HomeMy WebLinkAbout1657 WP Ball Blvd 05-991 (int remodel) (a)CITI' OF SANFORD PERMIT APPLICATION
Permit #: c>S C QA,l11 Date: ICE-Z3-o%l
lob Address: 1"5-1 W.P. Ram —RI—go.
DescriptionoflVork: (WWvtE a0m)
Ilistoric District: Zoning: Value of Work: S -Ab.onn-e-0
Permit Type: Building _ Electrical Mechanical Plumbing Fire Sprinkler/Alann Pool
Electrical: New Service - # of AMPS Addition/Alleralion Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cale. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines'
Plumbing/New Residential: # of Water Closets Plumbing Repair - Residential or Commercial
Occupancy Type: Residential Commercial )t Industrial Total Square Footage: 7-o6o
Construction Type: _I # of Stories: # of Dwelling Units: Flood "Lone: (FEMA form required for other than X)
32-%*k-3o' Sol - 0")0 - OM10
Parcel #: 34'-30o bO3O - (Attach Proof of Ownership & Legal Description)
Owners Name & Address: f,1A9 Sm%k> l.> , IthAQ TPL.ACrE. L4-L , I 9b Houmma. 81UDGE 2D g,
Ltie. 7icoi 'dd— `G %
S0 . Q+OSWE"s -A 3b Phone: -Ma - G4S - (.SU, 1 , Contractor Name &
Address:
N.)T,s mAcr skmesw6, W . 20AD
1 -
IOIJ O n ,S,
t_
ate_
LiicenseNumber: G(7C+ DS3 Z Phone & Fax:7
O-S AA O 1
Z13
Contact Person: 1 7 hONA& Phone. -no- sm-cano Bonding Company: "IA
Address: Mortgage Lender:
IJ
1A Address: ,p,1
Architect/
Engineer: NwujPSPAtQT1,iEQ-SKw Phone: -n0-394- ibi b Address- "\m LRALmLD
1 11T G rAtt N1 Ib& '?0326 Fax: MO- Sly- 1!_lq 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 perfiorMcda to meet slandar of all to reg atin construction in this jurisdiction. I understand that a separate permit must be
secured for ELECTRICAL G A CES, BOILERS, HEATERS, TANKS, and AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT.
I certify that all o e oIgoi g in or anon aicu to d th al Sr ill be done incompliance with all applicable laws regulating construction and zoning.
WARNING TQ OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO ATTORNEY BEFORE RECORDING
Y.0 R ROT
R OF IF YOU
INCENp,TQ QBTAIN FINANCING. CONSULT WITH YOUR LENDER OR AN 4;:_: NOTICE: In
addition
to the requirementspinit, there may be additional restrictions appAcable to this property that may be found in the public records of tliiapfi this county, and
there may be additional pe rt uired th a@,c such
aswait
management districts, state agencies, or federal agencies ti Acceptance of
pe
it is verification that N Ilify the the firemen of Florida Lie Law, FS 713. 3 r, -azzx/
Si
at re
o Owner/Aeent Date Siena ure of Contractor/Agent Date5ETrF OC4 PA
t Q%%iier/
Agent's Na 2adiw I -0`
ign Me i1'
mota -State of Florida Date TI IVY S.
