HomeMy WebLinkAbout6001 Red Cleveland Blvd1
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PERMIT ADDRESS
CONTRACTOR
ADDRESS
PHONE NUMBER%An Aca as
PROPERTY OWNER
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ADDRESS
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PHONE NUMBER
ELECTRICAL CONTRACTOR��
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MECHANICAL CONTRACTOR
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PLUMBING CONTRACTOR
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MISCELLANEOUS CONTRACTOR
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PERMIT NUMBER
FEE
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MISCELLANEOUS CONTRACTOR
PERMIT NUMBER
FEE
CITY OF SANFORD PERMIT APPLICATION /�
Permit # : a 3 - 0110 $ o'- Date: 8 -; T - O 3
Job Address: lo001c A2j=
Description of Work: F wV C 2L0!4 L }=02 MEW r41Tf-NQAN7— (1007 { IoAlekWV4 LO %
Historic District: Zoning: Value of Work: $ -� 3. o00
e>fl
Permit Type: Building Electrical is Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration X
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 Industrial
Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units:
Flood Zone: (FEMA form required for other than x)
Parcel #: b 3 - ?0 - 31 - 3 bo - QO) O - 0000
(Attach Proof of Ownership & Legal Description)
Owners Name&Address: 5At0F01-Ln AaS(L.i'OR,T / lbHN
i:azrN t 8$11 GR.£A-; COV£ J>2.
O(LI�ANpof Y'L 328111-
Phone: 440%- 31,3-y 73cI
Contractor Name & Address: }Fi4CG E L1"e-CAXe �J1G 407-
lIS.T i` COtdA-T I 0/21-A IV00, F- L-
3
State License Number: E Cl Ooo 1 -;�L 3 0
Phone &Fax: qoiSSS-, AM Contact Person:
m'Zt1.£ STww Phone: qo?- SST- 3200
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Phone:
Address:
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 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 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 t y b ound'in the public records of
this county, and there may be additional permits required from other governmental entities such as water man�g�- is state,agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: BldgA Zoning:
: (Initi t &I Da
Special Conditions:
Date
8-2s-03
Print Conftc—tor/Agent's Name
,y,—9.,-Z7o3
of Florida Date
9WZ'9lIeQV0MKbG M1pIN
i " uolSslulwwJ NNIt
Contractor/Agent is _Personally Kno r �
Produced ID 1IMS A limp" 4040
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Date)
CITY OF SANFORD PERMIT APPLICATION
Permit No.:O " Date:
Job Address: '06 -A
Parcel No.: (Attach Proof of Ownership & Legal Description)
Description of Work: r: 13(- -f- frd
Type of Construction: Flood Zone:
4-7
Valuation of Work: $ , 1 Occupancy Type: Residential Commercial Industrial
Number of Stories: Number of Dwelling Units: Zoning: Total Square Footage:
Owner:
Address
City: S'
.`Il�d..t_h
State: ./ter
Zip: 3,_2?T,3
Phone No.:
�jct-�.-s'—��'ci
Fax No.:
Contract(
Address:
City: and o State:
1:4—
Phone No.: 4CIAW 0_7'?1Vn1
Contact Person: `n1r "► C,�'1 C�+��1 i.e
Title Holder (If other than Owner):
Address:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect:
Address:
Zip: 2S(C) State License No.: CGC, 0644(y
Fax No.: -+ D -7 - 75%2-,5
Phone No.:
Fax No.:
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
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 permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Signature of
ja
ame
/ �.- <�_3
Date
CCU3
Signature ofNotary-State of Florida Date
G ,CtE: Not wL
Nnta�,ry PLb!fcC 5,1U w M7
of FWiida
MyCorltl�l`J*#271M
Commission / DD120998
Bonded By Natir_.na! Nrtary Assn.
Owner/Agent is A Personally Known to Me or
Produced ID
APPLICATION APPROVED BY:7 S M;
Special Conditions:
J,, 1?4�J16,3
Signature of Contractor/Agent Date
!,bree'4_ �_.
4ig
'' t Contractor/Age Name
nature of Notary -State of Florida Date
FLORENCE A. DE GRAVE
* MY COMMISSION # DD 164280
D fi
fj EXPIRES: November 12, 2006
OF F�� Bonded Thru Budget Notary Services
Contractor/Agent is
Produced ID
Date:
Personally Known to Me or
s\I—
LIMITED POWER OF ATTORNEY
Date: USi Z" 2c03
I hereby name and appoint L Q V eer be r l ly)
Of A0.0-e35 Uoff(01 rec ino fcai es to be my lawful attorney
in fact to act forme and apply to the c04 62nFad
Building Department for a L 1 i (I i PC1 cn. permit
for work to be performed at a location described as:
Section Township Range Lot Block
Subdivision
Address of Job)
(Owner of Property"and Address)
and to sign my name and do all things necessary to this appointment.
