HomeMy WebLinkAbout145 Lakeside Cir (2)CITY OF SANFORD PERMIT APPLICATION
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Permit # : os
Job Address: 145 Lakeside Circle
Date:
Description of Work: Re—roof 23 Squares Shingles
Historic District: Zoning: Value of Work: s 4 , 3 8 9.0 0
Permit Type: Building X 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 X Commercial Industrial Total Square Footage: 23 Sq. Shingles
Construction Type rP—rno F of Stories: 1 # of Dwelling Units: Flood Zone: (FEMA form required for other than a)
Parcel #: 1 1- 2 0- 3 0- 5 KB- O O O O- 0 6 0 0 (Attach Proof of Ownership & Legal Description)
Owners Name&Address: Brad & Tisa Morgan 2661 -'Madeline Ave , Winter Park, FL 32789
Phone: 407-647-44;9
Contractor Name & Address: David Lundberg 1709 HnwP 1 1 gra nnh Rd-,
Winter Park FL 32789 State License Number: C'(`(' 1 15841
Phone&Fax407-672-0001 .407-647-9-3 (2ontactPerson: naVrirl T,ttn(1ht-rc_Phone: 4(17O72—flf)01
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
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 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 f p mit is verification that l will notify the owner of the property of the requiremAeon
a Lien w, FS 7l3 /
iM,
Signature of Owner/Agent Date Sigactor/Agent Date
Li5A 2 1t0RAW� 3(6�e
Print O er/Agen 's NamePrint Contractor/Agent's Name
lorida 6 S
t �ommissan of lorida Date
�'+orww Expires 07/1212009
Owner/Agent is y�Pers nallyn44��wn�p Mir �y ✓/Q/�
Produced ID
APPLICATION APPROVED BY
Special Conditions:
Bldg: "Conine:
( nit MDe)
e 9 Y/os
r
of No State of Florida Date
�*F
Notary Public State of Florida
Contractor/ gPei�88 AM R48Wto Me or
Produ d My Commission DD440983
xplres 212009
(Initial & Date)
Utilities:
FD:
(Initial & Date) (Initial & Date)
r -
CITY OF SANFORD PERMIT APPLICATION
s
Permit # : os
Job Address: 145 Lakeside Circle
Date:
Description of Work: Re—roof 23 Squares Shingles
Historic District: Zoning: Value of Work: s 4 , 3 8 9.0 0
Permit Type: Building X 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 X Commercial Industrial Total Square Footage: 23 Sq. Shingles
Construction Type rP—rno F of Stories: 1 # of Dwelling Units: Flood Zone: (FEMA form required for other than a)
Parcel #: 1 1- 2 0- 3 0- 5 KB- O O O O- 0 6 0 0 (Attach Proof of Ownership & Legal Description)
Owners Name&Address: Brad & Tisa Morgan 2661 -'Madeline Ave , Winter Park, FL 32789
Phone: 407-647-44;9
Contractor Name & Address: David Lundberg 1709 HnwP 1 1 gra nnh Rd-,
Winter Park FL 32789 State License Number: C'(`(' 1 15841
Phone&Fax407-672-0001 .407-647-9-3 (2ontactPerson: naVrirl T,ttn(1ht-rc_Phone: 4(17O72—flf)01
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
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 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 f p mit is verification that l will notify the owner of the property of the requiremAeon
a Lien w, FS 7l3 /
iM,
Signature of Owner/Agent Date Sigactor/Agent Date
Li5A 2 1t0RAW� 3(6�e
Print O er/Agen 's NamePrint Contractor/Agent's Name
lorida 6 S
t �ommissan of lorida Date
�'+orww Expires 07/1212009
Owner/Agent is y�Pers nallyn44��wn�p Mir �y ✓/Q/�
Produced ID
APPLICATION APPROVED BY
Special Conditions:
Bldg: "Conine:
( nit MDe)
e 9 Y/os
r
of No State of Florida Date
�*F
Notary Public State of Florida
Contractor/ gPei�88 AM R48Wto Me or
Produ d My Commission DD440983
xplres 212009
(Initial & Date)
Utilities:
FD:
(Initial & Date) (Initial & Date)
LIMITED POWER OF ATTORNEY
I hereby name and appoint
Date: August 3, 2005
Liza Denton
of David Lundberg Building&Roofingto be my lawful attorney in fact to act
for me and apply to City of Sanford for a Re -roof
permit for work to be performed at a location described as: Section: 11
Township: 2 0 , Range: 30 , Lot: 5 KB
Block: 0000 , Subdivision: 0600
;
Address of job: 145 Lakeside Circle ,
Name and address of owner of property: Brad & Lisa Morgan k
2661 Madeline Ave., Winter Park. FL 327
and to sign my name and do all things necessary to this appointment.