FLANDERS ry Public, Cobb
County, Georgia Commissie Expires January27, 2007 Owner/Agent is _/'-. Personally Known to Me or Produced ID i6 -
A Print
Contractor/Agent'
s Name Signature of Notary -
State of Florida Date Contractor/Agent is _
Personally Known to Me or Produced ID APPLICATION
APPROVED BY:
Bida. Z O Zoning: ('LZ'a'( Utilities: Z ///e12(A FD: Initial & Date) (Initial &
Date) (Initial & Date) (•I Special Conditions,
CITY OF SANFORD PERMIT APPLICATION
Permit #: 10 S —C 9 ( Date:
Job Address: 1(, 57-7 " 6;911 91 VP
Description of Work:X.,) I , t sotf
Historic District: Zoning: Value of Work: $ ZC OOt o0
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mecbanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cald. Required)
Plumbing/ New Commercial: # of Fixtures S # of Water & Sewer Lines E # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than x)
Pared #: (Attach Proof of Ownership & Legal Description)
Owners Name & Address: Ahre7h /rev, G',4 p
Contractor Name & Address:
t''PAIWDO, 974
Phone & Fax: 1,6 7—Z95--Z370 ,r Y67—ZIFO 2374, Contact Person:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
State License Number: C F"C 02-362
pmwy, /*f1CJ6S Phone: 907-YG6-et Y3
Phone:
Fa::
Application is hereby made to obtain a perm» t to do the work and installations as indicated. 1-certify that no work or installation has commenced prior to the
issuance ofa permit and that all work will be performed to meet standards ofall laws regulating construction in thisjurisdiction. I understand that a separate
permit must be secured for ELECTRJCAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: 1 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. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR 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 t is vent, tion that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
e /-;? 70S
S.t_g tature of Owner/Agent Date Signature of Contractor/Agent
Z8-or
i MY COMMISSION l DD 164280I EXPIRES: November 12, 2006
Bonded TAru Budget Notary Services
is Pengrtally_ Known to Me or
APPLICATION APPROVED BY: Bldg:
Initial & Date)
Special Conditions:
Date
Zoning:
Print Contractor/Agent's Name
Date
Signature of Notary -State of Florida Date
ContractonAgent is _ Personally Known to Me or
Produced ID
Initial & Date)
Utilities: FD:
Initial & Date) (Initial & Date)
SANFORD FIRE DEPARTMENT
D
FIRE PREVENTION DIVISION
300 N. Park Ave., Sanford, FI.32771 / P. O. Box 1788, Sanford, FI.32772
407 302-2520 / FAX (407) 330-5677
Pager (407) 918-0395
Plans Review Sheet
i
Date: November 16, 2003 Business Address: 1657 W.P. Ball Blvd.
Occ. Ch. 36 New Mercantile
Business Name: New Interior White Box @ 1657 W.P. Ball Blvd.
Contractor: Young Contracting Company
Architect: Phillips Partnership
Reviewed [ ]
Ph. (770) 522-9270
FAX. (770) 522-9273
Phone (770) 394-1616
Fax (770) 394-1314
Rejected [ J
Reviewed by: Timothy Robles, Fire Protection Inspector/Plans Examiner
Comment: Plans reviewed as Mercantile Occupancy Class "C". FD reserves right to require
applicable code requirements if occupancy use changes.
Application — New Building. 2,000 sq. ft. New Mercantile occupancy
Mixed — N/A
1.1 Special Definitions — N/N
1.2 Classification of Occupancy — Class "C" (LESS THAN 3,000 sq. ft.)
1.3 Classification of Hazard of Contents — Ordinary per 6.2.2.2. F.F.P.C.
1.4 Minimum Construction — N/R (NO SPECIAL REQUIRMENTS)
2.2 Means of Egress Components -isles shall be maintained at all Imes
2.3 Capacity of Egress — O.K. Less t-han 40 occupy
2.4 Number of Exits — Two (2)
2.5 Arrangement of Egress — O.K, will field verify, per section 7.5>F.F.P. C.
2.6 Travel Distance — Shall not exceed 75 ' 36- 2.4.
SANFORD FIRE DEPARTMENT
D
FIRE PREVENTION DIVISION
300 N. Park Ave., Sanford, FI.32771 / P. O. Box 1788, Sanford, FI.32772
407 302-2520 / FAX (407) 330-5677
Pager (407) 918-0395
21 Dischar from Exits — 4_ 'isle wav t-hrouQh st_oc-_. room, al al_l t- me_s
2.8 Illumination of Means of Egress — O.K.; will field verify
2.9 Emergency Lighting — O.K.; will field verify
2.10 Marking of Means of Egress — O.K.; will field verify
2.11 Special Features — Reserved
3.1 Protection of Vertical Openings — Provide a basic degree of compartments
3.2 Protection from Hazards — N/N
3.3 Interior Finish — Class "B" "A" or "C" allowed per 10.2.8.1
3.4 Detection, Alarm and Communications Systems — Not required
3.5 Extinguishing Requirements — as per iFPA l U, Two (r) 10 B. fre extini
rLqu%,yd
3.6 Corridors —
4 Special Provisions
5 Building Services
5.1 Utilities — as per sec 9-1
5.2 HVAC — as per sec 9-2
5.3 Elevators, Escalators, Conveyors (4A-47) — N/A
5.4 Rubbish Chutes, Incinerators, and Laundry Chutes — N/A
Sanford City Code — Chapter 9
Fire S _ri' ISO-]"'r', !
