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HomeMy WebLinkAbout117 S Laurel Ave (2)CITY OF SANFORD PERMIT APPLICATIO> Permit #l� y 1cxVe p � �r _4Date: , a-1 ( os- Job S Job Address: �—17 <, � > 1 V `Q . ��an �f�U F L 3a 1-1 ` Description of Work: V'- `t" — r0nT Historic District: Zoning. Value of Work: $ S 7S-0 r Mechanical Plumbing Fire Sprinkler/Alarm Pool CITY OF SANFORD PERMIT APPLICATIO> Permit #l� y 1cxVe p � �r _4Date: , a-1 ( os- Job S Job Address: �—17 <, � > 1 V `Q . ��an �f�U F L 3a 1-1 ` Description of Work: V'- `t" — r0nT Historic District: Zoning. Value of Work: $ S 7S-0 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 Industrial Total Square Footage: Construction Type: re—rouF# of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than x) Parcel #t: a S — 1-1 — 3 O — S7 A 6 ^ 03 0 —7 —• 0 1 LIZ (Attach Proof of Ownership & Legal Description) Owners Name & Address: -h 5 :F -l1 cam* b 1 1—I S'Lak-ir'e l ' ft` - Contractor Name & Address: i A -Aa n n- • c S leli n Q Le -ho -1 H Ave 0r Ah o,F—L 35saa [—1 Qj JtateLicense±Number: �3L0 304 Phone & Far: '40-1.)'1-1410 L4Q-1 &71938 9 Contact Person: t4 h i'1 Ljaho be--fPhone: Z 07 932 5_34S 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 WIT14 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 ey2itiesat as water management districts, state agencies, or federal agencies. Acceptance of permi yeti-catioa th t J lSt n to of er/Agent rfi s -�E Print ZXZT Signature f No - ?attw'Y Owner/Agent is Produced ID APPLICATION APPROVED BY: Bldg: Special Conditions: L'. I ��wi y the owner of the prope f the requireme is f Flori ten Lai , S 713. % Date S' ature of ntrac gent Date toPrint Co tr torlAgent's Name T tEXPIRES: 44�" at Signator o aLiiC;:BERN.JOHNSONOMMISS09 j ;.; MY COMMISSION # DD 394025 February 8, 2009•. EXPIRES: Februa 8, 2009 T . N Public Underwriters ' ty nr 114 130� Contractor/A nt Pet@@ltoad[rlllhpary�dslfdRl6irydters Produce Zoning: Utilities: FD: (Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date) f.( POWER OF ATTORNEY Date: ' a - (-i's I hereby and appoint (('1llr t/ of VS- Ch6 t a? Pey-rn (ffinq to be my lawful attorney in fact to act for me and apply to the C, k S C -Y--,� c,1 Building Department for a C sQ permit for work to be performed at a location described as: Section �X -)7_ Township U Range �57 M 6 Lot 0 3 U-� BlockU 10 p Subdivision Address of Job I I % S . LO Uye, 1 )4 u -e Owner Cuty W !s E:u C bC and to sign my name and do all things necessary to this appointment. Print Name of Certifie Signature of Certified The foregoing instrument was acknowledged before me this D% day of who is personally know to me / who produced as identification and who did take oath. State of Florida County of 0 va Notary Public N. NN. JOHNSON MY COMMISSION # DD 394025 EXPIRES: February 8, 2009 WWW Th, Notary Public Undarwfh- CEft11FIff COpI( MARYANNE MORSE CLERK OF CIRCUIT COURT SEMINOLE COU V3 • f± ORIDA Permit Numbiar 'arcel tdenkfi atlon Number — — —Qt Ua BY - _ DEPOT' rr o �o Prepared or l !`2 C�QC v- jot -Iced-tc 5�din� 110 11#0 most k0111111111M 1111111111101 toll Return to - 001 -1 +)- o:C01-.+)' ClOn, NOTICE OF COMMENCEMENT state at _T �cJy td a ::Dunt! of rwk e MARYANNE MORSE, CLERK OF CIRCUIT COURT SEMINOLE COUNTY Btu 05831 FOG 0873 CLERK'S # 2005 1 27 5557 RECORDED 07/28!8005 03:311106 pig RisCtNDIN8 FEES 10.00 RECORDED BY D Thosas The undersigned hereby gives notice that improvements) will be made to certain real property. end in accordar., With Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencemen!. bescriptlort of p petty {legal" description of the property, grid street address if available) L-o-�- i d �'S —TIK —7 TbwY) of SGL►' �) O, -,5t F6 f V f CQ 2- General description of Improvement(s) , _e 3, owner Information '^ Name ct�Y -h S { (.LY VQ Telephone Number ,ddress i (-TS LCL ;K-,eFar, Number Sd: r1✓�( (_ 3a -i "� r interest in Property: 4. Fee Simple Title Fiolder�m other than owner shovni above) Name Telephone Number Address Fax Number 