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HomeMy WebLinkAbout105 Bristol Forest Trl 04-23 fenceCITY Oil SAND RD PERNUT APPLICATION Additional Information for Electrical & Plumbing Permits Electrical: Addition/Alteration Change of Service Temporary Pole New AMP Service (# of AMPS ) Plumbing/Residential: Addition/Alteration New Construction (One Closet Plus Additional) Plumbing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines Occupancy Type: _"Residential Commercial _ Industrial Total Sq Ftg: Value of Work: $ U ' o Type of Construction: Parcel No.: Owner/Address/Phone: Contractor/. 0 Contact Person: Title Holder (If other than Owner): Address: Bonding Company. Address: Mortgage Lender: Address: Architect/Engineer Address: Flood Zone: Number of Stories:__ Attach 0 X/5 f- Number of Dwelling Units: of Ownership & Legal Description) t - State License Number: Phone & Xx Number: v -6 s7 3/ a77 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 permifand.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 rida Lien Law, FS 713. Signature of Owner/Agent Date Si of ontr ctor/Agent to Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is _ Produced ID Personally Known to Me or APPLICATION APPROVED BY: t1t11111 1111/// N Contractor/Agent is /PersonalW&n ffi9w8# y Produced ID • a : x 94a, Jt Date: ' f,,, •a:;'No SS W ` Special Conditions: 10/03/2003 14:14A _ ORLANDO TEAM SPORTS 4 4073310772 NO.B74 _ 901 Commerce Title Company TITLE AFFIDAVIT to be executed by Seller or Mortgagor (ifno sale involved)) STATE OF FLORIDA RE:FILE NO. 03-06-1007 f COUNTY OF Seminole Before me, the undersigned authority, personally appeared Centex Homes, a Nevada General P_artnershiD t who, being duly swom accarding to law, deposes) and say(s) as follows (as used in this Affidavit, the term "Affiant" and "Affiante t ! shall include all parties emccuting this Affidavit): 1. That Affiant is the owner of and A_ Haa Agreed to sell to Jenny Lynn Patrick, Krietof fer Jordan Patrick or B. Will execute a mortgagdtrust dad to encumbering the fol lowing described property situated in the County of Seminole State ofFloride; Lot 90, THE PRESERVE AT LAKE MONROE. according to the Plat thereof, as recorded in Plat Book 62, pages 12 through 25, of the Public Records of Seminole County, Florida. 2. That Aunt has been in full, continuous,..open, exclo•eing, peaceable and undisputed possession of said property since the time of vesting of title to said property in Aftient; that there are no parties who have any interest or right to claim an interest in said property other then Affiant; and that there are no facts known to Affiant which could give rise to a claim being adversely asserted. to any of said property, except: N/A 3. That, other than as shown in Item 1, Affiant has entered into no agreement, contract or commitment for the sale, lease, mortgage, option or cueation of any other encumbrance on said property, except: N/A 4. That there are no taxes, liens or assessments due or about to become due which have attached or could attach to said property, except: Taxes for the year 2 003which are not yet due and payable. S. That Affiant is a citizen of the United states, of legal age, under no legal disabilities and hat never been known by any name other than that shown above. 