Monitoring:
Other: NFPA 1
3-5.1 Fire Lanes — Not required
3-6.1 Key Box — required
3-7.1 Bldg. Address Number Posted and Legible: Post address on building 6" in
size
2
12/17/2004 14:29 4876657367
COUATN.R OF S$MII%OLB
IMPACT FEE STATMOM
PAGE 07
STATEIODTP 1 000145
101566BULDINANNIAIONBUILDING
PERMIT NUS: 04-10Q01506 DATE:
December 17, 2004 UNIT
ADDRESS: W.P. BALL BLVD 1657 32-19-30-501-0000-0020 TRAFFIC
ZONE-022 JURISDICTION• SUBDIVISION:
31 : RUG:
SUP: PARCEL: TRACT:
PLAT
BOOK: WORTHPLAT BOOK PAGE: BLOCK: LOT: OVUM
NAME: ADDRESS:
1080 O OBBRIDDGGEERRDDBBLD TIES
200 ROSWELL GA 30076 APPLICANT
YOUNG RO.
SWELLROAD ING
00. DGATLhWA GA 30350 ADDRESS: 8215 LAND
USE. THE MARKETPLACE 0 SEMINOLE TYPE
USE WORK
DESCRIPTION: CITY-SANFORD FEE
BENEFIT RATS UNIT CALL UNIT TOTAL DUE TYPE-----•-------.
DIST__-• SCiUrD --- -RATE - ---UNITS---.TYPE ROADS -
ARTERIALS N/A 00
ROADS -
COLLECTORS N/A 00
FIRE
RESCUE N/A 00
LIBXVL"
N/A 00
SCHOOLS
N/A 00
PARRS
N/A 00
LAW
ENFORCE N/A 00
DRAINNIOE
N/A SS
AMOUNTDUBSTATEMENT
I
BY.
sx OXGMTURE: PLEASE
PRINT NAME) DATE
EN
S'UREE TRECEIVING YPA087 ffi71' MAY RESULTIN YY0 IAABILITY FTo ORTHE'
1
FEB.• DISTRIBUTION: 1-BLDG
DEPT APPLICANT 2-FINANCE i -
LAND MANPIGPK2NT Nan** PERSONS ARE
ADVISED
THAT THIS IS A STATEMENT OF FEES DUE UNDER THE SEMINOLE COUlWY ROAD
FIRE//RESCUE, LIBRARY AND/OR EDUCATIONAL ISSUANCE OF A
BUILDING PERMIT. ES PAYMEAT SHOULD
BE
MADE TO: SEMINOLE COUNTY OR CITY OF SANFORD BUILDING DEPARTMENT SAONFORDD,
FL FI32771
RAP PAYM@NT
SHOULD
BE
BY
CHECK OR MONEY ORDER AND SHOULD REFERENCE THE COUNTY BUILDING PERMIT
NUMBER AT THE 'SHOP LEFT OF THIS STATEMElff. TMS STATEMENT IS NO
LONG>D1 VALID IF A BUILDING PNWaT IS NOT*** ISSUED WITHIN 60 CALENDAR
DAYS OF THE RECEIVING SIGNATURE DATE ABOVE DETAIL OF CALCULATION AVAILABLE
UPON REQUEST. CALL 407-665.7356.
NOTICE OF COMASNCENOM
Permit No. Tax Folio No.
State of Florida
County of Seminole
The undersigned hereby gives notice that improvement will bo made to certain real propery, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of properly. (legal description of the property and street address if available)
1657 W.P. Ball Blvd., Sanford,, FL 32771
2. General description of improvement Mercantile (Suite 1657 Interior Finish)
3. Ovvue r :inforrnation
a. Naive and address NAP SEMINOLE MARKETPLACE, LLC.