5. Contractor Name l -V ary 7C 9A(t 1 ✓,- Address y'7 1o'Z HQ fh--," ✓ Pcvt C>✓loulctcj f=l— 3,�Lvaz- 5. Surety (If any) Name Andress Telephone Numbe7 y n q 3,:�_ t:-3 4-g Fax Number j LF\ L171 -71** 1 t ( Telephone, Number Fax. Number Amount of bond 4 7- Lender (if any) Name Telephone Number Address Fax Number 8. Persons within the State of Ficrlde designated by .0wzter upon whom notices or other documents may r.. served as provided by §713.13(1)(a)T. Florida Statutes. Name Telephone Number Address Fax Number '. In addition to himself or- erseif, Cwner designates the following to receive a copy of the Lienor, s Notice Provided in §713.13(1)(b), Fioritia Statutes. Name Telephone Number Address Fax Number 10. Expiration date of notice of commencement (the expiration date is one year from the date of recordi„ unless a different dale is speciffed): _ Date Signed Sig re �iwnsr mer §713.13(1 )(g}. °owner must sign ...and no one else may be permitted to Stnn his or her stead." Sworn to and su scribed before me 7is day of /, 1 1 V-+-7 C� -X::�l -6-1,0 N nY who ispersonally known to me OR ✓ _produc•e` 3. 7 ns identifcation. AMBER N. "'N'ON � Signatu of Notary (not seal to appear bele u) MY COMMISSION # DD 394025 EXPIRES: February 8, 2009 '•': - o° Rpndad Thm Nota.ry Pthiio undenwrher$ CITY OF SANFORD HISTORIC PRESERVATION BOARD APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS P.O. Box 1788, Sanford, FL 32772-1788 Phone: 407 330-5672 Fax: 407 330-5679 TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA 0 Downtown Commercial Historic District 0 Residential Historic District ❑ This application is filed in response to a notice from the Code Enforcement Department ADDRESS OF PROPERTY: I ' S /-A AV r- , 54,0 -Wb, Z277/ Property Owner Signature: Print Name: LuR I I S El-tZR 13C Mailing Address: Ili S l.ALAIlC(- A✓L Phone: 40 - 277 ~ SII l Fax: Applicant/Agent Signature: Print Name: Mailing Address: 67 0 46kf-NcV- A -J ©Q �-i-r46 �?ZE2 2-, Phone: Fax: I certify that all informa 'on on ained in this application is true and accurate to the best of my, kn wledge. Applicant/Owner:_ % Date: 7 Please use the attached criteria checklist as a guide to completing the application. Incomplete applications cannot be reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at 407-330-5672 to make sure your application is complete. Description of Proposed Work/Application Category: (Check all that apply) ❑ Site Improvements/driveway/walkway ❑ Storage shed ❑ Moving structures ❑ Replacement windows or doors ❑ Underskirting ❑ Awnings ❑ New construction/additions ❑ Signs ❑ Demolition O,Roofs/gutters/downspouts ❑ AC/Mechanical ❑ Fences/Gates/Pergolas ❑ Replacement siding/flooring/porch ❑ Paint ❑ Other Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building, where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is recommended. Attach additional pages if necessary. `� r c= " (L� F S � ! n1 GLr � � o C'.��}-►J � To �o � (, f'jl �j l� A Certificate of Appropriateness is valid for six months unless otherwise noted Historic Preservation Board Muting Date: Application is Approved Conditions: Signed: OFFICIAL USE ONLY Approved with Conditions Date: Staff Review Date: Denied ***This Certificate must be prominently displayed on the building when work is in progress*** FASHA_ENGWistoric Preservation Board\C of A Application.doc AFFIDAVIT REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS Company: L l C s- G, License #: C 6 C 053O �L 670 4D�F*-12 Ad 0 222 Project Information Owner: J_�r Z_�_Lr � 6 &!- name tk RCL AV � S,q-s✓Fo2 address phone Permit #: Subdivision: Lot #: I, 1)" 1 _Z__) N(Fac t -Q , 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: S�'L signature RCe printed name STATE OF FLORIDA COUNTY OF This instrument was acknowledged before me this day of , 20 , by the above referenced individual, ,who acknowledged that he/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 to me or produced as valid identification. WITNESS my hand and seal this day of 20 Notary Public