HomeMy WebLinkAbout504 N Grand View DrCITY OF SANFORD PERMIT APPLICATION
Permit No.: L Date: _
Job Address: ` Jn N' r} G h v i e u 2 •«' 1. 3-1 -1 1
Parcel No.: (Attach Proof of Ownership & Legal Description)
Description of Work: IR L -
Type of Construction: oo Flood Zone:
Valuation of Work: $ 5 g , d U Occupancy Type: Residential Commercial Industrial
Number of Stories: Number of Dwelling Units: Zoning: Total Square Footage:
Owner:
Address:
City: State: Zip:
Phone No.:
n
Fax No.:
Contractor: l O(_/LI
Address: Q. C f ) O X 1c S 14
1(- -
City:
1 '
C ivs50 bo (r State: r I. Zip: License No.: C-CCc7jg ZZ— Phone
No.: j-- j(p Fax No.: D —3OD— 3 5- (o _ Contact
Person: 1 /OI." C Phone No.: Title
Holder (If other than Owner): /t) Address:
Bonding
Company: Address: /
Mortgage
Lender: Address:
Architect:
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 I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. n
Z Signature
of Owner/Agent Date Signatuurretf Cont ctor/Agent Date Yr
e_ L1 . Jot'<lA5 LQtiiv22_ Print
Owner/Agent's N me 7Print
Contractor
gent's Name f-/(.-dZ
y-Ito oL ignature of
Notary -State 6f Florida Date Signature of Notary -State of FI Date o l",
Sandra Leper t*My
Commission CC767102 nn'v
Expires August 13, 2002 P-09
SPINOwner/Agent
is _ Produced ID
Personally Known
to Me or 4F Sandra
Leger s *MY
Commission CC767102 Expires August
13, 2002 Contractor/Agent
is Personally Known to Me or Produced ID
APPLICATION APPROVED
BY: Dhi r ~ Special Conditions:
Date: 4-
lg'OZ—
Permit # Tax Folio #
NOTICE OF COMMENCEMENT
eU
State of —
Countyof 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 the
Notice of Commencement. I. 1.
Description of property: Sdy' N 2.
General description of improvement: fL 9-- 3.
Owner information: a.
Name & Address: \CAr 42: 6.
b.
Interest In Property: c.
Name & Address of fee simple titleholder (other than owner): Contractp;'
s Name & Address: ti a 'S (20 a-C ; Y -— - 0 '
14os 1t. rtss r 33. gs Surety
Information: a.
Name & Address: b.
Phone Number: JIV I c. Fax number: d.
Amount of Bond: $ Lender'
s Name & Address: 7.
Person within the State of Florida designated by owner upon whom notices or other documents may
be served as provided by 713.13 (1)(b), Florida Statutes: Name &
Address: a.
Phone Number: b. Fax Number: 8.
In addition to himself, owner designates To
receive a copy pf the Lienor's Notice as provided in
Section 713.13 (1)(b), Florida Statutes: a.
Phone Number: - b. Fax Number: 9.
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording
unless a different date is specified): Signature
of owner) tAt- Sworn
to and subscribed before me Sfe e rc ctiC- C ` vv th'
day of _, 20 7:
LNWNK KWj CLERK OF CIRCUIT COURT q `
Sandra legeO,EUgI OF ENINOLE COUNTY o
dS"cjQW83 PO 0334. Notary
Public CERTIFIED COPW..-' E-P1resAupuf Ib& NUM 2002864276 My
commission expir ARYANNE M0RSE o 6M 080104 AN tRRK
OF CIRCUIT COURT 00
SEMINOLE
COUNTY. FLORIDA RECORDED
8Y N Noldae l
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