HomeMy WebLinkAbout508 Grand View AveCITY OF SANFORD PERYHT APPLICATION
Permit No.: 0 2
Job Address: 5-4704
Permit Type: Building
Description of Work:
Electrical
MAI
Date: 3 / L / 0 3
Plumbing Fire Alarm/Sprinkler
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: XResidential _Commercial _ Industrial Total Sq Ftg: Value of Work: S %9e "—
Type of Construction:
Parcel No.:
Owner/Address/Phone:
Title Holder (If other than Owner):
Address:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer
Address:
Flood Zone: Number of Stories:Number of Dwelling Units:
Attach Proof of Ownership & Legal Description)
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. A
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,
Signature of Owner/Agent Date &Si,aontractor/AgenDate Print
Owner/Agent's Name Signature
of Notary -State of Florida Date Owner/
Agent is Personally Known to Me or Produced
ID APPLICATION
APPROVED BY: C/// YU r-
KrintContractor/Agent's Name YY1 '
UV1 j 2.S • 2 i
ature of Notary -State of Flori0yDate o.
JO ANN M. JOHNSON rMY
COMMISSION # CC 921BOB EXIMAES:
March 23, 2004 X. n '
L
Broad Thre aedael Notary Service nt
is Personally Known to Me or ID
89359 10 3 5OD4=> Date: 3 —
Z S -d 2— Special Conditions:
Ile
bat NOTICE
IIrBUInr la auluaal ul M wumw ulun
MMRYMM NORIEv CLERK OF CIRCUIT COURT
NNIN XE COUNTY
BK 04359 PG 1902
CLERK'S B 2002851264
COMMENCES SoF 66.00
EM o91 107 AN
RECORDED BY L NeKinity
TAX s'OLIo no.
OF
STATZ OS FLORIDA PEAT NO.
COUNTY OF
The QRDXRXX = hereby gives notice that improvement will be made
to certain and real property, and in accordance with Chapter 713,
Florida Statutes, the following information is provided in thisNoticeofCommencement.
DZ30LIPTION O! pROVERTY (Legal Description and Street Address4
General Description of .improvement •-Q%?00
011NZR XWORNATION
Name and Address Sa4 /tG•u•
Interest in Property (foe simple, partnership, etc) Q.IP,
MUM AND ADDRZBB or r= BXJWLZ TITLZXOLDZR lit ether then ewneel
CONTRACTOR a G?-..e. ,
t sae and uddr..
F 3 L 7—a
SZMTT (Bonding Company) CERTIFIED COPY
MARYANNE MORSENameandAddress
CLERK OF CIRCUIT COURT
SEt#NOLE CPyPZQ&WR=
Amount of Bond
LZWD=R MAR .2 5 2002
Name and Address
Persons within the State of Florida'designated by owner upon whom
notice or other documents may be served as provided .,by section713.13(1), (a), 7., rlorida statutes.
tnas and addreesl _ _...._.. --•
In addition to himself, Owner designates
or
to r4ceive a copy of Lienors Notice as
provided in Section 713.13(2), (b), Florida statutes.
xpiration Dohs of Notice of CO2maoacement
The expiration date is 1 year fro date of recording unless a different dataspecified.
7`' 7c+nirn K Xdenyg
r
OM50141 WIREg sa t e
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zoos -d W ) o g 4 H 71fGTMR!; 7tOY iNN MJS J EW
Sworn to sod subscribed belor4s we this Day of 1P
A MYCOMM SSIONO pppdaNny1 VMStaryPublicV'••Af,14``' WWon 2 mmjeeLon Zspires- O T vit_c K o o,o y
N ore oing instrument vas acknowledge before me this Zfay of
1 yQ by li (name oT personwleed who is personally known to me or w ed
type identification) asientiicationanwhoiinottakeanoath,