Fillable Commercial Permit Application 102618ADA (Seminole County Government)

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Commercial Permit Application 102618ADA (Seminole County Government)

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File type: PDF

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1101 EAST FIRST STREET SANFORD FL 32771-1468 PHONE (407) 665-7050 FAX (407) 665-7486
Building Division
COMMERCIAL PERMIT APPLICATION
Page 1 of 2
** SITE PLANS REQUIRED FOR ALL COMMERCIAL PERMITS **
Job Street Address:
Date:
City & Zip:
Bldg / Complex:
Parcel ID: - - - - -
Property Owner Name:
Address:
State:
Zip:
Phone:
Fax:
Fee Simple Titleholder’s Name (if other than owner’s):
Address:
State:
Zip:
Contractor Company:
License Holder Name:
License Number:
Address:
State:
Zip:
Phone:
Fax:
Architect/Engineer’s Name:
Phone:
Address:
State:
Zip:
CONTACT PERSON:
PHONE:
EMAIL:
FAX:
Florida Building Code in effect:
Life Safety Code in effect:
Type of Construction per FBC:
Occupancy Classification:
Automatic Sprinklers:
YES NO
Existing Use:
Proposed Use:
Other:
Work Valuation for project (Est.)
Square ft. of Cond. Space:
Total Square ft.:
Affected Square ft.:
Description of Work:
New Construction
Addition
Alteration
Change of Use
Demolition
Well
Roof
Electrical
Mechanical
Plumbing
Sign
Security Alarm
Fire Alarm
Fire Sprinkler
Other
Utilities: Check all items that apply, if other than Seminole County Water & Sewer,
a Utility Letter is required
Septic Tank
Well
Existing Well
Public Water
Public Sewer
(Continued on next page)
Permit #
Workers Comp. Verified:
1101 EAST FIRST STREET SANFORD FL 32771-1468 PHONE (407) 665-7050 FAX (407) 665-7486
Building Division
COMMERCIAL PERMIT APPLICATION
Page 2 of 2
Complete below if project will have Seminole County Water and Sewer
If Restaurant:
Current Seating:
Proposed Seating:
If Doctor’s Office:
Number of Doctors:
Number of Staff:
Subcontractors
License #
Business Name and/or License Holders Name
Est. Work Valuation
ELECTRICAL
MECHANICAL
PLUMBING
ROOFING
LOW VOLTAGE
GAS
IRRIGATION
NOTICE: This application becomes null and void 180 days after the date of filing, unless such application
has been pursued in good faith or a permit has been issued. Extensions may be granted by the Building
Official if requested in writing and justifiable cause is shown.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND
CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE
AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERMANENCE OF CONSTRUCTION.
The valuation for this permit will be calculated using the ICC Building Valuation Data. By my signature, I
acknowledge this fact and waive any rights to appeal said valuation and/or permit fees.
ELECTRONIC SUBMISSION STATEMENT: Under penalty of perjury, I declare that all the information
contained in this building permit application is true and correct.
Printed Name:
Signature of Contractor:
Date:
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Commercial Permit Application 102618ADA (Seminole County Government)

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Completed 6 August 2020

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