-7��6 —1 a —"�
Signature of certified contractor
David C. Lundberg CCC 1325941
Print name and license # of certified contractor
STATE'OF FLORIDA
COUNTY OF ORANGE
Ahe foregoing instrument,�xas acknowledged before me this % day of
, 2010!�, by David C. Lundberg who is personally known
to me (X ), 4 who presented ( ) , as identification,
and who did ( ) or did not ( X) take an oath.
Notary Public's 61nature
Notary's stamp:
Notary Public State of Florida
Wendy R Benson
My Commission OD440983
or r� Expires 07/12/2009
This Instrument Prepared By:
Name: Sara Kiikenney
Address: 2952 Bridgehampton Lane
Orlando, FL 32812
Permit No.
STATE OF FLORIDA,
COUNTY OF Seminole
14ARYAlV1+IE 1`11110-t-1 U -EW W CIRWIT WAT
Siad IN011 E cilmly
CLERhx S 41 ;E.'d>051 28977
REWRDED 010112(M 12;29:59 FH
RE INI)IM Z=EE'S 10.00
Rut ]Ptkb BY t hol&n
Tax Folio No. 1 1-20-30-5KB-0000-0600
NOTICE OF COMMENCEMENT
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: (le al description of pro erty, and street address if available) 145 Lakeside Circle
Leg Lot, 60 Hi den Lake PH 3p Unit 7 PB 38 13gs 79 & 80
2. General description of improvement: RE -ROOF
3. Owner information:
a. Name and address: Brad & Lisa Morgan
2661 Madeline Ave.,
b. Interest inProPertY: N/tinter Park, FL 32789
c. Name and address of fee simple titleholder. (if other than owner): N/A
4. Contractor: (name and address)
5. Surety:
a. Name and address: N/A
David Lundberg
Building & Roofing Contractor
1709 Howell Branch Road
Winter Park, FL 32789
CBC017995; CCC 1.325941
�ERTIFif- D 1
pPY ANNA MORS
r,t11T CCIJRT'
CLERK 0r CIR
sErallNOL1 c )u1NTY. F1.oR1®A
BY
b. Amount of bond: $ N/A V e1�
6. Lender: (name and address): N/A —
7. Persons within the State of Florida designed by Owner upon whom notices or other documents may be
served as provided in Section 713.13(1)(a), Florida Statutes: (name and address) N/A
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as
provided in Section 713.13(1)(b), Florida Statutes: (name and address) N/A
9. Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording
unless a different date is specified): N/A r
Sworn to d s bscribed before meds t LUG( R f ' � &7
day of 200� , by (Signature of Owner)
who is p rsonaj y known
to me or ) who produced$ /Yt(
as identification.
Owner's Printed Name: L1 fit�ra
Owner's Address: QG( I YV1iqCa J 101 &U
1 � �-�.r ��2� E rt✓ ���
S i na re of Notary,Publ tary Fubiic state of Florida
( g)� Wendy R Benson
My Commission DD440983
Notary's Stamp: t OF Expires 07112/2009
Notary's Commission Expires:
ALL INFORMATION MUST BE TYPED OR PRINTED LEGIBLY TO COMPLY WITH RECORDING REQUIREMENT
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company:�l� L ]a n eta License #: Cl L I 3 � S (+I
�W-�ClCLnCn -i- �o�Yiy�� l
Owner.® MDQ, - o
n e
address
phone
Project Information
Permit #: o ) (e:�q 3
Subdivision:
Lot #:
I,
affiant, hereby affirm that I am the duly licensed
contract r 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 -A'
ignature
1_ LZPt l )F-n)TbIJ
printed name
STATE OF FLORIDA
COUNTY OF
This instrument was acknowledged before me this day of _ , 20 �by the
above referenced individual, ,who acknowl ged 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 o 20
Notary Public
F-Q"
B9ANTONBBBB!�N?Yt t P�,'!i;BION # DD 188491ebruary 25, 2007�lft'i FL i•deter� piscount As oc. Co.