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HomeMy WebLinkAbout3100 Sanford Ave - BC04-000623 (CUMBERLIN FARMS) INTERIOR REMODEL (DOCUMENTS)PERMIT ADDRESS .31 Q0 4S" CONTRACTOR ADDRESS `b35 Auyv_St, ©V4"-fc, 3Z-8C5 PHONE NUMBER 40'7 1 4A I —2-34. 7 PROPERTY OWNER ADDRESS -I f 1 rt,®/Yyl T l-(l PHONE NUMBER 4 z 7 3bZ ELECTRICAL CONTRACTOR MECHANICAL CONTRACTOR PLUMBING CONTRACTOR MISCELLANEOUS CONTRACTOR PERMIT NUMBER FEE MISCELLANEOUS CONTRACTOR PERMIT NUMBER FEE SUBDIVISION PERMIT # () c-1 -(0 23 DATE 1 PERMIT DESCRIPTION L' , - PERNQT VALUATION 7; 5, O0 O SQUARE FOOTAGE I CERTIFCATE OF OCCUPANCY REQUEST FOR FINAL INSPECTION INTERIOR COMMERCIAL REMODEL**** DATE: PERMIT #: ADDRESS: CONTRACTOR: PHONE #: 04/02/04 04-623 3100 SANFORD AVE ALAMO CONSTRUCTION SEAN 352-266-8865 The building division has prepared a Certificate of Occupancy for the above location and is requesting final inspection by your department. After your inspection, please sign off and date the C. O. or submit addendum if it has been denied or approved with conditions. Your prompt attention will be appreciated. Engineering 0 Public Works D Utilities CK- D. sir 4Y14- DFire DZoning DLicensing CONDITIONS: (TO 13E COMPLETED ONLY IF APPROVAL IS CONDITIONAL) Ezu=sa r CERTIFCATE OF OCCUPANCY REQUEST FOR FINAL INSPECTION INTERIOR COMMERCIAL REMODEL**** DATE: PERMIT #: 04/02/04 04-623 ADDRESS: 3100 SANFORD AVE CONTRACTOR: ALAMO CONSTRUCTION PHONE #: SEAN 352-266-8865 The building division has prepared a Certificate of Occupancy for the above location and is requesting final inspection by your department. After your inspection, please sign off and date the C. O. or submit addendum if it has been denied or approved with conditions. Your prompt attention will be appreciated. OEngineering , OFire Vl/lIr0Y7 Zonin g O Utilities OLicensing CONDITIONS: (TO BE COMPLETED ONLY IF APPROVAL IS CONDITIONAL) 1 CERTIFCATE OF OCCUPANCY a REQUEST FOR FINAL INSPECTION; o INTERIOR COMMERCIAL REMODEL*1 DATE: 04/02/04 00 It It Y i PERMIT #: 04-623., c ADDRESS: 3100 SANFORD AVE t3 W W W aca c a CONTRACTOR: ALAMO CONSTRUCTION g o PHONE #: SEAN 352-266-8865 The building division has prepared a Certificate of Occupancy for the above location and is requesting final inspection by your department. After your inspection, please sign off and date the C. O. or submit addendum if it has been denied or approved with conditions. Your prompt attention will be appreciated. OEngineering OPublic Works tilities CONDITIONS: (TO BE O Fire OZoning OLicensing Y IF APPROVAL IS CONDITIONAL) CERTIFCATE OF OCCUPANCY REQUEST FOR FINAL INSPECTION INTERIOR COMMERCIAL REMODEL**** DATE: PERMIT #: ADDRESS: CONTRACTOR: PHONE #: 04/02/04 04-623 3100 SANFORD AVE ALAMO CONSTRUCTION SEAN 352-266-8865 The building division has prepared a Certificate of Occupancy for the above location and is requesting final inspection by your department. After your inspection, please sign