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HomeMy WebLinkAbout1606 Magnolia Ave (3)n r Permit # : � CITY OF SANFORD PERMIT APPLICATION" Date: JobAddress: lu�(�yJo, ��k�, �`e Description of Work: lee — ec— \ i s suc s water management districts, state agencies, or federal agencies. Historic District: Zoning: Value of Work: Permit Type: Building Electrical Mechanical Plumbing Tire 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: # of Dwelling Units: Flood Zone: (FEMA form required for other than Y) Parcel #: Vy wC) ~ Y" Attach Proof of Ownership & Legal Description) Owners Name & Ad Contractor Name & Phone & Fax:1 l I" Bonding Company: . Address: Mortgage Lender: _ Address: Arc hitectlE ngineer: . Address: Person: Phone: License Number: 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 en ' i s suc s water management districts, state agencies, or federal agencies. Acceptance of per t s verificatio t the owner of the property o e requireme is f rida Li Law, 7 Sign tre of Owren gent Date ate onature of tractor gent cy _�he�t� x -10-M Print Own /agent's N e Agent's N m --- \ J I W *r,-,lContrac JQA 6" gra "� �'O"" """� Date f Notary -State o Florid ture of, Date HEA KING MY COMMISSION # DD 397446 EXPIRES: February 17, 2009 APPLICATION APPROVED BY: B Zoning: Special Conditions: _ Produced (Initial & Date) Utilities: kALJ R KING4�� 397441Qargi7 2006'ufiliC�damrhers FD: (Initial & Date) (Initial & Date) ?ermit Numbar ?arcel tdent'iiicatto"umber - ( n 000 ® - 0 09 G y�j L� t'repared oY: �1 t14 c` !fel ill 1if111 oil 0 ill 1111111111111111111111 1111111110111 H all I loll < l'r f ��'�T-j C- i Nk-e MRYANNE MORSE, CLERK OF CIRCUIT COURT I Return to: �1r ct- r) J t✓ v�' O�.7INOLE COM65 06E5 Con�-raci-zr NOTICE OF COMMENCEMENT State of C �.- o c�L - :'ounty of CLERKS S # 2005141a40 :) RECORDED 08/18/2005 04109145 PN RELUNDING FEES 10.00 RECURRED BY D Tho®as The undersigned hereby gives notice that improvements) will be made to certain real property. and in accorde with Chapter 713, Florida Statutes, the following information is proNfided in this Notice of Commencement Description of property (legal.desizrippon of the property, and street address if available) �L General description of Impro einent(s) MARY AT11N MOF;SE CLERK OF zp::!� CvCOURT owner nfatmatl n SEMINOName(0 YC\C:%u 11 V- Telephone Number address Fax Number BY U' XI Interest in Property: Fee Simple Title bolder (if other than owner shoe above) 4 Name Telephone Number ` 1 Address Fax Number t�& Contrar Name - ter C ��- I Telephone Number�j Address-�;��J�` Fax Number Surety (if any) (( Name Address Lender (it any) Name Address TelephorTe Number Fax Number Amount of bona g Telephone Number Fax Number B. Persons within the State of Florida designated by Owner upon whom notices or other documents may b, se -ed as provided by §793A3(1)(a)7., Florida Statutes. Name Telephone Number Address Fax Number ?. In addition to himself orhersetf, Owner designates the following to receive a copy of the Lienor's Notice provided in §713.13(1)(b). Florida Statutes. Name T etephone Number Address Fax Number 10. Expiration data of notice of commencement (the expi tion date is one year from the date of recordir, nless a different date is specified): Date Signed S nature of Owner Note: per §713.13(1)(9), "owner must sign ...and no one else may be permitted to sio„ his or her stead." who is personally known to me OR es identification. POWER OF ATTORNEY Date: I hereby and appoint aIy 16t of F1 VSA ch 41 C e ee �m fl n G to be my lawful attorney in fact to act for me and apply to the Building Department for apermit for work to be performed at a location described as: Section Township Range Lot Block Subdivision Address of Job 14E)6 HAI e� /,* may_ Owner 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 �� day of /h' bus ) 03 by LAW Ldp b-ey-+ who is personally know to me / who produced as identification and who did take oath. State of Florida County of van cA e - Notary Public gets' v, AMBER N. JOHNSON r: .t MY COMMISSION # DD 394025 EXPIRES: Febwary 8, 2009 Dandad Thru Notary Public Underwriters AFFIDAVIT REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS Company: V (_ J 0 & b767 1-WfM1;k " 0 t2 I, w-r/b D License #: �fzc ©6 30 5L d Project Information Owner: GOf) o d g w -, c *Z (� Permit #: name 1(o6 I" l AG Allo IA AV Subdivision: address Lot #: phone 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,,ature a la ue(2cea printed name STATE OF FLORIDA COUNTY OF This instrument was acknowledged before me this " O day of, 200 ��by the above referenced individual, "%,44 I'b Mc -acts 2 , who acknowl ged that he/she is a duly licensed contractor with I� z_e*y Tic s;� ;,�G , and who acknowledged that he/she was authorized to execa e this document. He/she is either personally known to me or produced `f ')� • L .' H & 26,110 56 , 273 - 3 as valid identification. WITNESS my hand and seal this day of 20 61"kco�� . Notary Public