HomeMy WebLinkAbout1001 Grove Manor Dr 05-1571 (reroof)t
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CITY OF SANFORD PERMIT APPLICATION
Permit # : 0S �I 1 .0
Job Address: 100 1 G4o/nv�
Description of Work: E 1w1:
Historic District: Zon
Permit Type: Building Electrical
Electrical: New Service - # of AMPS
Mechanical: Residential Non -Residential —
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial
Construction Type: I # of Stories:
Parcel M 7) • 0• 31 513 • -
Owners Name & Address: J 1 -r" I ri
Name & Address:
Phone & Fax: 41
Bonding Company:
Address:
Mortgage Lender: _
Address:
Arch itect/Engineer:
Address:
Date:
-7 1
r1 i,JV 1L
Value of Work:
Mechanical Plumbing Fire Sprinkler/Alarm Pool
_ Addition/Alteration Change of Service Tempot'ary Pole
_ Replacement New (Duct Layout & Energy Cale. Required)
_ # of Water & Sewer Lines # of Gas Lines
Plumbing Repair - Residential or Commercial
Industrial Total Square Footage:
_ # of Dwelling Units: J— Flood Zone: (FEMA form required for other than X)
f/ # V (Attach Proof of Ownership & Legal Description)
Q /P!hone: 07- :E7 3 - -% ($ -7
State License Number: C c,(- O'2 -7 y 72-
Contact Person: I �Y Z10f0J-7 ! 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: 1 certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws copulating
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.
N TICE: 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 is water management districts, state agencies, or federal agencies.
Acceptance of it is v 'fication that-lavill notify the owner of the property of the requirements Florida Lien Law, FS 713.
ignat e o Agent Date Sign r of Contracto Agent "Date
t r"► O � •
Tint Owner/Agent's Name Print ontractor/Ag is Name
IeA
Signature of Notary -State of Florida �Dl Si lure of Notary -State of Florida Date
My Corrtrrtlt>dpt DG0101� KatltOrlrte MOO=
Owner/Agent is _ Personalh Known to Me or 1+0►V ExD�Apffl*9l��/Agent is _ Personally Known
Produced IU Produced ID . WlyCorrtrni8a10!tD0019M
o► w Expires April 1 O, 2W1,
APPLICA PION APPROVED BY: Bldg �j��i�: Utililics: 171):
(initial & Date (Initial & Date) (Initial & Date) (initial & Date
Specia! Conditions:
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WAYW Mal MM OF CIRCUIT mw.
Permit Number MI"M V cum
Hit .abr;c 5 FS "8N91
Parcel Identification Number 31 • �i -3) • 5 )3 OOOc.. OVI& K9 ter, i1 ZBW5831513
Prepared by:.. 1. dry; OJ�i� J t47t19 P1
INS FEES 1IL rib
MW 8Y 0 Thomas
Return to: Roof li ater of Central Ronda Inc• 3 200�
_. 190.4.WoO Colonial Dr..:
Orlando: FL.32804 F E B , ?
CERTIFIED C01'Y
NOTICE OF COMMENCEMENT MARYA?-n!'7 MORSE
CLERK OF CIR-11T COURT'
State of r LPURPIR
xp- , >?A SEMINOLE CO '
County of 16 ..+ r40t
BY D PUTY CLERK
The undersigned hereby gives notice that improvement(s) will be made to certain real properly, and in accordance .
with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of property (legal description of the proper
and street address if available)
IS-C. CvT 7.5 Gee m : )
ICX71 G Yi: r'lq:aa2 J r'b jlg� •Fr. 3--)•771
2. General description of. improvements)
/o
3. Owner I formation
Name �grvr r�. CJSYrgy.al, Telephone Number %f.07 - 3Z 3 �: `7
Address Fax Number
-6 Interest in Property:
4. Fee Simple Title Holder (if other than owner shown above)
Name Telephone Number
Address Florida Infax Number
{foOlMaster-of Ce�al
5. Contractor 1904 pest Colonial Dr.
Name Address odando, FL 3Z804 Telephone Number 407—'87 2 3'Zc>O
Fax Number
" 4v7— g72—w7Z;1$0
Surety (if any)
Name Telephone Number
Address Fax Number
Amount of bond $
7. Lender (if any)
Name Telephone Number
Address Fax Number
B. Persons within the State of Florida designated by Owner upon whom notices or other documents may be
served as provided by §713.13(1)(a)7., Florida Statutes,
Name Telephone Number
Address Fax Number
9. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as
provided in §713.13(1)(b), Florida Statutes,
Name Telephone Number
Address Fax Number
10, Expiration date of notice of commencement the expiration date is one Zear from the date of recording
7 17
�i rent dat�ecified):
I / C�
��•� �a �„ b/gna C te: per §713.13(1)(g), "owner
must si n ...an n one else may be permitted to sign In
his or her stea .
Sworn to and st
who is
as identifi lion
i
KWMG** Mtl *k
My CWVfYylO WM=
"1lr,M
Form Revised: 3/99
LIMITED POWER OF ATTORNEY
Z-ZI-o*
Date
I hereby name and appoint
Of RoofMaster of Central Florida, Inc.to be my Lawful attorney
In fact to act forme and apply to C l--y o 1 for
a Ro� permit for work to be performed at a location
described as:
Section Township Range Lot 7 J
Block Subdivision 20 Ve_
D I �o✓to.Ir� i�a•►v�t .�. S'�-►��z,7 �i 37-7 7 j
(Address of Job)
(Owner of Property and Address)
and to sign my name and do all things necssary to this appointment.
Jimmy W. Wrve CCCO27432
(Type or Prnt a of Certified Contractor, License #)
nature of Certi ied ontractor
Acknowledged:
Sworn to and subscribed before me this o�.1 day of
A.D. 20 D 5 by Jimmy Wayne Wrye who is personally known -to me.
COW*"
&00Am1q3M ,�-
Signature
SEAL:
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
AFFIDAVIT
COMPANY: ROOF MASTER LICENSE NO: CCC 027432
PROJECT INFORMATION
SUBDIVISION: "ye- ( • A WQ0W__ ADDRESS: J igrh J L__
I� v n71v-40rL_ Jam.
Fv2� 7r 32'% 7 %
PERMIT NO:
LOT: 5
I; JUVIMY WRYE , afliant, hereby affirm that I am the duly licensed contractor of record for the above referenced
project, 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: JEMMY WRYE
(Printed Name)
re)
STATE OF FLORIDA
COUNTY OF
This instrument was acknowledge before me this a9l day of III& %I &W- 2405 by the above
referenced individual Timmy Wrye , who acknowledge that he/she is a duly licensed contrctor with Florida
and who acknowledge that he/she was authorized to execute this document. He/she is personally known to me
or produced as valid identification.
WITNESS my hand and official seal this 2 1
day of ✓E,)rw w
le�,/'�1 eq. : A
eKwwft Mermw No ary Pubic
my CW4*NW 000�
QW& Evk"Apo I%=I WNW Printed Name:
My Commission Expires: