HomeMy WebLinkAbout119 W 5 St (2)Permit #
Job Address.
Description of Work:
Historic District:
SV' 5-%
Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date: C V
7 -
Total Square Footage
Value of Work: $ AK s7cc
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — H of AMPS '— Addition/Alteration 'Change of Service — Temporary Pole—
Mechanical:
oleMechanical: Residential — Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures — k of Water & Sewer Lines a of Gas Lines
Plumbing/New Residential: k of Water Closets — Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial !/ Industria)
Construction Type: Z q of Stories: b of Dwelling Units: Flood Zone: (FEMA form required )
Owners Name & Address:
Phone -
Phone & Fa:: __Yo
Bonding Company:
Address:
Mortgage Leader-
Address:
enderAddress:
Arclik" /Engineer:
Address:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 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: 1 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, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of permit i§ verilo that 1 w' ify er of the property of the requirements of on 3
-T o e I
Si of owner/A nt Date d t Date
)y A
Name
Owner/Agent ispersonally
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 03/2006
DEBRA C. SIMMONS
Notary Public, State of Florida
My comm. expires July 25, 2008
No. 340621
iton Agency, Inc. (800)451-4851
/
UTIL: FD:
of Notary -State
-71Z�7y(,
DEBRA C. SIMMONS
Notary Public, State of Florida
My comm, expires July 25, 2008
No. D62
Bonded thru Ashton Agency, Inc. 1B00)45144854
Agent is Personally Known to e
ced iD �(, -Z40/ XS Czce7(SL�
ENG:
BLDG:
CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FdR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407 330-5672 Fax: 407 330-5679
TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA
0 Downtown Commercial Historic District 0 Residential Historic District
0 This application is filed in respopse to a notice from
-the Code Enforcement Department
ADDRESS OF PROPERTY:
PrORerty Owner
Signature: C1- Print Name:
Mailing Address: S cj %CL c?oL-7 7 Z
Phone: Fax:
Applicant/Agent
Signature: Print Name:
Mailing Address:
Phone: Fax:
I certify that all information containe to this. application is true and accurate to the best of my knowledge.
Applicant/Owner: ( VZ, 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 D Underskirting o Awnings
o w construction/additions o Signs o Demolition
oofs/gutters/downspouts o AC/Mechanical o Fences/Gates/Pergolas
O Replacement siding/flooring/porch O Paint o 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
reO cgd. ttachditigpal pages if�pecery
v
A Certificate of Appropriateness is valid for six months unless otherwise noted
Historic Preservation Board Meetin ate:
Application is Approved
Conditions:
Signed:
OFFICIAL USE ONLY
Staff Review Date: 1 ( 7
Approved with Conditions Denied
Date:
***This Certificate must be prominently displayed on th_ e.bu ding.when.work is in progress*** _
FASHA_ENGWistoric Preservation Board\C of A Application.doc -+ ,r �C l; %/ w fI
This insturnient prepared by:
Name: Cj ►"6i i� �N-TT''n f�t�lD / / /
Address: �/��0//o�ill°�► �'S(�f i /16r `lG/C�o�j r� �3 g l
Permit Number:
Notice of Commencement.
State of Florida
County of Polk
MARYANNE MORSE, CLERK OF CIRCUIT COURT
SkMINOLE COUNTY
SK 0631E PR 17561 flpg)
CLERK'S # 2006107750
Rl'LAWDFD O//OWROOS 09151IV AM
RWINDINO FEES 10.00
REWNDED BY L McKinley
The undersigned hereby gives notice that improvement 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.
Description of Property:
General description of improvemen
Owner inforniaiton Name and address
Interest in property
Name and address of simple
fee title holder (if other than
owner):
Contractor Name and address &,4" �� ,�,'{y f�po �M / �J�J03 flo k e✓r ADC. /4 *'— Xwydi;
CV)
Telephone O3 / J
- I,EP,TrI� IFD COPY
Surety Name and address MAPWYA `1NE I?ORSE'
Bond Amount Cll.' F CIRCUIT COURT.
Telephone (( r SEMI ' L FLORIDA
Lender Name and address BY
Telephone I
QUL 5 20.
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided in
Section 713.13 (1) (a)7., Florida Statues:
Alternate
Telephone
In addition to himself, Owner designates the following person(s) to receive a copy of the Lienot's Notice as provided in Section
713.13 (1) (b), Florida Statutes:
Lienor
Telephone
Expiration date of Notice of Commencement:
(the expiration date is one year from the date of recording unless a different date is specified)
i�
Signature of owner: , n
Sworn to and subscribed before tine by •• L✓ �l r% `LLr+-� JiYs - who is personally known to me or
produced as identification, this FrK day of , 20Q�;
Seal:
Notary Public, State of Florida
D BRAC. SIMMONS
Notary Public, State of Florida
My comm expires Jul 25, 2008
Bonded thru Asnton Agency, Inc. (800)4514484