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HomeMy WebLinkAbout110 - 120 W Lake Mary Blvd 04-575 (int remodel)Avod CITY OF SANFORD PERMIT APPLICATION I t , " • O 3 t Permit #: 0 575 Date: v —n o 3 Job Address: ilQ-120 West Lake Mary Bivd.,Sanford, FL 32113 Description of Work: Retail Tenant Improvements for H&R Block " _y-040 C _J Uh Historic District: Zoning: Value of Work: slj 10, nob 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 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 #: 11-20-30-518-0000-0050 (Attach Proof of Ownership & Legal Description) Owners Name & Address: Sandefur & Associates, Inc. 806 E. 25th Street, Sanford, FL 32771 Phone: (407) 321-8200 Contractor Name & Address: Chess Incorporated P.O. Box 621466, Oviedo, FL 32762 State License Number: CBC A11037 Phone & Fax: (407) 365-6897 Contact Person: C'hl ick Pratt Phone: (407) 365-6 97 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 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 requ2- gnagture5of Contract r/—Agent SANDEF SSOCIATES,INC. tip " Signature of O ge ate rDate Stanley H. Sandefur, President Print wner/Agent's Name Print Contractor/Agent's Name r l 1 • l-7 ' a3 Signature of Notary -Star gnature of Notary State=of-=F1 rich — Darei 4 ' N KATHLEEN E STANLEY MY COMMISSION # CCYWI l9 Owner/Agent is Pe AV-1 to HtWRES: Fcb8,2004 Produced [D SV" & Bon m co APPLICATION APPROVED BY: Bldg: 12- 2 Zoning: Initial & Date) Special Conditions: Initial & Date) MYCOhJM S6iCP1# CC'808 EXi IRE: nv°orch :0 Agent is ° Person Ily J wn o C( Utilities: FD: Initial &Date) ( Initial &Date) Chess, Inc. Job: H & R Block C. W. Pratt Owner: Sandefur Properties, Inc. Building Contractor 110 - 120 West Lake Mary Blvd, Lic # CBCA 11037 Sanford, F1 32773 407-365-6897 3 /16' = V fire inkier Fire Dept. 0c supply duct —1FD o/c return duct m L- n M CD 0 mCA CD D A" Z MAl bUULLYAHU - H1W VARIES 9 LP- 1 CITY OF SANFORD FIRE DEPARTMENT FEES FOR SERVICES PHONE # 407-302-1091 * FAX #: 407-330-5677 DATE: )a— I - D 3 PERMIT #: " BUSINESS NAME / PROJECT: / ADDRESS: I J, PHONE NO.: FAX NO.: ol- CONST. INSP. [ 1 C / O INSP.:[ ] REINSPECTION [ ] PLANS REVIEW F. A. [ ] F.S. [ ] HOOD [) PAINT BOOTH [ BURN PE MIT ] TENT PERMIT ] TANK PERMIT [ ] OTHER r 1 K TOTAL FEES: $' "© (PER UNIT SEE BELOW) COMMENTS: Address / Bldg. # / Unit # Square Footage Fees ZrBldg. / Unit SPA-- t-aj. 1. 2. 3. 4. 5. ! 6. 7. \ 8. ) w 9. G 10. 11. ( 12. 13. 14. 15. r 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. z r Sanford.Fire P vention Division Applicant's Signature THIS INSTRUMENT PREPARED BY: Name: _ Stanley H. Sandefur Address: c/o Sandefur & Associates, Inc. 806 East 25th Street, Sanford FL 32771 Permit No. STATE OF Florida COUNTY OF Seminole MARYANNE MORSE, CLERK OF CIRCUIT COURT SEMINOLE COMITY BK 05099 FAG 1926 CLERKIS * 2003204832 RECORDED 11/17/2003 10:09:49 AM RECORDING FEES 6.00 RECORDED BY L Woodley NOTICE OF COMMENCEMENT THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statues, the following information is provided in this Notice of Commencement. 0) 4. Description of property: Lot 5 Boulevard Plaza Subdivision Plat Book 58 Page 47 Public Records of Seminole County Florida Street Address: 110 - 120 West Lake Mary Blvd.,Sanford FL 32773 General description of improvement: Retail tenant improvements Owner information a. Name and address b. Interest in property: Sandefur & Associates, Inc. 806 East 25th Street, Sanford, FL 32771 Fee Simple C. Name and address of fee simple titleholder (if other than owner): N/A Contractor: (name and address) L1 Surety a. Name and address: Chess Incorporated CBC A11037 P.O. Box 621466 Oviedo, FL 32762 Phone: (407) 365-6897, Fax: (407) 365-5600 CERIIFI€D COPY b. Amount of bond $ N/A Lender: (name and address) MA!%YMINE MORSE CURK Or CIRCUIT COURII S.E- NdLU LORIEW DEPUNov,- 7 Persons within the State ofFlorida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (1) (a) 7, Florida Statutes: (name and address) None In addition to himself, Owner designates the following person (s) to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes: Timothy Alfes c/o H&R Block, 648 S. Highway 17- 92, Longwood, FL 32750 Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified): SANDEFUR & ASSOCIATES, INC. Ems: '"- Signature of Owner) STATE OF FLORIDA COUNTY OF SEMINOLE Stanley H. Sandefur President Print Owner's Name) I HEREBY CERTIFY that on this day, before me, an officer duly authorized to administer oaths and take acknowledgments, personally appeared STANLEY H. SANDEFUR , as President of SANDEFUR ASSOCIATES, INC. , a Florida corporation, known to me to be the person described in and who executed the foregoing Notice of Commencement, and acknowledged before me that he executed the same. Said person is ( check one) X personally known to me or produced as identification. WITNESS my hand and official seal in the County and State last aforesaid this L L day of N,jVe^b&P, 2003 SEAL) i1q, 14, KATHL. EENESTANL. EY 0 MY COMMISSION # cc 9(Iy119 NOTARY PUBLIC, STATE OF LORIDA EXPIRES:FebN2(1()4 1 A* Fla Notmy Service 3 Bonding Co.