Loading...
HomeMy WebLinkAbout610 East 5th StCITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION '. D MAY 2 4 2016 I Application No: / 6, - BY: ov Documented Construction Value: S 00 Job Address: Historic District: Yes ❑ No Parcel ID: L5 - /q -,:�n - fl =a - 2(00 G - 0040 Residential ® Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration ❑ nRepair ❑ Demo Change of Use ❑ Move ❑ Description of Work: '�Ibgmo cit ksi,( /12 h=5 i•z1hl) r 5 C= Plan Review Contact Person: Title: Phone: Fax: Email: Property Owner Information NameLiO5 / t� 10.d t i i F - %S Phone: 46 7 -,2,2 - 7a;5-9 Street: /n &-0-- 5-'*- ��ra-z� Resident of property? City, State Zip: � n�2r�f--1 _ 377`71 Contractor Information Name ,S/7 -off �712��nA / tom- (_2tJ,Q Phone: 467 -.388 -SEE-0 C Street: Fax: R(o City, State Zip:/w�-�2_.�'�ZY�/rl (78 7 State License No. Name: Street: City, St, Zip: Bonding Company: 411,4 Address: Arch itecVEngi nee r Information Phone: Fax: E-mail: Mortgage Lender: Address: WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 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. FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 51° Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application 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 of Florida Lien Law, FS 713. The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal. The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value, credit will be applied to your permit fees when the permit is issued. 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. Signature of Owner/Agent Print Owner/Agent's Name Date Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID Signature of Contractor/Agent Date Print Contractor/Agent's Name Signature of Notary -State of Florida Date Contractor/Agent is Personally Known to Me or Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas[] Roof ❑ Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes ❑ No ❑ APPROVALS: ZONING: ENGINEERING: COMMENTS: Flood Zone: # of Stories: Plumbing - # of Fixtures # of Heads Fire Alarm Permit: Yes ❑ No ❑ UTILITIES: FIRE: WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application 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, beaters, 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. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. 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 of Florida Lien Law, FS 713. The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in order to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the plan review fee based on past permit activity levels. Should calculated charges exceed the documented construction value when the executed contract is submitted, credit will be applied to your permit fees when the permit is released. Sip -We of Owner/Agent '' AA Date ✓y� Signa ture of (Contractor/Agent Date e S i 0 k --A ✓L \ 2ls4w-{ b Print r/Agent's Name ontmctor/Agent's Name Sign o to of a Date ignature Notary- to of Florida Date BOBBIE G OWENS MY COMMISSION #FF170911 EXPIRES November 22, 2018 Owner/Agent is Personally Kno ' Floridallota se Agent is --kiersonally Known to Me or Produced ID ,/ Type of ID Fe- Lle---1Produced ID Type of ID APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: FIRE: COMMENTS: Rev 11.08 BUILDING: THIS INSTRUMENT PREPARED BY: Name: Keith Owens Address: _1d44A Ham c— RaItr:irrb Wintbr Gardro Flnrida 4d7A7 I "I'll 111:1 fiiii ME Nil M11 1111 1111 I I19I MARYANNE MORSE, SEMINOLE COUNTY ULENK Uf �iRCUIi UUURT r, COMPTROLLER BY, 8693 P9 737 up9s) CLERK'S 4 2016053522 NOTICE OF COMMENCEMENT RECORDED 05/24/2016 09:27:24 All NLCURVINb ILLS $10.00 Permit Number: lD' c� RECORDED BY hdevore Parcel ID Number: 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) ,�.y�4• � � \ 1S to ���' � Jw •1 c �� �.. H r�►=�� ^..� i�� 1 '�JCr � (�� 2. GENERAL DESCRIPTION OF IMPROVEMENT: 3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and address: --, :-, << <_ 6) (O iz_ S ' ",k. eL- V.) Interest in property: o , A..:l e-4'— Fee Simple Title Holder (if other than owner listed above) Name:_( Address: 4. CONTRACTOR: Name: Blackstreet Enterprises LLC. dba BSE Construction Group Phone Number. 772-344-8201 Address: 535 NW Mercantile Place 8107 Port SL Lucie, Florida 34986 S. SURETY (if applicable, a copy of the payment bond Is attached): Name: N/A Phone Number. Address: Amount of Bond: 6. LENDER: Name: NIA Phone Number: Address: T. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section T13.13(1)(a)7., Florida Statutes. Name: Keith Owens Phone Number. 407-388-5820 Address: 14338 Hampshire Bay Circle Winter Garden, Florida 34787 8. In addition to himself or herself, Owner designates of to receive a copy of the Lienors Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number of person or entity designated by owner: 9. Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a different date is specified) !if- '31 1 co WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF Ir -M COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, a FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A CI -41 NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST f INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY � �p��,.....,• BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. i oIe: ,,��•- ire, Under penalties of perjury, i declare that I have read the foregoing and that the facts stated in it are tru to thes of myy�knowledge and belief. f ��;•.. , ::> (SI ure of Owner or Lessee, or Owner's or Lessee s (Print Name and Provide Signatorys Title/Office) Wa orized ORIcer/DirectorlPartner/Manager) N Stateof f-1[.7/Z;/0.A County of 0'2.d:n:� z The foregoing Instrument was acknowledged before me this 25 day of AAA I2 C /7 .20/ z D by L �C15 / c=/ L �S Who Is personally known to me ❑ < LL Name of person making statement OR who has produced Identification © type of identification produced:.�L t, 0 BOBBIE G OWENS MY COMMISSION MFF170911 %t!.L , v O w m EXPIRES November 22. 2018 (407) 798-0157 Floridallota Service.com CITY OF SANFORD ** S E R V I C E O R D E R ** ** C A P S E W E R T A P ** CREW CODE: SECTION: GE GEORGETOWN LOCATION ID: 90765 CLASS: RESIDENTIAL ADDRESS: 610 E STH ST CITY: SANFORD CUSTOMER ID: 89800 NAME: DANIELS, MOSES L UT500L CYCLE/ROUTE: 14 04 SVC ORDER NO.: 494177 ISSUE DATE: 5/25/16 ISSUE TIME: 9:46:50 REQUEST DATE: 5/25/16 USER ID: WAGNERC PHONE: 407 323-5593 -------------------------------------------------------------------------------- SERVICE/SEQ: SW 000 SEWER FLOW ---------------- C O M P L E T I O N I N F O R M A T I O N ----------------- DATE: —/—/ MISC CHARGE: AMT: ACTION: COMPLETION METHOD: SVC ORDER MAINTENANCE COMMENTS BUILDING SCHEDULED FOR DEMO COMMENTS PLEASE CAP SEWER LINE PLEASE CALL CYNDI WHEN COMPLETE 1 : 6# 5993 9a�PRI�NT PER ANN+ETTE' IN' BLDG : CUSTOMER W IN,G.,�-FiOR AaES',V,+LTS V,)Ct+a bep� dn ncc+-enc( / !mac