off and date the C. O. or submit addendum if it has been denied or approved with conditions. Your prompt attention will be appreciated. OEngineering OPublic Works OZoning O Utilities O Licensing CONDITIONS: (TO BE COMPLETED ONLY IF APPROVAL IS CONDITIONAL) CERTIFCATE OF OCCUPANCY REQUEST FOR FINAL INSPECTION INTERIOR COMMERCIAL REMODEL**** DATE: PERMIT #: 04/02/04 04-623 ADDRESS: 3100 SANFORD AVE JCONTRACTOR: ALAMO CONSTRUCTION t PHONE #: SEAN 352-266-8865 The building division has prepared a Certificate of Occupancy for the above location and is requesting final inspection by your department. After your inspection, please sign off and date the C. O. or submit addendum if it has been denied or approved with conditions. Your prompt attention will be appreciated. OEngineering OFire 0Public Works 0 Utilities oning OK D. Sw w''r Cx4' OLicensing 5 CONDITIONS: (TO BE COMPLETED ONLY IF APPROVAL IS CONDITIONAL) 1 Permit No. State of Florida County of Seminole Ti NOTICE OF COMMENCEMENT Tax Folio No. o2 a 3 a/ 0000 The undersigned hereby gives notice that improvement will be madeto certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of legal description ofthe property and street address if available) 2. General description of improvement: 3. Owner information a. Name and address b. ! Inferest in property IF c. Name and address of fee simple titleholder (ifother than Owner) Contractor ZJ a. Name and address AJ4rYW Gb-rvS-r20Li a Lr _3S A•c• •n e• t T. ®!Z I o-r.." 5. b. Phone number Q u 7 H l Z 3 4 LE L t.r Fax number O Surety a. Name and address N LrY-Q 1 IIII II Ifl U NI II lil U III II IN 1®1111 n W fl 11 IA I illl b. Phone number Fax nARjME MORSE9 c. Amount of bond SEMINAL 6. Lender ,1 a. Name and address CLERK'S # 2003202851 b. Phone number Fax n RUED-II'X. McKi lie 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 wT t)N--Q -- b. Phone number ax number B. In addition to himself or herself, Owner designates Mof 713. 13(1)(b), Florida Statutes. to receive a copy of the Lienor's Notice as provided in Section a. Phone number Fax number 9. Expiration date of notice of commencement (the expiration date is 1 year from date of recor ing unless differ nt date is specified) ,t Signs a of Owner Sworn to (or affirmed) and subscribed before me this 119day of Ni9&H , 20 perby Personally Known OR Produced Identification Type of Identification Produced Signature of Notary Public, State of Florida ComAIISStA k.?J G ............................ av"rPlo,, NORMAV. REIS Conwinion • DD0200729 11( AA(+• p Iny.,risrioo7 i VVr1Vi ZT yvaugh Florida = Aun., km NN...Y..NNN.. N. THIS INSTRUMENT PREPARED BY: NAME AUt S / e t tr3 AODR. G 3 — e T. CMTIFIED COPY MARYANNE NORSE CLERK OF CIRCUIT CO I LE COU NOV ..12 2003 I FTP 26 2T) TOP PORTION OF FTP 25 AND 26HAVEARLECTIVEBLIPBACKGROUNDW/yVyTE REFLECTIVESYMBOLANDBORDER BOTTOM PORTION S{-IA11 HAVE AREFLECTIVEWHITEBACKGROUND WITHBLACKOPAQUELEGENDANDBORDER. FTP 