HomeMy WebLinkAbout2843 Empire Pl 05-489 RoofPermit #
Job Address: '-f % 5_
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date:
WWATJZllAU
U e!
Zoning: Value of Work: S TD
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 #: - J
Owners Name & Address:
Y
6
e"i)117
Contractor Name & Address:
Phone & Fax: j
Bonding Company:
Address:
Mortgage Lender:
Address: &_
Architect/Engineer:
Address:
423 ;74_1) (
Attach Proof of Ownership & Legal Description)
0
d G !- l J 27 -7 Phone: 40 7 J ,0
State License Number: /4 C-11,C2 Lo C_ .; /.;t
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Contact Person: Phone:
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= v " tcation that I will notify the owner of the property of the requiremen f Florida Lien Law, FS 713.
O gnature of ner/Agent Date tSaur f Contractor/Agent Date
o " o %.
m $ 'ntt ,Own r/Agent's Name Print Co ractor/Agent's Name
Z H ! <0 Ce % G - D I i -d3 o y
Igna Notary-S of Florida Date Sig a jreiTState[DtfJ9,?E!aBLAANT0N DatMYCUMMESSION # DD 188491O`
EXPIRES: February 25, 2007QAR`(
V ner/Agent is r nally Kpo to Me r ContraPesloi%dwBN iiWPE®r
Produced ID Produced ID
Rr N APPROVED BY: Bldg ) oiiing: Utilities: FD:
Initial & Date) Initial & Date) (Initial & Date) (Initial &Date)
s
y
THIS INSTRUMENT PREPARED BY: j
NAME: P7 , l kyt P,i- _ Building & Fire Inspect oI
ADDRESS ' / ,:%rr' ' SFntl gotC 1101 East 15t Stre
i10s 5 '1antCtiJC
i Sanford, FL 327-
NOTICE OF COh MM' NCEM ENT
State of Florida Count v of Seminole
Permit No. Tax: Folio No. (PID)
The undersigned hereby gives notice that improvement will be made to certain real property; and in accordance 1vith Chapter
713, Florida Statutes, the following information is provided in this ,Notice of Commencement.
DqCRIP IION OF PROVERTY (Legal description of theproperty and street address) A GENERAL
DESCRIUTON OF iI1II
1111h MARYANNE
M4Rr-, CLERK O CIRCUIT COURT Qj:
Am SI c rta n,ma BE
055,24 Pr, rl
41 °A •mow: $ J dR . q OWNER
INFORMATION. '-m Name
and address ' d j
R
1lf2D 1) 1 !'i?kz-112W12144152 PN G
LiC r / // E . SEES° Interest
in property (Fee Simple, Partnership, etc.) A oy ANNT MnF ,
L HOLDE)
L (IF OTHER THAN OVngER) INOLE C U NAMEANDADDRESSOfFEESIMPLEITITLEBY
ITy CONTRACTOR
ameagnNd
address L'
RETY (Bonding Company) Name
and address Amount
of Bond LENDER
Na=
and — address e,
5 &/'/V 1,Y41 _ 7 r X Z V S 56 CG S , drZi q32Z V 4 S',5. Persons
within the State of Florida designated by Owner, upon whom notice or other documents may be served as prnvided by Section 713.
13(1)(a)7., Florida Statutes: Name
and address K.-
u— -- —
A lu-4 A.-oly ut- uy owner upon whom notice or otmer uocuments may be served as provided
by Section 713-13(1)(a)7.,Florida S- Name
and address: 14 In
addition to himself, Owner Designates vided
in Section 711.13(1)(b), Florida 0
3
N ,)
iration
Date of Notice of Commencei o
a expiration date is 1 year from date of m
Ca .
ik 2 aE
to and subscribed before me tbis My
i
of To
receive a copy of the L=nor's Notice as itatutes.
X
a
different date is specified.) T
Owner Day
of L 4 E
Copy
MORSE
UIT
co T VTY,
FL PSI A CLERK
i 2
2 n 7.
3 J
ry
Public foregoing
instrument was aamowledged before me this day of r/(/ , a6w by Dy/O xe eC%?dQ Name
of person acknowl ged), who is personally known to me or who has arced (
T 91). as identification and who dididid not take