1080 Holcomb Bridge Road, Bldg. 200, Ste. 150, Roswell, GA 30076
b. Interest in property Owner
c. Name and address of fee simple titleholder (if other than Owner) Same as above
Contractor ' , ,
a. Name and address YOUNG CONTRACTING CO., INC. U(,
8215 Roswell Road, Bldg. 400, Atlanta, GA 30350
b. Phone number. 770-522-9270 Fax number 770-522-9273
5. Surety
a. Name and address N/A CEBFFflfDF nN,. .
b. Phone number Fax number l:l€RKRe r — • •"nit
c. Amount of bond S r
6. Lender
a. Name and address U S BANK NATIONAL ASSOCIATION c/o FROST BROWN TODD LL _
2200 PNC Center, 201 East Fifth Street, Cincinnati OH 45202 A : Jeffrey us
C, RK
b. Phone number 513-651-6893 Fax number 513-651-6891
7. Persons within the States of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 3(1)(a)7., Florida Statutes:
a. Name and address TBD
b. Phone number Fax number
S. In addition to himself or herself, Owner designates Jeff Pape of
NORTH AMERICAN PROPERTIES to rcomve a copy of the Lienor's Notice as pro-vided in Section
713.13(l)(b), Florida stag.
a. Phone number 770-325-4913 Fax number 770-643-9540
9. Expiration date of notice of commenoenxent (the expiration date is 1 year from tho date of recording unless a different
date is specified) n
Signature of Owner
SIP ) 'bed before me this day of
L
111111111111111101U Ia1Rln.D/IIIIU
QR Produced Identification 11111 IIPersonallyKn .
Type ofIde'itifi O'#iF6auced CLERK OF CIRCUIT COURT
a • . MARY INNE tjORSEs
SEMINOLE COUNTY17WJ 1436BK05550PG
CLERKS # 2004194465
gma e o u1;lic, CLEStateofFlorida kDED 12/ 17 /2004 12:10:42 PfiLregrIFANYS. FLANDERS RECO
gilry Public, Cobb County,. Georgia RECORDING FEES 10ford
MjComtnissionExpiresJanuary27, 2007 RECORDED BY G Harfo
p 6( / - 2 7-a5
CITY OF SANFORD FIRE DEPARTMENT
FEES FOR SERVICES
PHONE # 407-302-1091 * FAX #: 407-330-5677
DATE: O PERMIT #: of `Vq
BUSINESS NAME / PROJECT:
ADDRESS:
PHONE NOA;
CON ST. INSP.
F.A.[]
TENT PERMIT
TOTAL FEES:
COMMENTS:
Q
9
p
FAX NO-)/ S' D — /.If
C / O INSP.:[ ] REINSPECTION [ ] PLANS REVIEW [}Q'
F.S. [ ] HOOD [ ] PAINT BOOTH ] BURN PER IT [ ]
TANK PERMIT [ ] OTHER
pO l Gl,nSs
PER UNITBELOW)G
Address / Bldg. # / Unit # Square Footage Fees per Bldg. / Unit
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, FI. 32771 Phone # -407-
330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take
place. I certify that the above is true and correct and that I
will comply with all applicable codes and ordinances
of the City of Sa ord, Florida.
San ord ire Prevention Division Applicant's Signature
CW 9q%
5
NORTH AmER]CAN PROPERTIES
January 21, 2005 oW - 2 5"10 - so..
OS• °loll - .tee. City of Sanford
Dan Florian, Building Official
P. O. Box 1788
Sanford, FL 32772-1788
RE: Prepower Inspection Request for 1657 WP Ball Blvd
Seminole Towne Center — Shop E Suite 1657)
Dear Dan,
Please accept this letter as our written request for a prepower inspection for the Shop E
Suite 1657 store located at 1657 WP Ball Blvd in the Seminole Towne Center project.
We understand that the building cannot be opened to the public prior to the release of a
Certificate of Occupancy by the City.
Thank you for your assistance in this matter.
Sincerely,
NAP Seminole Marketplace LLC
By: North American Properties — Atlanta, Ltd
ex,PE
Authorized Agent
io8o Holcomb Bridge Rd., Building Zoo - Suite 150 • Roswell, GA 30076
ph: 770.645•6566 fax: 77o•643.9540 web: www.naproperties.com
Atlanta I Cincinnati I Dallas I Ft. Myers I Minneapolis
C" P%
Agent
N rz PAP&
Print Owner/Agent
C;LpJ_ Date
ure
of Notary — State of Florida Date Owner/
Agent is Personally Known to Me or 1D
CITY OF SANFORD PERMIT APPLICATION
Permit #: . 9/1
w n 3" Date:
Job Address: l (0 / !-' ry Description
of Work: Historic
District: Zoning: Value of Work: S 115 1p. Oe7 Permit
Type: Building Electrical Electrical:
New Service — # of AMPS Mechanical:
Residential Non -Residential Plumbing/
New Commercial: # of Fixtures Plumbing/
New Residential: # of Water Closets _ Occupancy
Type: Residential - Commercial Mechanical _
X Plumbing Fire Sprinkler/Alarm Pool Addition/
Alteration Change of Service Temporary Pole Replacement
New (Duct Layout & Energy Calc. Required) of
Water & Sewer Lines # of Gas Lines Plumbing
Repair — Residential or Commercial Industrial
Total Square Footage: Construction
Type: - # of S%ries: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #:
Owners
Name & Address: _ Contractor
Name & Address: ljc( &.