25 AND 26 MAY BE FABRICATEDONEITIIERO;I PANQ OR TWO. FTP 25 IS FOR USE N AREAS WHENSPACEISLMTED. FOOT TYPE III SILT FENCE va- 10^ G b B Oa9M 8)0 Woo &)L SOC`> CI Ci > STOPE V9522 SANFOI D, FLOQIDA LEGAL DESQR TIONLot "C", FLORA HEIGHTS, according to plat thereof, as recordedInPlatBook3, Page 19, of the Public Records of Seminole County, Florida. Also: The South 544.5 feet of the North 577.5 feet of the West179feetoftheEast229feetofSection12, Township 20 South, Range 30 East, Seminole -County, Florida, Less Road Right of Way. TAX PARCEL N . 20 3012 300 0010 0000 EXISTING 4" PVC S.S. LINE TIES INTO WOODLAND a I 3 0 _11 DR. j b I ZI F APPROXIMATE LOCATION OF p z 9 g' r WM EXISTING SANITARY CLEANOUT. m jl QRELOCATECLEANOUTTOLOCATION TIE—IN INV. SHOWN AND TIE PROPOSED 4' SSLINETO TRANSIRPN.CURB I C F 5 3g EWTTNG aaac rui TL EXIST'G II I OJMATUH h S rQ sa.00 z VALLY GUTTER SAWCUT AND MATCH Ch W C+1 TIE—IN INV. play- 1CAL CURB hI u¢r C. EXISTING PAVEMENT 5i roEL50.62 I TYPICAL UNLESS OTHERWISEON NO ) I I CD Y N G ICONSm Y h1' 66G; I LnDh•- a—'' g14elRLAND FARMS g fp IyA, nw_- azu 28' c s SITE BENCH MARK m b 6`I'1R" Q g SEMINOLE COUNTY P.K. AND DISKNUMBER1710601 — ELEVATION 52.747 IS f IZ yti yp' STOP SIGN I w m PSOUTHEAST CORNER OF AMOCO SIGNCORNERAIRPORTANDhlANDBARmgIJ SANFHRD ASANFORDAVENUE. CITY OF SANFORD FIRE DEPARTMENT FEES FOR SERVICES PHONE # 407-302-1091 * FAX #: 407-330-5677 DATE: I ;— IO Z PERM T #: '" Z BUSINESS NAME / PROJECT: C U i4 L4aC ADDRESS: 2IO0 S% A)(t,= - PHONE NO. yp7) 3ag — 03C aFAX NO.: -L zr1g CONST. INSP. [ ] C / O INSP.:[ ] REINSPECTION [ ] PLANS REVIEW [ ) F. A. [ ] F.S. [ ] HOOD (] PAINT BOOTH [ ] BURN PERMIT [ ] TENT PERMIT ,/] TANK PERMIT [ ] OTHER [ ] TOTAL FEES: $ (PER UNIT SEE BELOW) Address / Bldp,. # / Unit # Square Footage Fees per Bldg. / Unit 1. 2. 3. 4. 5. 6. 7. 8. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, FI. 32771 Phone # -407- 330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take place. I certify that the above is true and correct and that I will comply ith all applicable codes and ordinances of the City Sanford, Florida. n Sanford Fire Prev tion Division pplicant's Signature i 11/13/2003 20:55 4076657456 SEMINOLE CO DEV REV PAGE 01 COUNTY OF du:[l-DXI,4G Al-'PLICATION 0- DATE-.. Nkn MIXI-DING P0Zf-IJ:T NOINSFR: O-Z-1000.1274 U141T ADDRESS: AVE 35100 12-20—ZO-3( 1'RArI::JC ;ZONE .'022"- TUrklfj):[CTj:Om- SEC it TWF" SUF aSUPINIVISION.- PARCEL F'.LAT B()OKI :;:.PLAT BOOK PACE., TF. BLOCK: a OwNt..'R NAP'lr.':t. A' AMO 'CONSTRUCTION INC Fl- 32 LAND 11M E: a C'U"iB.-i'Ri AN11) FAR'll Fy S6wrr,r7:ctm. CITY—SANFORD 1;:'C I Al_ INOTES a Nu r in (in-4tall new casll:ter CCALKie irs) dd 1.) PENEFIT RATE UNIT CAI-c UNDIEjTSCHEI) RATE UNITS TY 4 4bcm, 1-3, Fs 200io-0000 CT GT TOTAI... DL11.