HomeMy WebLinkAbout712 Osceola Dr0
Permit No.:
Job Address:
Permit Type: Building
Description of Work:
CITY OF SANFORD PEP,;QT APPLICATION
Date:
Electrical M ec Fire
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: If Residential Commercial — Industrial
Type of Construction: i Flood Zone:
Total Sq Ftg: Value of Work: $8 . GG
Number of Stories: Number of Dwelling Units:
Parcel No.: U (" 20 v . fL-f / (AD Attach Proof of Ownership & Legal Description)
Owner/Address/Phone: V5Cer iO l. `7G1'1 F •/', 5-2 773 Contractor/
Address/Phone: Mme _ fI ttQU EW 7- f
State License Number: 0 s
ContactPerson: `Alu Phone &Fax Numbet •• " , Title
Holder (If other than Owner): Address:
Bonding
Company: Address:
Mortgage
Leader: Address:
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 constructiu., 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 pub!ipjecords of this county, and there may be additional permits required from other governmental entities such as water
manage nt istricts, state agencies, or federal agencies, is
verification that I will notify the owner of the property ok the requirements Agent
Date Print
er/Agent's me Signature
of Notary -State of Florida Date SAM
STROTHER Notary
Public, State of Florida My
comm. exp. Dec. 8, 2002 Comm.
No. C 5445 Owner/
Agent is ersonally Known to Me or Produced
ID / r'+ L. `SGe.S? APPLICATION
APPROVED BY: e
of Contractor/ orida
Lien Law, FS 713. Print
Contractor/Agent"i Name Signature
of Notary -State of Florida Date YP•,,
Melissa Cameron s .
COtantIWOU # DD079918 cs'
Eq)iM Dec 20, 2005 MY
F oQ• Bonded 7bm oil % `
Atlantic Bonding Co., br_ Contractor/
Agent is Personally Known to Me or X—
Produced ID 7-_CZ - %T/oyu Date:
512,7 Special
Conditions:
Limited Dower of Attorney
Date: 3 02
I HEREBY NAME AND APPOINTC,Q
OF _ GG. TO BE MY LAWFUL A ORNEY IN
FACT TO ACT FOR ME AND APPLY.TO THE
BUILDING DEPARTMENT FORA d!d PERMIT FOR WORK TO BEPEFORMEDATALOCATIONDESCRIBEDAS:
Osc- -eo/ca Pr IV For
OWNER: N ! v S d"
AND TO SIGN MY NAME AND DO ALL THINGS NECESSARY TO THISAPPOINTMENT
SIGNATURE OF OtATPIED CONTRACTOR
State of Florid
County of
The foregoing instrument was acknowledged before me this
6 day of k 2002 by n
whoAM personally known to me. 12
Mk- &nn4f VOTARYPUBLICSTOFFLORIDA Lawrence J McDonald My
commissionccewe39 PRINTED
NAME OF NOTARY ,""Vbe`
08' jo03 Commission Expires:
ERTIFIED-CRY
MARYANNE. MORSF-
Pc:mil Nuu;wr '
1'aJt Porccl Nu;ubcr
CLERK OF CIRCUIT COURT
TY. FIARI
NOTICE OF COMMENCEMENTScat. utJ=Ja•idttrounty ..: volusia
r5o V'tDERSICr' : ') Ja py biw) noric. -hc i irnp —cat w111 m.Je 10 eown re -a ptoperry, 3: J in A=r&r p wj(h Charmr 713, i :aid. q Ibcfi111;, inCcma ..: n a prQ%iJ.><1 it 1hi:..• ,w oCCv rmd. ancnr.
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2. Ocn,craJ dcscripti,::t ufJmprovc...:It:_ ejp
3 Omni, Informa6c:
a. Name and add.:ass-
5C eC iLA..
b. .interest iu. pm:: ,:,-ty
c. Nark and adc: ;y of fcc sirr. titlt hoJdcr;—
rl. Ct)rjt18C;. : (naruc r
5 Y' i )
Surety:
a. N<ui :•e and add., : 5:
b. Pbow numbcr:
G. Atnauut u,f bor..
6. Lender: Nau:e aac idirss
7. Persons within the .:atc ofFloric.. designated by Owmer upon whore ;lotic:es or other docurner•.: s rcay beserved :;s grovidec :v Section 7V .13(J)(a)7.,1%rid;t Statues:
a. Nnn..e-and adds..:;:___
b. Pho,-:c
S. La addi.:on to hivas•.:.; Ow11cr des:..;tates —
provide:! in Sectioc - 13.13(1)fbj, . iorida Stattits
to rcccive a copy t f he Liaot':. Nwkc as
9.
a di ffati at
date f _ Mice of Cotr...encetl nt (thO piratioja date. u 1 ;•-car from the date of reeo. dir.g Blues) u difi'crcot d s.-:i6cd.) _ _ •
STATE OF
slrjuturc c. iwMr
A COI.'. TY OF
qFJ7CdtCd :. c mrc thi._ 74 Tday of
who is ycfJD)1;)1dcotiticatio: — personal) Down lu ooe rr who has product We__jry ,
NARYAIdE NopA F, CLERK OF CIRCUIT COURT
rc of No r
OF BENINOLE COUNTY
Vurary SealSK r . —
FILE NUM 2002 5 '9"1
RECORDED 031VIM 01154154 PN
ewrence.l McDonald RECORDING FEEB 6.00
My Commission CCO93039 RECORDED BY N Nolden
W F. ores December 00, 200S
IIMI N110088101610Nmiswal
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Licensee Details
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el61
MLicenseeInformation
Name: ROBERTS, QUINNN ITCHELL (Primary Name `
HOME DEPOT INSTALLED
r
ROOFING (Alternate Name)
u Address: 207 KELSEY LANE SUITE G
TAMPA, Florida 33619
o' Z58
License Information
License Type: Certified Roofing Contractor r
Rank: Cert Roofing .—
License Number: CCCOSS327
Status: Current, Active -
Licensure Date: 11/19/2001
Expires: 08/31/2002
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