HomeMy WebLinkAbout2543 Clairmont AvePermit # lO A a /
CITY OF SANFORD PERMIT APPLICATION
Date:
le --2--b-05
Job Address: 2.54.3 C L.0} 6 K M4 N T AV 6, FL. 32--7-73
Description of Work: R E - e_ o
Historic District: Zoning: Value of Work: S s ir �J Q
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool _L('6 -C,) J
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: �Qo
Construction Type: �f _ # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: ()Z_ - 3 0 _ 5/n� c) f') ` oyo O -0o 10 (Attach Proof of Ownership & Legal Description)
Owners Name & Address: 15 fwjj r--Y60R6:SS OR—
ALM
R -
ALM r-O&S I: Phone: 44n T. ? �� 4
Contractor Name & Address: 4,9/, F� �� na E 4A/C- a o�q 1 t 4
State License Number. e- C,=,-
Phone
,=PPhone & Fax: Contact Person: Mh ^ M -A Phone: 4O'7- moi - 539
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 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 permit is verification that I will notify the owner of the property of the requirernentAf Florida LIZZ�o7t7
713.
jf- 2 g _o c(.
Signature of Owner/Agent Date Signature of Corftm6odAgent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
_ Produced ID
l
APPLICATION APPROVED BY:oQrlb ? ` A n ng:
(tnitia & Date
Special Conditions:
MA -X M*Zjfi r
Print Contractor/Agent's Na e
S
Signature of Notary -State of Florida Date
Contractor/Agent is __Personally Known to Me or
iPtoduced ID F-/
_ c
Utilities:
(Initial & Date)
(initial & Date)
ELAINE NOLLAN
411 Notary Public, state of0
My Comm. expires Jan. 29,, 2006
0 20066
No. DD8 691
Bonded thru Ashton Agency Inr, (800)451-4664
FD:
(Initial & Date)
Rpr 27 05 06:03p
Hpr 26 05 06:19p
Chert'] Rmirzadeh 407-774-1663 p.l
Rrchway Group, Inc. 407-864-4451
P.1
ARCHWAY GROG jNCq
CGC_1504899
CONTRACT
Na o1'3o
M& Nbib Angeline
IS Pony Exprtm Dr.
Palm Coast Florida 32164
�OJF.CT LQGA_ npN
2543, 6547, 49, SI 43 Clairmont Avc.
Saaftttid Florida 32714
Pte: 407-774.4423
Fax. 407-774-1663 ci1yYCo-nV. Sanford
SCOPE p' p WORK
I • AGI to obtain pennit(s) to insula new roofing (ISsquares)
2. Removt and properly (KMx) a exis4ns shiu&k vents and lead boots dt metal flasbin
3. Dry -in raofdoek wA IS* felt 6s
4. Install new kitrbcn & bathroom vents.
5- ItrstaA new Eave Dr*
6. Install new mil4w msistarroe 3 Tab, 25 years fiberglass shilas.
7. Rmww and ek" all roof related debris_
8. Rotted or bad plywood 4=ldng m be replaced at 543 00 per sboa
9- Client is rapoostble far removal tit reirrstallati00 ofsolar MCI$ d: satellite disb(sj
Forthe Sum ot! F*Q►yeco 1M0Gsaad Six Handred Twculy Five Donate
option
1 • 30 Years Architectural Shingles add:
2. 30 abs felt underlaYment add:
S750.00
5300 00
General Coadiuoas
1. This Propri9 is valid for 30 days.
2. Payment: Cliuu agrees that if the arao
'*pay an
a I" of a ees tiot� i the amo a � tdue and �g h°�'� �e not paid -hen dt c� � "I be liable
3 W ail sums duo and owing hw=n et shall bear mlertsa at k attotneya fee and Doses, which >i:muraa mgdbcr
ARRAN1tY: b. The M. The fiberglass shingles will earrya (25) Years roaaufachaVes warraa
per movil
Ckrgua1zi0°e8 Pertaratmtxofthe new ,aof �'
4- PAYMENTS: '/s due er atccptanoe, t4 alt- epm*Qcu g fiat iaspesbon by � ps Years.
S COMPLETION DAIS: 3 %cc]. from date of aha,
o4 -76 -CS
coanacters sigtutrue ��
Date
!�OCEP Jr ANCE OF PR[)teAc� r .w.
The above prices spe rm CT
tondo m m hereby accepted You aro autbotized to do the
work as pe
CtienCs /" , •/• •• c�• �/1 / �' i ' ? d — Ori sufmd
Print
skis 's l�r+trfactorw
P.O.Box 916219 !
Longwood, Florida 32791-6219 o Tel. 407-864-4273 • Fax. 407-884-4451 .
2
1•d 626E-986-986-1 eiow eut102ud ebS:90 SO 92 add
r
gra
�t77�1
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: A17 C4WO-1 �,o U P IJJC.
Po 00K 91&Z-19
L0A16-00oD,F1, 3279M
License #: CSC 15 o �-g of
Project Information
Owner: ! o �� Z �E Permit #:
name
15 rabk� 00- Subdivision: W,0 00 M ME T&e&A(f C
address
1
,It 6-7 - -7'7 Lt-- 1t Lt 2-3 Lot #:
phone ,
I, I`� �'2WA-E� , 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 dr), in, flashings at the above referenced address or lot has been
installed in accordance with the ap licable codes and standards.
Contractor:
sign
printed name
STATE OF FLORIDA
COUNTY OF :2 �-r-ti l 6L&
This instrument was acknowledged before me this `-- day of (}6'/21 L_ , 20 Q S by the
above referenced individual, MA-ZRREdf , who acknowledged that he/she is a
duly licensed contractor with ."c H -a1 ft n IA/C' , and who acknowledged that
he/she was authorize�to execute this document. He/she is either personally known to me or
produced B Or k �- z �— as valid identification.
WITNESS my hand and seal this U day of A -M ( L
Notary Public _..
ELAINE HOLLAN
.f Notary Public, State of Florida
My comm. expires Jan. 29, 2006
17No. 0087691
Bonded thru Ashton Agency, Inc 1800)451 4854