HomeMy WebLinkAbout1307 E 24 St5
Permit # :_
Job Address:
1-h
CITY OF SANFORD PERNUT APPLICATIOi•
Date: 5 -(23105 -
Description,
(23l0 J
Description of Work. V•e"YWT
Historic District: ^ Zoning:
Value of Work: S qX3 S • 00
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 Cala 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: Z (0 tP
Construction Type: ft roy- # of Stories:
# of Dwelling Units: Flood Zone: (I'EMA form required for other than X)
Parcel ft: 57aLl - a 2 O
O - 00 3 d (Attach Proof of Ownership & Legal Description)
Owners Name & Address: it h ixvle (fi'e K V1QVJ
it S 1,30-1 is • Z�C-tSt-
.� —M } F L 3 it -77-7 (
Phone:
Contractor Name & Address: La✓V (*e Yl �i• Q
bid"d6lFU _32933 State License Number: ._O_.0 sz:72 (0 U
Phone & Fax: qO-7S(I 08 afencontactPerson: Lynh Phone: 146993Z63Y
Bonding Company:
Address`.
Mortgage Lender:
` Address:
Architect/Engineer: Phone:
I 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, PLUMBLNG, 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 Nit is verification that I will notify the owner of the property of the requirements of Florida Lien e FS 71
Signa a or Owner/A&E t: Date Sitr toe ofCtorlAgtntY Date
KeAs�—
Print vner(Agent's Name Print Contractor/Ag Ys Name
M;W-P� s/,,:s �� 7).
Signat
tgyr •rs MY COMMISSION # DD 394025 I Date Sign. tun r AMBER N. JOHNSON
�j ,.�'iA.fyy_
zIr MY COMMISSION # DD 394025
ytr EXPIRES: February 8, 2009 I1 ,>:a,= EXPIRES: February 8, 2009
Owne '4` Th Publ c U n tars I Contract A
131�a(b9e�iPe&IioltrNA�Wl6r
_
Pro need I 'r Pro
APPLICATION APPROVED BY: Blg: Zoning: Utilities: FD:
I
(Ini 5a1 &Date) (Initial &Date) (Initial &Date) (Initial &Date)
Special Conditions:
?ermtt Number
?arcel Iderrtsfrcatlon Number - I - 21 00-;0
Prepared by:
Return to: ��� oCQ`-�
II
c.
NOTICE.OF COMMENCEMENT
t�
State of�---
,-;Ounty of
A4§'i��t����i���l���ltl�4kf��1�IIN➢�
"St" LUW OF CIRCUIT MT
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iCL E R A S #!I �ia�3 "vim ro� �t5
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I JJ` By 0 Them>as
CERTIFIED CDI?Y ,
MARY4l,g4F WORSE
U
COURT
S. FLORIDA
8YERK
MAY 2 5 2005
The undersigned hereby gives notice that improvement(s) will be made to certain real property, and in accordan.
with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of prop' rty(I at description of the property, and street address if available)
P. �2=scri�jof tmproveiWe (s)
VQ Ir �vfi
3. Owner In-forrPation
Names Telephone Number
Address �i b 11� Fax. Number,,
(C��� bovInterest in Property.
4. Fee Simple Title Holder if other than of er s e
Name Telephone Number
Address Fax Number
5. Contractor
Name LGLY ,4 r�L_Yto�'S; InL,
Address 16 U0 f
iJ✓ t arl j
5• Surety (if any)
Name
Address
Telephone Number
Fax Number ` U2 -�-177_�f 111
Telephone Number
Fax Number
Amount of bond S
7- . Lender (if any)
Name Telephone Number
Address Fax Number
8. Persons within the State of Florida designated by Owner upon whom notices or other documents may b,
served as provided by §713.13(1)(a)7., Florida Statutes.
Name Telephone Number
Address Fax Number
t?. In addifion to himself orherself, Owner designates the following to receive a copy of the Lienor s Notice
provided in §713.13(1)(6), Florida Statutes,
Name Telephone Number
Address Fax Number
10- Expiration date of notice of commencement (the expiration date is one year from the date of recordir,
unless a different date is specified):
Date Signed lgnature of Owne o §713.13(l)(9), "owner
must sign ..,and rib one else may be permitted to sign;
f his or her stead-"
Swam to and subs ibed before me chis ! f _da of M � _ `'0 �� by
who is personally known to me OR _produced
as identification. ` ^
AMBER N. JOHNSON SignatL re of Notary (notari eal to appear below)
*:= MY COMMISSION # DD 394025
EXPIRES: February8, 2009
, --D
POWER OFATTORNEY
I, Larry Meyers, by this instrument constitute and appoint Anne Meyers of
Orange County, Florida, my true and lawful attorney, for me and in my name
to execute all necessary written instruments in connection therewith and to
whomsoever as may be designated by my said attorney.
Executed on this 23rd day of January, 2004
Signed:
Larry eye s
Subscribed and sworn to before me this 23' day of January, 2004 by Larry
Meyers, who is personally known'tome and who did not take oath.
State of Florida
County of Seminole
m
Notary Public Signature
SPRY PUe OFFICIAL NOTARY SEAL
0 GINA SANTOS
*' ' j, * COMMISSION NUMBER
Notary Seal.
1p, ir'j Q DD 048387
P� MY COMMISSION EXP
�OFFLO AUGUST 7: 2005
t
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHINGS INSPECTIONS.
COMPANY: L a NN InC•LICENSE NO:
SUBDIVISION( j�11�1 I VVOUC _ADDRESS: 133 Z s�•
:
PERMIT NO: LOT:
affiant, hereby affirm that I am the duly licensed contractor of record for the
above referenc permit, that all of the foregoing information is true and'accurate, and thatz the dry -in, flashings at the
above referenced address/lot has been installed in accordance with'all applicable codes and standards.
I
CONTRACTOR: PSS
i
(Pri ted name)
(Si nature)
STATE OF FLORIDA
COUNTY OF ()y Gl.f 1
This instrument was acknowledge before me this day of ! ZG,
by the above referenced individual; , who acknowledged that
he/she is a duly licensed contractor with La.rry MjCgt rS, nC , and who acknowledged
that he/she was authorized to execute this'docurnent. He/she is either personally known to me
or produced as valid identification.
WITNESS my hand and official seal this 23 day of
Notaq Public
AMBER N. JOHNSON
MY COMMISSION # DD 394025
EXPIRES: February 8, 2009
.p� Bolded nru Notary Pudic Undo OWS
(seal)