HomeMy WebLinkAbout312 W 1 St (2)CITY OF`SANFORD, FLORIDA
APPLICATION FOR THE DEMOLITION AND REMOVAL
OF BUILDINGS AND STRUCTURES
PERMIT ADDRESS 31 , vy L,45+- Lf Flooe— PERMIT NUMBER OZ / ICJ T
TOTAL CONTRACT PRICE OF DEMOLITION Zf0 0 01 - TOTAL SQUARE FT. /,20 O
TAX PARCEL NUMBER
OWNER S2c-.-- it ".4 1a.' PHONE NUMBER YO'%- 0-067f
ADDRESS ( -Z W, ( 6
CITY -'Te, ro.4 STATE Fj_ ZIP 32-77/
CONTRACTOR E' PHONE NUMBER 2 7 -
ADDRESS t9Ocf ST. LICENSE NUMBER
CITY ' purw« /*•r' STATE F (. ZIP 3 '71 3 $
TYPE OF STRUCTURE TO BE DEMOLISHED: i--- ^ 61
FRAME CONCRETE BLOCK STEEL OTHER
PREVIOUS USE OF BUILDING OR STRUCTURE
PROPOSED USE OF THE SITE 00
GAS COMPANY DISCONNECT NUMBER (IF APPLICABLE)
GAS COMPANY PERSONNEL ISSUING NUMBER
NOTE: GAS COMPANY SECTION MUST BE COMPLETED BEFORE DEMOLITION PERMIT WILL BE ISSUED.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED
WITHIN 180 DAYS OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
180 DAYS AT ANYTIME AFTER THE WORK IS COMMENCED.
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.
THE NAMED CONTRACTOR/OWNER BUILDER TO WHOM THE PERMIT IS ISSUED SHALL HAVE THE
RESPONSIBILITY FOR SUPERVISION, DIRECTION, MANAGEMENT, AND CONTROL OF THE
CONSTRUCTION ACTIVITIES ON THE PROJECT FOR WHICH THE BUILDING PERMIT WAS ISSUED.
OWNER'S AFFIDAVIT: I CERTIFY THAT ALL THE FOREGOING INFORMATION IS ACCURATE AND THAT
ALL WORK WILL BE DONE IN COMPLIANCE WITH ALL APPLICABLE LAWS REGULATING CONSTRUCTION
AND ZONING. A COPY OF THE RECORDED COPY OF THE NOTICE OF COMMENCEMENT. WILL BE POSTED
ON THE JOB SITE WITH PERMITS NO LATER THAN SEVEN (7) DAYS AFTER THE PERMIT HAS BEEN
ISSUED. FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE
FOR THE IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
ASBESTOS NOTIFICATION STATEMENT (SEC. 553.79(11), FL STATUTES) FOR FACILITIES OTHER
THAN SINGLE FAMILY OR DUPLEX HOUSING.
I HEREBY AFFIRM THAT I HAVE COMPLIED WITH THE PROVISIONS OF SECTION 455-302, FL
STATUTES, AND HAVE NOTIFIED THE DEPARTMENT OF ENVIRONMENTAL REGULATION OF MY
INT ON TO REMOVE ASBE OS, IF APPLICABL'Q
SIGNATURE 0 OWNER/AGEN D E SIGNATURE OF CONTRACTOR b DAqi
TYPE OR PRINT OWNER/AGENT NAME TYPE OR PRINT CONTRACTOR'S NAME
4'S IGNATURE OF NOTARY b DATE SIGNATURE OF NATARY b DATE
OFFICIAL SEAL) (OFFICIAL SEAL)
J0 ANPJ M. JOHNSGN rp.N
1°Q"*.. _.. _
MY COMMISSION # CC 9210 ' O ON M. JOHNSON
r
f * EXPIFES: A1 u 23, 2004 a l"y C\ ilF MQl0N # CC 921808
si gP ,
ices
j Tn(U 9cdget NWar9 Snrvi- ef"REB: Aaft 23. 2004IcqinFOiRDYBhuTnrgudyqt/y Ssry
APPLICATION APPROVED BY DATE
FEES: BUILDING 1.51 APPLICATION /OTHER % O'
PERMIT VALIDATION: CHECK CASH DATE 3 — _ BY
ORIGINAL (BUILDING) YELLOW (CUSTOMER) PINK (COUNTY TAX OFFI )
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DIRECrORS
James V. Suskiewich
Chairnwn
Aubrey H. Wright, Jr.
Dr. Samuel C. Certo
George W. Foster
Kenneth W. Hill
Dennis J. Harward
312 W EST FIRST STREET
SUM 400
SANFORD
FIARIDA
32772.1867
PHONE
407/323.1833
FAX
407/3024595
FEDERAL
TRUST BANK
February 14, 2002
City of Sanford, Florida
Building Department
P.O. Box 1788
Sanford, FL 32772-1788
Dear Sir or Madam,
Please allow this correspondence to be authorization for Florida Concepts, Inc. to
apply for and pick up the demolition permit for work to be done at:
Federal Trust Bank
312 West First Street
Sanford, FL 32771
Yours Truly,
Aubrey H. Wright
Senior Vice President &
Chief Financial Officer
Enclosure
State of Florida
County of Seminole
The foregoing instrument was acknowledged before me this 14'h day of February
2002 by Aubrey H. Wright who is personally know to me and did not take an oath.
1i k%rm Zdanp
1r * NM Commission cC933zn G -e s%
Ewiss June 23. 2004 N tary Pub
My Commission Expires:
oo F C I
FLORIDA CONCEPTS, INC.
February 14, 2002
City of Sanford, Florida
Building Department
PO Box 1788
Sanford, FL 32772-1788
Dear Sir or Madam:
Please allow this correspondence to be authorization for Owen H. Hurd to apply for and pick up the demolition permit
for the work to be done at:
Federal Trust Bank
312 First Street West
Sanford, FL 32771
at
Joseph C. Corbett, Jr.
President
License #CB C057256
JCC/tac
State of Florida
County of Pinellas
The foregoing instrument was acknowledged before me this 14th day of February 2002 by Joseph C. Corbett, Jr., who
is personally known to me and did not take an oath.
4 .. Theresa A. Christensen, Notary Public
01"p4gTHERESA A. CHRISTENSEN
i 8`
MY COMMISSION* CC 784267 My Commission Expires: 1 /4/03
pave, EXPIRES: January4,2003
1-800,.NOTARY Fla. Notary Service 8 Bonding Co.
804 N. BELCHER ROAD, SUITE 200 9 POST OFFICE BOX 5026 • CLEARWATER, FLORIDA 33758-5026 • (727) 447-6776 • FAX (727) 447-1801