HomeMy WebLinkAbout1320 Elliott Sty� CITY OF SANFORD PERMIT APPLICATION
Application # : /� V Submittal Date:
Job Address: / 3Zo l-�'�C ,,p 1 a Value of Work: $ 30-00
Parcel ID: Zoning: Historic District:
Description of Work: Square Footage:
........................................................................................................................
Permit Type: Building JIL Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service — # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
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 ❑ Commercial ❑
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
•.••••...••••••........••..w�•.•.................••••.•..•..••••••..•....••.••...•..... ..............................
Property Owner: A n'a e�"'-CS Contractor:�<19e1��6<2ZM /k -k
Address: M Address: JO /,,i7AQ , 44l 4t—A
G /XJ49 t Pam (--? ° 32.-7R S
c� 0L'Q 3-24Og
Phon . ?Filo 1116 E-mail: Phone: ���Go 3oC State License Number:
Bonding Company:
Address:
Arch itect/Engineer:
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, 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.
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APPROVALS: ZONING:
Special Conditions:
Rev 02/2007
at at I rotify owner of the property of the requiremen �FS
�Agtnt Date Signatu of C ntr ctor/Agent Date
s Name Print o a r/A n s N
tate FloriL Date I Signature of otary- tate of Florida Date
MEGAN S. GREEK'��s""'t' '�`� r.
Nci:ary Public, State of Florida 'D B'
MY COMM S tON # 00629096
Commission# 00517688 EXPIRES: Feb ruar 25, tot I /
srd dlPy ItfhIv0oF008 Contract / Ppr�g�lbys Ad�.t@o. �rr o ��
Pro d'ID,
UTIL: FD: ENG: BLDG:
THIS INS RUMENT PREPARED BY:
Name:��� >�Acer�r,ee
Address: /0;50 MA 1
State of Florida
SEAVNOLE COUNTY
FLORIDA'S NATURAL CHOICE
Building & Fire Inspection
1101 East First Street
Sanford, Florida 32771
County of Seminole
NOTICE OF COMMENCEMENT
Parcel ID Number (PID) 4 v ` D 5 a v
The undersigned hereby gives notice that improvement 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.
DESCRIPTION OF PROPERTY Legal description of the property ands eet addr ss)
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GENERAL DESCRIPTION OF IMPROVEMEN
OWNER INFORMATION;
Name and address: A �' S
AT -
CONTRACTOR°
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Jame and address: /o S0 IeA
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rersons within the State of Florida Designated by Owner upon whom notice r other documents may be served
as provided by Section 713.13(1)(b), Florida Statutes.
Name and address: __,ue
In addition to himself, Owner Designates
To receive a cop of the Lienor's Notice as Pro ei
Section 713.13(1)(b), Florida Statutes. ftD COPY
ExMARYANNE MORSE
piration Date of Notice of Commencement C E K OF CIRCUIT COURT
(The expiration date is 1 year from date of recording unless a different date is specified.) SE L C TY, FLORIDA
STATE OF FLORIDA BY
COUNTY OF SEMINOLE ' � U /Z,/ /] ,
of
7�
sign......
The fo�re/ oing instrument was acknowledged before me this
by
Name of person making statement
OR who has produced identification`—
`d
�•r AG MEGAN S. GREER
9� Notary Public, State of Florida
Commission# 0517668
My cornet, expires Jan. 25, 2008
Owner tNOT 'F
no one else may
)P�day of _
N71,
Florida Statute 713 .3'(1) (g), ,owner must
permitted to sign in his or her stead."
200
rsonally known to me
—type of identification produced
N¢tary Sihnatu