HomeMy WebLinkAbout3291 Sanford Ave 05-477 RoofCITY OF SANFORD PERMIT APPLICATION
Permit #
Job Address: _-Dol-I_
Description of Work:
Historic -District: Zoning:
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 Commercialr
lV
Industrial Total Square Footage: 31 Construction
Type: 1 # of Stories: !. # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: (
A ttalc PGroof of Ownership & Legal Description) Owners
Name & Address:C7 )
fa
nw Cou r l oy LI V of I vXM/ 1l)( A /_ 5 `
SOY 2-1 i-i CRICA(-Y) (L w' 10upPhone:(9l>— 9-160k 03 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 he 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
additiorAo 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 the .may be additional ts required from other gove ntal entities such as water management districts, state agencies, or federal agencies. Acceptance f
pe fit' verification t I will no i o er o e property of the requirements of Florida Lien La FS 713. i Si
of
Ownfer/ a gent' Date Signature of Contractor/A((gent% Date t ('iit
CLULGt ^ t/ 1.15 111 G+ 11 1 1 l C 10i NVj Print Owner/
Agent's Name Print Contractor/Agents Name Sig Lure
of Notary -State Florida Date Signature of Notary- to fFlorida Date MMeyy 27
w orOwner i
l` Perof:;On6xpiM,, y APPLICATION APPROVED
BY:
Bldg
11 \ L-onitil Initial & Da e) Special
Conditions: avor., .Kim
Contracto4/ rsona ?
K)Dwn
to Me or Pr*uII( om isei
367212 0 1 n sea Expires
October
31, 2008 Utilities:, Initial & Date) t FD:
Initial &
Date) (Initial &
Date)
r - • --
State of Florida County 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 with Chapter.
DESCRIPTION OF PROPERTY (Legal description
j
of the property and street address)`
GENERAL DESCRIPTION OF IMPROVEM TENT ue Y `U ((1 CCLYI A 4Y
i
j.
i
OWNER INFORMATIQN
Name and address `--&0 nfd I ICJ V L,-j 1)
3 Ij 9`11401 CHlC14(-7 iL
fr— c:....,I- t,. i —.—I
D, CERTIFIED COPY
kARYANNE MORSEri
C I'nn
i
NAME AND ADDRESS OF FEE SIMPLE TTiLE
i
DOLDER{IF OTHER THAN OWNER) R
111li
V
CONTRACTOR { ame and address Leet Fl
3a I i
Bonding
Company) e
and address i
unt
of Bond NDER
i
N
me and address I
1
s.*
s*a*s**ssssss*ss*sssssss:sss*ss*sssss**ssasssssssssssssssssssssssssass*sssssss*ass*s**s** sons
within the State of Florida designated by Owner II
upon
whom notice or other documents may be served as provided y
Section 713.13(lXa)7., Florida Statutes: me
and address j
sss*
s***ss*s**ss*sssssss*sss*ss*s*sssssrssss**:sssssss:sssssss*sss*s*ssssss**s*ss**sss*s**** In
addition to himself, Owner designates of to
receive a copy of the Lienor's Notice as provided
in Section 713.13(l)(b), Florida Statutes Expiration
Date of Notice of Commencement The
expiration date is 1 vear from date of recording less a diffi ' riatr. is . fiywi-1 Si
of Owner Sworn
to and subscribed before me this ---f
f-'— Day of % P /,X&, y oa+ Ptu Lynne Mezalis My
Commission My
Commission Expires: u
E—m- Mav 7 41otar4
Public Theforegoinginstrument
was acknowledged before 7 t
5" me this /—
Z day of /by I (name
of person acknowledged), who is onally knQwn-to type of
identification) as identification me orwhohasproducedandwho
did / did not take an oath> RK OF
CI CUIT COURT O FLORIDA
t y
CLERK 2-22Qg
rn Tr
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LD DD324292
2008
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
1,
AFFIDAVIT
j
COMPANY: lie&n 1 n LICENSE NO:
PROJECT INFORMATION
SUBDIVISION: pgpf u,{- ADDRESS: Y\&-d &ye
PERMIT NO: LOT:
I, , affiant, hereby affirm that I am the duly licensed contractor of record for the above reference
permit, that all of the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address/lot has
been installed in accordance with all applicable codes and standards.
CONTRACTOR:
Printed name
Signature)
STATE OF FLORIDA
COUNTY OF'
2—')
gmi4l.
This instrument was acknowledged before me this 1) day of _ by the above referenced
individual, 1nQ who acknowledged that he/she is a duly licensed ontractor with
C_ , and who acknowledged that he/she was authorized to execute this document. He/she is
eith erso n wn to me or produced as valid identification.
WITNESS my hand and official seal thisV-" Kimberly
NoY Ny
Commission DD367212 er
n Expires October 31, 2008 day
of \Aj V^-e'f Notary
Public " I
Printed
Name: Ctvt 1J l e My
Commission Expires:
C UNTY
CHOICE
LIMITED POWER OF ATTORNEY
I hereby name and appoint:
Printed Name of Appointee
Company Name of Appointee
to be my lawful attorney -in -fact to act for me in applying to Seminole County
Government Commercial/Residential Permitting for a permit enabling work to be
performed at the location below -described and to sign my name and do all things
necessary to this appointment:
Section
Township
Range
Subdivision
Block
Lot
State of Flo ida
County ofi7
Address
of Property
Address
Signed
certified contractor signature
Date:
a
to , ! ,, t ?i( VI e eat,11
Certified Contractor:
printed name
Contractor License #:
S ripntoendsubscriedbefremethisA7tdayofAawmbscby
name of person acknowledged) who is rsonall nown
to me or who ha produced entification).
Notary Public
r
Commission expires:
11IJULIA BI V.PyB :
Notary Public -
5 1, 1 - lodda FORMpowerofattomey/0425o1/
dv :NbCOmmisgonE- 128,
2008 Commission # D)
367002 F., n ,
1 ' Bonded By National Notary V