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HomeMy WebLinkAbout1805 Mellonville AveCITY OF SANFORD PERMIT APPLICATION Permit No.: I 1 /., 61 : : Date: Job Address: 1 go .S' 7'ha /O iy; /f'•C a :& Permit Type: Building Electrical Mechanical Plumbing Fire Alarm/Sprinkler Description of Work: .tye D f A-4 4Additional Information for Electrical & Plumbing Permits Electrical: Addition/Alteration _Change of Service Temporary Pole New AMP Service (# of AMPS ) Plumbing/ Residential: Addition/Alteration New Construction (One Closet Plus Additional) Plumbing/ Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines Occupancy Type: Residential Commercial _ Industrial Total Sq Ftg: % e4, Value of Work: $ Type of Construction: Flood Zone: Number of Stories:_1 Number of Dwelling Units: Parcel No.: / r ( Attach Proof of Ownership & Legal Description). Owner/ Address/Phone: :J:h-Q. CeY)7 V-r" 1&- fCK2Y%Q_ I`d5m)(F, T Ue 17120- 3 E . 3 12-d —ST , S 2- QO/ %5 AA 1 196W -4L- 3-cn7 J A., a no fl--eAft. A A v c . CAA Z.-ri( A/. -? 17 7/ State License Number: CC C D ,2 Z .T 0/ Phone & Fax Number: Y0 ,7.,l J 7 • %('Xr- Title Holder ( If other than Address: Bonding Company: / V Address: Mortgage Lender: Address: Architect/ Engineer y .. Phone No.: Address: Fax No.. 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 will notify the owner of the property of the requirements of Florida Lien Law, FS 713. Gar - fi- e -k)Q 0 Stgn a of Own gent Date Signature of ontractor/Agent Date Print Owner/ Agent's Name Print Contractor/Agent's Name AA a yozSignature of Notary -State of Florida Date Signature of Notary -State of Florida Date Owner/Agent is U Personally Produced ID APPLICATION APPROVED BY: BONNIE RAE DAVIS M*" PUbk - Stab of FWA. Commlealon 0 0007437T Bonded BY N80mal Nota v A. nt is Personally Known to Me or ID Date: b L S SpecialConditions: e ft FWD-1 U.S. Department of Housing ' A. Settlement Statement and Urban Development _ OMB No. 2502-W15 B, Type of Loan 0 1. FHA 0 2. FmHA 3. Conv. Unft 6. FRO Number 7. Loan Number ' 6. Modg. Uri. Case Num. 0 4. VA. O 5• Conv. Ira. 02-C11.885 ID; C. NOTE:ThIs form is fumIshed to give you a statement of actual settlement costs. Amounts paid to and the talNsmentby agent are sheen. Items marked `{p.o.c r were paid outside the dosing; they are shown here for informationat puq mses and we not Included in the totab. D. NAME OF BORROWER; THE CENTER FOR AFFORDABLE HOUSING. INC., a Florida Corporation Address of Borrower. E. NAME OF SELLER: : ; DU MORTGAGE CAPITAL,' INC. Address of Sailer. do 96M Great HUI Trail, Austin, Texas 78759 TIN: F. NAME OF LENDER; Florida Community Loan Fund Address of Lender. ' G. PROPERTY LOCATION: 1805 MELLONVILLE AVENUE, Sanford, Florida 3277t N. SETTLEMENT AGENT; The Law Offices of David J. Stem, P.A. TIN: 65-0452471 Plane of SeWsment: 801 S. University Drive. Suite 5W. Plantation. Florida 33324 Pam: L SETTLEMENT DATE: 5r22ra2 DISBURSEMENT DATE: 5raW SubaUtute Form 1099 Seller Shhnrent: The information contained in bIwAs E, G, H, and 1 and on line 401 is Important tax Information and is beltfurnishedtotheIRS. if you am required to ft a return, a negligence penalty or other sanction will be hnposed on you If this item is repaired to be reported andtheIRSdeterminesthatdhasnotbeenreported. Seiler Instructions: K this real estate was your principal residence, fk Form 2119. Sale or Exchange of Principal Residence, for any gain. with your taxrealm: for other transactions. oernpl to the applicable parts of Form 4797 ;Form S262 