6. That, if married, Affiants have been continuously married during the entire time of ownership of said prop", have never been divorced and have not entered into any separation or property settlement agrcement. 7. That, if unmarried, Affiant has never been married during the time of ownership of said property. d. That, if tide to said property is held by a corporation, partnership or trust, such corporation, partnership or trust is in good standing under applicable laws and the contemplated sole or mortgage of said property by said entity is pursuant to proper authority. 9. That there are no proceedings now pending in any State or Federal court to which the Affront is a pony including, but not limited to, proceedings in bankruptcy, roceivenhip or insolvency, nor are there any judgments or liens of any nature which constitute or could constitute a charge or lien upon said property. 10. That there have been no improvements, repairs, additions or alterations performed upon said property within the past QQ,_ days; that the Affiant has not entered. into any agreement or contract with any party for the furnishings of any labor, services or material in connection with any improvements, repairs, additions or alteradons within the referenced time period; and that there are no parties who have any claim or right to a lien for servies, labor or material in oonnection with any improvements, repairs, auditions or alterations on said property. 11. That, to the knowledge of Affiant, the binder/eommitmcnt of Commerce Title Company, the policy issuing agent, and Commerce Title Insurance Company , the underwriter, ura- ,Sinder/commitment Number Info taken by Chart.# Do not write above this line Today's Date Appt Date Time Day M Tu W Th F Office: Alt Orl OV OC Patient's Name (First) (Last) DOB Address City ST/ZIP PhoneHome(_J WorkC__) Patient's SSN Referring Dr. Name Family PhysicianName Address Address . Telephone( ) Fax Telephone(__j Fax Who Authorized/referred Referral # Insurance Co Insured's Name Insured's DOB Insured's Employer Insured's ID/SSN. GroupName/# Relationship of Pt to insured Phone # to lycrify insurance s/w Effective date of coverage Deduct amount Satisfied? Co -Payment or Percentage Pre -Existing Clause? Is Allergy'evaluation, testing and treatment in MD office covered? Is SKIN testing covered?(CPT 95024/95004) Is RAST testing covered?(CPT 86003) Are Allergy Injections covered?(CPT 95117) Vials?(CPT 95155) What company does the patient get Nebulizer Machine from? Lab Can we bill lab work? or must be billed by lab Flu INJ? Needs Dictation? (all managed care) Authorization needed? Is authorization required for each visit Expires Insurance Mailing Address Approved Not Approved Verified by Date correctly and accurately reflects the status of the title to said property, including all liens, mortgages and other etcutnbrern. -rteffecting said property. 12, Affiant(s) further states that nrssne/they are familiar with the nature of the oath anu'ihe penalties as provided by law for falsely swearing to statements made in an affidavit of this nature. Affient(s) finally state(s) that hdshelthey havc have read and/or have had read to them the contents of this affidavit and that he/she/they do fully understand and attest to the correctness of its contents. Affiant makes this Affidavit for the purpose of inducing Commerce Title Company, policy issuing agent for this Commerce Tittle Insurance Company , the underwriter, to issue its Policy or Policies of Title Insurance in connection with the above referenced transaction. Centex Homes, a Nevada General SWORN TO AND SUBSCRIBED before me Partnership this 29th dayof August 2002 Dy: Shawn Kenney, Div AsaL. Controller Printed Name: Notary Public Commission Expires: ramorratm Row. 90 Info taken by Today's Date Chart # Appt Date. Patient's Name (First) (Last) Time Do not write above this line' Day M Tu W Th F Office: Alt Orl OV OC Address City PhoneHome(_) Work( ) Patient's SSN Referring Dr. Name Family PhysicianName Address Address Telephone( Fax Telephone(___) Who Authorized/referred Referral # Insurance Co Insured's Name FW' ST/ZIP Fax Insured's DOB Insured's Employer Insured's ID/SSN GroupName/# Relationship of Pt to insured Phone # to verify insurance s/w Effective date of coverage Deduct amount Satisfied? Co -Payment or Percentage Pre -Existing Clause? Is Allergy evaluation, testing and treatment in MD office covered? Is SKIN testing covered?(CPT 95024/95004) Is RAST testing covered?(CPT 86003) Are Allergy Injections covered?(CPT 95117) Vials?(CPT 95155) What company does the patient get Nebulizer Machine from? Lab Can we bill lab work? or must be billed by lab Flu INJ? Needs Dictation? (all managed care) Authorization needed? Is authorization required for each visit Expires Insurance Mailing Address Approved Not Approved Verified by Date ORLANDO TEAM SPORTS -> 4073310772I I r. 4 CLMCFENCE y CUSTOMER NAME--' ADDRESS. %S` 1 ' a _ _ _L '7 LINEAL FEET: HEIGHT 4 5 ff 6 8 i L UUNTY: TYPE QFFENCE-..~.",. STYLE Cypress ©PIP OStockade Chal? Link[]PVC []80 on 8D hItcawood WhAqow BOX UPicket BOARD SIZE RAIL SIZE GOOD SIDE0112x4021x30In4j21x400ut9xi A KGATES: QTY: OPENING: 442 DRIVE GATES. OTY: I OPENING: / LINE POSTS: CITY: I TERMINAL POST: OTY: i TOP RAIL: OTY: , n n . _ WIRE GAUGE: KK: FENCE TO FOLLOW CON' FENCE TO BE LEVEL: L] 13EMOVE EXISTING FEN, FENCE LINE TO BE CLEt CORNER LOT: PERMIT NEEDED: pink F'ntc W.11 it4tt ItM .uHtUN in ally I'sy tpar3n:vc t'Wir wcIrAcy C7auic Frnfe will a1nnne IN n .Iu, F+AnI Dift.I:g +ell M hawd tdt :ti :lt; I rr1111g Ill llnvt Pf 01111 id•:ht, A 11 110, IN I.M1E r11 flus u%Mlf%j. The Cq f pit I:1y.e 160.6i u, :dh,w 64: Am Wrist ee nlryct prate, plot, ow.4 mat ulnrntr ususrlts iull ftSf m+sM:ni• vnal fentt nixen-Aht •rfC rnugn nl:q we;Xed twtugmcc. Omit refit'. HAVE REAO AND UNE KT: OF GROUND: [] E: D YES NO 4ED: YES D Pilo YES niO YES NO NO.647 1703 P.3 330 Dog Track Rood . Longwood. FL 32750 407-331-0755 Phone n 407-331-0772 Fax DATE: 007 - PHONE;144D AE # 4 WORK FAX # _ X-MoBILE # FRONT 1• pn IC11utSI. in Ifcicrn. ipi11 W ItJf:• the ICnq::z lu nl! ercCred. ton OWL, ek- circt:nlsnu.ccA duet Clasfit Fcntc pfiumt any st3fNC•><iWKn• P"Ir 'sty rtn. Wilmot n., bIJItU. It I,- riC:unm mlttl •lut Ihr Cuznuller lt vc the ps•ry\rly iufuCyCd. CM0.tmiTy pRlptrty fimCR rx haiy f n sMt:Iy tnW01'JI'm fin cnhU.t :u1d uGGdtS, In't.-Ct'er. Clnt'1C Fence 1z vtu rcalRtllbinle for any Aprinkten !m n:hs. lnmmtCd NOW lines tm IdgecnI.Rt of iesclnF trrrted. f . .( Cl It dvC :rl s4r. tifnt of Crnnplttiea of tv..rlt, ;wd a finagcc chsfp of 17-T. Irr m,mtr. Mil he aprWeNj a+ W1 xcouM.r film DJid !n (fillrill r Ag ttrhtiA 1 p4%%2 ,•f Clhstic Ftfiet until fulyftldll ill tetewed in fill) Aitlu 41! ac v a and n nu•tul I. rlanlea to Clsock FMet in the 17e11t of F SI(fillf . fir II Kc•, h• f1aT rdl :n[;;Ctl and an•. calfl incaatd u1 %I%d:•IICclian of this dtay. Inttpid 1v.