thank you.
DISTRIBUTION: Engineering Department
Fire
Public Works
Utilities/Cross
Zoning
Connection,,,-''
C
k
i
DATE?STARTED: cam'
7
CITY OF SANFORD. FLORIDA
Request for Final inspection for'
C0rtf.JcaU':4f: ocupancy
ADDRESS:.
The Building Department has prdpared a certificate of occupancy fortheabovelocationandisrequestingafinalinspectionbyyourdepartment.
After your inspection, please come to the Building Department to
sign -off on the Certificate of Occupancy, or submit a certificateofoccupancyaddendumifithasbeendenied.
Your prompt attention will be appreciated. Thank you.
DISTRIBUTION: Engineering Department
Fire
Public Works
Utilities/Cross Conne io
Zoning
4
I
i
DATE STARTED: 5T +
CI7Y 0F SANFORD. FLORIDA
Re>Iuest for FInni Inspection for.
CerfinfI. ncupancy
ADDAEAS!;
The Building Department has prApared a
the a%ove location and is requestingdepartment.
Af t
certificate of occupancy for
a final inspection by your
er your inspection, please come to the Building Department tosign -off on the Certificate of Occupancy, or submit a certificateofoccupancyaddendumifithasbeendenied.
Your prompt attention will be appreciated. Thank you.
DISTRIBUTION: Engineeng Department
Fire :
Public Works
Utilities/Cross Connection
Zoning
ADDRESS:.
DATE+STARTED:
F
My OP SAMRD. FLORIDA
Requast for Finai Inspection for'..
carfif1P-W',.=: ccup ancy
o 1<, Z'
The Building Department has prepared a certificate of occupancy fortheabovelocationandisrequestingafinalinspectionbyyourdepartment.
After your inspection, please come to the Building Department tosign -off on the Certificate of Occupancy, or submit a certificateofoccupancyaddendumifithasbeendenied.
12-
Your prompt attention will be appreciated. Thank you.
q:v_,V-'2_JD .3 L (z) UDC)C_)CA 0
DISTRIBUTION: Engineering Department
Fire
Public Works
STRUCTURAL STEEL CERTIFICATION AFFIDAVIT
STATE OF FLORIDA
SEMINOLE COUNTY
REFERENCE ADDRESS:110 Keyes Court - Sanford, Florida
I, Brian J. Flynn , DO SOLEMNLY SWEAR
THAT I AM A STATE OF FLORIDA REGISTERED ENGINEER. I HEREBY CERTIFY
THAT THE STRUCTURAL STEEL ERECTED IS IN CONFORMITY WITH THE
APPROVED PLANS AND WITH THE STRUCTURAL PROVISIONS OF THE TECHNICAL
CODES.
AYFIX, SEAL HERE)
Brian J. Flynn N
NAME OF ARCHITECT/ENGINEER PRINTED
Personally appeared before me, the undersigned authority,
who, after being duly sworn by me say
on oath that they have read the foregoing, and that the matters and
things contained herein are true and correct.
Subscr 'bed and sworn to ( r affirmed) before me this _ day
of Zl , 19 , who is personally known to me or
has produced (type o i ication).
State of Florida + ukKP Nr- M DEHAVEN
My Comm Exp. 7126MIlkBWdedSySmiteMsrueua
No.CC672778
i Penmwky 14wnn+ (( 0k%v 1. 0
Name of Notary typed, printed or stamped
CITY OF SANFORD, FLORIDA
PERMIT NO. Cl')' C ( y DATE 1/1-7/1-7
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO INSTALL THE
FOLLOWING H.A.R.V. MECHANICAL EQUIPMENT:
OWNER'S NAME KayES A..<L5r::: 1 j4AN ?- ADDRESS
OF JOB 110 KF- y E_5 < T. MECHANICALCONTR.
5T's4AJ6A-(t13 '414, RESIDENTIAL COMMERCIAL
Subject to
rules and regulations of Sanford mechanical code. rL ff
V,4 G_- ' v 3 `
7-
a N :5 b tr ; -r- s v 6 n — FUEL B.
T.