V Phone &
Fax: _3_3 S1 Bonding
Company: Address:
Mortgage
Leader. Address:
Architect/
Eagiecer: Address:
Attach
Proof of Ownership & Legal Description) 6
to License Number: G/ALOS y9 304y,(
j i3 dyI- oLct Person: Phone: 33y sB8-3o Phone:
Fax:
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 pemtit 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 all applicable laws regulating construction
and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. EF 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 perntit is verification that I will notify the owner of the property of the require is Florid Lien Law, FS 713. Signature
of Owner/Agent Date a ContracWr/Agent Data' Print
Owner/Agent's Name Contractor g is Name Signature
of Notary -State of Florida Date Signature of No E 610 ' X.
W DEBBIE
BLAN'0 MY
CO, i SION # DD 168491 Owner/
Agentis _ PersonallyLowntoMeor Contractor/Agen isongali i5& fmt~&, 2007 Produced
ID Produced I Ay - FL Mtrrt• Discount Assoc Co. APPLICATION
APPROVED BY: Bldg: Initial &
Date) Special
Conditions: Zoning:
Initial &
Date) Utilities:
FD: Initial &
Date) (Initial & Date)
Leq
CITY OF SANFORD PERMIT APPLICATION
Permit # : oe — C10i 1 Date:
Job Address:
Description of Work: w w y-!>aX Oy\ /
Historic District: Zoning: Value of Work: 00 .02—
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # ofAMPS 7,00 Addition/Alteration Change of Service TemporaryPole Mechanical:
Residential Non -Residential Replacement New (Duct Layout & Energy Cale. Required) Plumbing/
New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines Plumbing/
New Residential: # of Water Closets Plumbing Repair— Residential or Commercial Occupancy
Type: Residential Commercial 6 Industrial Total Square Footage: 7-1000Construction
Type: &)UA) # of Stories: # of Dwelling Units: Flood Zone (FEMA form required for other than X) Parcel
N: (Attach Proof of Ownership & Legal Description) Owners
Name & Address: _NOM AW691t*t> woystmec, i o8a Hoy a Dmo> tagAiie Zoo
eW Ile ISO A. 30D S Phone: l-moo-Gc4S- 446 Contractor
Name &Address: si G 2 tf . '' ^
L 3 State LJtense Number: ,EC OOOO D FaL —
Contact Pctsoo: OMMGI R NLDIV Pbon fi0 S r
Bonding
Company: Address:
Mortgage
Lender: Address:
9tFrbheetlEnglneer: .
oxDRr) 4 ->"Lt4 Emil n%eei-s, , T*x • Phone: Address:
51K OP&BIA1DY-- PAil-Y-P1h NeWIV-S' e- }. 100e13 FEZ• o2h7-- Application
is hereby made to obtaina permit to do the work and installations as indicated. 1 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 alltaws 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 theforegoing information is accurate and that all wont will be done in compliance with all applicable lays regulating construction
and zoning. WARNING TO OWNER. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEMUR OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. -------- NOTICE:
In addition to the requirements of thispermit, there may be additional restrictions this
county, and there may be additional permits required from other governmental entities s Acceptance
of permitis verification that I will notify the owner of theproperty of theSignature
of Owner/Agent Date Print
Owner/Agent's Name Signature
of Note yState of Florida Date Owner/
Agent is _ Personally Known to Me or Produced
ID APPLICATION
APPROVED BY: Bldg: Initial &
Date) Special
Conditions: this
property tfllt may be found in the public records of naagement ,
stare agencies, or federal agencies. FS
713. Z—%.
O Date
Print
Co dAgen ' Name •• n
4 Sign9aot
Notary-Sra a 6f Florida Date Sandra
I Ballam" My
t;orrt talon D"207 Contractor/
Agen An $006 Produced
l Zoning:
Utilities: FD• Initial &
Date) (Initial & Date) (Initial & Date)