HomeMy WebLinkAbout855 E. 25th St 05-355 Roofr— - — —.. -._—_ — ..
Permit #
Job Address: L n a -
Description of Work:
CITY OF SANFORD PERMIT APPLICATION
Date: _
Historic District: Zoning: Value of Work: $ 1-,-) ,, 0 00—
Permit Type: Building Yt 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: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address:
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender: -
Address:
Architect/Engineer:
Address:
ICI
s 4
L1 I
it' s
S.
Attach Proof of Ownership & Legal Description) //
JJ
Phone: 44v'7- J'-- - - 9 /
State License Number:
Contact Person: Phone:
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 is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Signature of Owner/Agent Date Signature of Contractor/Agent
Owner/Agent's
n n
of Florida
v jDate
DEBBIE BLANTON
fvi+CC^"•it?1tS S IO,N, # 1 91Owner/L,— Pew@ual1} YW toarYge SP42007Pro -NO
ount Assoc. Co.
APPLICATION APPROVED BY:
Special Conditions:
Print Contractor/Agent's Name
Date
Signature of Notary -State of Florida Date
Contractor/Agent is
Produced ID _
OOn ng: Utilities:
Initial & Date)
Personally Known to Me or
FD:
Initial & Date) (Initial & Date)
NOTICE OF COMMENCEMENT CERTIFIED COPY
Permit No. Tax Folio No. MAR)YANNE RMORSE
State of Florida N
County of Seminole Sq10E C U T FLOR A r
BY
The
undersigned hereby gives notice that improvement will be made to certain real property, and in b'AM-66RWithChapter
713, Florida Statutes, the following information is provided in this Notice of Commencement. 1.
Description of property: (legal description of the property and street address if available) . / NnV 2.
General description of improvement: 7,4 /- O yr 2_ , % c / < ;'N; / _, Coo— 3.
Owner information I
a.
Name and address Se u 4— T y L. .; i J, e, 1a ra i-cam Interest
in property c.
Name and address of fee simple titleholder (if other than Owner) 4.
Contractor a.
Name and address O14,-,,v-z 131111
11111411 111011b.
Phone number Fax number 5.
Surety MARYANNE NMI CLERK OF CIRCUIT COIURT a.
Name and address SEMINOLE COTYg- BK05510F-16 0580 b.
Phone number Fax ntWiFe,iRK' S # 2004173242 c.
Amount of bond RECORD 11: B: 2 AN 6.
Lender RECORDINS FEES 10.60 a.
Name and address RECORDED BY L McKinley b.
Phone number Fax number 7.
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes: a.
Name and address b.
Phone number In
addition to himself or herself, Owner designates Fax
number of
to
receive a copy of the Lienor's Notice as provided in Section 713.
13(1)(b), Florida Statutes.. a.
Phone number Fax number 9.
Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date
is specified) 99
eoLtd" % _ -, Signature
of O " er Sworn
to (or of ed) and subscribe before me this day of /i yr hX "P , 20o V , by Personally
Known L, OR Produced Identification Type
of Identification Produced THIS
INSTRUMENT PREPARED BY: ir DEBBIE
BLANTON NAME 5-0 4 c' MY
COMMISSION # DID188491 SignatuP6
of Notary Public, State of Florida a EXPIRES: February 25, 2007 ADDR. Commission
Expires: 1-800-3-NOTARY FLNotaryDiscount Assoc. Co.