U. -'54p VC INPUT -OUTPUT - VALUATION APPLICATION
FEE
j TOT, Master
Mechanical
COMPETENCY CARD
NO.
41
9! - . q, Jac Q t a/)
Whole Building Performance Method for Commercial Buildings
ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
Florida Department of Community Affairs
FLA/COM-94 Version 2.1
PROJECT NAME Acousti-Fab
ADDRESS: 'Keyes Ct. Sanford
OWNER: _Keyes Asset Management
AGENT:
S h 4ed
Form 400A-94
PERMITTING OFFICE:
Sanford
CLIMATE ZONE: 5
PERMIT NO: sD
JURISDICTION N0: 691500
BUILDING TYPE: _Business (Office)
CONSTRUCTION CONDITION: Existing Building
DESIGN COMPLETION: _Renovation
CONDITIONED FLOOR AREA': _1040 NUMBER OF ZONES: 1
MAX. TONNAGE OF EQUIPMENT PER SYSTEM: 3
COMPLIANCE CALCULATION:
METHOD A DESIGN CRITERIA RESULT
A. WHOLE BUILDING 89.49 100.00 PASSES
PRESCRIPTIVE REQUIREMENTS:
LIGHTING
EXTERIOR.LIGHTING 60.00 400.00 PASSES
LIGHTING CONTROL REQUIREMENTS PASSES
HVAC EQUIPMENT
COOLING EQUIPMENT
1. EER 11.00 9.90 PASSES
IPLV 12.00 11.00 PASSES
HEATING EQUIPMENT
1. Et 0.00 N/A
AIR DISTRIBUTION.SYSTEM INSULATION LEVEL
1. Ventilated 6.00 6.00 PASSES
WATER HEATING EQUIPMENT
PIPING INSULATION REQUIREMENTS
COMPLIANCE CERTIFICATION:
I hereby certify that the plans and
specifications covered by this calcu-
lation are In compliance with the
Florida Energy ' :d;,;;
en CoAPREPAREDBY:-,
DATE: r
I hereby certify that this building is
in compliance with the Florida nergy
Efficiency Code'.
OWNER/AGENT,;
DATE: -;0
Review of the plans and specifica-
tions covered by this calculation
indicates compliance with the
Florida Energy Efficiency Code.
more construction is completed,
this building will be inspected
for compliance in accordance with
Section 553.908, Florida Statutes.
BUILDING OFFICIAL:
DATE:
I hereby certify(*) that the system design is in compliance with the Florida
Energy Efficiency Code.
SYSTEM DESIGNER REGISTRATION/STATE
ARCHITECT
MECHANICAL:
PLUMBING :
ELECTRICAL:
LIGHTING :
Signature is required where Florida law requires design to be performed
by registered design professionals. Typed names and registration numbers may
be used where all relevant information is contained on signed/sealed plans.
BUILDING INFORMATION COMPLIANCE
CHECK
401------- GLAZING --ZONE 1------------------------------------------------ v-
Elevation Type U SC VLT Shading Area(Sgft)0
0
East Commercial 1.31 .01 .01 Continuous Ove 1050
South Commercial 1.31 .01 .01 Continuous Ove 450
North Commercial 1.31 .01 .01 Continuous Ove 450
Total Glass Area in Zone 1 = 1950
Total Glass Area = 1950
402.------WALLS--ZONE 1------------------------------------------------ 0---
Elevation Type U Added R Gross(Sgft)°
0
North Metal Curtain Wall + With Air Sp 0.230 4.2 1200
East Metal Curtain Wall + With Air Sp 0.230 4.2 5200
South Metal Curtain Wall + With Air Sp 0.230 4.2 1200
West Frame Wall + 3" InS. 0.081 11 5200
Total Wall Area in Zone 1 = 12800
Total Gross Wall Area = 12800
403.------DOORS--ZONE 1------------------------------------------------ 0---
Elevation Type U Area(Sgft)°
0
East .25 GLASS 1.00 420
Total Door Area in Zone 1 = 420
Total Door Area = 420
404.------ROOFS--ZONE 1------------------------------------------------ 0---
Type Color U Added R Area(Sgft)°
Steel Sheet with 1" Insulation Light 0.213 11 10400
Total Roof Area in Zone 1 = 10400
Total Roof Area = 10400
405------- FLOORS -ZONE 1------------------------------------------------ 0---