-:Y::O P Al F i JA *t o,54 <�
Hype cry Print paqfe o Certified Contractor and License #)
(Signature of Certified Contractor)
Ud, %r&f d
T-C,o✓idC4
The foregoing instrument was acknowledged before me this ��ay of 744 61-5-t,
20C_.
By John &fk)
Who is personally known who produces JU /A
As identifications and who did not take oath.
My Commission Expires: � dC'aClSf �Sf 2CC5
Notary Public, State of Florida
County of 00
himkw� -
4nature o otary
(Seal)
MYCOM 1I10na Pima
MISSION # DD046827 EXPIRES
August 1, 2005
'�� BONDEDTHRUTROYFAININSURANCEINC
MARY4NE MORSE, CLERK OF CIRCUIT COURT
SEMIN E COUNTY
BK Q4966 PG 0517
CLEF KI S # 2003143008
Permit Number RECORI ED 08/15/2003 10042023 FBI
RECOR ING FEES 6.00
' Parcel. Identification Number RECOR ED BY L McKinley
Prepared by:
17I 1 G 1-0'Ciet+ C.InGt C�
cc _ S s
Return to: Dz,�8 t V 3,q-) i V)0' A�
l 3 ) 8Q
NOTICE OF COMMENCEMENT
State of 1-wV l c CAI
County of YYI 1 ou I r
The undersigned hereby gives notice that improvement(s) will be made to certain real property, and in accordance
with Chapter 713, Florida Statutes, the following information,is provided in this notice of commencement.
1. Description of property (legal description of the property, and street address if available)
2. General description of improvement(s)
Ati, 4-1 /3
60+11)
3. Owner information /
Name - i i'o . h d�' �✓ ��' - J y'` Telephone Number ��0 7 8`� S �;
Address 9, 3 oC� c J�:.> �n ^ � � � Fax Number c d
4�T 3�2 - rag.34
�
✓ ^r /` � /—/ � � 171 S Interest in Property. d � f' G e Se ��
4. Fee Simple Title Holder (if other than the owner shown above)
Name / Telephone Nupiber
Address Fax Number
5. Contractor
Name 3jj�V'1
Address K� It
(,Yec,4 Ccj�t D vivc
rypb 001 GCS
6. Surety
(iO )
Name
Address
'
7. Lender (if any)
Name
rU/�
Address
Telephone Number 4t 7 - =-3 & 5 _ O —73c1
Fax Number 4 0-1-- 2q'7
Telephone Number
Fax Number
Amount of bond $
Telephone Number
Fax Number
8. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by §713.13(1)(a)7., Florida Statutes.
Name Telephone Number
Address Fax Number
9. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as
provided in § 713.13(1)(b), Florida Statutes.
Name Telephone, Number
Address Fax Number
10. Expiration date of notice of commencement (the expiration date is one. year from the date of recording unless a
different date is specified):
D8 -0e -- 103 � Yect,•,prl�slds. lAo�n,�',, J S AR
Date Signed Signature of Owner Note: per § 713.13(1)(g), "owner
must sign ... and no one else may be permitted to sign in
his or her stead."
6EftTlF6E6 COpY
QAARYANNE
sworn and subscribed before me this ' , MORSE
4s day of (-'�by,
who is personally known to me OR produced CLERK OF CIRCUIT COU
— � OLE CQU%i , .
as identification. 1 l
F
� �,,, CASTE NOELL Signature of Notary (notorial seal must appear TIN I FaK
I. Notary Public - State of Florida
s My Canrri Sion E)im May 27, 2008
Commission # DD120990
�;;` Bonded By National Notary Assn. AUcy 15 2003
City of Sanford
3�acsimite
TRANSMITTAL
DATE: B-0-o3
TO.-- t n 6\j
FROM:
DEN L\,1. ►J
DEPT:
DEPT:
PHONE #:
PHONE #:
FAX #:
FAX #:
LD. �3
PAGES: including this cover sheet
:V - -
i
CITY OF SANFORD FIRE DEPARTMENT
FEES FOR SERVICES
PHONE # 407-302-1091 * FAX #: 407-330-5677
DATE: L1 PERMIT #:0— ��rJ
t
BUSINESS ME / PROJECT:
ADDRESS:
PHONE NO.: FAX NO.:
CONST. INSP. 1 ] C / O INSP.:[ ] REINSPECTION [ ] PLANS REVIEW,
F. A. [ ] F.S. [ J HOOD [ ] PAINT BOOTH [ ] BURN PERMIT [ ]
TENT PERMIT ;� J TA K PERMIT [ ] OTHER TOTAL FEES: FEES: $ A a (PER UNIT SEE BELOW)
COMMENTS: to ou,�� cxr.4 A e— (2-� 9�-'
Address / Bldp,. # / 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 Sanford, Florida.
Sanford Fife Frevention Division U I Applican�-Aignatu7e