The URL can be used to link to this page

Home My WebLink About137 Pinefield Dr 04-652 FenceCITY OF SANFORD PERMIT APPLICATION Permit # : v ! Date: Id '1? 0 -193 Job Address: % k lI E r ir' 1 A Description of Work: a t,>paa FtnCP Historic District: Zoning: Value of Work: $ 19 aS ; n 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: 11 # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: _% I cal Fry /fit kd3 26h/Se '73 %(Attach Proof of Ownership & Legal Description) Owners Name & Address' __S0. rte-- h 5 6 L 5 k 1 / Phone: 9,37Jr .%y Contractor Name & Address: L I Q 5-S "e- rf nc Co h ll State License Number: Phone &Fax: y0/ 331 1017k yp7..3.3 0 Contact Person: ndr A g 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 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 La , FS 713. l L Signature of Owner/Agent Date 9ignature of Contractor/Agent 1 1 Date Print Owner/Agent's Name Print tractor/Agent' ame Co7 Zt% Signature of Notary -State of Florida Date(Signature of Notary-Sta a of Florida Date Owner/Agent is _ Personally Known to Me or Produced ID 4—) APPLICATION APPROVED BY: Bldg: Zoning: Initi 1 & ate) Special Conditions: Contractor/Agent is _ Personally Known to Me or . ........ 6) ;IX Produced ID O MISSIONF A•• o A 6 ? Cps 9N Utilities' FD * % o • o initial &Date) (Initial &Date) iigal& DAW109666Scncded Q Q Fa 12/19/2003 14:30 4073228436 SPOLSKI CONSTRUCTION PAGE 01/03 FAX TRANSMOTTAL SHEET DATE: Id -,(7 - 0 j TIME: / 'Ya S OF PAGES: (INCLUDING TRANSMITTAL SKEET) TO: C L A ss i` 4 FG-: w e L^ FAX lAa,7_j/ -071-% - PHONE: FROM: COMMENTS:-- NOTE: IF THERE WAS ANY PROBLEM WITH THIS TRANSMISSION, PLEASE CALL (407) 322-8424. Spdiskl Construction, Inc. ® 1425 E. Airport Blvd. 4 Sonford. FL .3277.3 Phone: 407.322.6424 a Fax. 407.322.843(S n 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 Who Authorized/referred : _ Referral..#....._ .... Insurance Co Insured's Name Insured's DOB Insured's Employer Insured's ID/SSN GioupNaine/# 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) `'` : Via ls?(.CPT,. 95155) What company does the patient get Nebulizer Machine from? Lab Can we bill lab work? or must be billed by lab Flu [NJ? ' ` Needs Dictation? (all managed care) Authorization needed? is authorization required for each visit Expires Insurance Mailing Address .;,., ",: Approved Not Approved Verified by Date r- 2003 14:30 4073228436 SPOLSKI CONSTRUCTION PAGE 02/03 PREPARED BY: WAYNE VON DREELE 4005 Maronda Way Samford, Florida 32771 ATC# 03.14458 kT# 55040 A MMIVSW 0 Ay 0s peei l I)eed Made the 1801 day of December , A.D. 20 03 by MARONDA HOMES, INC. OF FLORIDA a corporation existing under the laws of the State of Florida , and having its principal place of business at1101N.1i1ELLER ROAD, SUITE p, ORLANDO, FLORIDA S2810 hereinafter called she grantor, to JANELL A. SPOLSKI, a mingle woman Whose post office address is 137 Pinetield Drive, Sanford, Florida 32771 hereinafter called the grantee. IA+h!re er used ll.relm thr. orm! 'Iprntor' nnA "Rrelmee,' Intllale ,I) th! Ilwlee to till$ 11101traloont sndth! firinIV-gill ml eprrgntmtlles n nl P"llats o(indlvldltmis. mitt] 111r +laeesnere Roll Assigns e(eorperm lon) . . Ws se o That a grantor, for and in consideration of the sum of $10.00 and other valuable considerations, receipt whereof is hereby acknowledged, by these presents does grant, bargain sell, alien, re» rise, release, convey and confirm unto,the grantee, all that certain land situate in Seminole County, Florida, viz: LOT 121, CELERY LAXES, PHASE 1, according to