HomeMy WebLinkAbout1007 Palmetto Ave 05-346 New roofr
CITY OF SANFORD PERMIT APPLICATION
Permit # Date:
Job Address: / UG 7
Description of Work: /Utz v 7C
Historic District: S aL,.a`L—C Zoning: %'ua r ye-5^-i i / Value of Work: $ i0 n(7 .0
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool _
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole —
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. 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 #: _o` "` f. lr- " 0 - r-,4 1- /d o% _ o L. o
L (
Attach Proof of Ownership &Legal Description)
pOwnersName & Address: /r e,a cC C!L! +/0..rr a / / a7 7 Ca 1'&r a oi•/ L c+y r e ry fL D
Phone:
Contractor Name & Address: / /n /<Cj,s / /so.A yz r
State License Number: C lie
Phone & Fax: Cya Contact Person: 4ni`c/ /'L cGit J' Phone. / i /C 7 f/.2e
l\nding Company -
Lender:
Address:
Address:
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 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 f Florida Lien/Laaw, FS 713.
Signature of Owner/Agent Date Si/gnature of Contractor/Agent Date
Z
Owner/Agent's Name'Print Contractor/Agent's Name
sign re of otary Stagy rC o-rFtarida Date Sig ature of Notary -State f Florida Date
DEBBIE BLANTON -
MY COMMISSION # DD 188491 """
EXPIRES• Feb ru 5 n DLBSIE B
fit is Persona y Ki1awR7to M or Co r tilt j P qna lMetvn to a or
FC Not Discount Assoc. Co. --
7 ced lr
of DD 1884
b t-000-3-NOTApy ruary 25, 2007
FL Notary Discount
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Assoc. ,
APPLICAMN/PPR6VED BY: Bid ing: ~Utilities:
1kftAJK D ) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:
L._
PROJECT:
1007 Palmetto Ave
Sanford, Florida
AFFIDVIT OF AUTHORIZATION
I, Daniel Shannon Hendricks, do hereby authorize Pamela Hendricks, whose signature is
shown below, to act as my Agent in filing and execution of all construction permits for
the above referenced project: occupational licenses, applications, registrations and all
other necessary documents necessary to operate my contracting business until further
notice. This includes, but is not limited to the project referenced above.
This AFFIDAVIT OF ATHORIZATION sh be i effect ntil fk her notice.
Daniel Shannon Hendricks
108 Channel Drive
Lake Mary, FL 32746
License Number: CGC1505377
STATE OF FLORIDA
COUNTY OF SEMINOLE
This foregoing AFFIDAVIT OF AUTHORIZATION was acknowledged before me
this 8th day of November 2004 by Daniel Shannon Hendricks, who is personally known
to me and who of take an o th.
Way J. Thompson, Jr.
r r MYCOMMISSION# DD226089 EXPIRES
Not y P =; ads July 21, 2007
G.
Q: BONDED THRU TROY FAIN INSURANCE, INC
L y r1471y8COh , SEAL
Printed Name
My Commission Expires: . u, y 011,400
PAMELA HENDRICKS
108 Channel Drive • Lake Mary • Florida 32746 • phone (407) 810-7428 • fax 407 322-8254
NOTICE OF COMMEN
Permit No.
State of Florida,
County of Seminole
The undersigned hereby gives notice that improvement will be made to
Chapter 713, Florida Statutes, the following information is provided in
1. Description of property: (legal description of the property and stree
2. General description of improvement:
3. Owner information
a. Name and address „ e 1c 1/r'A_ee,. - /-r
Y') X.-
b. Interest in property
c. Name and address of fee simple titleholder (if other than
4. Contractor
a. Name and address.
b. Phone number
5. Surety
a. Name and address
Q
b. Phone number _
c. Amount of bond
Lender
a. Name and address
a /-n //L:ne4f, 0,
lf/ c ..
b. Phone number
7. Persons within the State of Florida designated by Owner upon
provided by Section 713.13(1)(a)7., Florida Statutes:
a. Name and address
b. Phone number
8. In addition to himself or herself, Owner designates
Tax Folio No.
ertain real property, and in accordance with
is Notice of Com 001teopy
MARYANNE MORSE
address if avJ7lB]6))F, CIR^i ur rni rnr
vim. L ! /n, y /' 3yz 7 Y,
MARYANNE MORSE, CLERK OF CIRCUIT -COURT
PRT COUNTY
K' a # 2004172327
RECORDING FEES 10.00
Fax number
om notices or other documents may be served as
Fax number
to receive a c
713.13(1)(b), Florida Statutes.
