HomeMy WebLinkAbout114 Lakeside DrMike Staggs
Permit # : C) kP
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Job Address:
Description of Work:
Historic District:
Zoning:
407-880-9968 p.2
CITY OF SANFORD PERMIT XPPLICATION
Date: —Z" -o 6
Value of Work. G 0
Permit Type: Building Elocuical Nltx:lmicc _ Plumbing- Firc SprinkledAlarm �_ Pool
Electrical: New Service — 0 ofAMPS Addition/Ahcration Change of Service Temporary Pok
Mechanical: Residential __ ?Von-Resdential Replacanent New (Duct Layout& Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures _ # of Water & beaver Lines # of Gas Lines
Plumbing/Now Residential: # of Water Closets Plumbing Repair —Residential or Commercial
Occupeacy Type: Residential Cornmrcial _ Industrial Tobi Square Footage
Construction Type: K of stories: # of Dwelling Units: Flood Zone: __ (HEMA form requhvd for other than Xl
MRS
Parcel X: -2r "30 ,8'r, - l%`/ao____(AttaehProofofowacrship&LeEtllhseription)
Owners Name & Add re % f
~ '� Phone:
Contractor Name & Address:
C Sate License Number_`rir. 43
Pbone A Fax: "122Cooisct persan A ! ✓ Pbonc: Jg I ��YJ
seeding Company:
Address:
Mortgage Leader.
Address
Archltert/lEniseer. _Phone:
Address: Fax:
Application is hereby nude to obtain a permit to do the work and insialletions as indicated. I certify that tw wark or installation has commenced prior to the
issuance of a permit cod Ilw all work will be perFermed to meet standards of all lays regulating construction in this jurisdiction. 1 understand that $separate
permit mane be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WIRE14 POOLS, FURNACES, BOILERS` HEATERS, TANKS, and
ALP. CONDITIONERS, etc.
OWNER'S AFFIDAVM I certify that all of the foregoing infamation is accurate end that all work will be done in a mplience 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 IMPROVE.NENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT 87TH YOUR I JWDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: In adildion to the requiremoub of this permit, thane rmy be additional restrictions applicable to this property that maybe found in the public records of
rias cam and there may be addilxml permits required from odrer Eovernmental entitle such as water nu magement districts, state agencies, or federal agencies.
A eplanc f itiaverificattandw. I will aot:fy tho owner ofthe property ofthe mquiremcm o° tor' Lie 13.
Sipa um: ofOwtner/ASwt Dalt: Si Lure of ' /A
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Print 0%wer,Ager9's a contrum
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Signature of N data of Flonda 14 Dale S' um of Notary State of Florida Do.
noir I cd,� z v� e r� ��► .�o� ��
Owner/Agent is Personally Known to Ale or Contractor/Agent is _ Peacnally Known to Me or
Prod iced ID �. produced ID
ADPL; I� BY: Bldg Loniug: _ Utilities: FD:
'Q� ,oz GyF /yam (Initial car Dare) (Initial & Date) (Initial & Date) Onitial dr Date)
�� V�••••1SSIpN•�•.9j�
���►: Rebecca H. froward
* �•� ;* _ ';` Commission #DD2V153
#DD IWn; c �.�'�= Expires: Mar 14, 2008
* .' ry�bed • •TOQ` OF , Bonded Thru
�. •. yrp . • �.� Atlantic Bonding Co., Inc,
'����i� �BCIC•ST A�������\
fit if 11
IttIJ IIiJI �' ' '•'-'
hIRFtY l01R6-k-, LUM OF CIRCUIT COURT
NAME /, D
/S�F��o "WE Ulm
8K 015331 Pq'`'6; Upg)
3I70F NOTICE OF COMMENCEMEIgtERK' s 0 2*eXWa1 i 5j (A
REMED 07/18/2006 12:51:23 PH
Permit No. 99"AWRIM JIMA _
Slate of Florida RWINDIM 8Y i holdeln
County of Seminole
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Stalutes, the following information is provided in this Notice of Commencement.
1. 1)ycriptign of property:_(
2. General description of fm
3. Owner information
a. Name erdadd ess
_/Azov
b. Interest in property _
C. Name and address of
4. Contractor
a. Name and
b. Phone number L
5. Surety
a. Name and address
b. Phone number _
c. Amount of bond _
6. Lender
a. Name and address
ofthe p�perty and street address if available)
C-- 7,R 773
i�d i� r'Sf.i75 del. l;t 'F ED COpY ...
MAPY 'n► • . •P
CLERK 0' 'NT
QV ai � t
,Ider (if other than Owner) �J
e',r ,f•
�_ �D uVI
W 7 "a47
Fax number
b. Phone number Fax number
7. Persons within the State of Florida designated by Owner upon whom ner'ces or other documetrts may be served as
provided by Section 713.13(1)(a)7., Florida Statutes:
a. Name and address
b. Phone number Fax number
B. In addition to himself or herself, Owner designates -- — _ of,
to receive a copy of the Lienor's Notice as provided in Section
713.13(l Xb), Florida Statutes.
a. Phone number Fax number
9. Expiration date of notice of commencement (the expiration date is(!=iLginature
ding unless a diJierent
date is specified)
)�
o Owner
Swum t (qr arrned aq�sbwtibed before met is I day of j J �� , 20 O (n , by
Personally Known OR Produced Identification
Type of Identification Produced �V
Signature of Notary Public, Statckbf Florida
Commission Expires: .7-7
)0,
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company:/�L.icense #: �« lJ� �2,3y/
Project Information
Owner: 4C
// name
c"
address
phone
Permit M _
Subdivision:
Lot #:
I, 4J, affiant, hereby affirm that I am the duly licensed
contractor of record for the abodWreferenced permit, that all the foregoing information is true
and accurate, and that the dry -in, flashings at the above referenced address or lot has been
installed in accordance with the applicable codes and standards.
Contractoy�
si urc
L --
printed name
STATE OF FLORIDA
COUNTY OF
This instrument was acknowledged before me this day of , 20 , by the
above referenced individual, , who acknowledged that he/she is a
duly licensed contractor with , and who acknowledged that
he/she was authorized to execute this document. He/she is either personally known to me or
produced
WITNESS my hand and seal this
as valid identification.
day of t n
DEBBIE
g
1
F,
EXP : a
Notary Public