HomeMy WebLinkAbout203 S Hampton CtCITY OF SANFORD PERMIT APPLICATION
Permit No.: C) Q_—/ 3 0 P Date:
Job Address: '0 _ 5, ` t-A Jdtr ` c" i 17 3
Parcel No.: 67-aV- 000 Or / 1 ca D (Attach Proof of Ownership & Legal Description)
Description of Work:
Type of Construction: Flood Zone:
Valuation of Work: $ t " 13 0,Ss t Occupancy Type: , Residential Commercial Industrial
Number of Stories: Number of Dwelling Units: Zoning: Total Square Footage:
Owner: C I-&c ,mot 2 St n ep i,.- -,z-
Address:
City: State: Zip: 7 73
Phone No.: Fax No.:
Contractor: b Q 6 j
Address: /2 ( !S> q-r Q`A ,:,- L..AI
DD
City: V State:ILZip: State License No.: L'
Phone No.: Q7 3,2-7Sk, Fax No.: I/A 7 5 -J1 / X q R
Contact Person: 1 ' i OLV) r-t% Phone No.: 8 7
Title Holder (If other than Owner):
Address:
Bonding Company:
Address:
1Gl6rtgage Lender: H p i Le J= y-
Address: Fi Ot 0 a y 2 57 S .Jg; Ksv -n N c l F/. 2-2,3 / , y,A Sir Architect:
Address:
Phone
No.: 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 I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. Signature
of Owner/Agent Date G-
ra, iC_1A 'elr1"of31G:lv Gt1Gz MrinWwner/
A_aerWs dame SHARON
D. ALEXANDER Notary
Public, State of Florida My
comm. expires Dec. 21, 2005 No.
DD78961 Bonded
thru Ashton Agency, Inc.(800)451.4854 Own
r/Agent is Per pally Kno n tQ Me or roduced
ID(_Um APPLICATION
APPROVED BY: Signature
6f Contractor/Agent urate Print
Contractor/Age 's Name ig
ure of Notary -State off lorida Date Lynnette
Mote k '*
My Commission CC762328 a,
nV Expires July 26, 2002 Contract .
r/A ent isV Personall Known to M gYe or roduced
ID /oaf I Date:
Special
Conditions:
r:.-*i.+q+ va .. T a » f e r - .. l Y dY,:+i^aC,.r,7'-s,. r ,r. ";r ,."7 5., r "Ft '.F«.a, y..
CITY OF SANFORD PERNIIT.APPLICATION
Permit No.: / w` Date:
Y0. -
Job Address:C1dA s, Na. rlo Aj, tii
Parcel No.: b 7- (-. '• Q lo'` t UU f)* 1 ! c (Attach Proof of Ownership, & Legal Description)
Description of .Work t^:
Type of Construction:- Flood Zone:
q '
Valuation of Work: $ ' V 0SAP Occupancy Type:: Residential Commercial Industrial
Number of Stories: Number of Dwelling Units: Zoning: r Total Square footage """"` a
Owner: 'CZ t' Qrl e t f3 d t C." " { .
t.
Address:
City. -n r?i a State. 1Zip. '•","`'s Phone
No,;: I . - - (FaX No 1 „, l Contractor:,.
ea:,i . * [- ,. Address
e"H City
t E'_yltsa VGA_ •. , ....: State: . Zip: Z'2 State License No.: 1 G ejU ;Z / FaxN
oPhone No. S. S Lt'4 191 Contact
Person. tiva, V 'I yl i, tad. Phone No. Y,6 Title
Holder (If other than Owner) Address.• ,
Bonding
Company ` Address:
Mortgage
Lender: m, -tr •, 4 fi°•. / , 4 Address:—,
1,a 12 Architect:
Phone No.: p
r
Address : °` _ 1; ax °No P'
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 with all
applicable laws regulatirig 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 IVOTICE.
OF COMMENCEMENT. . NOTICE:
In addition to there of this, permit, there may be additional restrictions applicable to thisproperty that may be found
in the public records of this county, and there may, be additional permits required from other governmental entities suchas water management
districts, :state agencies, or. federal agencies. E} Acceptance
of
permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.. Signature of
Owner/Agent Date ..4 / '"S re of Gontracfor/Agent~. r ; mate
7 -
d
r
Prmt,
Own6r%
Agent's Name PH Contractor/AgeAN f)
dnt's
Na e` ti 67ii fi'
p - S. S'ignatur - '
Date Sig Lure of Notary -State of Florida Date SHARON D.
ALEXANDER Notary Public,
State of Florida My. corn
ezpices Dec.,21 2005 No`DD78961 <;
N. Bantletl,thru?
Ashton Agency,inc: (800)451-48P `1 V4L Owner/
Agent
is Personally Known to 1VIe or Contractor/Agent is Personally Known to Me or Produced ID .
f "/ ' . 1•!}¢ 1 1 L fl ? iProduced ID % C. t APPLICATION APPROVED
BY: Date: Special Conditions:
r.....°...,-+f+'.r4,."...,,:':;.-ti..w-w-^N+..:.__. ....-......,.y- - .y... ..... ...........:._ -^ 3. ': -.,e °' ---._. . ..-w' -- , "e.„;1 .. ... ..........r }.... ...,
CITY OF SANFORD PERMIT APPLICATION
Permit No.: .. ' Date:
Job Address: VAS vin
Parcel No.: &7. V • Y 6 Attach _Proof of Ownership; & Legal Description)
Description of Work: r 13t
Type of Construction: p " Flood Zone:
Valuation of Work: $ Occupancy Type: j Residential Commercial Industrial
Number of StoriesNumber of Dwelling Units: Zoning: Total Square'Footage -- Owner: §
t t ° SQ,,t C; 1. City
State Zip- , lp
Phone
NotFaX No t t, ' Contractor'
Address
Lh!; City.
KY fs E°:1 ...:,. State: Zip:., State License No:: v
Phone
No. Fax No.:,. Contact
Person . t `i ,3. r;s
Phone
No.: d / " Lr# c Title Holder:(
If other than Owner),, Address: Bonding
Company:
Address: Mortgage
Lender:
Address: i `
i Architect: Phone
No.: Address --A
Application Application
ishereby 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. .. q permit,
y NOTICE: Inadditiontotherequirementsofthisermttheremaybeadditional 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 requirements of Florida Lien Law, FS 713. tis, •:t, '
b .
9' 1 ^iA .lf .! '\ 7 YG--w. 'X +.id_ i i .t Signature of
Owner/Agent Date f' Signature o ;ate f Contractor/Aent D _ ARW fu
t...
L ' . ("d l 4` %i'! AR^"ii '! .... IME !...w FS , .'.' .l`+'"J' ^z ii' '!` F :d` r4 :1' •-: !%' i .. Print Owner/
Agent's -Name Prmt Contractor/ geA ntyh s Nacn`e h ! F
VT 1 '
S1
ature of Nota State of'Florida .v 'Date
Si
nature of Notary -State of Florida ry- arYDateSHARON D
ALEXANDER Notary Public;
Stafe of Florida My comm,
expires Dec 21; 200.5 No: DD7896t.
Bonded thru
Ashton,Agency, Inc (800)451 48.59 . Owner/Agent
is Personally Known to Me or. Contractor/Agent isi Personally Known to Me or Produced ID -,
roduced ID x APPLICATION
APPROVED
BY: Date: Special Conditions:
i
t
NOTICE OF COMMENCEMENT NOTARIZE
I'
State of Florida County of Seminole
a
i, Permit No. i% - ' G 3o T Folio No. (PID) o to ' U U oO . / r 07, d
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 OF PROPERTY (Legal description of the property and street address) y-t S.
v -t I
CU*iED COPY
GENERAL DESCRIPTION OF IMPROVEMENT A ARYANNE MOi SE
Y'l'k(`1 mrnv nr nrrx+rirr raorrsx
OWNER'. INFORMATION MAY 2 1 2002.
Name and address 6 r-a ,)Ja- S e,z o20. S. m e u 4
J„`c r-6 S1 z.277
Interest in property (Fee Simple, Partnership, etc.)
71
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER -(IF OTHER THAN OWNER)Mad ORIC
W ru
IF e M H1 U %
CONTRACTOR
S N m 31
ro
N d address DUCT Rite Roofing 12 -0 Saratoga 1 n . Geneva. F 1 32732 W - R
M Ln —
l' -I a
Ttilru 1NSTRlJMEW PkEPMW BY11
SURETY (Bonding Company) NAME
Name and address
11) ,
4
Amount of Bond
ENDER (mortgage. co) '
Name and address C `m (f—
P, (0. Aro x L-/q 2 fib ,I %e- k Snv v r
Persons within the State of Florida designated by Owner upon whom notice or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes:
Name and addiess
In addition to himself, Owner 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
The expiration date is 1 year from date of recording unless a diffeWnt
Sworn to a
Notary Public
The for oing
ire
me or who has
and who did /
MY COMMISSION N CC B32532
EXPIRES: July 19, 2003
Bonded Thru Notary Public Underwriters
subscribed before me this
1
date is specified.)
Signature of Owner
tlo
Day of )9
My Commission Expires:
ZC zSZ
instrument was acknowledged before me this day of sp9 by
W, f Ct SGol (name of person acknowledged), who is personally known to
type of identification) as identification
id not take an oath>