HomeMy WebLinkAbout2841 Sanford Ave 05-508 Roofi
y
C
CITY OF SANFORD PERMIT APPLICATION
r Permit #y
Date:
Job Address:
Description of Work:
Historic District: Zoning: Value of Work: S j
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 Cato. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential:# of Watt Closets Plumbing Repair — Residential or Commercial
Occupancy Type: id ntial Commercial Industrial Total Square Footage:
Construction Type # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Attach Proof of Owncrf ip & Legal Description)
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 thaP 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.. laves 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 o e 's verificatio hat [ 'I e own property of the requireme of Florida S
Sig atur o Own r g t Datew 1V l SignatureofContractor/Agent ate
v'*'
Pn ne en ' e rint n ctor/Agent s Na
ature of Notary -State of Florida Date ' nafirre of 'otary-State of )''lpR(b_" Date
Chrystal •
My Commission DD358594
Owner/Age
14lJ08
Produced I 2l!/
APPLICATION APPROVED BY: Bldg: Zoning:
Initia & Date)
Special Conditions:
r
Contractor/A gei ill
Produced lD
r MY Commission DD356594
titres September 20, 2006
Personally Known to Me or
Utilities:
Initial & Date) (Initial & Date) (Initial & Date)
PLEASE l RINi ALL INFORMATION LEGIBL V7
NAME OF FIRM:
QUALIFIER / LICENSE HOLDER:
LICENSE NO.:
do hereby authorize 4JQ"
to obtain a permit on my behalf under my li
address:
Signature of License Holder
ate
for the job at the following
This foregoing instrument was acknowledged before me this,2 ray of
0, :y G(!/!
pecwhois _gnaily known to or who has
produced (type of identification) as identification.
STAMP)
Wary Public, State of Florida
Ch"W Wright
t4 • My Commission DW56"4
or
Expires September 20, 2006
l'N V I JR-E Vr I-V1VIIVILIN (.;E1V EN T
State of Florida
Permit No.
Coun of Seminole
r:
Tax Folio No. (PID).11
I
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter
713, Florida Statutes, the following information is provided in this Notice of Commencement.
CERTIFIED COPY
DESCRIPTION OF
OF IMPROVEMENT
OWNER INFORMATION
Name and address,' r fil ) (_S4S l
Interest in property (Fee Simple, Partnership, etc.)
MARYANNE MOP!
A ANNE-M9R., CLERK 6F Cl<W ITT WIRT
MINOLE COUNTY
NAME AND ADDRESS OF FEE SIMPLE TIT OLDER -(IF OTHEP'
C MV
REi 313D I N13 FED 3 1 & i
RECORDED BY L McKinley
CO TRACTOR (
adNatleandaddressP1'I ,o 14 v4e4 tz
TY (Bonding Company)
and address
j-t of Bond NAME -,Wf
IER
and address
ersons within the State of Florida designated by Owner upon whom notice or other documents may be served as provided
b Section 713.13(1)(a)7., Florida Statutes:
ame and address
I d on t hilnself caner designates j L12 iKk y of
LA 61 to receive a copy of the Lienor's Notice as
provided in Section .713.1 ( (b), lorida Statutes.
Expiration Date of Notice of Commencement
The expiration date is 1 year from date of recording unless a different date is specified.)
FFs- JENNIFERA CAVERLY*
MY COMMISSION # DD 067915EXPIRES: July 26, 2005o.
Bonded Thru Notary Public Undenydlers
Sworn to and subscribed before me this r`Day of N ov , a
My Commission Expires: I Zoo IDS
N to Pu is
The foregoing instrument was acknowledged before me this Z day of N D V W by
f(`( o—r fYlQ.i' ct as (name of person acknowledged), who is pers2E4LIy, known to
me or who has duced (type of identification) as identification
and who did / did not take an oath>