-- 0o NIA. N/A N/A 00 R m3 N/A Oo Alij N/A N/A 00 AMOUNT DUE dOovE:l) Ely:: 3 rl: 7r C)'T'I:: TO I"AlLURE TO NOTIFY OWNER ANDTIN..:l y Fp MAY IN YOUR I-JAjil-LITY FOR TIAE Ff-E. D:C:TI'T.Ltl1'r7:CJiia 1-101-DO DEPT 3—APPLICAl'-IT2--- F:IN'c)4i4CE 4--ANDMANA301ENT t)DVIBE' l) THAT TIAIS IS A STATE.:NENT 0' f:'EES I>U,,:;- U, 4DtR Ti--r-." ROAD- F1RI'---/RES-QUE. LIBRA.-RY AND/(IFS EDUCATIOINCAL A FJ'X4A)J'At3 F-E-1--z-NIT. A -LSO ADVISEDTl--.A,r ANY RX(31-ITS OF THE M"FILICANT oR I:?OFA"4'Y OF ABOVE. FlF=NTIO.AI:rD 1:14"PACT IFFE'S MUST VEBYFlI-Ilmr3 11 WRITTEN I",7FOLIEST WITHIN 45 CALENDAR— F '11;: qwI: ",!::. SIGNATURE DATE: ARC)Vff, 7 OROCCUPANCY_ THE RE.'QUEST 170'R-ra-VIEW PUT NOTL-/,%Tl:,F,, TRAm T ::Fj R'"EDUIREMENTS Or' THrc': COUNTY LA -ND DEVELOFMEIlITCODE. AFF176;LSMAYBE: PICKED UP OR REQUE Tl;-:'D, 1161. .ASTFIRtTSTREET'i'- S;:f" YJ-J) E'lE MADE. TO; 1-3EVIIHOLE COUNTYR CITY OF SANFORD 1-J- 01. E.AST S277:1. a BYCHECK n 10I..qF ORDERAND SHO 1 (.41I'l .YUlk D RF-FERENCW COUNTY RF,r--Rij:,r 'NUME11- AT THE tc-P LEFTOF. 'Y'"IS SrATEMENT- IS 140 L-ONIGER VA? 11) F A E49JII..DING PERMIT 60 CALEINDARDAYSOF' - I THE RECEIVING SICnNATURE R!•1.Tc DETAILOF CALCULATION AVAILABLE UPON REQUEST. CALL 407-665-=73-56- It Permit # : r.y Z Job Address: 1:2) 1 oo CITY OF SANFORD PERMIT APPLICATION Description of Work: I et,0 n Date: 2- Historic District: Zoning: Value of Work: $ 2 6 O o o = 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: # ofFixtures # 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: oc)o Construction Type: # of Stories: _I # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel#: Z.c) JC i Z 30C Mi61 6,W 0iOwnersName & Address:: CU fA b PiLL-ci FAI&M 5 77 P_d1.n..,. S7D.,oP.L t,/oit) T"r Attach Proof of Ownership & Legal Description) 5107 32Y o'3 L Contractor Name & Address: 111Cl yyw C 0 Yl S A?JC T! ei—> C i7 _T A% l- 1 5 Aorn f `' T. DeLa-r'd o 1 t'- L— State License Number: Phone & Fax: AJC Bonding Company: Address: Mortgage Lender: Address: 11 r Architect/Engineer: H [= C `JG'YV It P pi C Noy 1 Address: I1pl1- 14 0ISe-rw t.cODS LG y F. 1 ayy'L C,L . 1:: (— Application is hereby made to obtain a permit to do the ivoik and i 1 att s ind t issuance of a permit and that all work will be performed tp;rneet st all r 1 permit must be secured for ELECTRICAL WORK, PI UMBING, I O L AIR CONDITIONERS, etc. D2- 77*0 3 Phone: 0 l 3 C'l' Z 4 Fax: r rc )S `r Z (o(c•() that no work or installation has commenced prior to the truction in this jurisdiction. I understand that a separate ACES, BOILERS, HEATERS, TANKS, and OWNER' S AFFIDAVIT: I certify that all ofthe 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. AcceptanePrinOwner/ Agent's erijr/ Age t [ Nill notify the owner of the property of the require is of FloridaLien Law, FS 713. wnate Si nature of C tractor/Agent Date r Go h la l F WY 1'1 Name PrintConactorlAgeameCyh.,.....tr............/,%/.. nq 7 Signatu-Ste' 4Srfitis18f# DCO2,0729 Date t Expires 4/25/2037 OFRjo° Bonded through ow"WR rr'S I Y ', nrnl ...s Produced ID APPLICATION APPROVED BY: Bldg 2- u C)3 Zoning: Initial & Date) Special Conditions: 1.) rl M l I S` fe—l- L My Gomm E*. 