HomeMy WebLinkAbout220 Tuskegee St HVACt u 4 ri Py5v
j CITY OF SANFORD PERMIT APPLICATION ±uu6ti,;tl`"i:N+' R!
Z IPermit # 0
A — .
Job
Description of Work:
Historic District:
Date: — j% _ 0_3
Permit Type: Building Electrical Mechanical V Plumbing Fire Sprinkler/Alarm PoQI. ____
Electrical: -New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole _
Mechanical: Residential _on -Residential Replacement New (Duct Layout & $nergy Cale Required}
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Wate Closets Plumbing Repair— Residential or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage: /Sdro
Construction Tyne: # of Stories: #.of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: oe (Attach Proof of Ownership & Legal Description)
Owners Name Add ress i
or
Phone: Phone: 7D 7—
Contra5ptr Name &^Address:
rAe4At* Itrr S Z State License \umber: WA41e p
C Phone &
Fax: — no 49ontactPerson: 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 l;rlor 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 applicahl(c l;,v,,t, rr:f t,lating construction
and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULTIN Y O i M, PA Y NG 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 distracts, state agencies, to fc iet s+i agencies. Acceptance of
permit is verification that I %%ill notify the owner of the property of the requirements of Florida Li LUaw, SZignatur of
Owner/A ent Date TIPature of Contractor/Agent Date 86f-T-
Y 14P, PARt 0 J AO* Print
Owner/Agent's Name rat Contractor agent's Name A Yl0,u
Signature of
Notary -State of Florida Date O Owner/
Agent is k- Personalk Known to iVte or Con; Produced ID _
L APP j(
I ION APPIWVLD BY: Bldg: _ Zoning. 0 ; Initial &
Date) (Initial . Date) p c
f l r t C my is
I:
1Ut Y 3
1
ersonalit Known -
to i tr c 4-/ -? ro3
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331v Lr..::i.s:
FD: k Initial & Date) (
ItHhal &
Datc 17c:cial l
onditions.
Year a Nf ConCidening Inc.
658 Douglas Ave. Suite 1102
Altamonte Springs, Ft. 32714
Phone (407) 774-9850
Fax(407)774-4419
Building Department
To Whom It May Concern:
I, Russell Childress, being the license holder lelstle- toU.
II ating & Air
Conditioning Inc., hereby authorize
pull a permit for the job located at 2•
Russell Luther Childress
CM CO56240
Sworn and subscribe to me this /&/ day of 7c*P' l lb 204 •
My commission expires:
11
MARYANNE MORSE, CLERK OF CIRCUIT CQURT '
SEMINOLE COUNTY
BK O5006 PG 1424
CLERK'S # 2003161739
NOTICE OF COMMENCEMEkdbRDFD 09/15/2003 09:00:47 AN
RECORDING FEES 6.00
KNOW ALL MEN BY THESE PRESENTS, that rehNf1fR A(1n W8Yi work shall
be initiated on the following described real property (list legal description and street address) situated
in Seminole County, Florida, to wit: Parcel # 35-19-30-523-0000-0040 Lot 4 Academy Manor Unit
Two, according to the plat thereof recorded in Plat book 16 Page 24 Public Records of Seminole
County, Florida 220 Tuskegee Dr Sanford Florida 32771
within thirty (30) days from the date of the recording of this Notice in the office of the Clerk of
Circuit Court in Seminole County, Florida with the commencement of improvements generally
described as: Rehabilitation Work.
The name and address of the OWNER as defined in Section 713.01, Florida Statutes, his or
her interest in the site of the improvement, and the name and address of the fee simple title holder,
if other than the OWNER(S) are as follows: Betty Hampton, 220 Tuskegee Dr Sanford Florida
32771.
The name and address of CONTRACTOR with whom the OWNER has contracted for
the construction of such improvements is as follows: Suncraft Engineering and Construction
932 Centre Circle, Suite !1100 Altamonte Springs F132714
The name and Florida address of the person other than the OWNER who is designated as the
person upon whom notices or other documents shall be served is: SUBGRANTEE
ORGANIZATION NAME AND ADDRESS: Meals on Wheels, Etc., Inc., P O Box 151690
Altamonte Springs, FL32715-1690.
A copy of this Notice to OWNER shall be provided to the Community Development
Principal Planner, Seminole County Housing Rehabilitation Program, Seminole County Services
Building, 1101 East First Street, Sanford, Florida 32771.
This notice is given pursuant to Chapter 713, Florida Statutes.
IN WITNESS WHEREOF, the OWNER has executed this notice this 9th day of
September , 2003.
WITNESSES:
tSnaturername
Signature
Print Name
STATE OF Florida)
COUNTY OF Seminole)
OWNER(S):
X & &
Signatur
Belly ampton
print name
t;l li;r'E1' t;ill'Y
1',;ARYli:NNE NIOME
3t.[OK OF CIRCUIT COURT
160LE COUN-Yi.FLOR D
ot.
AFP 15
The foregoing instrument was acknowledged before me this 9th day of September
2003, by _Beqy Hampton , who is personally known to me or who have produced
as identification.
Notary Signature
Print Name_ Marci H Carter
Notary Public in and for the County
and State Aforementioned
My commission expires: 7-21-03
Mard H. Carter
This instrument prepared by: Return to:
g My Comm"lon DD21I 385MarciCarter, Marci Carter
o Expires July 21, 2007MealsOnWheels, Etc., Inc. Q/ Meals On Wheels, Etc., Inc.
P O Box 151690 C P O Box 151690
Altamonte Springs, Florida 32715-1690 Altamonte Springs, FI 32715-1690