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HomeMy WebLinkAbout3510 S Park AveCITY OF SANFORD PERNUT APPLICATION Permit No.: ( /, / 2.— i Job Address:,S Parcel No.: , o7 - y Description of Work:, Type of Construction: Valuation of Work: $ y UD Occupancy Type: Number of Stories: I Number of Dwelling Units: kOwner: Address: City: .; Phone No.: Contractor: Address: Residential Zoning: State: F I' I r+ A*V Date: %- op f - 0201 Flood Zone: Commercial Total Square Footage: City: S.4Wr-aa State: Zip: 36A'%%3 State License No. Phone No.: Ttv% ,i/ Fax No.: Contact Person: Title Holder (If other than Owner): Address: Bonding Company: Ai A - Address: Mortgage Lender: A Address: Phone No.: Architect: ri 'T Phone No.: Address: Fax No.: Industrial 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. 1 understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR CONDITIONERS, etc. rA 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. 1F 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 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713. 4,Z -02 Signature of Owner7AgeAt 0 Date Ale av Ar w A Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is P Personally Known to Me or Produced ID APPLICATION APPROVED BY s—/a: of Contractor/Agent Date Print ntractor/Agent's Name Signature of Notary -State of Florida Date Melissa ,•1 RrPom. Cameron0 Commission # DD079918 s ;4= Expires Dec. 20, 20055 ` o. i'F inifll A[1 Bonded 7 antic Bonding Co., Inc. Contractor/Agent is Personall Known to Me or Produced IDJ L/i-$'9d7 Date: Special Conditions: H}S Its MENT PARED Iry SEMLLU INOLECOTYFWR1LkAS wsvaiu GSOICE NOTICE OF COMMENCEMENT Statnof F rida County of Seminole Permit No. 0 2 — " o Tax Folio No. (PID) The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the falling information is provided in this Notice of Commencement. OF PROPERTY (Legal description ofthe property and street address) GT/!' Tir i li"r&*L!7 o L- SO$$tI GEN im AL DESCRiPTION OF 6VEMEN k OWNER Name and a Interest in property (Fee Simple, Partnership, etc.) NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER (IF OTHER THAN OWNER) CONTRACTOR Name and address_ J SURETY ( Bonding Company) s 8S2AIA IAI AATAIIIAI ID Name and address IT COURT S ENINOLEAmount ofBond R COE DEDOl/29/PO02 10122: 4 All LENDERRECORDING FEES 6.00 RECORDED BY 6 Harford Name and address Persons within the State of Florida designated by Owner upon whom notice or other documents may be served as provided by Section 713.13(lxa)7., Florida Statutes: Name and address In addition to himsd% Owner designates of to receive a copy of the Lienor s Notice as provided in Section 713(l)(b), Florida Statutes. Expiration Date of Notice of Commencement The expiration date is 1 year from date of recording unless a e is specified.) f%' ZriC Signature of Owner S Illy / jl y wA S41orn to and subscribed bqfwe me this Notary Public acknowledged before me this 'L3 day of 20_&Z by t9U, l t 6 t.L— (name of person admowl ed), who is (mown to me o "M Me-pmdaeed and who did/did not take as oath. type of identifirdtion)CL 0 c MARYANN 9N CLERK of tiiT.COURT jitwni G cn Ty. WOR1DA