HomeMy WebLinkAbout2410 S Oregon AveCITY OF SANFORD PERMIT APPLICATION
P,...,, 1Vn Date: zo .o Z
Job Address: a?cll 0 S. O r e_eo,n hvC Sote,
Permit Type: or- Building Electrical Mechanical Plumbing Fire AlandSprb"r
Description of Work: rw- - ccbo-..IS NIXIX (es
Additional Information for Electrical & Plumbing Permits
Electrical: —Addition/Alteration _Change of Service Temporary Pole New AMP Service (11 of AMPS )
PlumbingMesidential: 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 Fig: Value of Work: S
Type of Construction: Flood Zone: Number of Stories: Number of Dwelling Units:
Parcel No.: ZQ • 19 - 30 - $• C-AS •- DO 00 ' lS-1t) (Attach Proof of Ownership & Legal D=dption)
Owner/Address/Phone: S f- Ore. yo M tA0 5r.., rftrri r= I .3 A-)71
Contractor/Address/Phone: 4Z L. Ucklne% Con-sfeur-key-N 1 -?%o c A )UArnAhf nark tOr. 0--(Ls
W%-e- J'o r- PC_ E 1 3 a.-) 9 1-State License Number: C _Gir )A--n e 7 6 s U
Contact Person: w UI1eo n Phone & Fax Number: Acm b1s739(,u009,
Title Holder (If other than Owner):
Address:
Bonding Compauy:
Address:
Mortgage Lender:
Address:
Architect/Engineer
Address:
Phone No.:
Fax No..
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 Owne en Date Signature of Contractor/Agent Date
rt`. - : c• csr d t. pia nr;o
Print Owner/Agent's Name Print Contractor/Agent's Name
01,AIM-7 M 0, r,-* 1kjLj%, C,, tn Pw-u,-- 1-w
Signs a off Wtary-Vta-ffbf Florida Date Si lure of Notary- late of Florida Date
Cynthia M Papania +.O` Cynthia M Papania
My Commission CCO73306 * *My Commission CC073306
Expires September 22, 2003 ''•.,d Expires September 22, 2003 %
Owner/Agent is v1 Personally Known to Me or Contractor/Agent is r Personally Kno-Av to Me or
Produced ID .,14N Cynthia M Papania Produced ID
My Commission CCO73306
Expires September , 2003
APPLICATION APPROVED BY: Date: 2O • O 2
Special Conditions: %
POWER OF ATTORNEY
Date: 6/13/02
I hereby name and appoint Tiffany Moore to be my lawful attorney in fact to act for me and
apply to the City of Sanford Building Department for a Reroof permit for
work to be performed at a location described as:
Parcel ID Number: 32-19-30-5GS-0000-0510
Subdivision: Kaywood Replat
Address of Job: 2410 S. Oregon Ave.
Sanford ,F1. 32771
Owner of Property and Address: Rose Inez P
2410 S. Oregon Ave.
Sanford ,F1. 32771
and to sign my name and do all things necessary to this appointment
Type or Print Name of Certified Contractor: Richard L. Haines
Signature of Certified Contractor
The foregoing instrument was acknowledged before me this _11, day of , 200:x
produced
State of Florida
County of Orange
who is personally known to me / who
as identification and who did not take an oath.
Signature of Notary R uM M QG40azy-
Printed name of Notary t%4y, d tin 20-ecG ntc:
Commission No./Expiration: (%nfQ 1-60U Cl Q
Seal:
V N Cynthia M Papania
My Commission CC873306
7V Expires September 22, 2003
1
INIININANIAMNAlINN1AINNNNNIIIIIAAl11NN
This instrument Prepared By:
Name: Tiffany Moore
Address: 130 University Park Dr., Suite 125
Winter Park, FL 32792
Permit No.
STATE OF Florida
COUNTY OF Seminole
M RW ME MORBE9 CLERK OF CIRCUIT COURT
SEMIMXE COUNTY
BK 04438 P8 1137
CLERK'S N 2002896157
RECORDED 06/18/2M 0003slS PN
RECORDING FEES 6.00
RECORDED BY L k*inley
Tax Folio No:
NOTICE OF COMMENCEMENT
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.
1. Description of property: (legal description of property, and street address if available)
2410 S Oregon Ave Sanford ,FI.32771
2. General description of improvement:
Re -roof
3. Owner information
a. Name and address: Inez P. Rose 2410 S Oregon Ave Sanford ,Fl. 32771
b. Interest in property:
c. Name and address of fee simple titleholder (if other than owner):
4. Contractor:
Ci a. Name and address: R L Haines Construction, Inc.,130 University Park Dr., Suite 125,
b. Phone number: 407-384-1908 Winter Park, FL 32792
c. Fax number (optional, if service by fax is acceptable): 407-384-1909
5. Surety
a. Name and address:
b. Amount of bond $_
c: Phone number:
d. Fax number (optional, if service by fax -is acceptable):
6. Lender It
a. Name and address:
b. Phone number:
c. Fax number (optional, if service by fax is acceptable):
MAORTIFIED COPYCLERKOFGIROMph
BEM 01EUDR COUP aK .
JUN
7.
Persons within the State of Florida designated by Owner upon whom notices or other documents may
be served as provided in section 713.13(1)(a)7., Florida Statutes: a.
Name and:address: i b.
Phone number: c.
Fax number (optional, if service by fax is acceptable): 8.
In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice
as provided in Section 713.13(1)(b). Florida Statutes: a.
Name and address: b.
Phone number: c.
Fax number (optional; if service by fax is acceptable): 9:
Expiration date of notice of commencement (the expiration date is 1 year from the date of recording
unless a different date is specified) Sworn
to and subscribed before me by mtin
rc. who is personals known to me of produced as
identification, and who did ha4 take an
oath, this %4 day of 3V0•L_ , 2O Signature
of Notary l .01--,zi rA PLOCL1 Z _ Printed
name of Notary C, is ." Qa e&ft ui Commission
No./Expiration: CC! ki1740t. ti/]w I% — Seal:
Cynthia
M Pepenis My
Commission CC073300 an
Expires
September 22, 2003 Signature
of Owner 7 h M Owners
Name: Inez P. Rose Owners
Address: 2410 S. Oregon Ave. Sanford ,
Fl. 32771 0
ALL INFORMATION MUST BE TYPED OR PRINTED LEGIBLY TO COMPLY WITH RECORDING REQUIREMENTS