HomeMy WebLinkAbout819 W 3 StCITY OF SANFORD PERMIT APPLICATION
_ obPermit q ( a9_a3
—Job Address: I g Wes* 5(`a, k strCet �.+J 64c, io , Ule- S IX l I Tc�-n of S�••ft6ra /
Description of Work: Re M a V O �- O n e �, l� o I i U 5-` _ Total Square Footage
Historic District Uning: Value of Work: 5 9 A CC C
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service – I of AMPS Addition/Alteration Change of Service Temporary Pok
Mechanical. Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: it of Fixtures M of Water & Sewer Lines q of Gas Lines
Plumbing/New Residential: 0 of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial
Construction Type: N of Stories: 0 of Dwelling Units: Flood Zone: (FEMA form required)
—OwamName & Address, . Ike Center fCr P}Hcrt ot,61r. I-}oVS?- y
�CW pN. a s PQrK- Dr. , S..,, 3 a -77 Phone o7 - 3a3- 3a6 g
Contractor Maine & Address: e+ f 4 o% r1 HG l d i n S I A C.
A(6'3 Nob 1 L° C, re l State License Number p e e o S 6 6 S /
Phone & Fac q 7 G f! X36 p /Contact Pawn: V► f e 7G k�� h Phone:`� C4
Gooding Company: A.o n L F6 -y,- 4 — �1 — 7 n) — 7 S
Address: —
--
MortgageLender. /VGr1C
Address:
Architecl/EvOneer: N a ^ t Phone:
Address _.
rag:
Application is hereby made to Main a permit to do the work and installations as rndleaud. I caufy Mono work or installation has commenced prior to dee
issuance of a permit and that all work will be performed to meat standards of all laws regulating construe tion in this jurisdiction. 1 understand drat a separate
permit must be secured fbr 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 complimrce wiM all applicable laws rcgtdating
epnshuexion and inning WARNING TOOWNER: 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 NOTICF.OF COMMF.NCF.MFN'I'
N071C In addition to Rte requ'uetnents of this permit, there may be additional restrigrons applicable to this property that may be found in the public records of
this county. and Rtete may be additional permits required from agta govcmmental entities such as water manegentent distric is, stare ag=ies, or (adual ageacia.
Acceptance of permit is verification that I will notify the owner, of the property of Uwe mqui is of Florida lien I caw, 1 .
ignatwe of Agent Date Signature of Contractor/Agent Date
G re q o r y C- Jo h nJ c n
r/ is a Pri / 's Name
h t tate of Florlda Due DEBBI rills Date
TON
DEBBIE BLANTON V
COMMISSION # DD 188497
MY COMMISSION # DD 188491 EXPIRES: February 25, 2W7
EXPIRES: February 25, 2007 1-0003NOTARY FL Notary Discount Aux.
IP O) 0 _ Produced ID t? - /s/ / l L,
APPROVALS: TONING: UTIL: FD: ENG: BLDG:—
Special Conditions:
Rev 0312006
THIS INSTRUMENT PREPARED BY-
NAME Ct('e cr C_ all ,Jc_ MARYANNE MORSE, CLERK! IRCUIT COURT
ADDR. a%3 Nobly C: tL'I� (,� SEMINOLE COUNTY
BK 06382 Pg 19921 (1pg)
CLERK'S # 2006137(11 1
NOTICE OF COMMENCE RECORDED 08/24/2006 12:42:47 PM
' M W'DINQ FEES 10.00 1
RECORDED BY H Bailey 1
TAX FOLIO NO.
PERMIT NO.
STATE OF FLORIDA
COUNTY OF
The UNDERSIGNED hereby gives notice that improvement will be made to certain and real
property, and in accordance with Chapter 713, Florida Statutes, the following information is
provided in this Notice of Commencement. ? q \/V - ,
DESCRIPTION OF PROPERTY (Legal description and street address) 4 l' I Vy
Lcil % +C 10 . bl-Ks T R II , 1Gw.. of Sr,nfu
! I P 6; ro.1
General Description of Improvement !
RCf-10V- ( of 011 U5 r' (_7c% I
OWNER INFORMATION
Name and Address Tne CC n-tt'_'r -1�-r A f tico-rd ab 1 HcvJj%n
A-5 a4 S, Zr_k. Dr. 5��,�G ��, fL. 33 7-73
Interest in Property (Fee Simple, Partnership, etc.)
Fcc S;M PIt-
NAME AND ADDRESS OF FEE SIMPLE TITLEHOLDER (if other than owner)
CONTRACTOR Pet rO u a n Hr,1 d ; 1',q I, _r/v C . , a 6 3 Nob 1 c c � is
(Name and Address) FL-
SURETY (Bonding Company)
Arc h t
Name and Address
Amount of Bond
LENDER
Name and Address
RTIFIED COPY
Persons within the State of Florida designated by owner upon whom notice or other documents may 1WA RYA4Pi -M ORSE
be served as provided by Section 713.13(1), (a) 7., Florida Statutes. CLERK OF CIRCIT-COURT
(Name and Address) LE CMN.FLORIDA
It addition to hi imself, Owner designates
or
713.13(2), (b), Florida Statutes.
Expiration Date of Notice of Commencement
terms
DEPU SPIKO
to receive a copy of Lienors Notice as provided in Section,l r. n
2006
(The expiration, date is 1 year from date of recording unl r to is s)
n
Si a of Owner
Swore to and subscribed before me this t7 / day of
Notary Public My Col
I
The foregoing instrument was acknowledged before me this
. by
known to me or who has produced
identification and who did (did not) take an oath.
I
DEBBIE BLANTON
MY COMMISSION # DD 188491
-9 EXPIRES: February ,
NOTARY FL Notary D=W AMC. Co.
(name of person acknowledged), who is personally
(type of identification) as
W 4 4k ST
CITY OF SANFORD FIRE DEPARTMENT
FEES FOR SERVICES
PHONE # 407-302-2516 - FAX # 407-302-2526
PERMIT#:
DATE: W I dq I Ot.
BUSINESS NAME / PROJECT:
ADDRESS: F?1 9 W I r d S r
PHONE NO.:
FAX NO.:
CONST. INSP. [ J C / O INSP.:[ 1 REINSPECTION [ ] . PLANS REVIEW [ ]
F. A. [ ] F. S. [ 1 HOOD [ ] PAINT BOOTH [ J BURN PERMIT [ J
TENT PERMIT j TANK PERMIT [ ] OTHER [ J
TOTAL FEES: S $ JZ7 (PER NIT SEE BELOW)
COMMENTS:
R
Address / B1dQ- # / Unit # Square Footage Fees per Bldg. / Unit
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
H.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, FI. 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.
Sa ford Fire Prevention Division Applicant's Signature