HomeMy WebLinkAbout418 N Grandview AveCITY OF SANFORD PERNIIT APPLICATION
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Permit No.: 2 ' l
n
1 Date:
Job Address: 4//f a
Permit Type: Building Electrical
Description of Work: 'ez` 2
1- .30 - 0 L_
Plumbing Fire Alarm/Sprinkler
Additional Information for Electrical & Plumbing Permits
Electrical: Addition/Alteration _Change of Service Temporary Pole New AMP Service (# of AMPS )
71,
Plumbing/Residential: Addition/Alteration New Construction (One Closet Plus Additional)
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Plumbing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines
Occupancy Type: Residential _ Commercial _ Industrial Total Sq Ftg: Value of Work: S aOd
Type of Construction: Flood Zone: Number of Stories: / Number of Dwelling Units:
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Title Holder (If other than Owner):
Address:
Bonding Company:
Address:
Mortgage Lender;
Address:
Attach Proof of Ownership & Legal Description)
State License Number: Z20•s.L SL
Phone & Fax Number:" % 221 /yl
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 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Signature of Owner/Agent Date Signature ofC nbiietor gent Date
Pr" /Agent's Name ' t Clatfaeter/Agent's Name
Signer
STACIA.HICK3
Date $- ature of Notary -State of orida Date
y(i""'
MY COMMISSION t CC 863M
EXPIRES: August 15, 2003
Banded Thru Ndery Pubk Undwwam
OySa/Agent is Prsonall Known to Me or Co ctor/Agent is Persona lly Known to Me or
ioo"Produced ID L (_ produced ID U-iDL: I F l a JC7 3 7r1
APPLICATION APPROVED BY: Date:
Special Conditions:
Permit No.
State of Florida
County of Seminole
NOTICE OF COMN ENCEM ENT
Tax Folio No.
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.
legal description of the property and street address if available)
Vkr,t) Pit 3e logo11111111111111101010aO IN 2.
General description of improvement: 3.
Owner information BK 04394 PS 0354 a.
Name and address Ziln .r P Ahir? .io itYl CLERK'S * 2002670716 Rew+
ewsno r sa w b. Interest in property T`i Jd1eL BY Y Y_»__ c.
Name and address of fee simple titleholder (if other than Owner) Da
ontractorName
and address /J 1 b.
Phone number %!Z 7 ,Z fe S— /(.,r Fax number 5.
Surety a:
Name and address I ,;Jr- NAME Lf SG-1 i1J "
b.
Phone number Fax number c.
Amount of bond 6.
Lender a.
Name and address w 0a w"- 'ten Po bars, i 9 O Ci O 501"
lFv r.• , C... c1{ bl 4 b.
Phone number Jqo 7,G 101 ' 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( (a)7., Florida Statutes: ss
N a. Name and addreJq b.
Phone number Fax number 8.
In addition to himself or herself, Owner designates Jim 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 1 year from the date of recording unless a different date
is specified) Si
ature of O 2O
n ti
Ew S
to (or affirmed ands b cribe before methlsy day of ,.',y 20 0 , by UIR 70-- CERTIFIED COPY 0 MARYANNE MOMS
Personally KnownORProducedIdentificationCLERKOFCIRCUITCpUpTOType of
Ide ification ProducedM 2X- MYS 0 & /. "/ , /L p SEMINOLE COUNTY. FLORIDA DEPu CLERK
G , STACIA.
HICKS Signat a
of Notary Public, State of Florida .; ' MY COMMISSION 1f CC. "tfi:,: STACI A.
HICKS Co ission
Expires: EXPIRES: August tf..: :.= MY COMMISSION I CC 863083 P eawea
ThN „y Puy ,:, . 3 EXPIRES: August 15, 2003 R ftr&
d 7Mu Nohry Pub& Underwrhe's Y
LOUIS HEIT GENERAL CONTRACTOR
State certified 6c. # 005264
P.O. Box 468 Lake Wales, FL. 33898 Phone: (863)291-3007
Fax: (863) 696-1598
POWER OF ATTORNEY
Date - -.), - Z
I hereby name and appoint
Who's address is:
To be my lawful attorney in fact to act for me and apply to the
building department
for a permit for work to be performed
at a location described below.or
Address of ,job)
Owner of property and address)
and to sign my name and do all things necessary to this appointment.
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Signature — Louis Heit
The foregoing instrument was acknowledged before me this day of 200 by
Louis S. Heit who is personally known to me who produced State License as
identification.
State of Florida County of Polk
d:""'^
L REBECCA PRIESTES
Notary Public, State of Florida
a d My comm. expires Feb. 20, 2004
Comm. No. CC912082
Notary Seal