andfor Schedule D (Form 1040). BWML In18a 5erlere Initia a r=ti . Double7tme4b HUD-1 U.S. Daparbrtetrt of Housing and Urban oerreWprre. Pap 2 Paid from Paid from otal Salesl&okers Corn. based on price $66,000.00 ® 7.00W % = 4,520.00 9orraeWS Seders 2,640.00 4.00W %to REMAX PROPERTIES INC. Funds at Funds at Seltlerrrent Settlement77COmnf'33'mn 1.980.00 &0000 % to Devlin Realty paid at settlement 4.020.00 Line 701 Less $660.00 referral fee to Integrated Asset Services, Inc. POC 801. Loan orig'urathm be % to 802. Loan discount % to 803. Appraisal fee to APPRAISAL ASSOC. OF CENTRAL FLORIDA, INC. 275.00 804. Credit report to 805. Lender's inspection fee to 8M. Mortgage Insurance application fee to 801. Assumption Fee , to cue. to fl06. to 910. to 811. to 901- Interest from to ® /da 902. Mortgage insurance premium for months to W3. Hazard insurance premium for years to Home Builders Insurance Services, Inc. 904. Flood Insurance premium for years to 312.00 905• years to 1000 Reserves d, 1001. Hazard insurance months per month - 1002. Mortgage insurance months per month 1003, City property Woes months per month 1004. County property taxes months per month 1005. Annual assessments months per month 1006. Flood Insurance months per month 1007. months per month 1008. months per month 1009. Aggregate aocounIft adjustment 1101. Settlement or dosing fee to The Law Offices of David J. Stem, PA 125.00 1102. Abstract or title search to The Law Offices of David J. Stem. PA 125. 1103. Title examination to The Law Offuxs of David J. Stem, PA 125.00 1104. Title Insurance birder to 1105. Domiment preparation to The Law Offices of David J. Stem. PJL 125.00 1106. Notary fees to 1107. Atlomeys Fees to includes Rem numbers: 1108. Title 1n urance. to The Low Oftes of David J. Stem, PA 250.00 379. includes above item numbers: ) t 109. Lenders coverage (Premium): 563.000.00 (525.00) 1110. Owners eovarage (Premium): $66.000.00 ($379.50) 1111. Endorse: ALTA 8.1-25. .45 55•45 1112. to 1113. to _ 1201. RecordbV ices Deed 440W Mortgages) $37.50 Releases 48.00 1202. Clty/courriy tantlamps Deed Mortgages) $126.00 128.00 1203. State tw/*Wnp Deed S462.00 mortgage(s) $220.50 220.50L462-00 1204• Assignment to Clerk of Court 15.00 1205. Record UCC (3We/Cot W) to Clerk of Court 38.50 1301. Survey to AZIMUTH SURVEING 1302. Pest Inspection to TRULY NOLEN 1303. Mist Chefges to Integrated Asset Services, Inc. 1304. Courier Fee to The Law Offices of David J. Stem, PA 445.0- 100.00 45.00 1305. Payoff Lien to ARamonte Surveying and Mapping 385.00 1305. Tax and Lien Search to PROPERTY DEBT RESEARCH INC. 60.00 1307. 2001 Property Taxes to SEMINOLE COUNTY TAX COL-ECTO 1,297,79 1308. Outstanding U6TQy Bills (3195.27 and S to CITY OF SANFORD 217.51 1309. Enter on tines 1 J and SM. Section K) 1 have eme did miadhif Ow HUMI 3eltlenrn! Sfi&m s t sM M Ms h-d ..r 1,695.45 8,08t1.e0 Mr numunt or by In this baruacUon.1 tuNar Qrtlfy that I have raoehRd s Dopy Or InaHuat Sentement Sbmmant .._ . • w •• Borrower Seller Borrower ' Seller The myth N1 8911110101111 912kment which 1 haft PRWOMd Is a VW and amnata amount of this Winsadbn. I have paved. orwill crow ere.iunds to be dbbasad in a000rdanoa The Low Offices of David J. Stem, PA By , As Its Authorized Repressntalive Date WARNING: B d a mina to bieI ftif maYa false atttamants to the Untied Stan on thw or any ether dmnar form Peralees upon cony 0M.Wn jndudt anafine d brrprhv WW& Fordetaaa fee: Tire 1• U.S. Codi Smason loot and seeban 1010. Tooz HV3Z),L 008CCZC10b XV4 OS TT Q3M ZO/SO%90