HomeMy WebLinkAbout132 Clear Lake CirPermit #
Job Address:
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date: Z- /1 !J 12- CM
Zoning: v Value of Work: S `J q :5 �p
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary PA
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: 22
Construction Type: # of Stories: ' # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 0 % ' n �j��^�y yc►l1 j'�C) /�� �(Dn - O ZJ O (Attach Proof of Ownership & Legal Description)
Owners Name & Address: S I 1 f A 1 I t S 1 1 / I) 1 1 Q S I L( lr n r JU 'LP, l. 1 1 L (�'i
Phone: {�
Contractor Name & Address: rA �I
/1� ! (� State License Number:
+t Phone & Fax: 0 -7 ZJ -12 I Contact Person: ` c7 J1 S l r I Ablone:
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 ermit is verification hat I will no' the owner of the ope of the requirements of Florida Lien Law, FS 713.
ops Signature of Owner/Agent ate Signature of Contractor/Agent �— Date
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Print Owner/Agent's Name Print Contractor/Agent's Name 4 co
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Signature of Notary -State of Florida ate Signature of Notary -State of Florida Dat �n
3 c l.: a3 0 t rr is
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C,- Qwner/Agent is _ P ovally Known to Me or Contractor/Agent is Personally Known to Me or t � w, t
c? T _ProducedID _ Produced ID
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A C
TION APPROVED BY: Bldg: Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & D el,,
Special Conditions:
Power Of Attorney
Date: 2 -167
I herby name and appoint �e�SG O 1 t `(()M I of Advantage Roofing Inc.
To be my lawful attorney in fact to act for me and apply to the ( M I *
for a roofing permit for work to be performed at a location described as:
Parcel ID#: �L Z U_ d S �� " 0 0 Q- UZ ,1 0 Q
Legal Description: ��(� iib i -7—(-p +A 1(:i C1 CA LQ LLy 1 Gt S p M 3 1? i3 Z 0
Address of Job: 13�` 4—_
5-113 3 P h S
Owner of Property and Address: C''nOAT -t)—� �=-a 5 15 0-,nA P
And to sign my name and do all necessary to this appointment.
Contractors Name: Typed: Thomas Ringler. Advantage Roofing, Inca
State License#: CCC052477
Signature of Certified Contractor:
Acknowledged before me this _day of�f'i� , U Gq
By Thomas Ringler
ID Or Personally know to Me N
Notary Signature: seal
My Commission Expires:
ti,yq n� Notary Public State of Ro da
i sar"t e Macke
D.)381674
irareoft Number
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COY I Ci nC10 PL D-0
NanCE OF COMMENCEMENT
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111111►1 111111 Ili 111111111111 1111111111111111 II Iii 111111111111111
MARYANNE MORSEL CLERK OF CIRCUIT COURT
SEMINOLE COUNTY
BK 46606 Pq 12381 O pq )
CLERK'S # 2007031436
REf,01,100 0:3/01/!'007 10:01:42 AM
REC[7WNG FEES 10.00
RECORDED BY L McKinley
The urAws4md hereby pfws notbs that brprovamart(s) wO be mads to oartaht real property, and In s000rdenos with
Chspbr 71 a, FkrMa Statutes, the lbaowUrg k0on www b provided M this l' m m ra of Commsnanrart.
1. Deserlptlon of prope tyser'
`da"m of property, and street address 9 avarabb)
L� r✓v-�1C1de�n� vII G5 ISH 3 P13 z�
2 GOMMde plion Vis)
Nor. CCt (1 c lj 11'1 C M rA Tala�ror� l�aunb.r
Addrssw i .3 C ( •f U Y I � is C Loc Number
er r Y G Wei In Property
4. Pee >1Ntrrplo T� Holdaipf other than owner above)
Neme Tdephmri Number
Address Fax Number
Nese ti CI VO %) i 0 C J- C) fl r) 9 Tdophom 11 � U `I
LP *103 PGV Rr i Gi q e, Ll)-. Fax Number
Or14incA
L Sw*(Wwh O FL 3 -2 J�,a7
Nese Telephone Number
Add nae Fax Number
Mount of bond $
7. Name MoN) Telephone Number
address Fax Number
a Persons wNMn the Stab of PwW dedptabd by Owren upon wi mn rrotlas erether doaunenb my bs
served as provided by Seddon 715.13(s)7., Fbrdda Stdutw.
New Tdsomm Number
Addrew Fax Number
b. In addIdon b hMredf or heredf, Owrw dsdpndw tw ibibwlnp b modus a aopy ef9M Llmmeg PleBoe as
Provided In 8eetlon 713.13(1)(b), Florida SWutes.
Name Tab *ww Number
Addr!we Fax Number
10. w 1piratlon deb d'lades of omtwttonoement pw wq*aon deft Is 1 year from the deb d rman rdi a edeas s
deftae d dols M speoeMd): Rj
Dab gped Slpnsbtn d Owner Mot a per tasslhon 713A3(1X& bow tawt
sign ...aid roo ono doe uey be para 1141, b dpa M bb or her
sftsd."d
10 1 ttr I ir< i n o viz -7
wlis b.r,_„ PaeoeelA,tbrowa b ata OR � pndrresd
t3lprebas d Nob:y agWlsl Mel b appear betawj
aswumbsum
Fomt Ilsvbad: M
6
CERTIFIED COPY
MARYANNE MORSE
CL R OF CIRCUIT COURT
SE L TY, FLORIDA
BY
DEPUTy CLER
MAR 0 1 2007: