HomeMy WebLinkAbout118 S Sanford Ave (2)Permit #
Job Address:
Description of Work:
CITY OF SANFORD PERMIT APPLICATION
Date: 61z 1 Ib
N. It
Historic District: Zoning:
Value of Work: S_% 0 �eL 0 D
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 _
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential
# of Water & Sewer Lines # of Gas Lines
Commercial Industrial
Plumbing Repair—Residential or Commercial
Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Arclutect/Engincer:
Address:
State License Number: C Lf U-1 l JV 1
Contact Pelson:�'t i�q Phone: 3Z?- S�f
Phone:
Fax:
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 Ilialall work will he performed to meet standards of all laws regulating construction in this jurisdiction. 1 understand that a separate
permit must be s"aired for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATFRS, TANKS, and
AIR CONDITIONERS, ctc.
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 COMMENCEMENTMAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENT'S 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, and tore 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 require f Flor' icn Law, FS 71
`lam 4J..t, zz oto p�
Si tore o wncr/Agen1I)at Sign: c o ontractor/Ag Date �..
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dIrldrida*
V QPrint wn /Agent's amPrint Contractor/Agent's Name
Sign. urs ofNotrry- tat Dal ig aturc of Notary -Blatt of Florida Date
Owner/Agent is _ Personally Known to Me or Contractor/Agent is _-. Personally Known to Me or
Produced ID - — — _ Produced ID _
DAFNNY E ADCOCK
NOTAAV PUBLIC, OTATI OF FLORIDA
MY Oomm, Ettplrne DEWS
APPLICATION APPROVIill Utilities:
(Initi h Initial & atc)
Special Conditions:
(Initial & Date)
�(l& llat
SCD �Q�,t,, NOTICE OF COMMENCEMENT
ate of Florida County of scminolc
�Prvl Fe f� Permit No. Tax Folio No. (PID) _
7L 577 %-7 ( The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with C''wptcr
713, Florida Statutes, the following information is provided � tkis Notice of Commencement.
DESCRIPTION OF
ow
of Re property
Or
L_
,/� �iq,rtfrr.
GENERAL DESCRIPTION OF IMPROVEMENT 1C 0 0 F- CEP, . ED co , `j" .,
LAMIN VP URT
RIDA
OWNER INFORMATION
Name and address
r .A .
Interest in property (Fee Simpft, Partnership, etc.) In IAS,ir-t JUN
NAME AND ADDRESS OF FEE SIMPLE TITLE IIOLDER•OF OTI•IE•R THAN OWNER)
CONTRACTOR
Narg{e and address 'lam 1/�0 �� Q0 p �i7�� io 90D et -1 t,4 /T
`fir,,. , �.. r7_r--� ."-'],� `2'� —•r � ► '
SURETY (Bonding Company)
Name and address
Amount of Bond
.LENDER
Name and address
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Persons within the State of Florida designated by Owner upon whom notice or other documents may be served as prov idcd
by Section 713.13(lxa)7., Florida Statutes:
Name and address
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In addition to himself, Owner designates of
to receive a copy of the Licnor's Notice a:
provided in Section 713.13(l)(b), Florida Statutes. r -
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c it�iE4fl�Pdt N. fT+P�tf1%t1APU10tc f recording unlcca a differrnt data R
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R MY Comm. Expires DEC. 2, 2008 — Cog
'rah COMM. # DD376609
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"!"'icer f Owner �.• r,; a
Q � w
Swo ;tstaribacdorLemthis Day of r(.0
My Commission Expires: 0, �R
Notaryub is .n.,
The fore 'ng instrument was owledged before this�� day of �l oa to v
o f, �,O b.. L (name of person acknowledged) o is rsonally kno to
me or who has produced (type of idcntt n ica; ion
and who did / did not take an oath> >�
111857
LD41TED POWEROF ATTORNEY
Date: -LZ 0
I he.: eby name and appoint
of _ C a L K-oo , r•' to be my lawful attorney
r
in fact to act for me and apply io A, for
a _ _ 0 t 200--L
'Go o --L permit for work to be performed
at a location described as: Section Township _ Rafe
Lot Block Subdivision
S�
(Address of Job)
�V � � S . � �
o.. (L
_ Ovp
er of Property and Address)
and to sign my a:�ame and do all things necessary to this appointment
Awaa---�
(Type or Prim
aC— CL(�DZ-ZSO1
Contractor and License #)
/ 0
(SipaWm OCertiSed Contractor)
Acknowledged:
Sworn to and subscribed fore: me this
Day Of Q_ A.D. aO a L -P
Notary Public, State of Florida DAFNEY FAYE ADCOCK
NOTARY PUBUC. STATE OF FLORIDA
�� MY Comm. Expires DEC. 2.2008
(Se�.l) COMM. N DD376609
My Commission Expires- D
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Y ' f
. Company: o o � License #:
e v O �✓' —1
Project Information
�1
Owner: o
p C name
I � O a • � 1` 'O
v� aels
rm I _ 3��1
�b
I l - 37, z S'S I
phone
Permit #:
Subdivision:
Lot #:
I, 'AK , affiant, hereby affirm that I am the duly licensed
contractor of record for the above referenced permit, that all the foregoing information is true
and accurate, and that the dry -in, flashings at the above referenced address or lot has beer.
installed in accordance with the applicable codes and standards.
Contractor:
�kE21c=4Svc
print d name DAFNEY FAYE ADCOCK
/ NOTARY PUBLIC, STATE OF FLORIDA
•( MY Comm. Expires DEC. Z, 2006
STATE OF FLO A ,, �, ' COMM. # DD376509
COUNTY OF f'i►nA.� �► o
1 �1-
This instrument was acknowledged before m this 7,T day of eJ v�••-e_ , , 20D(Aby the
above referenced individual, o (-- , who acknowledged that he/she is a
duly licensed contractor with o owledged that
he/she was authorized to execute this docum nt. a/she is eit4�.§�ersonallto me or
produced as valid iden-ifr`ca-ion.
WITNESS my hand and seal this ZZ day of ��-^�-�- , 20 vL
Notary Pu lie
CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 40.7.502.5805 Fax: 407.330.5679
TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA
0 Downtown Commercial Historic District D Residential Historic District
O This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PROPERTY:
ProueM Owner��'
Signature: IJB�
Mailing Address: ,7
Phone: Fax:
Signature:
Mailing A
Phone:
I certify a
Print Name:,Xo4Wf
Print Name:
all information contained in this application is true and accurate to the best of my knowledge.
Applicant/Owner:
Date:
Please use the attached criteria checklist as a guide to completing the application. Incomplete applications cannot be
reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at
407-330-5672 to make sure your application is complete.
Description of Proposed Work/Application Category: (Check all that apply)
o Site Improvements/driveway/walkway o Storage shed o Moving structures
D Replacement windows or doors o Underskirting D Awnings
o New construction/additions O Signs O Demolition
[PKoofs/gutters/downspouts O AC/Mechanical O Fences/Gates/Pergolas
D Replacement siding/flooring/porch o Paint D Other
Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building,
where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is
recommended. Attach additional pages if necessary.
i
A Certificate of Appropriateness is valid for six months unless otherwise noted
Historic Preservation Board Meeting Date:
Application is Approved l
Conditions:
Signed
OFFICIAL USE ONLY
Approved with Conditions
Date:
Staff Review Date:
Denied
***This Certificate must be prominently displayed on the building when work is in progress***
Requirements for Certificate of Appropriateness Application