HomeMy WebLinkAbout4000 Bedford RdCITY OF SANFORD PERMIT APPLICATION
Application # / r, `V Submittal Date: j
Job Address: t j'C7C7to, -� / `'0
Value of Work: $ � �'i ,� I), ,,
0000 Parcel ID: '7 i 5 ?s P i '; t5 l) 6 Ll t;N 0;Coning: Histpric District:
Description of Work: 1 1 0 o c)
P� C.5 /tli',/'A-.,it`�,�(�' ('h,h-',\, SquareFootage':
.............................................................................:...:..........................:....:....
Permit Type: Building ❑ Electrical ❑
Mechanical ❑ Plumbing. ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service — # of AMPS
Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑ '' " Non -Residential
Q ^ Replacement ❑ ' `" New ❑ (Duct Layout& Energy Cale. Required) '
Plumbing/ New Commercial: # of Fixtures
# of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets
Plumbing Repair —. Residential ❑ . Commercial ❑ `
_ Occu anc T e dential ❑ Commercial
P YYP ' Residential,
, .,... Use G
ElIndustrial Occupancyroup(s):'
Construction Type: # of Stories:
# of Dwelling Units: Flood Zone: (FEMA form required )
........................................................................... .................. .... ...
Property Owner: -ARa I— !'f��,'V
Contractor
Address: D '� , i n/�' I (�" h r' r' . �'u '` ' Address. ' . L/3 0 ,,,; j
Pbone: zj^ 7• y /; i l a' E-mail: L9 b l :(`
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Z n.1 (o Ate- Phone: L/ a7-yw tate License Number:
.. Bonding Company:
�� . Mortgage Lender: %kr
Address:
.:Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Phone: Fax:
Phone:
Fax:
E-mail:
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 constriction 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: 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 YOU INTEND TO OB'T'AIN FINANCING; CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ,a
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 Ovate management districts, state agencies, or federal agencies
Acceptance of permit is verification that 1 will notify the owner property q
p P fy of theof the re uiremen of Flor d ien aw, F 713.
Signature of Owner/Agent Date Signature of Contractor/1Agent ,
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is
_ Produced ID
Personally Known to Me or
APPROVALS: ZONING . e Js 1.ql UT11.: FD:
Special Conditions: y4' '(rG a-�e c,£- kao-a
Rev 02/2007 \�� �2 rL� L�7ci r r t r cr~F
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Agent's Name
Date
Signature ot`fNotary-Statc of Florida Date
nr.rurtwuos ,
UEBBIBBLANION
MY COMMISSION N DI)629096
o EXpllR S:February 25,2011
YCJ, O-7-NO'rAAY OF °P FI. Notwy Digit A35v— CO—
Contractor/Agent is c o A y sown o Mr�er,
Produced ID i L- C
ENG: 4'�17
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FOUND ROUND CONC.
MON. (NO N)
0.15NORTN k 0
0.15' EAST
5
0.
NW CORNER SE 1/
SECTION 13, 7--20
SET IRON
& CAP #338241
4,
!Pt» f
47•' W
FLAT OF BOUNDARY SURVEY
for
LARS J. and MARTHA D. ERIKSSON
Legal Description
The SE'/4 of the S"N'/4 of the NW'/4 of Section 13, township 20 South, Range 30 East, Seminole County,
Florida; LESS the East 25.00 feet AND ALSO LESS Right-of-way for County Road 427.
SURVEY NOTES:
1) The above-described property lies in Flood Zone X.
2) 71e street address of the above-described property is County Road 427
3) No underground utilities or improvements were located by tois survey.
4) Bearings shown hereon are based on the South Loe of the NW '/4 of Section 13 being
N.87011'20""E.
5) This survey was completed on the ground on 27 December 2000.
SURVEYOR'S CERTIFICATE
This is to certify to LARS ). ERIKSSON, MARTHA D. ERIKSSON, JAMES A. BARKS, ATTORNEY, and
ATTORNEY'S TITLE INSURANCE FUND that I have completed this "Boundary Survey" of the above-
described property and the plat hereon delineated is an accurate representation of the same. I further
certify that this sun/ey meets the Minimum Technical standards set forth by the Florida Board of Surveyors
and Mappers pursuant to Chapter 61G17-06 of the Florida Administrative Code pursuant to Section
472.027 of the Flonda Statutes.
KITNER SURVEYING
R. BLAIR KITNER — P.S.M. No. 3382
P. . 0. Box 823 — Sanford, Florida 32772- (407) 322-2000
Not valid without raised seal of Surveyor
SE CORNER SE 1/4 SW 1/4
NW 1/4 SECTION 1.3
It
PROJECT NO. 00-472
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