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Home My WebLink About1197 W Airport Blvd (3)C)�o ~ �� CITY OF SANFORD PERMIT APPLICATION Permit # : UVO i 10 Job,Address: 1 61 Description of Work: Historic District: Zoning: Permit -Type: Building Electrical Electrical: New Service — # of AMPS Mechanical: Residential Non -Residential _ Plumbing/ New Commercial: # of Fixtures Plumbing/New Residential: # of Water Closets Occupancy Type: Residential Commercial Construction Type: # of Stories: Owners Name & Address: b n L, Contractor Name & 1301 N-6 Phone & Kt1. Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer: Address: Mechanical Plumbing Fire Sprinkle VFD _ Addition/Alteration Change of Service // Temporary Po if x j Replacement New (Duct Layout & Energy Calc. Required) �oo 6 # of Water & Sewer Lines # of Gas Lines Plumbing Repair — Residential or Commercial ✓ Industrial — # of Dwelling Units: Flood Zone: (FEMA form required) a.� 1JMt_ 41- l onto-�IfiAm�a: ress: tj 4- dvyn fi lvr%ft •la -Z a.r _2�c_ t`"t.... - '15n Contact Person. - q3b -141 State License Number: 9.0 a- 11 (o b 0 0 O 1 -;l.0 6j 3 / / 'j h � Phnnr 0— vO+ 16 b -/ 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 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 is verification that I will notify the owner of the property of the requirements of Ion ien FS 713. Signature of Owner/Agent Date Signaturef Contractor/A en t Date D Print Owner/Agent's Name Print Contractor/Agent's NwAe SC Signature of Notary -State of Florida Date i ature lotary-State of Florida Date �h Jacqueline S Court j�zf) My Commission DDIS25Z or ti Expires October 25, 2000 Owner/Agent is _ Personally Known to Me or Contractor/Agent is )( Personally Known to Me or Produced ID Produced ID APPROVALS: ZONING: Special Conditions: Rev 03/2006 UTIL: FD: 6 ENG: BLDG: r o0 FREEDOM FIRE PROTECTION 1307 CENTRAL PARK DRIVE SANFORD, FL 32771 P -407-328-1663 F -407-328-4768 TO: CITY OF SANFORD 300 N PARK AVE SANFORD, FL 32771 407-330-5660 WE ARE SENDING YOU Attached �X Under separate cover via Shop Drawings Specifications LETTER OF TRANSMITTAL MAIL FEDEX -UPS -NEXT DAY COURIER Date: 6/13/2006 lJob. No: ATTN: RE: HIGHSTEPPERS KARATE the following items. Prints Plans Samples Copy of Letter Change Order Other Copies Date INo. Description 3 6/13/2006 SETS PLANS THESE ARE TRANSMITTED AS CHECKED BELOW: For approval Approved as submitted Resubmit copies for approval For your use Approved as noted Submit copies for distribution As requested Returned for corrections Return approved sets Please return one executed contract/change order for our records OTHER FOR BIDS DUE 2002 PRINTS RETURNED AFTER LOAN TO US REMARKS: COPY: FILE SOI i(, Copy: [:] Transmittal only ® Transmittal and attached documents SIGNED: Fred Lupo Blank Transmittal 01 6/12/2006 Received Fax Jun 1' 2006 •:22AM Fax Station FREEDOMPROTFCTION FROM :Design Enterprises, Inc. FAX NO, :4678308446 Jun. 08 2066 10:10AM P1 Iirilna�pl�ai�a�alnlltBla�e�a�alBlt Inatmrmt prepared by Seminole Cnonty Gnrlpuolkes 0(re flWOMM1: ►IMCrOAP" C6i(11IT COW C�; Name; Elaine Miller Attn: Official bcords `► Design Enterprises, Inc. BM 062/2 17261 Upi) 815 Orients Ave., 01040 CLERK/ S 0 2606077686 Altamonte Springs, FL 32701 RECORDED 111/12/2066 11906/11 rMt 111=10I11111 FEES 11600 RECORDED BY H Way Permit # Tax. Folio # NOTICE OF COMMENCEMENT STATE OF FLORIDA COUNTY OF SEMINOLE 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. l . Description of property; (legal description of property and street address, if available: 1197 West Airport Boulevard, Sanford, Florida Parcel I.D.