Type R Area(Sgft)d
0
Slab on Grade/Uninsulated 0 10400
Total Floor Area in Zone 1 = 10400
Total Floor Area = 10400
406.------INFILTRATION -------------------------------------------------- 0---
CHECK°
Infiltration Criteria in 406.1.ABC.1 have been met. 0 0
407------- COOLING SYSTEMS ----------------------------------------------- 0---
Type No Efficiency IPLV Tons°
0
1. Air Cooled 1 11 12 3.000
408.------HEATING SYSTEMS -----------------------------------------------0-.:_
Type No Efficiency BTU/hr0
0
1. Electric Resistance 1 0 100000
409. VENTILATION ---------------------------------------------------- 0---
CHECK°
Ventilation Criteria in 409.1.ABC.1 have been met. 0 °
410.-----AIR DISTRIBUTION SYSTEM ---------------------------------------- 0---
AHU Type Duct Location R-value°
0
1. Constant Volume Ventilated 60
411.-----PUMPS AND PIPING -ZONE 1--------------------------------------- 0---
Type R-value/in Diameter Thickness°
0
412------ WATER HEATING SYSTEMS -ZONE 1---------------------------------- 0---
Type Efficiency StandbyLoss InputRate Gallons*
0
413.-----ELECTRICAL POWER DISTRIBUTION ---------------------------------- '0---
CHECK°
Metering criteria in 413.1.ABC.1 have been met. 0 0
Transformer criteria in 413.1.ABC.2 have been met. 0 0
414.-----MOTORS --------------------------------------------------- 0----- 0---
motor efficiencies in 414.1.ABC.1 have been met. 0 0
415------ LIGHTING SYSTEMS -ZONE 1--------------------------------------- 0---
Space Type No Control Type 1 No Control Type 2 No Watts Area(Sgft)°
0
Reading, T 1 On/Off 3 400 10400
Total Watts for Zone 1 - 4000
Total Area for Zone 1 - 10400
Total Watts - 4000
Total Area - 10400
CHECK°
Lighting criteria in 415.1.ABC have been met. 0 0
0-----0---
16. HVAC load sizing has been performed. (407.1.ABC.1) 0 0
0-----0---
17. Duct sizing and design have been performed. (410.1.ABC.1.2) ° 0
0-----0---
18. Testing and balancing will be performed. (410.1.ABC.4) 0 0
0 - - - - - 0___
19. Operation/maintenance manual will be provided to owner.(102.1)0 0
Whole Building Performance Method for Commercial Buildings Form 400A-94
ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
Florida Department of Community Affairs
FLA/COM-94 Version 2.1
PROJECT NAME Acousti-Fab PERMITTING OFFICE:
ADDRESS: to_Keyes Ct. Sanford Sanford
CLIMATE ZONE: 5
OWNER: Keyes Asset Management PERMIT NO: N/A
AGENT: JURISDICTION NO: 691500
BUILDING TYPE: _Business (Office)
CONSTRUCTION CONDITION: Existing Building
DESIGN COMPLETION: _Renovation
CONDITIONED FLOOR AREA:: _1040
MAX. TONNAGE OF EQUIPMENT PER SYSTEM: 3
COMPLIANCE CALCULATION:
NUMBER OF ZONES: 1
METHOD A DESIGN CRITERIA RESULT
A. WHOLE BUILDING 89.49 100.00 PASSES
PRESCRIPTIVE REQUIREMENTS:
LIGHTING
EXTERIOR LIGHTING 60.00 400.00 PASSES
LIGHTING CONTROL REQUIREMENTS PASSES
HVAC EQUIPMENT
COOLING EQUIPMENT
1. EER 11.00 9.90 PASSES
IPLV 12.00 11.00 PASSES
HEATING EQUIPMENT
1. Et 0.00 N/A
AIR DISTRIBUTION.SYSTEM INSULATION LEVEL
1. Ventilated 6.00 6.00 PASSES
WATER HEATING EQUIPMENT
PIPING INSULATION REQUIREMENTS
COMPLIANCE CERTIFICATION:
I hereby certify that the plans and
specifications covered by this calcu-
lation are in compliance with the
Florida Energy cie Code.,
PREPARED BY:
DATE:
I hereby certify that this building is
in compliance with the Florida Energy
Efficiency Code.
