HomeMy WebLinkAbout213 E 1 St (2)CITY OF SANS ORD PERMIT APPLICATION
Permit # : W - I d-� , Date: K\�1��Ca 0 (J
Job Address: C. Sk S-�f-elc+
Description of Work: VV ` yo r —O�Q� ; V�.Y Connnjipm�� _O\ie f S��` l.� ak k
Historic District: Zoning: Value of Work: S r� I U ��
Permit Type: Building Electrical V-*' 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: N of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel N:9 5- 19 (Attach Proof of Ownership & Legal Description)
Owners Name & Address:y\oyjaca *,-I Vobtn
mai
Contractor Name &Address: � I��il iv l O �F F 1 or ldQ O 1 - l
t( `Q t y�U L -pV�O State License Number:
/t
Phone & FaxAo-\- pS `y 4V /OS �ad-W Contact Person: ��� hone:
Bonding Company: ICA --
Address:
Mortgage Lender: A
Address:
Arch itect/Engineer: n In Phone:
Address: 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. 11 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 YO 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, ti�lere 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 froml other governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the dwner of the property of the r FI n a
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Print Contractor/Agent's Name
Signat of Notary -State �of Florida
Contractor/Agent is�rs allt
Produced ID
Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date)
Date
Notary Public State of Florida
Patricia A Kadlac
My Commission DD403373
CITY OF SA;NFORD HISTORIC PRESERVATION BOARD
APPLICAMN FOR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407302.5805 Fax: 407.330.5679
TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD', FLORIDA
0 Downtown Commercial Historic District 0 Residential Historic District
O This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PROPERTY: WA RP C - R081P MARK.9 PO 80� 3cf375 o KA, az fAg.< FL
Property Owner 3Z?
Signature: 1/ywA" -� Ry(,i✓ Ni%12yr S Print Name:
Mailing Address: CO 6016 'SY!H With v a2 790
Phone: `f o ? — °i Fax:
Applicant/Agent -93% -33 99 cos�
Signature: l`�ARn Nt K . 6=( T ravyw ��'�fnt Name: /wt (�kj/
Mailing Address: ?cj S ff, ()(Z -C 2
Phone: OJ /2'ZO ax: LL,7J&J
I certify that all information c ntaine m this ap licatio ' true and accurate to the best of my o ledge.
Applicant/Owner: E X-[-� Date: -q A710 6
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)
• Site Improvements/driveway/walkway O Storage shed O Moving structures
D Replacement windows or doors O Underskirting o Awnings
o New construction/additions O Signs o Demolition
o Roofs/gutters/downspouts o AC/Mechanical o Fences/Gates/Pergolas
o Replacement siding/flooring/porch o Paint ther
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 pa es if necessary.
W, Rg- Foe 7 Ll6frT VNDEK. Ct "fy clt-perK S/v*- b✓ALk-
A Certificate of Appropriateness is valid for six months unless otherwise
Historic Preservation Board Meeting Date:
Application is Approved
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
111897 1
f
LIM=D POWER OF ATTORNEY
Date: June 0 (,, d ov
I hereby name and appoint - Mo. i k m( k -e— S(f� l I
of�TxT �( (�V C t�1 C qtr \U -A T)YY1T4 to be my lawful attorney
in fact to act for me and apply to for
a f\ L: 'f permit for work to be performed
i?/C I CSI kA - 30 _ S/\G- 03bQ,- co 10
at a location described as: Section Township Range
Lot Block Subdivision
SoL nk),(d
(Address of Job)
Ainwn r ra t pbin Mar kC ?D 9PV 3 4 �-t- w rr
of Properly and Address)
and to sign my name and do all things necessary to this appointment.
of Certified
Acknowledged:
Sworn to and subscribed before me this
�k Day of T l( r� L A.D. o c>(,
w",
Notary Public State of Florida
Notary Public, State of FloridaPatricia A Kadlac
My Commission DD403373
(Seal) a Expires 03/2812009
My. Commission Expires: M A f-\- C (4- ;LdE r-1002