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Home My WebLink About301-308 N Lake StPermit # : D, ` -s (., �qC Job Address: '91f:S Q, Lfty-E Description of Work: Historic District: CITY OF SANFORD PERMIT APPLICATION 3 \ ) _ 3 � Date: L4 S �j a¢ e*h 44L s Zoning: Value of Work: $ /J ted "" Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical: New Service - # of AMPS Addition/AIteration 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 Industrial Total Square Footage: Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: r �(Attach Proof of Ownership & Legal Description) �o., Owners Name & Address: �`4-- ! r e - Z -n3 » - L 4tDe- Phone: Contractor Name & Address: � Y State License Number: CCe J5S +7 C ,� Phone & Fax: Orlando; Ft 32810 Contact Person: J YMDA LcA Gr) Phone: LJD4g Lt 3- 60G 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 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 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. Acceptance of permit is verification that I will notify the owner of the property of the requirements ofFlorida ien Law, FS 713. Signature of Owner A/ gent Date Signature o ontractor/Agent Date 1 J41 we �±Oh nSt& Print Own r/ ame Print ontractor/Age is Name 68I' otary-State o FI i Date S gnature o tary-State of Florida BETWE LOWMAN NOTARY PUBLIC - STATE OF FLORIDA COMMISSION # DD388731 EXPIRES 4/28/2009 Own gent is _Personally Known to Me or Contractor/Agent is _Personally KnowtitiMNMgFIRu I-eea NOTARvt Produced ID - Produced ID APPLICATI N APPROVED BY: BI Zoning:. ••^•(Initial &, 'dt.)............ LYNDA LEACH ""x Special Conditions: °��uri C nwA P c.2�.f GOOie7s9� moM V1U M (Initial & Date) Utilities: (Initial & Date) M41 FD: (Initial & uate) AFFIDAVIT REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS Company: License #: One Source Roofing Inc. 894 W. Kennedy Blvd. Orlando, FL 32810 Project Information Owner: Permit #: name Subdivision: address Lot #: phone 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 )qu-t-r-JoaN5D►4 printed name STATE OF FLORIDA COUNTY OF V This instrument was acknowledgq above referenced individual, duly licensed contractor with he/she was authorized to execute th produced day of , 200S , by the who acknowleg ged that he/she is a =.-J..�-._..--; and-who-acknowled2ed that document. Wsh$eA�eitheer personally known to me WITNESS my hand and seal this day of '200-5. BETTY L. LOWMAN Notary P c NOTARY PUBLIC - STATE OF FLORIDA COMMISSION # DD388731 EXPIRES 4/28/2009 BONDED THRU 1-888-NOTARYI ONE SOURCE ROOFING, INC. 995 West Kennedy Blvd., Suite 32 Orlando, FL 32810 (407)660-8010 (407)660-1359 Fax 2 -139 - State License #CCC055607 AGREEMENT Name: V/-, Address: L'1l G'r__-- r City: �G�rj C'✓ L/ ZIP:_ Dater - Home Phone: 1'f a —�-7*" &-"yWSSork Phone: ..SPECIFICATIONS (Grade of Shingle: !3 , r, ��yle of Shingle: E,1 :01or of Shingle: Li -.-1 E?A,idge Material: Galley: 2Vents: E;'Plumbing Stacks: ER-lear off EZ -,Yes ❑ No layers C-1-relt: , tch: 2 -story i.-- ' L�emove trash from roof, gutters and yard C�J�/,.RProtect landscaping where needed- oil eeded- oll yard with magnetic roller F�Furnish permit SPECIAL ATTENTION AREAS E1 Existing Driveway Damage a- Yes ❑ No �kylights: at eaks: [Anterior Damage: .40 aAII sheathing lobe replacedQr „L; �er sheet L.F 1660 Old Dixie Highway Vero Beach, FL 32960 (772)567-4300 (772)567-4650 Fax SPECIAL INSTRUCTIONS COMPANY'S LIMITED WARRANTY — 2 YEARS ON ROOF REPLACEMENT AND ONE YEAR ON REPAIRS. PAYMENT SCHEDULE Personal checks must be made payable to One Source