OWNER/AGENT:
DATE:
I hereby certify(*) that the
Energy Efficiency Code.
SYSTEM DESIGNER
Review of the plans and specifica-
tions covered by this calculation
indicates compliance with the
Florida Energy Efficiency Code.
Before construction is completed,
this building will be inspected
for compliance in accordance with
Section 553.9081 Flo 'da Statutes.,
BUILDING OFF CIAL :
DATE: / a -
system design is in compliance with the Florida
REGISTRATION/STATE
ARCHITECT
MECHANICAL:
PLUMBING :
ELECTRICAL:
LIGHTING
Signature is required where Florida law requires design to be performed
by registered design professionals. Typed names and registration numbers may
be used where all relevant information is contained on signed/sealed plans.
BUILDING INFORMATION COMPLIANCE
CHECK
401------- GLAZING --ZONE 1------------------------------------------------ v-
Elevation Type U SC VLT Shading Area(Sgft)0
0
East Commercial 1.31 .01 .01 Continuous Ove 1050
South Commercial 1.31 .01 .01 Continuous Ove 450
North Commercial 1.31 .01 .01 Continuous Ove 450
Total Glass Area in Zone 1 = 1950
Total Glass Area = 1950
402------- WALLS --ZONE 1------------------------------------------------ 0---
Elevation Type U Added R Gross(Sgft)O
0
North Metal Curtain Wall + With Air Sp 0.230 5 1200
East Metal Curtain Wall + With Air Sp 0.230 5 5200
South Metal Curtain Wall + With Air Sp 0.230 5 1200
West Frame Wall + 3" InS. 0.081 11 5200
Total Wall Area in Zone 1 = 12800
Total Gross Wall Area = 12800
403.------DOORS--ZONE 1------------------------------------------------ 0---
Elevation Type U Area(Sgft)O
O
East .25 GLASS 1.00 420
Total Door Area in Zone 1 = 420
Total Door Area = 420
404.------ROOFS--ZONE 1------------------------------------------------ 0---
Type Color U Added R Area(Sgft)O
0
Steel Sheet with 1" Insulation Light 0.213 11 10400
Total Roof Area in Zone 1 = 10400
Total Roof Area = 10400
405. FLOORS -ZONE 1------------------------------------------------ 0---
Type R Area(Sgft)d
0
Slab on Grade/Uninsulated 0 10400
Total Floor Area in Zone 1 = 10400
Total Floor Area = 10400
406.------INFILTRATION -------------------------------------------------- 0---
OCHECKO
Infiltration Criteria in 406.1.ABC.1 have been met. 0 0
407.------COOLING SYSTEMS ----------------------------------------------- 0---
Type No Efficiency IPLV TonsO
O
1. Air Cooled 1 11 12 3.000
408------- HEATING SYSTEMS ----------------------------------------------- 0-=-
Type No Efficiency BTU/hrO
0
1. Electric Resistance 1 0 100000
409------- VENTILATION ---------------------------------------------------- 0---
OCHECKO
Ventilation Criteria in 409.1.ABC.1 have been met. 0 0
410------ AIR DISTRIBUTION SYSTEM ---------------------------------------- 0---
AHU Type Duct Location R-valueO
0
1. Constant Volume Ventilated 60
411------ PUMPS AND PIPING -ZONE 1--------------------------------------- 0---
Type R-value/in Diameter ThicknessO
0
412.-----WATER HEATING SYSTEMS -ZONE 1---------------------------------- 0---
Type Efficiency StandbyLoss InputRate Gallons*
0
413. ELECTRICAL POWER DISTRIBUTION ---------------------------------- 0---