•fk of n1 t:..ntf:Itst µtor :flpriq-i' h*. hr N1 att'CM mglCr:als c.•nIn;ICd sir. HnV_Ya Icaz to I'Oy sdiri, (iquidatCq dJ opo 6(J Awn tclu0111% 7t'11sX. tial::mt1 Labttralre:Wy Rtrslzhd. I.r in pnggcrl. tmlt lrnlR lu•mh•wucrl sR.lci tinn Aplmnlal fix Ibc type end hu:alitln fir fcuc.. Nr1'rlCli'r0 NtfNCF1ASERS nF WfN)n F6.N('f•:: p/CCt'S_ N't IJ Yont:e has a leltd0tt' 4:• r1Iqnl. Y /nnl::.nt! warp 1n Iml• In1A1id wdlnlCr :1•ul sn1a11 falls will 1frjlepr (MlwcCh I>r.Jrdc Cfltkt ifi'dY O.th1d 0 ct011t1M1 UdEYaf:Mat IIL 1+CArnanship CIII %11:1d ft'11.Ct for I vent RSTANOTHE ABOVE CLAUSE- ONTRACT AMOUNT: OWN PAYMENT: hh ALANCE DUE V PON COMPLETION Y Co. Dal lower Co. j eleDhone Co. AND FOR CUSTMER CUST01NEq TE LFA- ampl. go S*^^ S* S epso a, J3/2003 10:32 ORLANDO TEAM SPORTS i 4073310772 NO.266 902 PLOT PLAN DESCRIPTION: (AS FURNIStIED) LOT 90. PRESERVE AT LAKE MONROE AS RECORDED IN PLAT BOOK 62, PACES 12—t5 OF THE PUBLIC RECORDS OF SEMINOLE COLINTY, FLORIDA 10 0 k- W IV uJ O H 20N.4C MOTACC VP r0 Ct— 07 00 LW TO CIAO CONTAINS SRO SQUARE FEET s s SWOUCRAC COMA $ 231j SOUARE FEET i ONCREn 938 50 ft. t ArQY0W0 ISOEw.I,k APA&I) TOTAL SOD 3510 $a FT. : 41PIK~ CaemAiOrs [LIST OwLY) LOT QO CDNTAINS 5250 SOVOC FCET I tLOT ONLY) IrOS SIRT,TCTURE CONTAINS 1352 SQUARE FEET : TOTAL CONCAErE 605 (TPTHIN LOT ONIry 5O. DT, t TOTAL SOD J FT. PERCENT or CONCRETE k SMUCFURE TO lot 371E 1 8MOING SETBACKS FRONT; 25 REAR: 20' SIDE: 5' CORNEA: T5' PREPARED FOR CENTEX HOMES I. ELIVATKINS SrIOYAT ARE PER LOT CAADIN6 PLANS PROND(0 AY fKC CLIENT. DS PLOT PLAN IS INTENDED FOR PER1aTTINO PURPOSES rt Y. THIS 15 NOT INTENDED ran ME CONSTRUCTION OF IE PROPOSED HOUSE REFER TO MOUSE PLAIN AND OPT;ONSTFORCONSTAUCAOH. I. Ol14ANfC SC.T DACE LINES SNOwM HEREON IS PC$ DATA IRNISH[O AV CLIENT AND IS FOR INrDRMATIONAL PURPOSES Y TINTS IS NOT A SURVEY THIS IS A PLOT PLAN ONLY i HAVE EAALANEO Ng F,1.R.4. C0Y4LINITY PANEL NO 12029- 0075 E DATED 4/17/7s AND FOUND loft SUOJCCt PRDPERTY APPEARS To UE IN LOHC A AREA ISUfSjot 100 YEAA FLOOD PLANE I YCARINCS SNOIMI HEREON MC B45ED ON I9-4 NORrN LINE OF LOT 00 atINC N 41616'10' E PE4 PLAY. Q71 BRISTOL FOREST TRAIL IS' InONr-al—', LOT 91 S;(,Oe V$°w ClfA)IC d III* YwDIIAI 10f NOW 05 Ppwl Or OOYAO.RY MCHr Of RAT lt'Tl PtCAm AO4rr Of CotMa40 CIARVAnNICvainONPAIN PROPOSED[1Lw.nON PO oI.H (IS oclAt0w10.1 o P4tN ONO 04AIVAOC %0. 0 DCNOR{S OENA AlArAE Q L ltNOTEs ARC te.cnl coaatK c.IS. rcHD,cs coo usK to imp ONAKYwr OVshc!! et K.,Owl Awl ce advAruK LS LAND umvr o AI ilwalts MAT or •A1mmm MY PLR4Aw(Mt REft4E-lef IrDIN4CN, PAC RaDaTt! re.l orof itrgAlc A'CFCANAwCNICOMrRAPOW, TM I1PI(At P) KR AIAt A/C AN c"I'l0(R gum E!w COrPCrr OLOCA • LLfu C/w CONCACIC ITAN 4. CS R•O." POWTCoKwItANSM50er.La CONC4TIe PAD c aalIS 10414 A0 PLAT DOD. is fr sDU.AC feel 4 4ADIV3, G tLAIW.t C4.K 0, PACLS Mj\r AIc4l.Or-V.T I, THE 511"TOR MAT. NOT ABSTRACTED THE LAND SHOwN NE4EQN FOR tASEI`Nrs, 4i6+.T OF war. REST41C tOiS OF 4ECd10 wHICH WAY AFFECT THE RILE rR USE OF RiE LAND 2. NO UNDIE ROUND I.sROVCW(KTS HAVE BEEN LOCATED ERCCPT AS :NOIIAr. I. "OF VALO MTIIOUT ME 9040MIE AND ME OM*HAL RAISED SEAL OF A FLDROA LICENSED SURVEYOR ARID YAPPER. I J -2A,O,A