HomeMy WebLinkAbout211 S Summerlin Ave1 CITY OF SANFORD PE10117 APPLICATION
Permit # : �� ^ `' Date: C7 C�
JobAddress: 5 S w.ww►aorl t (J-vp
Description of Work:
I•listoric District: Zoning: 'Ailue of Work: $ 1100 • C -Do
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole _
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair— Residential or Commercial
Occupancy Type: Residential _Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other Ilton X)
I'arcel o: 30— 19 (Attach Proof of Ownership &Legal Description)
Owllers Name & Address: L7,,A e"C- ly IL✓VV I,A- S ZKr we -,-I i 1A Ve
rhotic• �-/ o �- � v�- Y u F�3
Contractor Namc & Address: _(&a 4lZ J COCOA- lAeLron cc.
�h/�� State License Number: �— n iS700y
Phone & Fax: LACil—, $' — SBSNd�S Contact Ycrson: ����„ , Lea Phone:
Bonding Company:
Address: �r
Mortgage Lender:
Address:
Architect/Enginccr:
Address:
Phone:
Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify thnt no work or installation has commenced prior to the
issuance of n 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, a d t e may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of rm verificatio ' that 1 will notify the owner of the property of the
Sialinjure Iter Agent Date
Print Owner/Agent's a e
r� -6
Signature of Notary-Stnte of Florida Date
Owner/Agent is"Personally Known to Me or
_ Produced ID
APPLICATION APPROVED BY: Bld&M I 614D 'J Zoning:
(Initial & Date)
Mamene Elizabeth Bailey
F My Commission DD519012
Expires 0513012010
Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date)
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1
l'eti,it.Nyatber MARYANNE MORSE, CLERK OF CIRCUIT COURT
SEMINOLE COUNTY
Parcel Identificatiolt Number 5s 00 X>BK 06313 Pg 0473; 0pg)
CLERK'S # 2006108036
Prepared vy; RECORDED 07/05/2006 01:29:30 PM'
RECORDING FEES 10.00'
PAftblip 1 RECORDED BY H Bailey
Lob. 1 CERTIFIED COPY
Return to:MAR ANNE MORSE
3a-)r1J-c9•8X1 rl FRK OF I UI - T
SE FLORIDA
t;
Y 0 _ PUT Cl
NOTICE OF COl�✓ MENCElV�IENT JUL �2006�'
State of
County of
The undersigned hereby gives notice that improvement(s) 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,
1. Description of property (legal description of the property, and street address if available)
oLl1 b .5vc�yl(rit'1� nC i�� . Se,Y,d?o�el may.._. c3a.`7 ?
Le -b\ -O3- 7 t3\ k INI�,y �c. i t -P 6 3
2. General description of improvements)
h,,--cboP
3. Owner information
Name JL- rn K.w►t„lk- Telephone Number `-+o) - 70a - -Iqv,)
Address al\ • SumMR,rl+ 1�/ C Fax Number
Sc,�ro�c�-�-- C3,a7 7 ► Interest in Property:
4. Fee Simple Title Holder (if other than the owner shown above)
Name Telephone Number
Address Fax Number
5. Contractor
Name ae� key Coa�;51,r„��!-ro, Co -I �/� . Telephone Number C/U) S"SS Ua00
Address 0,)S-o$rr- Ca.c-.- p_V e Fax Number i-/07 576
6. Surety (if any)
Name Telephone Number
Address Fax Number
Amount of bond $
7. Lender (if any)
Name Telephone Number
Address Fax Number
8. Persons within the State of Florida designated by Owner upon whom notices or other documents may be
served as provided by §713.13(1)(a)7., Florida Statutes.
Name Telephone Number
Address Fav M111"I'Pr
9. In addition to hi iself or herself, Owner desil;nates the following to receive a copy of the I'lienor's Notice as
provided in §713.13(1)(b), Florida Statutes.
Name Rdpl-N�9j.t,e,y Telephone Number O
Address ! � � g e-1 -7 �7
((�3d2 ►V y C7cy�r Va- e 1, 3Z7,3,k .Fax Number
10. Expiration date of notice of commencement (the expiration date is one year from the date of recording
unless a different date is
�ecifie
.Date Signed Signature of Owner (Note: per §713.13(1)(g), "owner
must sign ...and no one else may be permitted to sign in
his or her stead."
Sworn to andsub cribed before me this. �day of
who i%. K personally ]mown to nue
as identification.
Form Rcviscd: 3/04
prouucea
Signature of Notary (n
20 t_ by
�tiA'areena Elizabeth Bahey
MY Commission OD519012
Expires 05130/2010