CHECK°
Metering criteria in 413.1.ABC.1 have been met. 0 0
Transformer criteria in 413.1.ABC.2 have been met. 0 0
414------ MOTORS --------------------------------------------------- 0----- 0---
motor efficiencies in 414.1.ABC.1 have been met. 0 0
415------ LIGHTING SYSTEMS -ZONE 1--------------------------------------- 0---
Space Type No Control Type 1 No Control Type 2 No Watts Area(Sgft)0
0
Reading, T 1 On/Off 3 400 10400
Total Watts for Zone 1 = 4000
Total Area for Zone 1 = 10400
Total Watts = 4000
Total Area = 10400
OCHECKO
Lighting criteria in 415.1.ABC have been met. 0 0
0-----0---
16. HVAC load sizing has been performed. (407.1.ABC.1) 0 0
0 - - - - - 0 - - -
17. Duct sizing and design have been performed. (410.1.ABC.1.2) 0 , 0
0 - - - - - 0 - - -
18. Testing and balancing will be performed. (410.1.ABC.4)' 0 0
0-----0---
19. Operation/maintenance manual will be provided to owner.(102.1)0 0
CITY OF SANFORD, FLORIDA
PERMIT NO 9 7 _ q'57 DATE LZ 3 — 9'7 THE
UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO INSTALL THE FOL. LOWING
PLUMBING WORK: OWNER'
S NAME ADDRESS
OF JOB // O
le-,rv'AES PLUMBING
CONTR. /`' _ Res. _ Comm — Subject
to rules and regulations of Sanford plumbing code. Residential:
I Number Amount Alteration,
Addition, Repair Now
Residential. I One
Water Closet Additional
Water Closet Commercial:
Fixtures.
Floor Drain, Trap Sewer _
Water
Piping as
i ing actory-
built housing Mobile
Home Ap
lication Fee Minimum
Commercial Permit: 525.00 total 1 Motor
Plumber COMPETENCY
CARD NO. C"/C:e-- O-Z
DEVELOPMENT FEE WORKSHEET
CITY OF SANFORD
UTILITY - ADMIN.
P. 0, BOX 1788
SANFORD, FL 32772-1788
Project Name: L/aifc ^94yQ,647L.9'f CAC"rrt Lo7- /1 Date:
Owner/Contact Person: Phone:
Address: I%O 114Y,6S CT.
Type of Development:
1) RESIDENTIAL
Type of Units (single family
or multi -family):
Total Number of Units:
Type of Utility Connection
individual connections
or central water meter &
common sewer tap):
Water Meter Size (3/411,
111, 2", etc.):
REMARKS:
2) NON-RESIDENTIAL
Type of Units (commercial,
industrial, etc.):
Total Number of Buildings:
Number of Fixture Units
each building):
Type of Utility Connection
individual connections
or central water meter &
common sewer tap):
Water Meter Size (3/4"
10, 211, etc.)
REMARKS:
CONNECTION FEE CALCULATION:
Nd.
l-7
tnr97 //7P9c7 fcE _G sv
D s-c
76 TAL
Name - Signature - Date
q
µ cr lti% / /2
REVISED 3/20/96
CITY OF SANPORD, FLORIDA
PERMIT NO `S DATE IIZ111 7
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO INSTALL THE FOL-
LOWING ELECTRICAL WORK:
OWNER'S
ADDRESS OF JOB+17 dt s G'%. f
y
ELEC. CONTR j.. Residential_ Non-residentiaL
city and national electric codes.
Numbs AMOUNT
Alteration Addition R air
Change o f Service Residential
Commercial
15-6 P4
Mobile Home
Factory Built Housing
New Residential 0-100 Amp Service
101-200 Am Service
201 Amp and above
New Commercial p Service
Ap ication, ee
Ll d'L
I
TOTAL
By signing this application I am stating I will be in compliance with the NEC including Article 110, Section 110 9 and 110,10
9uifding Official Master Moctrieian
STAT EE COMPETENCY NO.
