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HomeMy WebLinkAbout2020 Washington Ave - E05-003799 (WIRING FOR GENERATOR) DOCUMENTSCITY OF SANFORD PERMIT APPLICATION Permit # : M- 11� ,r Date: 0 S Job Address: Mao Description of Work: ns kCt1 r�,1 � Historic District: Zoning: Value of Work: $ U U Permit Type: Building Electrical^^Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical: New Service — # of AMPS Mfr-- Addition/Alteration Change of Service Temporary Pole Mechanical: Residential Non -Residential Plumbing/ New Commercial: # of Fixtures Plumbing/New Residential: # of Water Closets Occupancy Type: Residential Commercial Construction Type: # of Stories: Parcel #: Owners Name & Address: Replacement New (Duct Layout & Energy Calc. Required) # of Water & Sewer Lines # of Gas Lines Plumbing Repair — Residential or Commercial Industrial # of Dwelling Units Total Square Footage: Flood Zone: (FEMA form required for other than X) (Attach Proof of Ownership & Legal Description) �D A� "U" S/k)/;VS �3�-17 Phone: Contractor Name & Address: l 4�0 I' �2f �N I + V1' ti t�� + �(✓� i+.^L,. 0")- �A— State Licensee Number: ti�� � ��y 01 c Phone & Fax: i0 l� 1' l �i�� � r T Contact Person: PAW' IjD 4��&4---Phone: � �i� d 4 r� C 7 � Z Bonding Company: 0'— Address: Mortgage Lender: _ Address: Architect/Engineer: Address: 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 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. 2and ion to the requirements of this permit, there may be additional restrictions applicable thi property that may be found in the public records of ere may beadditional permits required from other governmental entities such as term ragement district ,state agencies, or to ala encies. mit veritica hat I r notify the o ner of the p r of the requirein its f F Lien S 71 iature of Owner/Agent Dat r�► Sig ore of ntr ct Agent Date Ifil Owner/AgenCsName PMnlrgentsNameQ�ICK ' �I� u a'0\' -U� ignature of N Ary -State of Florida NOTARY PUBLIC - SAF FLORIDA Signature of Notary -State of Florida Date COMMISSION 233/Q2008712 EXPIRE9 DEBBIE BLANTON BONDEDTHRU 1 -88 -'-NOTARY! Ni)' COMMISSION # DD 188491 Owner/Agent is ✓ Personally Known to Me or Con , c F t is F,P! Ptrrs d611u 2gy2D09 Me r Produced ID Prrody- -Ip.n' APPLICATION APPROVED BY Special Conditions: BI g Zoning: (Ir itial & Date) Utilities: FD: (Initial & Date) (Initial & Date) (Initial & Date) Permit No. State of Florida County of Seminole teat to ns n stt tt ant s1 etyl Y� [�Q Atlfjp tQ tip FHxI: $$ i(i n: Q$i t idBl . NOTICE OF COMMENCE WYULE CURNTr CLERK, OF CIRCUIT G IRT OLE UWtfrY ' PIK 05867 PS 1973 r- L`):2R14Fb15) I10.200514 2930 REL'UNDEU 08/EE/20005 01:50:38 Pm- R "L'UNDINU FEES 10.00 R 'CUNDE.D BY D Thosas The undersigned hereby gives notice that improvement will be made to certain real property, 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 property and street address if available) 2. General description of improvement: t��o-rc�t� wt�Te12 3. Owner information a. Name and address��vn 1=. b. Interest in property 1-� c. Name and address of fee simple titlehol, 4. Contractor r e m r e c y a. Name and address _i�itorESS to N !4 L b. Phone number 5. Surety a. Name and address b. Phone number _ c. Amount of bond 6. Lender a. Name and address ►C,4 <; I' . a V— (it other than Owner) ntjo' ©C- CXFS i ►Nft, SLt ra1cwt Co74,4-C??62-S G F Fax number '3Iq (o -W ,-j Fax b. Phone number Fax 7. Persons within the State of Florida designated by Owner upon whom provided by Section 713.13(1)(a)7., Florida Statutes: a. Name and address b. Phone number Fax i 8. In addition to himself or herself, Owner designates 713.13(1)(b), Florida Statutes. to receive a copy a. Phone number Fax 9. Expiration date of notice of commencement (the expiration date is 1 yl date is specified) Sworn to (or affirmed and subscribed before me this (% day of _N o r /AuL u0 C Personally Known ✓ OR Produced Identification Type of Identification Produced DONNA D. SOUTHWICK C NOTARY PUBLIC - STATE OF FLORIC i e of No Public, State of Florida COMMISSION # 1 EXPIRES 9/23/20083/2008 Commission Expires: BONDED THRU 1-6B' NOTARY! s or Ce A]9KL Ro lac �'t, Ft.ORtDA . Y ��' r, htlnr4 may be served as of 's Notice as provided in Section the date of a different of Owner 20()5 , by