HomeMy WebLinkAbout3071 Mellonville Ave (2)CITY OF SANFORD PERNIIT APPLICATION
Permit No. d7"' 0, Dater A Z
Job Address: 70 7 / n v, Ile 1 yE___
Permit Type: Building Electrical Mechanical Plumbing
1
Fire Alarm/Sprinkler
Description of Work: e.awy4 o K uEoZerq /o rr 70 41417 y p 7a+ot.K
Additional 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:
Type of Construction: Flood Zone: Number of Stories:
Parcel No.:
Owner/Address/Phone:
11//
e
QK7/p
Contractor/Address/Phone:_ fi
dfFA f7K7 Contact
Person: .-/o e / Title
Holder (If other than Owner): Address:
Bonding
Company: Address:
Mortgage
Lender: Address:
Architect/
Engineer Address:
e
iLlw
Value
of Work: $ !2 0000Number
of Dwelling Units: ProofOwers`
hip &Legal Description) d"
Pt I S.. N .-A a l e Y f 0
Zrf 135 State License Number' fee 04C4 742 f
L
Phone &
Fax Number: _JQ-735- 400 13 5 3Siz' 7 S- 1848 3 l 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 FINANCIN(j, 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 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. Vgn
a of Owne lZagentate Si ture f Contractor/Agent Date Lnrry
A. ])o le , 9rez1d9P±SAA C £ wewl4p ex Print
Ovmer/Agent's Name Print Co//ntrra or/Agentt's Name Aony
da 0415b2C a `1/ Z Signature
t - t e Florida Signature of Notary -State of Florida Date DIANE
CREWS ys
Charles
Kirk Roncone MyCOMMISSIM#
F CC96M EXPIRES September
t Notary Public - 8Wa`dr FIOf1da j' = TZ 2004 3• •
I
C m* tiA N/`l1, I„ i\ INSURANCE INC. lONOEOTNRUTROYFAINCommission
0 D0024806 Owner/
Agent is ersona y t o Contra /Agent is Personally Known Me or Produced
ID uced ID APPLICATION
APPROVED BY. r Date: Special
Conditions:
Return to: (enclose 5e9-addressed stamPed "Ve") NOTICE OFC717 11 i 1 1 g"o 10 o n, Nome: i rpplanerPs
f , /
Address: ,, `
YE/A R 7Mn 1e 2ma rs
AIA/
a te
9 MM W ClinZT WjR
d N •+ , rl~ X2 713 Y SK 04390 PO 0875
This Instnlme re by;, CLERK* S N 2002962499
1WlFV y"• ^ RMMD 04/15/8W 0313DO01 PM
t371,
o Y/
J
IPr INB FEES LOD Plop"
APpral.•r. PaOpo (.q 4 i.
l uW) .Z
7,! NMW BY N .). Neldsn O
SPOPE
ABOVE TM LM FOR PROCESSWO DATA SPAN ABOVE TN4 UNE PORREOORDINo DATA Permit
No. NOTICE OF COMMENCEMENT State
of Florida County
of / 7 e wt . +td The
undersigned hereby gives notice that improvements will be made to certain real property, and In accordance with section 713.
13 of the Florida Statutes, the following information is provibed In this NOTICE OF COMMENCEMENT. Legal
de t n of property (Include eet ddress, U."lable) 3O 7 / Ile lox Yr(IC Yd' General
Owner
Address
h'.. e Kea( G(eV'If (a...4 Owner'
s Interest In alto of the Improvement Fee
Simple Title holder (If othert"n owner) Name
Address
Con
trac Address
Surety
Address
Amount of bond =_ Any
person maldng a loan f9r1he construction of the Improvements: Name
Address
Persdn
within the State of Florida designated by owner upon whom notices or other doc0ments 1p WSftVV as provided
by Section 713.13(1 8)7., Florida Statutes. MARYANNE MORSE Name
CLERK OF CIRCUIT COUKT- Address
K11NOLE COUNTf.LOftID In
addition to himself, owner designates to
receive a copy of the Llenor's Notice as provided In Section 713.13(1xb), Florida Statutes. Expiration
date of Notice of Commencement (the expiration date Is 1 year from the date of recording unless a different date
Is ldfied). 04
sipnslun
of Ogfwm P&Mdd Shan wner ONOTARY
RUBBER STAMP SEAL. Swum and subscribed byrole we tills 15 day or A r 1 Check
one:)110 Aunt is personally known to me. O Arliaot provided the rolbwring
type or identification: N fA r
DIANE
CREW$ Nil"
Public - 8Ws of FMIM Mr
faslmitsbn Et ssJrn /B» Commission
0 OD024366