Roofing, Inc. Agreed Amount With Customer. $ Z < Additional Work Requested By Customer $ TOTAL AGREEMENT AMOUNT $ CK# DATE Down Payment Materials Check $ Final Payment $ ACKNOWLEDGEMENT UPON SIGNING THIS AGREEMENT, CUSTOMER AGREES TO PAY ONE SOURCE ROOFING, INC. TEN (10) PERCENT OF THE TOTAL AGREED AMOUNT. UPON DELIVERY OF MATERIALS, CUSTOMER AGREES TO PAY ONE SOURCE ROOFING, INC. HALF THE TOTAL AGREED AMOUNT FOR THE PROJECT. UPON COMPLETION OF THE PROJECT, CUSTOMER AGREES TO PAY ONE SOURCE ROOFING, INC. THE BALANCE DUE FOR THE PROJECT. CUSTOMER'S INITIALS TERMS: This is a binding agreement. Any additional work requested by the General Contractor/Customer will become part of this agreement and General Contractor/Customer agrees to be financially responsible for all amounts due herein. By signing, this agreement, General Contractor/Customer authorizes One Source Roofing, Inc. to undertake the construction of project through to completion, and General Contractor/Customer agrees to pay One Source Roofing, Inc. all amounts due herein. PERSONAL GUARANTEE: I have reviewed this agreement and by executing below, agree to be personally responsible for all sums due and owing to One Source Roofing, Inc., agreeing to do work for and on behalf of my company or other entity. One Source Roofing, Inc. shall not be responsible for any incidental and/or consequential damage including, but not limited to, driveway cracks, loose wall or ceiling hangings, etc., and shall not be liable for any fungus, mold and/or indoor air quality issues related to this work. This proposat/contract is valid for fifteen (15) days Accepted by General Contractor/Customer on: Date: _k1 �% By: 1 , t-4-L.L_ By: Field Supervisor: p Management Approval: WHITE - COMPANY YELLOW - FIELD SUPERVISOR PINK - CUSTOMER POWER OF ATTORNEY Date_ I hereby name and appoint L%t.I 1)a too C(4 Of OKIC-- -6;0U4CF- 'V----;`0 6 aJG In fact to act for me and apply to the 5 (+M(,GM Building Department for a� For work to be performed at a location described as: Section Township Range Subdivision Lot to qe my lawful attorney lock permit (Owner of Property and Address) and to sign my name and do all things necessary to this appointment_ dice op)--ptj Ecco s!5,io Type or Print Name of Register or CeAifted Contractor and Contractor'l License Number The fi By_ was acknowledged before me this LT� day of Who is personallyknown to me/wh produced As identification and who did not take oath. NOTBEPUBLIC L. - LOWM AO State of Florida - COMMISSION # DD388' EXPIRES 4/28/2009 County of A— BONDED THRU "888 -NOTARY UCS/ i/'/u^"' Seal otary Publi , range County, Florida of 20 Division of Corporations Florida Deparbnent of State, Division of Corporations ij7�rl�iP, trrr ra.nr Public y Florida Non Profit Pagel of 2 NORTHLAKE VILLAGE V CONDOMINIUM ASSOCIATION, INC. PRINCIPAL ADDRESS C/O OFFICE SUPPORT SYSTEMS 753 S. RANGER BLVD. WINTER PARK FL 32792-4527 US Changed 05/01/1995 MAILING ADDRESS PO BOX 5717 WINTER PARK FL 32793-5717 US Changed 05/03/2004 Document Number FEI Number Date Filed N12733 592615643 12/23/1985 State Status Effective Date FL ACTIVE NONE Registered Agent Name & Address FERRARA, WILLIAM G C/O OFFICE SUPPORT SYSTEMS 753 SOUTH RANGER BLVD. WINTER PARK FL 32792 Name Changed: 05/01/1995 Address Changed: 05/01/1995 Officer/Director Detail Name & Address Title WILSON, KERRY 708 NORTHLAKE DR VD SANFORD FL 32773-6191 WECHTER, MS. PATRICIA 808 NORTHLAKE DRIVE PD SANFORD FL 32773-6100 ... /cordet.exe?a1=DETFIL&n1=N12733&n2=NAMFWD&n3 0000&n4=N&r1=&r2=&r3=&r,8/10/2005