HomeMy WebLinkAbout135 Anthony DrPermit 0! ,-W` (70
Job Address:
AIV
Description of Work:
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date:
Value of Work:
. 7
Permit Type: Building Electrical _—
Mechanical Plumbing ,_„^ Fire Sprinkler/Alarm Pool
Electrical: New Service – # of AMPS _
Addiiion/Alteration
Change of Service Temporary Pole
Mechanical: Residential _.,.,,– Non -Residential
Replacement
New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures —
# of Watcr & Sewer Lines # of Gass Lines
Plumbing/New Residential: # of Water Closets
Plumbing Repair – Residential or Commercial
Occupancy Type: Residential --X Commercial
,_,,,,, — Industrial
Total Square Footage:
Construction Type: # of Stories: _�— # of Dwelling Units:
Flood Zone: (FEMA form required for 4 ther than X)
Parcel #, ��% ��J �op�� - �1f�O�J l/// (Attach Proof of Ownership di
Owners Name & Address: /l /!'_�,,/�,�il��
t'C Phone:
Contractor Name tit Address:
Phone & Fax: 1
Bonding Company:
Address;
Mortgage Lender:
Address:
ArchlcectrEnglheer;
Address:
State License Number:
Contact Person: Phonc;
Phone:
Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior
issuance ora permit and that all work will be performed to meet standards of all laws regulating construction in Chia Juriadiction. t understand that a a,
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 ail of the foregoing information is accurate and that all work will be done in compliance with all applicable laws itgulatinj
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT M YOUR 4AYING
TWiCE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR A
ATTORNEY BEFORE RECORDING YOUR N017CP 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 rr4ords of
chis county, and there may be additional permits rcquircd from other governmental cntitica such as water management districts, state agencies, or federal genies
ptance of jerr4it is Vic Meati iai wj 1 n . o ,.the property of the
X
Sign rc of Owner/Agcni j� . —���
� G d r r "' `
Print Owner/Agenea Name
i�f3-OS
Si nature of Notary -State or Florida Date Signature of Notary -State of Florida Date
DEBBIE BLANTON
t r y P y t:t',r COivf'41 OON # DD 188491
Owner/Agcni is Personally Kno n to c JULIE A. AL�,,�t�aaor PErsonalty Known to c r
_ Produced 1 D MY COMMISSION # �t7ll a 10 ss >' c-,�t 1'tE :February 2 , 207
EXPIRES: June 28, 2007 800.9-N01'4W, PL Nviury Discount Assoc. Co.
mita&NhTAgv rt.
APPLICATION APPROVED BY: 7.oning: t� CisCoon.A= °° r Utilities: FD;
(Initial & ate) (Initial & pate) (Initial & Date) (initial &
Special Conditions:
TO 39VJ 3NI SNI-�00�1 rNVWTIV LtT6ZZELOb OT _69 SOOZ/bT/LB
This Name= /I l �Pared BY:
i4 v� A
Addressf /...
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final to= 8MUNW®sa<MISM8110816M
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SEMINOLE CLUM
BK 05814 4 FIC 030a)
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CLERKS S 0 24 IDS] 1992
REUIRM OVIS/MI5 10.-118
RECOKIPS FEES 10.0
PERMIT NUMBER TAX FOLIO NO,
NO'nCE OF COMMENCEMENT
STATE OF
d6uNTY
THE UNDERSIGNED herby 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 property, including address if available)-
'/ /-7/'. -5'Av-oW s' '77"
2 General description of improvement:
3. Owner information:
a. Name and address:tc�n7���
b. IntereSt in property:
c. Name and address of fee simple titleholder.(if other than owner):
CE(?`PiFlED rOPY
MA Y.4Al BOR
4. Contractor: (name and address) /)/�/V-'rte 170Df e Zir • CLE f IRC
Lay)Jst! �. cry f�..a�? x 73 SE V0 EOU IY co,U
Of
/BY
5. Surety N( o Wl CL K
a. Name and address:
a. Amount of bond $ w 2005
6. Lender: (name and address)
7. Persons within the state of Florida designated by owner upon whom notices or other
documents xnay be served as provided by Section 77.3.13 (1) (a) 7., Florida Statutes:
8. In addition to himself, owner designates the following person (s) to receive a copy of
the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes:
T LWRT
9. Expiration date of notice of commencement (the expiration date is (1) year from the date
of recording unless a different date is specified)
SWORN to and subscribed befame me by
who is rsonally kno to me or produce OW%� -6-6i e ] [ f
as i en a on, and who dict— GG, cz � /�' M r4Se 1
take an oath, this I. day of� v. Q c 120-05 (owner's name)
Signature of No
Printed name of notar Sv 0k s✓ t ---N 1a (owner's address)
Commission No./Expiration D O ate 3% O .
SEAL: �. .
JULIE A. ALLEN
��MY COMMISSION # DD 226360
aF � EXPIRES: June 28, 2007
"ALL 1NFORMAIMN MET 8E TYPED OR PRINTED UMLY TO COMPLY WMi RECORDING 1CBQUDLEM i 3"
Ze 39ad 3NI 9rIIA00�1 NVW-17V LbT6ZZELOt 0T:60 9002/bT/Le
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
114gk�'4�2 "',� z �M *,,I AFFIDAVIT
� l
COMPANY: 1 n O G LICENSE NO: �fp_4�t /�--,) '�e I
SUBDIVISION:
PERMIT NO:
PROJECT INFORMATION
LOT:
I, Ill &doi ( J A -Z 1 pg ->ti , affiant, hereby affirm that I am the duly licensed contractor of record for the above reference
permit, tilat 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:
(Printed name)
STATE OF FLORIDA
COUNTY OF �h? i ✓�
This instrument was ackno ledged before me this ;D day of �/ by the above referenced
individual, /� 2 _ (m i¢ �✓ , who acknowledged that h6/she is a duly licensed contractor with
and who acknowledged that he/she was authorized to execute this document. He/she is
either personally known me or produced as valid identification.
WITNESS my hand and official seal this day of
Notary Public
MY CO[+rM€ OON # DD 188491
Printed Name: _. _----25,2007
My Commissi p� _ 'P'L u, ni—ount Assoc. Co.