HomeMy WebLinkAbout2955 S Mellonville Ave (2)6-24-1995 10:25PM FROM P.1
CITY OF SANFORD PERMIT APPLICATION
Permit No..,
Job Address:
Permit Type: Building Electrical
Description of Work: A'r — O o d
Mechanical Plumbing Fire Alarm/Sprinkler
Additional Information for Electrical & Plumbing Permits
Electrical: _Additioo/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 &t Sewer Drainage Lines Number of Gas Lines
w
Occupancy Type: _Residential Commercial ZIndustrial Total Sq F%: / c"PO Value of Work: S d
Type of Construction: Flood 'Lone: Number, of Stories: I Number of Dwelling Units:
Parcel No.: (Anerh Prgof of Ownership & Legal inscription)
W4L—' #'ftk_J C WlJd,,, tSy?, f&_
Contractor/Address/Phone: Q Wa -P
Contaux Person: ,_ A
Title Holder (If other then
State License Number:
Pbone&Fax Number:
Address:
Bonding Company:
Address: ,
y
Mortgage Leads:
Address:
Architect/Fitgiaeer '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 informations is accurate and that all work will be done in compliancewith 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 FINANCIN9, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT. 1 NOTICE:
In addition to the requirements of this permit, there may be additional restrictions applicable to this property that maybe found
in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districrs, state agencies, or federal agencies. Acceptance
of permit is 'fication that 1 will notify the ownervf thproperty of the requirements of Florida Lien Law, FS 713. atu
re of Owner/Agent ate Signature of Contractor/Agent Date o_04 1
1 Lem Print
00,mer/ ent's Name Print Contractor/Agent:sName G -
r27 of
Owner/
Agent is _ Persu Produced
ID Signature
of Notary -State of Florida Date Y1/
w__ DIANE
CREWS. Notary
Public - Sbft of Florida QQ
MYCormtaaionEt inAm15, Kr
a orCommlaaion # DD04Mor) APPLICATION
APPROVED BY:f Q ViI(1 c 1I1Sdf1 / nt
is _ Personally Known to Me or ID
Date:
Special
Conditions: LOCATION:
RX TIME 02/21 '02 16:22
W- vJ1Ur1r1 r MW"I
IHIS INSTRUMENT PRE PARED 811
NAME OF CO1vIlv1ENCEMENT
Permit NAQQWW "` / ' Tax Folio No.
State of Florida $ U' / j7CountyofSeminole
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 the pro erty and street address if available)
aq 55- S. M e l l onv i l l e So rd
2. General description of improvement: 'Re -roof
3. Owner information
y a. Name and address -Ford ; hr0r+ u r i
l"J Or+s Red Clevie.la nd 8 yd ui +& 120f7 ord; TE- 3 773 b.
Interest.in property ' c.
Name and address of fee simple titleholder (if other than Owner) 4.
Contractor""""'a a tlt11wIR1111111A A1pNI111NN a.
Name and address cw M er b.
Phone number Fax numBBgyILE C61lv-UNWIT COW 5.
Surety BK 04338 PG 0602 a.
Name and address N CLERK'S # 2onpa3g9go , --- RECWM02/28/ b.
Phone number Fax au 8 6.00 nv-
wnuCU By A NQIdfn c. Amount of bond • 6.
Lender a.
Name and address NA --- b.
Phone number Fax number 7. ,
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes: a. .
Name and address Larry A . DDI-e,-1 t'residAr kED b.
Phone number(L n 8 5- * 0&7- Fax number "(!iCE1) 3 22 - S K 34- S.
In addition to himse or herself, Owner designates N /A _ of to
receive a copy of the Lienor's Notice as provided in Section 713,
13(1)(b), Florida Statutes. a.
Phone number Fax number 9.
Expiration date of notice of commencement (the expiration date is I yearfrom the da of recording unless a diffe ent date
is specified) Ski
nature of ey, - Sworn
to (or affirmed and subscribed before me this 8+h day of Feb roar y 20 02 , by r
y Personally
Known / OR Produced Identification Type
of Identification Produced ,.ro MARYANNE
MORSE Moft
DIANE
CREWS CLERK
OF CIRCUIT COURT Notary Public - 5tab of Fb 1da ELORI
M!
rCmvnbWmEVtw,Mn1k 6 Signature
of Notary Public, State of Floridi"'INOLE COUNTY. ail , commission
i DD02430e Commission
Expires: LOCATION: &
EB
2 OU09E 02/27 '02 15 :56