HomeMy WebLinkAbout526 Sanford Avea
Permit # :
Job Address: s
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date:
S --/a
Value of Work:
.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 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 t - Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for at)[or: than X)
Parcel # -9� ~� l ✓��~��� �� �, ' d d l� -
( ach Proof of Ownership & Legal Description)
Owners Name & Address:
Phone: s e,
Contractor Name & Addr
State 6cense Number.
Phone & Fax: Contact Person: Phone:
Bonding Company -
Address:
Mortgage Lender:
Address:
Architect/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 15nor 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. lays rcMdating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT FNT YOU:t. )"HYING
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 re ' is of F da Li w, 3.
G
Signature of Owner/Agent Da J Signature of Contractor/Agent Date
Name
DEBBIE BLANTON
MY CC?> ,.J!SSION # DD 188491
Owner/ ge l'T PP&rsonally i6ioQgi8ihe2M7 Cont
APPLICATION APPROVED BY, Bldv��� �J I ng
(Initial & Date) (Initial & Date)
Special Conditions:
Contractor/Agent's Name
DEBBIE BLANTON
MY CO`'I'MISSION # DD 188491
EXPIRES: February 25, 2007
entTisr., PersonallyoKMo .Ioo�o°r
Utilities: FD:
(Initial & Date) (Initial & Date)
a
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
--Z�
CEJ Project Information
Cr
Owner: �J� Permit #:
me
address
'20JA!4g —;4� / 3
pho
Subdivision:
Lot #:
I, , affiant, hereby affirm that I am the duly licensed
contractor of record for the above referenced permit, that all the foregoing information is true
and accurate, and that the dry -in, flashings at the above referenced address or lot has been
installed in accordance with the applicable codes and standards.
Contractor
signature
C�oz('Cf\ a
printed name
STATE OF FLORID
COUNTY OF
This instrument was acknowledged before me this day of , 200 by the
above referenced individual, . ,,who acknowledged that he/she is a
duly licensed contractor with Csonally
and who_acknowledged that
he/she was authorized to execute this document. He/she is either p known to me or
produced as valid ident><.
WITNESS my hand and seal this day of206 S
r
N ie
'� DEBBIE BLANTON
MY COMMISSION # DD 188491
�n EXPIRES: February 25, 2007
1 -800 -3 -NOTARY FL Notary Discount Assoc. Co.
1
48
`THIS INSTR�d PREPL;ED�Y:
NAME: 1 : ADDRES _ fl SEAuNOLE CouNry
TiOXIDA'S NAIURAr CH01Cr.
State of Florida
Permit No.
NOTICE OF COMMENCEMENT
Tax Folio No. (PID)
Building & Fire Inspectior
1101 East 1 st Strep i
Sanford, FL 3277
County of Seminole
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.
DESCRIPTION OF PROPERTY (Legal description of the property and street address)
t copy
rI roll �'_wft ORSE
LGDES5tIPTjI1 OF
OWNER INFORMAIJOIN
Name and address % V
Interest in property (Fee Simple, Partnership, etc.)
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER. (IF OTHER THAN OWNER)
CONTRACTOR
Name and addreo�_
SURETY (Bonding Company)
Name and address
C
Amount of Bond MARYANIC KMSE, GEED
9E"IWI ..E CONN .
BK 05721 PG t5Frs4
LENDER Ct_ERW S # 20cw50713265
Name and address RECMW 0-j/11/m 04s09:11 PH
RgMRDING_FM 10.00
Persons within the State of Florida designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes:
Name and address
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as
provided by Section 713.13(1)(a)7.,Florida Statutes:
Name and address:
FTT TTTTTTTTTTT�
In addition to himself, Owner Designates
To receive a copy of the Lienor's Notice as
of,
Provided in Section 713.13(1)(b), Florida Statutes. I
Expiration Date of Notice of Commencement
(The expiration date is 1 year from date of recording unless a different date is specified.)
Signature rd Owner U U
Sworn o nd subscribed be ore me this AV� Day of
My Commission Expires:
AIZADA WASHINGTON
* „ Notary Public - State of Florida
My commission Expires Jan 4, 2007
Notary Public ,��. commission # DD156630
�h�`d Bonded By National Notary Assn.
111 111
The fore oing instrument was acknowledged before me this U 7:0(- day of
&'27M I (Name of person acknowledged), who is persona y known to me or who has
produced (Type of identification), as identification --mind who did/did not tape .
and osth..