HomeMy WebLinkAbout110 North French AveMAY 212011
D . BY: _ CITX_O SANFORD .
BULLDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I I Documented Construction Value: $
Job Address: ptec?,er y 4y6- Historic District: Yes No
Parcel ID: ZS'• / 9 • 3 - SA'ry • O Zo 9 -DO/ o Zoning:
Description of Work: J N' 0_ e.c, C0 /d 0 f}-M Zyd oll- Tropm }6 Pow,7Z,Doc-C
Plan Review Contact Person: Title:
Phone: Fax: E-mail:
Property Owner Information
Name F d' R c o—rx p Los F1, [.. L r— Phone:
Street: 41& WO !7 -,*AA V L E 6 c.vffVAj L-- Resident of property?
City, -State Zip: 0A.4t.+A100 e FC . 3-ZQ-39
TD 1 ,,. , 0j&Contractor Information
leele/ V 'e/$o v#C/z
i r i Wit.
Name- Phone: 3 Zy ir^3 19— 7
Street: Fax: ?/ 3 ^ Z S'L Fri
City, State Zip: P47 3 3 w % jc State License No.: erz /30 d 3 LS(o
Architect/Engineer Information
Name: N / /T Phone:
Street:
City, St, Zip:
Bonding Company:
Address:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Building Permit
Square Footage: Construction Type: No. of Stories:
No. of Dwelling Units: Flood Zone:
Electrical
New Service - No. of AMPS: / 00
Mechanical (Duct layout required for new systems)
Plumbing
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm No. of heads:
TB o* A'514f 2'MY Pam
FO 7-)AI AwO'uter- o /= 3,-7 SW ,o._
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. 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.
Signature of Owner/Agent Date,.
Print Owner/Agent's.Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Signature of Contractor/Agent Date
Ac* ../ lzloo
Print Contractor/Agent's Name
V & a, 441,J6N,, ; - / 7,
Signature of•Notary-State of Florida Date
NOTARY PUBLIC -STATE OF FLORIDA
Mercedes A. Bloomer
1 ' Commission #DD935534
Expires: OCT 25, 2013
BONDED TARO ArL4\77C BO.\DL;G CO., INC..
Contractor/Agent is ersona ly Kno o Me or.
Produced ID Type o
WASTE WATER:
BUILDING:
Rev 11.08
Permit No.
Tax Folio No.
NOTICE'OF COMMENCEMENT
State of Florida
County of Seminole
The undersigned hereby gives notice that improvement
will be made to certain real Property, and in accordance
with Chapter713, Florida Statutes, the following
information is provided in this Notice of Commencement.
1. Description of property: (legal description of the property, and street address ifavailable) 110 North French Ave. N ,
Sanford FL 32771 (25-`19-`30-5AG-0209-0010)
2. General description ofimprovement:. Temporary Remediation ,System
3. Owner information: Name`_' F&R Enterprises LLC
Address:4680 S. Orange Blossom Trail, Orlando, FL 32839
b. Interest in property:'
c. Name and address of fee simple titleholder (ifother than Owner): Name:
Address:
4. Contractor Name:. GWTT, LTT Phone number: 813 249 - 8171
c. Address:125 Country Club Drive; Tampa; FL 33612
5. Surety Name
Address:
b. Amount of bond: S
6. Lender: Name:
Address:
6.'Lender`s phone number:.
7.a. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 113.13(I)(a)7., Florida Statutes Name:
Address:
8.a. In addition to himself or herself, Owner designates of to receive a copy of the
Lienoes Notice as provided in Section 7I3.13(l)(b), Florida Statutes.
b. Phone number of person or entity designated by owner:
9. Expiration date ofnotice of commencement (the expiration date is l year from the date of recording unless a different
date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THEEXPIRATION'OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART'1
SECTION'113<13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED ANDPOSTEDON THE JOB SITE
BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BFfJORE COI"IMENCING WORK OR RECORDING YOUR NOTICE OF COIvIMENCEIVI
f"` j-, r,
Signature
of Owner 6dNvnees Authorized Officer/Ditector/Partner/Mansger Signatory's Titlelomcc 1t ,
r `'P
Theforegoinginstrumentwasacknowledgedbeforethethis1dayof ,} un (year y (namee,a. oaf perso.n ash a of authority,) ..
e.f officetr trustee, attomFy in fact) for. (name of parry on bPW4tMt jAXfMWEVMWdd) . . uur4y,
t (
SEAL) K
Expires
411WO12 Signature
of Notary Public Fbrlda Notary Assn., inc Personally
Known _, ORProduced Identification T p ttPitfCiftif9t ltt tt>rlt ttt•°••' Verification
hursuant to Section 92.525_ Florida Statutes: Under penalties of perjury, I declare that have read the foregoing and that the
facts statKin` it arse to Ite best of my knowledge and belief. Signature
MN tuttl Person Signing Above Rev.
date 12008