the Plat thereof as Recorded in Plat Book 62 Pages 75 and 76, inclusive, of the Public Records of Seminole County, Florida. SUBJECT TO covenant,, restrtictions, easements of record and taxes for the current year. PARM IDENTIFICATION NUMBER: 32-19-31-515-0000-1210 l® 9ekrwith all the tenements, heneditamenre and appurtenances thereto belonging or in anywise appertaining, to awe W to Hold, the sartte in fee simple forever the grantor hereby covenants with sai.dgrantee'that it' is lautfudy' seized of said land in fee simple; thatIthasgoodrightandlawfulauthoritytosellandconveysaidland.; that It hereby full warrants the title tosaidlandandwilldefendthesameagoitrstthe16wfulclaimsofallperj-ns claiming by, through or under thesaidgrantor. 0 IRMU"Iess tobeftol. the grantor has caused these presents to be rcoRPOAATBsEALtexecutedinitsname, and its corporate seal to be hereunto affixed, by its proper officers thereunto duly authorized, the day and year first above written. ATTEST............................................ . SecretAry Signed, sealed and delivered in, the presence of BUXONDA JHOMES, INC. OF FLORIDA I.............................. 01 .............. By _ WITNESS ........ ANGELA Ni RGAN................. 'r lAR t'!nVL+74#ATUFA T T ............• ....... `.....:...... Address City_ ST/ZIP PhoneHome( rWork( ), Patient's SSN Referring. Dr. Name Family PhysicianName Address Address TelephoneC ' Fax Telephone( , Fax Who Authorized/referred Referral # Insurance Co Insured's Name: linsuied'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 covered2(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 I u lv rs nru, t, vice t1tesident C14 WITNESS: STATE OF FLORIDA COUNTY OF SEMINOLE I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State and Countyaforesaidtotakeacknowledgements, personally appeared TOM GREENAWALT, known to me to be theVICEPRESIDENTofMARONDAHOMES, INC. OF FLORIDA, a Florida Corporation, on behalf of thecorporation. He is personally known to me. WITNESS my hand and official seal in the County and State last aforesaid this 18thdayofDecember- A.D. 20 03 ; ANGELA.MOR(;A.N NOTARY PUBLIC My COMMISSION EXPIRES; 49/2912006 MY COMMISSION NUMBER: DD 154013 Info taken by, Chart # Today's Date Appt Date Patient's Name (First) (Last) Time Do not write above this line Address City Day M Tu W Th F Office: Alt Orl OV OC PhoneHome(Patient's SSN Referring. Dr. Name Family PhysicianName Address Address Telephone)_ Fax, Telephone(_, Who Authorized/referred Referral # Ki: SUMP Fax Insurance Co Insured's Name 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 BAST testing covered?(CPT 86003) Are Allergy-4jections covered?(CPT 95117)....Vials?(CPT 95155):. What, company does the patient get-Nebulizer Machine'from? ` Lab i. Can we bill lab work? or must be billed by lab Flu INJ?, Needs Dictation? (all managed. care) Authort'zation needed? _ Is authorization .required ,for:,each visit Expires Insurance Mailing Address Approved Not Approved Verified by Date 12/19/2003 14:30 4073228436 SPOLSKI CONSTRUCTION PAGE 03/03 1 l 1 PLAT OF BOUNDARY SURVEY for MARONDA HOMES Legal Description LOT 121, CELlI:RY LAKES PHASE 1, according to the Plat thereof as recorded in Plat Book 62, Pages 75 Find 78, of the Public Records of Seminole County, Florida. 