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Home My WebLink About1110 Windsor Lake Cirr, CITY OF SANFORD PERMIT APPLICATION Permit #: 09- 1 - )r1t_/ v % Date: Job Address: / // d 440" Description of Work: TCS jmig ,- J/ jr. 1,1 �CbleA•..-A//ow N'1 otal Square Footage 30 F' Historic District: Zoning: Value of Work: S Soo �0 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: Mechanical Plumbing Fire Sprinkler/Alarm Pool _ Addition/Alteration Change of Service Temporary Pole Replacement New (Duct Layout & Energy Calc. Required) # of Water & Sewer Lines # of Gas Lines Plumbing Repair - Residential or Commercial _ Industrial # of Dwelling Units: Flood Zone: (FEMA form required ) Owners Name & Address: A4,1—C PolP.S / 3 ayd-Sc.'e^« D / o 3 2-ir 24 Phone: y U 7.2 7S $ Sri / Contractor Name & Address: /0 -�2- 64 M,J /• at 9 e gQ /^' �-nq 4o,05SP% `L State License Number: I S-2 I S Phone & Fax: 'yU 1 7 Ax e305bit Contact Person: 13VALf fY & r^rpf; -+C Phone: 'yy 146-'7a T,s= 7 Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer. 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. 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 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 1 will notify the owner of the property of the requirements/of Florida Lien ,�w, F�S��}3----. Signature of Owner/Agent Date Signature of Contractor/Agent Date /?0110r5� 13c) rMSll' -e Print Owner/Agent's Name Print Contractor/Agent's Name Signature of Notary -State of Florida Date Signature of Notary -State ofFjoej�t�� DLORINDIAZ d+' NOTARY PUBLIC - STATE OF FLORIDA COMMISSION # DD467010 ��'` a�ppe.. EXPIRES 8/29/2009 Owner/Agent is _Personally Known to Me or Contractor/Agent is _ Pers'bra�iJMown to Me or _ Produced ID Produced ID BONDED THRU 1-888-NOTARYI APPROVALS: ZONING: UTIL: Special Conditions: Rev 03/2006 FD: ENG: BLDG: January 24, 2007 Air Time Promotions 3063 Temple Trail Winter Park, FL 32789 Dear Robert: Please let this letter serve as an official letter of permission for the placement of a balloon on our property in the Windsor lake Town home community in Sanford. Attached is the site plan of the community that shows where the balloon will need to be placed. Power for the balloon can be provided by using the power off of the existing model home located at 1110 Windsor Lake Circle in Sanford. If you have any further questions regarding the location of the balloon or the power source please call me at 407-275-5591 ext. 242 Sin erely, Chrissy Nic ols Sales and Marketing Coordinator .moi+e'GLORIA V. DIAZ 'IMAii / .4-. PUBM - STATE OF FLORIDA ` COMMISSION # DD467010 YY�a EXPIRES 8/29/2009 b Z j Y BONDED THRU 1-888-NOTARYI 12001 Science Drive, Suite 160 • Orlando, FL 32826 • Telephone (407) 275-5591 • Fax: (407) 282-1563 CGC036043 ACORPM CERTIFICATE OF LIABILITY INSURANCE 1 DATE 06/16/2006) PRODUCER (407)849-0333 FAX (407)425-5694 George Eidson Agency, Inc. dba Eidson Insurance P.O. BOX 540209 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 # INSURER A: AUtO-Owners Insurance 10898 2807 Edgewater Drive Orlando, FL 328.54-0209 INSURED Advertising by Accident, Inc. INSURERB: FUBA Workers Comp dba Airtime Promotions INSURER C: 3063 Temple Trail INSURER D: Winter Park, FL 32789 INSURER E: 06/15/2007 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW ITHSTANDINI 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. ?NSR DD' TYPE OF INSURANCE POLICY NUMBERti POLICY EFFECTIVE POLICY EXPIP.ATION DATE iMM/DDNYI LIMITS GENERAL LIABILITY 20669570 06/15/2006 06/15/2007 EACH OCCURRENCE $ 1,000,00(E7nonon DAMAGE TO RENTED $ 100,00( PAFMISFS (Fa X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR MED EXP (Any one person) $ , OO I PERSONAL & ADV INJURY $ , OO A !I GENERAL AGGREGATE $ , , 00 PRODUCTS •COMP/OP AGG $ 2 , 000 , 00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO-JECT LOC E AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO I ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS i HIRED AUTOS BODILY INJURY $ I (Per accident) NON -OWNED AUTOS, PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ P GARAGE LIABILITY ANY AUTO OTHER THAN EA ACC $ r AUTO ONLY: AGG $ EACH OCCURRENCE $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ 10637855 04/01/2006 04/01/2007 WCSTATU- OTH- B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? It yes, describe under SPECIAL PROVISIONS below E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 E.L. DISEASE - POLICY LIMIT $ 500,00 I OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS I ' I &-1 1 ATIAIJ CATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. For Information Only AUTHORIZED REPRESENTATIVE Louis J Marian CPCU LSW CACORD CORPORATION 19881 ACORD 25 (2001/08)