HomeMy WebLinkAbout2557 Palmetto AveA
CITY OF SANFORD PERMIT APPLICATION
Permit # : 'S _ 93/ Date: 'qI bCj
Job Address: Z�i�l� ��1.P1 LfI `Jl;. %A►y Folz j � (, �`Z-1—I
Description of Work: 2 E QG0 I `� �i D r ArLLt - i 1D CvC rt z
Historic District: Zoning: Value of Work: S D 60. 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 Calc. Required)
Plumbing/ Ncw Commercial: # of Fixtures _
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential
# of Water & Sewer Lines # of Gas Lines
Commercial Indus trial
Plumbing Repair -Residential or Commercial
Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
Ownners�Nante & Address: 7
�� 1 G�� Z 5 5 �
�� � Z 1 f�J l p Phone: �(—
Contractor Name & Address:
State License Number: CCC D ZZ b I
Phone & Far: �b � Z 2 � �) S�� I �07 330 � ?jContact Person: A� �� 4010d4-1' Phone: S A- kA --L
Bonding Company:
Address:
Mortgage Lender: g'
Address:
Architect/Engincer: Phone:
Fax:
Address:
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 ofthis 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 pirmil is veri
xr
ure ofOw er Age,
i
Print (OWner gent's Na)
owner o the pr petty of the requii
Da, c S
P
Signa a ofrNotary-StAta olorlorida Date
I
FAYE A�DyCOCK
•r''' UBLI��480
fr 2, wd �
008
APPLICATION APPROVED BY:Z_oning:
pig
ate)
Special Conditions:
Law, FS 71
's Name
of Notary -State of Florida
Date
n •t /Ape
, PBIE R6WTMnown o Me or
umctidCgmmisSION #
a cXPifiS: February 25, 2007
r-eo-ops--r�;o rf�tH.,v.� rt rjotcry Discount Arson Co.
Utditic`s":R ' FD:
(Initial & Date) (Initial & Date) (Initial & Date)
a "Di j R OCDC K
fob �2ENC+A AVE
State of Florida
5 �11 Permit No.
NOTICE OF COMMENCEMENT
Tax Folio No. (PID)
County of Seminole
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.
DESCRIPTION QF PROPERTY (Legal description of the property and street address)
I/ I—tj 4�71 I 3x-7-1 1
GENERAL DESCRIPTION OF IMPROVEMENT 10-C , 20 D r7 -
OWNER INFORMATION _
Name and address :Dp N3A L'-1 lQ
2.Gi S -7 ISA E T -t- 0 A y & . 5 s -N f -D 22� , 1 . 3 Z -7 -7 1
Interest in property (Fee Simple, Partnership, etc.) o Lv N F.
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER -OF OTHER TI -IAN OWNER)
CONTRACTOR /�
Name and address b �� J`� b D P-/ AJ (�
SURETY (Bonding Company)
Name and address C RTIFIED COPY
MARVANNc MOR
Amount of Bond
LENDER
Name and address
CLER'. 01' ('IR(' T -ft'
SEMI ,')LE C; �1lfUN, rLtilf
V r rot : ry r'p i:PK
Persons within the State of Florida designated by Owner upon whom notice or other documents may be served asprovided
b X) JUN 01
Section 713.13 1 a 7., Florida Statutes: 2005
Name and address
In addition to himself, Ovmer designates of
to receive a copy of the Lienor's Notice as
provided in Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement
e
ti n A
rdine unI e a different dat 'c c,�Pcif 1 EY FAYE ADCOCK
NOTARY PUBLIC, STATE OF FLORIDA X
MY Oamm, 1011'es DEC. 2, 2008
COMM, # m78609 Signature of 0
Sworn `t an subsc ed before a this Day of !t:� f9 Z o a cj
My Commission Expires: iZ Z ID
Notaryublic
,C -r' Zo o`Cj
The foregoing instrument was acknowledged before me this day of 3 9 by
I� l I - (name of person acknowledge), tspersona y to
me or who has produced (type of identification) as t en tcatton
and who did / did not take an oath>
rr "9 Ln ;
Co� � Ln
�
<C '' IP V
m
C,�
CL
V0
ta,.,tr
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AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: _AD&&Z 0&Z 6License #: C C e D 2 -Z,:; b
zSS-7 T14( -t -J ETQ �!E
Project Information
Owner:� b r)A L N k_N �� I
--)nafne
�vJ- 7�5Zf- G(lot�
phone
Permit #:
Subdivision:
Lot #:
I, 4 Dc0 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: a/a X
signature �
pried name
STATE OF FLO17
COUNTY OF 0
This instrument was acknowledged before me this day of Y , 20 a moi, by the
above referenced individual, �(� D� DCa('�l� , who acknowl dged that he/she is a
duly licensed contractor with -e- o P7- f -t -o ra-,- o acknowledged that
he/she was authorized to execute this document. He/she is eAgUersonallown to me or
produced as valid identification.
WITNESS Amy hand and seal this '771 day of VO _200
Notary Public
ujni,
NDAFNEY7FAYE DCOCKBOF FLORIDA.EC. 2, 200876809
POWER OF ATIT"
1 4RNEY
Date:
1, Andrew J. (Andy) Adcock do he lLthorize Ruben Birch
To pull the geroof permit for :r
(type of Permit) (address)
Signatur/
A
Notary
W
Personally known to me or driver license 1
day of A
DAPNEY FAYE ADCOCK
NOTARY PUBLIC, STATE OF FLORIDA
My COMM, EXPIres DEC. 2, 2008
COMM, # 00376609
Stamp
of State of Florida, County of