HomeMy WebLinkAbout1801 W 15 St - BR05-003053 (ROOF) DOCUMENTSPermit #-r
Job Address: / 7) ti
Description of Work:
Historic District:
sl CITY OF SANFORD PERMIT APPLICATION //
`"� _ Date: F/
Zoning:
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
Value of Work: S %YJ l Deg
Mechanical Plumbing Fire Sprinkler/Alarm Pool
_ Addition/Alteration Change of Service Temporary Pole _
Replacement New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial Total Square Footage:
Construction Type: _ # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
(Attach Proof of Ownership & Legal Description)
Bonding Company:
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: 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 TObWNER: 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: hi addition to the requirements of this permit, there maybe 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.
is verification that II notify . e owner of the property of the require is of F da Li Law, FS 713.
AcceptancOi—g.nature
17 0�
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of Owner/Agent Date
Signatureontractor/Agent Date
0 (2
nt O er)ent' ame
Print Con cto gent's Name
SigDatire,ofIQ(trSt}Matti oPFfclt?dial Date
Signature of Notary -State of Florida Date
IN CAO IISSIDN # DD 164230''"'
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% EXPIRES: November 12,200('
r'qr Thru Budget Notary Service
r� hvCpMMISSIONDp 64288
e`°c Bonded
OwneA ent is Personally Known to Me or
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Contractor/A ent ts`O Pel nail s"w'r� ftfl ' e or.
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fl,Ptoduced ID
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APPLICATION APPROVED BY: Bldg:
Zoning:
Utilities: FD:
(Initis Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:
'A. S4tWment'Statement
_
U.S. Department of Housing , �'
and Urban Development nnna ni nano nn..
ype of Loan ; h
FHA 2.❑ Fm HA V. Conv. Unins.
f
6. File Number
7. Loan Number
8. Mortgage Insurance Case Number
VA :.'c: 5.❑ Conv. Ins.
03050376
ote: This form is furnished to give you a statement of actual
settlement costs. Amounts
paid to and by the settlement agent are shown. Items
marked "(p.o.c.)" were paid outside -the closing; they
are
shown here for information purposes and are not included in the totals.
D. Name and Address of Borrower
E. Name and
Address of Seller
F. Name and Address of Lender
"Allison J. Lazoo
Addie L.
Mitchell
Karen S. Chana, a married woman
1400 Woodfield Oaks Drive
523 West Oakland Avenue
865 North State Road 434
Apopka, Florida 32703
Oakland,
Florida
Altamonte Springs, Flordia 32714
G. Property Location
H. Settlement Agent
1801 West 15th Street
Equitable Title Agency, Inc.
Sanford, Florida 32771
Leg E
Place of Settlement
I. Settlement Date
LEG E
2705 S. Maguire Road
"a
Ocoee, Florida 34761
05/20/05
v
DD: 05/20/05
- J. SUMMARY OF BORROWER'S TRANSACTION:
K. SUMMARY OF SELLER'S TRANSACTION:
100. GROSS AMOUNT DUE FROM BORROWER
400. GROSS AMOUNT DUE TO SELLER
101. Sales Price .
30,000.00
401. Sales Price 30,000.00
102. Personal property - -.11.' 1
402. Personal ro ert
103. Settlement charges to borrower line 1400
5,126.96
403.
104:.
404.
105. ., ., ..
'
405.
Ad ustments for Items Id seller in advance
Ad ustments for Items paid by seller in advance
106. Ci /town taxes to
406. Ci /town taxes to
107. Count taxes to '°
407. County taxes to
108. Assessments to
408. Assessments to
109. ' '
409.
110.
410.
111.
411,
112:
412.
120. GROSS AMOUNT DUE FROM BORROWER'
35 126.96 420. GROSS AMOUNT DUE TO SELLER
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER
30 000.00
500. REDUCTIONS IN AMOUNT TO SELLER
201. De osit or earnest mone
500.00 501. Excess Deposit see instructions
202. Prinoi al amount of new loans
25 000.00 502. Settlement char es to seller line 1400
203. Existin loans taken subject to
2930.50
503. Existing loans taken subject to
2�' " "
504. Payoff of first mortgage loan
205.
505. Payoff of second morta e loan
206.
506.
207.. ,...
507.
208. '.....
508.
209)
509.
Adjustments for Items unpaid by seller
Adjustments for Items unpaid by sailer
210. Ci /town taxes " to
510. Cit /town taxes to
211r'Co6n taxed '. 01/01 to 05/20
193.89 511. County taxes 01/01 to 05/20 193.89
212.'Assessments " to
`c�
512. Assessments to
213.' :
".,
513.
21'4:' ...
514. ^
215.
515.
16.
516.
217.' ...
517.
218.'
518.
2191.
519.
220. TOTAL PAID BY I FOR BORROWER 1
25 693.89 520. TOTAL REDUCTION AMOUNT DUE SELLER
300. CASH AT SETTLEMENT FROM OR TO BORROWER
3,124.39
1 600. CASH AT SETTLEMENT TO OR FROM SELLER
301. Gross amount due from borrower (line 120)
35,126.96 601. Gross amount due to seller (line 420)
302. Less amounts paid by/for borrower (line 220)
30,000.00
25 693.89 602. Less reduction amount due to seller (line S20) 3,124.39
303. CASH FROM BORROWER
9,433.07,603. CASH TO SELLER
-26875.61
RESPA, HB 4305.2 - REV. HUDt(3/86)