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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. 4 . 1. llc5cr)[1t1ot1 o// A- I P . pc e-` 2 / _ 5 N 'G C_G Lam( J% cJeZL iRiJ 2Q02 Ti^ —_.. r C.:gal dcscripq-: n uCtb. ptopc:.:.:u+G mca rdLm&:..•.-:ail bla) .. 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 Licensing Portal - Licensee Details Page I of I C4M Public Services 95 09:24:45 AM 3/2SV200: Licensee Details User Services 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 View Related License Information Terms of Use Privacy statgment q0 https://www.myfl.../w1l3.jsp;jsessionid=WDHNDLCIIFKkKj9f-zKC?fhash=809818f1g0&id= 3/29/02