a. Phone number
9. Expiration date of notice of commencement (the expiration date is
date is specified)
Sworn to (or affirmed) nd subscribed before me this day of
Personally Known OR Produced Identification
Type of Identification Producef_ j_
DEBBT 9LAN74SiateofNotary &ic, State.offlor ida MY CO"! j'UN # D[
Commission Expires: E-__ ruary2;
TAP. Y
of
of the Lienor's Notice as provided in Section
Lx number
year from the date of recording unless a different
Signature of Owner
20 Q, by
THIS INSTRUMENT PREPARED BY:
NAME
n
ADDR. A— A
HISTORIC
WATERFRONT GATEWAY
A
CITE' OF SANFORD
HISTORIC PRESER VATION BOARD
APPLICA TION FOR A
CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407 330-5672 Fax: 407 330-5679
In addition to a Certificate of Appropriateness, a building permit may be required. Check with the Building
Department: 407 330-5660. A Certificate of Appropriateness may be required for projects that do not require
a building permit.
This Certificate must be prominently displayed on the building when work is in progress.
1. General Information
Property Owner: property Address:
Mailing Address: A .. C Phone Number:
Fax Number:
Agent: Phone Number:
Address: Fax Number:
Downtown Commercial Historic District: 'XResidential Historic District:
This application is filed in response to a notice from the Code Enforcement Depaot:ni c l:i
I certify that all information contained in this application is true and accurate to the f: : << : "'4! ti'iy
knowledge.
Applicant: Owner: • -L_:.
Date: %/} % > Date:
Please use the attached criteria checklist as a guide to completing the application. Incomplete
applications cannot be reviewed and will be returned to you for more information. You are
encouraged to contact the preservation planner at 407 330-5672 to make sure your is
complete.
A Certificate of Appropriateness is valid for six months unless otherwise noted
OFFICIAL USE ONLY
Historic Preservation Board Meeting Date: Staff Review Date:
Application is Approved Approved with Conditions Denied
Conditions:
Signed: C// (SillilX. Date: , 2! Altl
F 1SfiA__ENG1, listoric Preservation BoardU#Certi,ficate of Appropriatencss.doc
r_ .. -. _ ,— —._
2. Description of Proposed Work
Application Category: (Check all that apply)
Site Improvements/driveway/walkway Storage shed iViEiviag:3 fructcfres
Replacement windows or doors Underskirting Awnings
New construction/additions Signs Demolition
Roofs/gutters/downspouts AC/Mechanical Fences/Gates/Pergolas
Replacement siding/flooring/porch Paint Other
Completely describe the entire scope of work: all changes in material, color or location to the
exterior of the building, where on the property the work will occur and how the vvork w411 Ld
accomplished. For large projects, an itemized list is recommended. Attach additional g), af: < if
necessary. /
G rc .!4C
3. Documentation: In order to be reviewed by either the staff or the Historic Preservation
complete. The documentation listed below must be submitted with the application form. 1 1 copies of all dra vu iatji-
17" and 1 1 copies of all photos must be submitted.
Paint: Color samples of all colors must be submitted.
Fences/Gates/Pergolas/ Sheds: I
A site plan of the property showing the location of the fence, gates and/or pergola. The plan must sln ,ic: ;: 0perly s j
dimensions.
A picture of the proposed structure. This can be an elevation drawing, sketch, brochure or photo of an existing shed,
fence, gate or pergola provided that the dimensions are included.
A description of the materials that will be used in the project.
Photos of the yard(s) in which the structure will be placed. (11 copies of each photo must be submitted). j
New construction/additions
Elevation drawings to scale of each fagade indicating proposed alterations or additions. Drawing must clearly depict the
existing building and the proposed changes.
Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed
addition, location of all exterior ground and roof mounted equipment..
Description and/or samples of materials to be used.
Where applicable, drawings and site plan of other improvements such as fences, walkways, lighting, decks, etc. j
Photos (1 1) of existing structure.
i
Awnings/ Signs
Sketch or elevation drawing of the building fagade with proposed sign/awning.
Dimensioned drawing of awning/sign.
Sample of colors.
Site Improvements/driveway/walkway/AC/Mechanical
Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed
improvements.
Description and/or samples of materials to be used.
Note: AC/Mechanical equipment must be screened by shrubs.
i tnric Prrvation I I oa r d'= Certificate of Annronriateness d o c 2.