10/2Z*4 No. CC 976926 rr• a IQ3-- Fi Utilities: ', i t I v FD: l Date) ( Initial & Date) 1 (Initial & i Date) 4 Cfa Se —k r A )o W 1 .` . Lr t< / 'Oyt- n BLUE I I I r b rro rut I_1 FTP 26 Te MPORTION OF FTP 25 AND 26BACKGR13SYASOLANDBOOLINDW/Wi.{iTE REFLECTIVERDER RE1=`LECTIVE WI-8TE H, C&GROI%J WITHBLACKOPAQUELEGENDANDBORDER FTP 25 AND 26 MAY Bc FABRICATEpONEITHER0JEPANELORTWO. FTP 25 IS FOR USE IN AREAS Wl-r=NSPACEISLIAMTED. 25 D DUD Lr' STOPE U9522 SANFORD, FLO2IDA LEGAL DESCRIPTION Lot "C", FLORA HEIGHTS, according to plat thereof, as recordedInPlatBook3, Page 19, of the Public Records of Seminole County, Florida. Also: The South 544.5 feet of the North 577,5 feet of the West179feetoftheEast229feetofSection12, Township 20 South, Range 30 East, Seminole • County, Florida, Less Road Right of Way, TAX PARCEL N , 20 3012 300 OOIO 0000 E>I VALLY GUTTER r-- SAWCUT AND MATCH EXISTING PAVEMENT I s SITE BENCH MARK SEMINOLE COUNTY P.K. AND DISKNUMBER1710601 — ELEVATION = 5G747CORNEROFAMOCOWSOUTHEASTH J I SIGNNBR'"':Sr CORNER AIRPORT ANDSANFORDAVENUE. Y DEVELOPMENT FEE WORKSHEET CITY OF SANFORD UTILITY - ADMIN. P. 0. BOX 1788 SANFORD, FL 32772-1788 Project Name: C U,A7 E4L/)ri S S 7v REh 4dL Date: "///y/63 Owner/Contact Person: Address: Phone: Type of Development: 1) RESIDENTIAL Type of Units (single familyormulti -family): Total Number of Units: Type of Utility Connection individual connections or central water meter & common sewer tap): Water Meter Size (3/4" 1" 2" etc.). REMARKS: 2) NON-RESIDENTIAL Type of.units (commercial, industrial, etc.): Total Number of Buildings: Number of Fixture Units each building): Type of Utility Connection individual connections or central water meter & common sewer tap): Water Meter Size (3/4" 1", 2", etc.) REMARKS: CONNECTION FEE CALCULATION: V EA 70 /L7/T, 1 J v F c 9V QPP, , fAte e /}-F REVISED G v /A7/-7 . l fir' S 7r-vc, J ?1-v6 Name - Signature - D te. 4e,,:E 1 ! z ,,, (171YAD Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 1 Personal Property I Please Select Account PARCEL DETAIL Back )' IET7- Eel leminnle Cowni, in1Lt.Vi at i!c tianrord Ft.127'71 2004 WORKING VALUE SUMMARY GENERAL Value Method: Market Parcel Id: 12-20-30-300-0010-0000 Tax District: Si -Number SANFORD of Buildings: 1 Depreciated Bldg Value: $198,769 Owner: NCBERLAND FARMS Exemptions: Depreciated EXFT Value: $54,910 Address: 777 DEDHAM ST Land Value (Market): $147,846 City,State,ZipCode: CANTON MA 02021 Land Value Ag: $0 Property Address: 3100 SANFORD AVE SANFORD 32771 Just/Market Value: $401,525 Facility Name: CUMBERLAND FARMS-SANFORD Assessed Value (SOH): $401,525 Dor: 2601-GAS/CONVENIENCE STOR Exempt Value: $0 Taxable Value: $401,525 SALES 2003 VALUE SUMMARY Deed Date Book Page Amount Vac/imp 2003 Tax Bill Amount $8,479 WARRANTY DEED 01/1975 01041 0165 $60,000 Vacant 2003 Taxable