#02-20-30-300-034A-0000 SEG 02 THP 205 RGI"s 30E W I/2 OF W 1/2 LYING HELY OF OR 411 t S 4LY OF AIRPORT F1Lrn N / S CA: 01.0 IjWF MARY RP (LEOO GSX RR R/W IN NW 1/4 SW OF AIRPORT t91.VV / I.F� MAT PARI OF LOT 45 LYING SWL'f OF AIFZPORT LILVU AVON NAL a Pe 3 PG 94) 2. General description of construction: interior Alteration 3. Owner Information: a. Brio, LLC 815 Orients Avenue #1040 Phone: (407) 830.1414 Altamonte Springs, FL 32701 Fax: (407) 830-8448 b. Interest in property: IW19 C. Name & Address of fee simple titleholder (if other than owner): N/A 4. Contractor (mune and address): Design Enterprises, Inc. 815 Orients Avcnuo, Suite 1040 Phone: (407) 830-1414 Altamonte Springs, FL 32701 Fax: (407) 830-8448 5. Surety: a. Name and address: N/A b. Amount of Bond: N/A 6. Lender (name and address): N/A 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7, Florida Statutes: R. In addition to himself, Owner designated the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(i)(b), Florida Statute: 9; Expiration date of Notice of Commencement (the expiration date is one (1) year from the date ofreoording unless a different date is specified). Date Sworn to and subscri efore nus this 41 t4 day of 0 6 Signature of Notary Public Notary Public Name: Pjaing V M11K_ Notary's Commission Expires: 04/11/10 — COIMIIS. 1 Do D10 ExMRE.4: Ap1A 11, t010 ;'+a„p/r raaarnww�sllaa/twa:IAY ALL DWORMA77t W MI.IST.FIF TYPED OR PRRJrM) I.nOI i1..Y TO COMPT.Y WITH RF.Ct7Rl)1NCF RRQi 1IRISMENT8. - �1CORD CERTIFICATE OF LIABILITY INSURANCE FREED -5 DA 05/05/06 PRODUCER SIHLE INSURANCE GROUP, INC. D 0. BOX 160398 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# AMONTE SPRINGS FL 32716 Prfone:407-869-0962 Fax:407-774-0936 INSURED INSURER A: Ace Amorlcan Insurance Company INSURER B: AIG REPRESENTATIVES. Freedom Fire Protection of Central Florida, Inc. 1307 CentralPark Drive Sanford INSURERC: Safeco Insurance Company 39012 INSURER D: ZENITH INSURANCE COMPANY INSURER E: VVYLrV1VG�7 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYY DATE MMID LIMITS A REPRESENTATIVES. GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR X Design E60 G21431734 05/09/06 05/09/07 EACH OCCURRENCE i 1 OOO OOO PREMISES Eaocaxencs S 100 ON MED EXP (Any one Person) $5,000 PERSONAL& ADV INJURY 31,000,000 GENERAL AGGREGATE s2,000,000 GEN'LAGGREGATELIMIT APPLIES PER: POLICY X SECT LOC PRODUCTS -COMPIOPAGG s2,000,000 C AUTOMOBILE LIABIUTY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 02CE10788000 06/07/06 06/07/07 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY $ (Per accident) PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT s OTHER THAN EA ACC s AUTO ONLY: AGG S B EXCESSIUMBRELLA LIABILITY X OCCUR 0 CLAIMSMADE DEDUCTIBLE X RETENTION $10,000 BE4765970 05/09/06 05/09/07 EACH OCCURRENCE s 2 000 000 AGGREGATE s 2 OOO OOO s $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? Ifes, describe under SPECIAL PROVISIONS below Z067588501 08/15/05 08/15/06 X TORY LIMITS I I ER E.L. EACH ACCIDENT $5001000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Pc0T1r1f%ATc unr noo CANCELLATION CITY SA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 10 DAYS WRITTEN CITY OF SANFORD NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 300 N. PARK AVE P.O.BOX 1788 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR SANFORD FL 32772 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Andrea Is. ACORD 25 (2001/08) e CITY OF SANFORD FIRE DEPARTMENT FEES FOR SERVICES PHONE # 407-302-2516 - FAX # 407-302-2526 DATE: J c ^ PERMIT #: QU BUSINESS NAME / PROJECT: ADDRESS: I« 1 1 1 w 12 PHONE NO.1 407 ) .ScAdFAX -as3� T CONST. [ jINSP. [ F S C / O INSP.:[ 1 REINSPECTION [ ] , PLANS REVIEW `/'�- TENT PERMIT ]HOOD TANK PERMIT PAINT[[ ] OTH OTHER H [ BURN P R0. � [ ] T � r�� TO AL FEES: (PER UNIT SEE BELOW) I COMMENTS: l - Address / Me. # / Unit # 12. 13. 14. 15. 16. 17. 18. 19. 20. Square Footage Fees per Bldg. / Unit tr ry *0 1.1 Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, Fl. 32771 Phone # -407- 330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take place. I certify that the above is true and correct and that I will comply with all applicable codes and ordinances of the City of Sanford. Florida. c Sanford vention Division Applicant's Signature