HomeMy WebLinkAbout1200 Magnolia AveBonding Company:
Address:'
ArchitectlEngineer:
Address:
Plan Review Contact Person:
Mortgage Lender:
Address:
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 construction in this jurisdiction. I understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES; BOILERS, HEATERS, TANKSf 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 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 reqWments of this permit, there Toy be additional restrictions applicable to this.property that may be found in the public records of
this county, and there may a itional pits requiredfwffi other governmental entities such as water management districts, state agencies,.or federal agencies.
Acceptance` of pe is v ithay1j�cGy}lrti the owner of the property of the require of Flor' Lien Law, FS 713.
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CITY OF SANFORD PERMIT APPLICATION
121
—7
01/
Application #:
Submittal Date: /
Job Address: 12Ct(o
4 Value of Work: $ 4D0 fd
Parcel ID: Z S '3 d 5 AG 'a
3 - del Zoning: Historic District:
Q 17
Description of Work: n
S ^-f Square Footage: .20
........................................................................................................................
Permit Type: Building 0- Electrical ❑
Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign '❑
Electrical: New Service - # of AMPS
Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑ Non -Residential
0 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 ❑ Commercial ❑
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories:
# of Dwelling Units: Flood Zone: (FEMA form required)
.................C................... ..................................... .....p.................... .......... ........ ...
- Property Owner. 7 `L�/� ��L �S fa Contractor: iw' `1 e�yx� 6/ �'
— Address: I Jf �4TT�t,� A- `;
�n
/� rL Address; 16� / ®6A`1 -f 7 C'Xe5! /_yt
��
/ L:-)-Af140 ���in�Gs ��
;� 2-:201 '3 9 ?,VJ1
,AmqOnP
Phone: y'�7 �� Y/Iy E-mails w—�S Y C�'� L . Phon 'Y1K030fo State License Number: CCC1326 (J'?I/
Bonding Company:
Address:'
ArchitectlEngineer:
Address:
Plan Review Contact Person:
Mortgage Lender:
Address:
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 construction in this jurisdiction. I understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES; BOILERS, HEATERS, TANKSf 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 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 reqWments of this permit, there Toy be additional restrictions applicable to this.property that may be found in the public records of
this county, and there may a itional pits requiredfwffi other governmental entities such as water management districts, state agencies,.or federal agencies.
Acceptance` of pe is v ithay1j�cGy}lrti the owner of the property of the require of Flor' Lien Law, FS 713.
G'
Signature of Owner/Agent
Date
Signature fContractor/Agent�Jm
h A)•
�\�\\\P�•�^MISS?C
°
°"F016�
Print Owner/Agent's Name
Pri ontractor/Agent' Name
� 7
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Signature of Notary -State of Florida
Date
Signature of Notary -State of Flonda � � • T wo;, `
19 •Q
y t
+DE BBI oNryN> 01e1'
nop, �
�j/9096 �� m ICE� A10-3
�
MY
25,2011
//
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-900 N FI. Notary Discount Assoc. Co.
+�oQOx
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Owner/ A r
/
(u L' I
Contractor/Agent i Personally Known o Me or
Produced ID L 2
1
_ Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 02/2007
UTIL: FD:
ENG: BLDG:
0 s 5,00
Permit Number ct
Parcel Identification Number c- 1 r�
Prepared By: r
Return to: �, �y,r!
NOTICE OF COMMENCEMENT
State of�
Countyof Seely e
Ii19�I9!IIoillaiiialNiiiiI11IImoil ow1a1mII1111loll
MARYANNE MORSE, CLERK OF CIRCUIT COURT
SEMINOLE COMITY
BK 06597 Pg 0787; (ipg)
CLERKI S # 2007026737
RECORDED 0212118007 0912808 AM
RECORDING FEES 10.00
The undersigned hereby gives notice that improvement(s) 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. CEI T-WIED COPY
Description of property: (legal description of property, and street address if available)
Jaao i4AJ,tti /r,a A (,--t A4�-' '19( —7-73
2. General description of improvement(s)
3. Owner Information
?� Name 54,AN
Address /
4. Fee SirtiplL
it
Holder (i other fhan owner shown above)
Name
Address
5. Contractor
Name )&".-egJ%If2'd
Address /0 J /�f f(7 T7 r1 tJC A
,`k
6. Surety (if any)
Name
Address q,4
7. Lender (if any)
Name wr�zl
Address
Telephone Number Ll 0 jp
Fax Number
Interest in Property
Telephone Number
Fax Number
Telephone Number
Fax Number O Yl., -0„3 04
Telephone Number
Fax Number
Amount of bond $
Telephone Number
Fax Number
MAI7Y ',1E M05.1;)%.
CLERK OF CIP, ;IT �0!1FIT
SEMINOt1F 1 ;QTY. FLS '(►7.
8.;
DEPUT CL FRES
r j FEB 2 1 2007
8. Persons within the State of Florida designated by Owner upon whom notices or other documents may be
served as provided by Section 713.13(a)7., Florida Statutes.
Name Telephone Number
Address dl.t%,z-1 E' Fax Number
9. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as
provided in Section 713.13(1)(b), Florida Statutes.
Name Telephone Number
Address Fax Number
10. Expiration date of notice of commencement (the expiration d s ar fro to of reco g unless a
different date is specified):
Date Signed Signature rnoone
er [Note: ection 713.13(1)(g), "owner must
sign ...and else ma permitted to sign in his or her
stead."]
Sworn to and subscribed before me this " day of 20 0 r-7 by
who is personally known to me OR produced
(l7 U Y
as identification.
Signature of Notary (notarial seal to appear below)
Form Revised: 3/98
DEBBIELANTON
My COMMISSION Ir DD629096
o"1�, ��tP EXPIRES: February 25. 2011
-OF RV' Fl. Notary Discount Assoc. Co.
i--M-7-NOTARY
CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407.302.5805 Fax: 407.330.5679
TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA
❑ Downtown Commercial Historic District i t sidential Historic District
❑ This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PROPERTY: 00
Property Owner
Signature: Print Name:
Mailing Address:
Phone:
Armlicant/Aeent
Fax:
l r
Signature: Print Name: iZ<-'q 2a C -QM / 4 fZf
Mailing Address: '/G 5-0 /%I/q -1; da A ,—k PA'A- k e::::!f 3
Phone: VV y/6 G -3O Fax:
I certify that all information co arced in this application is true and accurate to the best of my knowledge.
Applicant/Owner: Date: .212//v-7
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 ❑ Storage shed ❑ Moving structures
❑ Replacement windows or doors ❑ Underskirting ❑ Awnings
❑ New construction/additions ❑ Signs ❑ Demolition
Roofs/gutters/downspouts ❑ AC/Mechanical ❑ Fences/Gates/Pergolas
❑ Replacement siding/flooring/porch ❑ Paint ❑ Other
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 pages if necessary.
A Certificate of Appropriateness is valid for six months unless otherwise noted
Historic Preservation Board Meetin e:
Application is Approved
('nnA;tinne-
OFFICIAL USE ONLY
Staff Review Date:
Approved with Conditions Denied
***This Certificate must be prominently displayed on the building when work is in progress***
Requirements for Certificate of Appropriateness Application