1 1I 1 I1 1 I1 N 89*38'17" E 120.00' 122 SCALE: 1 "= 20' O -SET IRON do CAP (#3382) 0 w a W I Info taken by Chart # Today's Date Appt Date Patient's Name (First) Address PhoneHome(____)_ Referring Dr. Name, Address Telephone(__ Who Authorized/referred Insurance Co Last) WorkO Time Do not write above this line Day M Tu W Th F Office: Alt Orl OV OC DOB City Patient's SSN Family PhysicianName Address ST/ZIP Fax Telephone(__j Fax Referral # 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? Insured's Name 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 [NJ? Needs Dictation? (all managed care) Authorization needed? Is authorization required for each visit Expires. Insurance Mailing Address Approved Not Approved Verified by Date JNEAL FEET: COUNTY: HEIGHT TYPE OF FENCE STYLE 4 5 Cypress PTP OStockade i3 6 B Chain Link PVC BD on BD Ultrawood Shadow Box Picket BOARD SIZE RAIL SIZE GOOD SIDE 1/2x4 2x3 In 1 x4 2x4 Out 1 x 6 WALK GATES: QTY: OPENING: DRIVE GENES: QTY: OPENING: LINE POSTS: QTY: O.D.: TERMINAL POST: „QTY: O.D.: TOP RAIL: QTY: O.D.: WIRE GAUGE: KK: KT: FENCETO FOLLOW CONTOUR OF GROUND: FENCE TO BE LEVEL: REMOVES EXISTING FENCE: FENCE LINE TO BE CORNER• PERMrr NEEDED: SPEC A INSTRI>JC TI®rNS YES NO YES NO YES NO YES NO MAP PAGE: 330 Dog Track Road o Longwood, FL 32750 407- 331-0765 Phone o 4Q7-331-0772 Fax DATE: PHONE: HOME # WORK# ' 3'84,31/17 3S73" FAX # MOBILE # Classic Fence will assist the customer, upon request, in determining where the fence is to be erected, but under no circumstances does Classic Fence assume any responsibility concerning property lines or in any way guarantee their accuracy. If property pins cannot be located, it is recommended that the customer have the property surveyed. Classic Fe ice will assume the responsibility for locating underground cables and utilities, however, Classic Fence is not responsible for any sprinklers or other unmarked buried lines or objects. Final billing will be based on actual footage of fencing erected. Payment is due at the time of completion of work, and a finance charge of 1'/ % per month shall be applied to all accounts not paid in full within 10 clays of completion. All material will remain the property of Classic Fence until payment is received in full. Right of access and removal is granted to Classic Fence in the event of nonpayment per the terms of this contract. The customer agrees to pay all interest and any costs incurred in the collection of this debt. If the Buyer refuses to allow the Seller to begin work or to complete work already begun, or to accept materials contracted for. Buyer agrees to pay Seller liquidated damages of a sum equal to 33'/3% of entire contract price, plus cost of materials and labor already furnished or in progress. Customer : assumes full responsibility for obtaining homeowners association approval for the type and location of fence. NOTICE TO PURCHASERS OF WOOD FENCES: Wood fence materials are rough mill cut pieces. Wood fence has a tendency to shrink and warp in hot, humid Weather and small gaps will appear between boards. Cracks in the wood are a common and accepted occurrence. I HAVE. READ AND UNDERSTANDTHE ABOVE CLAUSE: APPROVED AND ACCEPTED FOR CUSTOMER CONTRACT AMOUNT: $ cl, —c DOWN PAYMENT: $ CUSTOMEK DATE BALANCE DUE q OU UPON COMPLETION $ TV Co. DATE CALLED Power Co. Telephone Co. Gas Co. INSTALLER DATE STARTED DATE COMPLETED s IABOR CUSTOMER DATE SALESPFASON DATE QUOTE VALID FOR 30 DAYS L- Do not write above this line Day M Tu W Th F Office: Alt Orl 'OV OC DOB yAddressCit ST/ZIP PhoneHome( ) - Work(_) Patient's SSN Referring. Dr. Name Family PhysicianName Address _-- Address Telephone( )_ - Fax . Telephone(_, 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 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