HomeMy WebLinkAbout119 W 16 St (2)Permit # :
Job Address:
Description of Work: KG —
Historic District:
Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date:
SQcJfO lel 717
Value of Work:
UO
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: # of Stories: 7- # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: b w 1 �Q'5 `r v wo — cl o 9'(Attach Proof of Ownership & Legal Description)
Owners Name & Address: /j% 0Z/UD
/<y 442- /C-';,% J r. c)C� ufO•�C. /� ( Phone: "/017�`j 2
Contractor Name & Address: T� f' . v �% St�• r,
'/ State License Number: G C - b 5-5Phone & Fax: 7D`1-ZGS -Z//G Contact Person: Phone:
Bonding Company: /1 ck�
Address:
Mortgage Lender: I w
Address: n' G
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. 1 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 add' nal permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance =ri ficati tlhat I will notify the own of the property of the requirements of Florida Lien Law, FS 713.
d� �la�1v�
Signature of wner/Agent f Date Sign ture of Contractor/Agent . Date
/,-'l, � � 5 -too 52ac, aro
*,n per/Agent' e P.ri t Contractor/Age 's amee f otar State of Florida Date Signatu - of Notary- tate of Florida Date
Owner/Agent is Pers all Cnown t e or
Produced ID %�-h
5 .SSD _ 53-Ze -G z
APPLICATION APPROVED BY: Bldg. Zoning:
(Initial & Date)
Special Conditions:
NOTARY PUBI<IC
Ki;iy'
Com
Bonder'
Contractor/Agent is
Produced ID _
Utilities:
(Initial & Date)
NOTARY PUBLIC -STATE OF FLORIDA
*Kinyel Marcarelli
Commission # DD451085
Expires: JULY 14, 2009
Bonded TN u Atlantic Bonding Co., Inc.
-I—I Kn wn SLlY]e.or—�
FD:
(Initial & Date) (Initial & Date)
NOTARY PUBUC-STATE OF FLORIDA
Kinyel Marcarelli
Commission # DD451085
Expires: JULY 14, 2009
Bonded Thru Atlantic Bonding Co., Inc.
z _.... r i .• k
Prepared by:
LG.G gmatlJO&
417
Altamonte Springs, FL 32701
Return to:
LG.Q
417 Mq00112
Altamonte 4paq,. 32 01
NOTICE OF C®11 MENCEMENT
State of rlavu`,
County of
MARYit Pte, CLERK OF CIRCUIT WJRT
SMINCLE CIR.NTY
BK .()5849 roG (PF,75
CLERKI S #i 20051349-84
REWRDED 08/0912(4 121I. -IS. -30 PH
REG'[l IN6 FEES 10:00
RECxlRDI_D BY t hnldera
The undersigned hereby gives notice that Improvement(s) wt7l 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. DescriptionWf1perty (legal- description of the property, and street addr�s if available)
rj
2. General description of Improvement(s) –Del
r T, CERTIFIED'Copy
Y
3.. Owner information A Y NN MOR
Name 2r�
e -e– �c�.r SE
GhTelephone Number Cl R 0 CIR IT � SE
Address j i I+t� 5 i/� . Fax Number SE E N LORI
�URT
a *xck r F 1 3 �1 Interest In Property:
4. Fee Simple Title Holder (if other than owner shown above BY
Name. j unr c1.E2�0�
Address � ` �`" Telephone Number � �\ n
Fax Number i
5. Contractor
Name_Y_17
6. Surety
Name
Address
7. Lender (if any)
Name
Address
Telephone Number��
Fex Number
Telephone Number
Fax Number
Amount of bond $
Telephone Number
Fax Number
8. Persons within the State of Florida designated by Owner upon whom notices or other documents may be
served as provided by §713.13(1)(a)7., Florida Statutes.
Name /
Address (fit Tetephone.Number. .
Fax Number
9. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Not!
provided In §713.13(1)(b), Florlda Statutes-. ce as
Name
Address Telephone Number
Fax Number
10. Expiration date of notice of commencement (theexpiry . date one year from the date of recording
unless a different date is specified): efr
Date Sinned
Sworn to and subscribed before me i
who is_ --personally known to me OR
as identification.
Signature of er [Nob(: per §713.13(1)(g), "owner
must sign ...and no oneelsemay be permitted to sign in
his or her stead." _ ,7.zz
of �t Z , 20 D--- —_ by
NOTARY PUBLIC -STATE OF FLOatuFot
Kinyel Marcare 1
Commission # DD451085
Form R :1?l00 for 19 {� 20_ *Expires: JULY 14, 2009
I"'-' BondQd Th:u e\daauc J30ndirls Co" Ins,
0 - GiSIn � i�
seal to appear
Date:
[3--
417 Magnolia Street, Altamonte Springs - Florida 32701
POWER OF ATTORNEY
I, Isaac M. Garvin, as President of IGC Roofing, Inc., give Power of Attorney to: 1*a
to be my lawful attorney-in-fact to act for me in applying for a Commercial/Residential permit enabling
work to be performed in the State of Florida at the property located at:
ISAAC M. GARVIN
OAXL�— ��
Wcdess
Sworn to and subscribed before me this
b ISAAC M GARVIN who is ersonall known to
City/FL �a % % 1 Zip
Witness
day of a, 2005
J , p y me.
State: FLORIDA
Phone: (407) 265-2700
.......
a ................... •3••NjROSK0
JENt�ii=k-
Gs;mmit DD0450121
`` °j s`''•7/14/2009
ExpifeS
Bonded thru (800N32'42M
Florida Notary A
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Website:IGCROOFING.com
Jacksonville: (904) 764-0164
Fax: (407) 265-2122