9 V"""r!/ z,7
DATE: Ll
HIMNESS NAME:
ADDRESS:
PHONE NU
CITY OF SANFORD
FIRE -DEPARTMENT
FEES FOR SERVICES
PHONE A 407-322-4952
PERMIT #: j:-_1i y
PLANS REVIEW TENT PERMIT
BURN PERMIT REINSPECTION
TANK PERMIT FIRE SYSTEM
AMOUNT J
9
COMMENTS: C_ U/ G*t r ,c C)t'r ,'Gc ..y, l's
Fees must be paid to Sanford Building Department, 300 N.
Park Avenue, Sanford, Florida. Phone # 330-5656.
Proof of payment must be made to Sanford Fire Prevention
before any further services can take place.
I certify that the above
information is true and
correct and that I will
comply with all applicable
codes and ordinances of the
City of Sanford, Florida.
Sanford Fire Pr ention Appricaftt Signature
CITY OF SANFORD, FLORIDA
APPLICATION FOR BUILDING PERMIT
v
Nw
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4)
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N
PERMIT ADDRESS 110
Total Contract Price of Job
Describe Work 12f 61 Ci
Type of Construction iv --AI `Ie G
Number of Stories _ L
Occupancy: Residential
LEGAL DESCRIPTION
TAX I.D. NUMBER 1 2 —
OWNER _
ADDRESS
CITY A
PERMIT NUMBER / I
J /
Total Sq. Ft. f /, Q
fw hs'' Flood Prone (YES) ( NO) I.'"
Number of Dwellings Zoning 1,eyduS7l+cTJ
Commercial Industrial k--- "
please attach printout from Seminole Count
TITLE HOLDER (IF OTHER THAN OWNER)
ADDRESS
CITY STATE ZIP
BONDING COMPANY VA
ADDRESS
CITY STATE ZIP
BER_J
ARCHITECT
ADDRESS O
CITY STATE /Cr/- ZIP '1,"y` .,
MORTGAGELENDER ADDRESS
CITY
STATE fi
ZIP
CONTRACTOR )
li' r'l t- ./)/ PHONE NUMBER f ADDRESS "`
ST. LICENSE NUMBER CITY
4/V S STATE ZIP""" ww
wwwww***www'wwww*w' ***wwwww**wwww*wwwrr*wrr*wwwwww*,r*wwww*w**ww***wwwww*ww**ww**w*w*' 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, PLUMBING, MECHANICAL, SIGNS, POOLS, ETC. OWNER'
S AFFIDAVIT: I certify that all the foregoing information is accurate and that all
work will be done in compliance with all applicable laws regulating; construction and
zoning. A COPY OF THE RECORDED COPY OF THE NOTICE OF COMMENCEMENT WILL BE POSTED ON
THE JOB SITE WITH PERMITS NO LATER THAN SEVEN"(7) DAYS AFTER THE PERMIT HAS BEEN ISSUED.
FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR THE
IMPROVEMENTS TO YOUR PROPERTY, IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 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, FS713. wwwwwwww;**
w+twww*wwwwwww+rwwwwwww,rwwwwwwwww**www*w*w*wwrttr*w*wwwwww+ww*ww*w*wtrwww,rwwwwwwww V O
M Signat
a of Owner/Ag nt 0 Date Signature of ContrActor & Date MI a 1 H
M Type
or Print-Owner/Agent Name Type or Print ontractor's Name W 0
b
M'
Signature
o Notary & Date Signature of Noijary & Date' Official
Seal) (Official Seal) I FC1.
4- ARHEA 1.. W MK4LLL .:" MY COMM1861C1N IM 0 W
COIMMI881dN O CC =140 ' OQgR B: hebnMu d pw0
p
cy
Application Approved
BY: Date: a FEES:
Building Rad, Police 14L'ire
2Gs_.
p, Open Space
Road Impact Application N c
o PERMIT VALIDATION+ CHECK/ CASH DATE BY i t7 N a
Q 0)
ORIGINAL '(BUILDING) YELLOW (CUSTOMER) PINK (COUNTY TAX OFFICE) GOLD (CO. ADMIN) Z a
E w w
THIS APPLICATION USED FOR WORK VALUED. $2500.00 OR MORE