Value: $406,394 DOES NOT INCLUDE NON -AD VALOREM Bind Comparable Sales within this DOR Code ASSESSMENTS LAND LEGAL DESCRIPTION Land Assess Method Frontage Depth Land Units Unit Price Land Value LEG SEC 12 TWP 20S RGE 30E S 544.5 FT OF N 577.5FTOF W 179 FT OF E 229 FT SQUARE FEET 0 0 98,564 1.50 $147,846 LESS RD) BUILDING INFORMATION Bid Year Gross Bid Est. CostBidClassFixturesStoriesExtWall Num Bit SF Value New 1 MASONRY 1997 8 4,000 1 CONCRETE BLOCK -STUCCO - $198769 $217,829 PILAS MASONRY Subsection I Sgft OPEN PORCH FINISHED / 400 EXTRA FEATURE Description Year Bit Units EXFT Value Est. Cost New COMMERCIAL CONCRETE DR 4 IN 1997 20,428 $33,706 $40,856 WALKS CONC COMM 1997 720 $1,188 $1,440 CANOPY GOOD COMM 1997 2,268 $19,596 $27,216 POLE LIGHT STEEL 1997 3 $420 $420 NOTE: Assessed values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes. If you recently purchased a homesteaded property your next ear's property tax will be based on Just/Market value. http:// www.scpafl.org/pis/web/re web.seminole county_ title9parcel=12203030000100001... 12/17/2003 uI CITY OF SANFORD PERMIT APPLICATION 16'I rmk#: V " Date: 44* A#tllrecs: 100 S \A \ C-, Z D of Work: r Tif,U f - v c, L\ Historic District: Zoning: Vsk"91 solosORmitType: Building ElectricalMechanical Plumbing Fire Sprinkler/Alarm Pool Electrical: New Service — # of AMPS Addition/Alteration X 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 otiscr thou X) Parcel #: (Attach Proof of Ownership & Legal Description) Owner Address:—y µS Re.4kT6 % cc kar, S V. C 4, ^ t tNl,4fs ntractor Name & Address: (C - . a try , l / •; her: C 2 -C C / 1.1 9 2.0 6 -60 - 3? 35 cow# .`k •-3 6..60 37 lJonalng Company: Address: Mortgage Lender: Address: Arch itect/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 theissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, andAIRCONDITIONERS, etc. OWNER'S AFFIDAVIT: I certify that all ofthe foregoing information is accurate and that all work will be done in compliance with all applicable laws regulatingconstructionandzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT. 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 ofthiscounty, and there may be additional permits required from other governmental entities such as watermanagement districts, state agencies, or federal agencies. Acceptance of permit is verification that I will notify the owner of the property ofthe requirements off Florida Lien Law, FS 713. Signature of Owner/Agent Date Signatu ctor/Agent 1_ . clLk;• Print Owner/Agent's Name CA, Ark e a _ -3SignatureofNotary -State of Florida Date gnature of Notary -State of Florida Date - a°p0.Y P0B FLORENCE A. DE GRAVE MY COMMISSION # DD 164260 Owner/Agent is _ Personally Known to Me or Co ntEXPIRES ,o$vernb r 1 2D06 grProducedIDlfttifcluced (Dd to -1 APPLICATION APPROVED BY: Bldg: Zoning: nit al & Date) Special Conditions: Initial & Date) Utilities: FD: Initial & Date) (Initial & Date)