HomeMy WebLinkAbout1015 W 1 St 04-513 fenceCITY OF SANFORD PERMIT APPLICATION
Permit #: `!
Date: ' a d '" 0
Job ,Address:
Description of Work: (1% 5t9 1 T.h LC
Historic District: Zoning: Value of -Work:
Permit Type: BuildingyElectrical 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: Residentii Commercial V Industrial Total Square Footage: Construction
Type: U90 4C # of
Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel
K: +_ , (Attac Proof of O,wnershi & i gal Description) Owners
Name & Address: l l — ( t-i1/ Phone:
i1 i 2 3 G G rf Contractor
Name &Address: 4wt' State
License Number: C 13 C 0 S L 1 Phone &
Fax: fIO%— J 1 ' 1, =iy 7 3a 1-'`tU Contact Person: PA'fi Phone: 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 issuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. 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 constructionandzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING jTWICEFORIMPROVEMENTSTOYOURPROPERTY. 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 t this property thatpay be found in the public records of this county, and there may be additional permits required from other governmental entities such r man a di cts, state agencies, or federal agencies. w 2
Agceptance
of permit is vyri on that 1 II notify the owner of the prrooppeerty of the requi g t`
Owner/
Ageent -,
Date-- ; Si ture of Contractor/Ag t Date-C) k,
4b e, NS
co
m P°°'_ Pei/Agent's, Name-., . Print Contractor/Agent's Name m L) S' nature
of Notary-S e f Florida Date 1 7 re
of
Notary-Sta f to da Date.*a1'OwnfAgent
is _ Personally nown to Mew ,s i0 Q Vc% r/Agent is Personal) I own}o r / 23 a
mProduced [
Df-4 X 'iri rj Sit/ Produced ID_ CO(O APPLICATION APPROVED
BY: Bldg: Zoning 4. a Utilities: FD: Initial & Date) (
Initial & Date) (Initial & Date) (Initial & Date) Special Condi
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A. Settlement Statement ~ U.S. Department of Housing
and Urban Development OMB No. 2502-0265
B. Type of Loan
1.0 FHA 2.0 FmHA 3.10 Conv. Unins.
4.0 VA 5.0 Conv. Ins.
6. File Number
03-318
7. Loan Number
17019514
8. Mortgage Insurance Case Number
C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items
marked "(p.o.c.)" were paid outside the closing; they are shown here for information purposes and are not Included in the totals.
D. Name and Address of Borrower
Mark Hatch
5300 S. Atlantic Avenue - Unit 5307
New Smyrna Beach, FL 32169
E. Name and Address of Seller
Tommye M. Johnson as to a Life Estate
Tommye M. Johnson, Trustee of the
Tommye M. Johnson Revocable Living
Trust Dated 2123/92
138 Mayfair Court
Sanford, FL 32771
F. Name and Address of Lender
Sunshine State Community Bank
4777 Clyde Morris Blvd
Port Orange, FL 32129
G. Property Location
1615 urest FjlrsitStreet
S F
H. Settlement Agent
Harry G. Reid, III -Attorney at Law
Place of Settlement
1120 W. First Street, Suite B
Sanford, Florida 32771
I. Settlement Date
11/18/03
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER
101: Contract sales price 212,500.00 401. Contract sales price 212.500.00
102. Personal property 402. Personal property
103. Settlement charges to borrower line 1400 4.251.25 403.
104. 404.
105. 405.
Adjustments for Items paid by seller In advance Adjustments for Items paid by seller in advance
106. City/town taxes to 406. Cityttown taxes to
107. County taxes 11/18 to 12/31 240.24 407. County taxes 11118 to 12/31 240.24
108. Solid Waste to 408. Solid Waste to
109. 409.
110. 410.
111. 411.
A 12. 412.
120. GROSS AMOUNT DUE FROM BORROWER 216 991.49 420. GROSS AMOUNT DUE TO SELLER 212 740.24
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT TO SELLER
201. Deposit or earnest money 1.000.00 501. Excess Deposit see instructions
202. Principal amount of new loans 170 000.00 502. Settlement charges to seller line 1400 22 585.00
203. Existing loans taken subject to 503. Existing loans taken subject to
204. 504. Payoff of first mortgage loan
2M. 505. Payoff of second mortgage loan
206. 506.
207. 507.
208. 508.
209. 509.
Adjustments for Items unpaid by seller Adjustments for Items unpaid by seller
210. City/town taxes to 510. City/town taxes to
211. County taxes to 511. County taxes to
212. Solid Waste to 512. Solid Waste to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
420. TOTAL PAID BY / FOR BORROWER 171 000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 22,585.00
300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
M. Gross amount due from borrower (line 120) 216,991.49 601. Gross amount due to seller (line 420) 212,740.24
302. Less amounts paid by/for borrower (line 220) 171,000.00 1602. Less reduction amount due to seller (line 520) 22,585.00
303. CASH FROM BORROWER 45 991.49 603. CASH TO SELLER 190,155.24
tN THE EVENT A REPRO TIO F THE TAXES IS CESSARY WHEN THE TAX BILLS FOR 2002 ARE PREPARED, PARTIES AGREE TO HAND SAID RE -PRORATION BETWEEN THEMSELVES.
I' Merle Hatch om ye a Life a
tbmye .Johnson, of
1 t-17-2003 at 4:13 PM RESPA, HB 4305.2 - REV. HUDt(3/86)
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