HomeMy WebLinkAbout2690 Pointsotta AveCITY OF SANFORD PERMIT APPLICATION
2 132-1PermitNo.: Date:
Job Address: cPo r' N I SGi'l l- Permit
Type: Building Electrical Mechanical Plumbing Fire Alarm/Sprinkler Description
of Work: , (L- S /54{ Additional
Information for Electrical & Plumbing Permits Electrical:
Addition/Alteration _Change of Service Temporary Pole _New AND 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 ommercial _ Industrial Total Sq Ftg: Value of Work: $ % d o , 1-
10 Type
of Construction: Flood Zone: Number of Stories: Number of Dwelling Units: Parcel
No.: O (, a 0 - 3(- So ,:5 - l Z o o - o o n _ (Attach Proof of Ownership & Legal Description) Owner/
Address/Phone: 26 7L) IgC2 r A'i=?j,4 Contractor/
Address/Phone: Z5- State
License Number: Contact
Person: 4-3 / L j''. Phone & Fax Number: c-3 7 --G, 5;- 2 Title
Holder (If other than Owner): Address:
Bonding
Company: Address:
Mortgage
Lender: J
Address:.
U 1 4/n 4y'Z- Z/ G l N 4 Architect/Engineer
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 I will notify the owner of the property of requirements of Florida Lien Law, FS 713. i afore
of er/Agent Date Print:Qwner/
Agent's Nme L-Sipo6e
of otar -State of Florida 6 mote
Date jFLy
nette
my Commission CC762328
o. Expires July
26, 2002 Signature of Contractor/
Agent Date Print Contractor/Agent'
s Name Signature of Notary -
State of Florida Date Own r/Agent
is Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced ID—F(
L jam„ Produced ID L. C) r
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4) 02 II ' APPLICATION APPROVED
BY: Date. Z_ Special Conditions: 74
5 Ag oye - 8
BOUNDARY SURVEY
LEGAL DESCRIPTION: LOT 5, BLOCK "14", A.B. RUSSELL'S ADD. TO FT. REED,
ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 1, PAGE 97, PUBLIC
RECORDS OF SEMINOLE COUNTY, FLORIDA.
THE ABOVE REFERENCED PROPERTY IS LOCATED IN ZONE "C', AREA OF MINIMAL
FLOODINGG AS PER F.I.R.M. COMMUNITY PANEL NUMBER 120294 0010 B, CITY OF
SANFORD, SEMINOLE COUNTY, FLORIDA. MAP DATED SEPTEMER 17, 1980.
SANFORD BUILDING DEpr. THESE PLANS ARE REVIEWED AND CONDITIONALLYAOOEPTEDFORP PNO LR .
CNSTRUEF
TO EREIEMIT• A PERMIT ISSUED SHALL BE
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CERTIFIED TO: MID FLORIDA TITLE SERVICES, INC.
THE GUARANTEE TITLE & TRUST COMPANY
LONG BEACH MORTGAGE
2690 POINSETTIA AVENUE JAMES LAW