HomeMy WebLinkAbout1953 Gale PlPermit H:
Job Address:
CITY OF SANFORD PERMIT APPLICATION
Date: 2-07,07
t
Description of Work: --If (SIS O J' i �t►T- Total Square Footage ci
Historic District: Zoning: Value of Work: $ A_-�z no, 0Z)
11
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool _
Electrical: New Service - # of AMPS Addition/AIteration Change of Service Temporary Pole _
Mechanical: Residential _V_ 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: Resideentiall Commercial
Industrial
If of Stories:
Construction Type:z2L
# of Dwelling Units:
Flood Zone:
(FEMA form required)
Owners Name & Address:/IYr+fav'oyti.r
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Contractor Name & Address: 60— 96 0
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Phone: o 2-
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License Number: C
C C Q t- ZX 61 1
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Phone & Fax: �/ fl I ` _.��_"T
Contact Person:
Al
Phone: Vd1
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 I will notify the owner of the property of the requiremprit of FI da Lien La 713.
S gn ture of Owner/Agent FL Date Sig at r f ntr or/A ent
Print Owner/Agent's Naroc-) /% Pri ntractor/Agents Name
xice.ataAtot ate-ofFlorida Date
�rP44 Not;.-, Public State of Florida
my :,Oi minion DD516629
ovao�° Expires 01/0912010
rer/Agent is Personally Known to Me or
Produced ID
APPROVALS: ZONING: UTIL: FD:
Signature of Notary -State of Florida
Contractor/Agent is
Produced ID
)?//)7
Date
Personally Known to Me or
ENG: BLDG:
Special Conditions:
Rev 03/2006,
lfo(Ocf 1100/-"rJ
14t State c,,'Florida
Iii �,.)TICE OF COMMENCEMENT County of Se I minole
Permit No. Tax Folio No. (PID)
77/ 'flie undersigned hereby gives notice improvement will be made to certain real property, and in accordance nit o; Chapter
713, Florida Sti'utes, the following i,,-: ,rmation is provided in this Notice of Commencement.
DESCRIPTIO j OF PROPERV,' (Legal description of t e pr perty and street address)
GENERAL 1) -,,�.SCRIPTION OF :,'14PROVEMIENT— t) r)
OWNER INF.',')RMATJON
Name and add-1-css.. MJ �OLA P/,4(4
O'e,
Interest in pros. :rty (Fee Simplcj-tnership, etc.)
NAME AND. -,,DDRESS OF VE1, FAWLE TITLE HOLDER-aF OTHER'MAN OWNER)
- CONTRACTOR
�.Name and add; css
r- 1/1-
SURETY (Bo.,,:.:6ng Company)
Name and add, ass
Amount of &: A
LENDER
Name and addloss
J01 -;k r - KOO )-A-(
111111111111111 11111
8K 06584 Pg 0113; (1pq)
RECORDED @8108/2007 M
T COURT
ff BE � V - A Y - T K I ci lk
Persons within :he State of Florida dk Ignated by Owner upon whom notice or other documents maybe served as 1; ovided
by Section 713.1.3(1)(a)7., Florida St.rtes: CERTIFIED COP'
Name and ad& --ss MARYAiNE MORSE
-tr r� CIRCUIT noURT
GIRC I,
OUNTY, FLORIDA
In addition to Owner des, -,,,ates
to receive a copy of the Lienor's Nilpncc as ,PEP TY CLERK
provided in Sf. Aion 713.13(j)(b)orida Statutes -
Expiration D;.1c of Notice of Co,, mencement Et 2007
(The expiration date is I Year fr6n; date of m-cordirw- unlem a diffemnt date i.- sn .ifim�
-VVV %nature of Owner
Sworn to anp -subscriffied o -,c this 73 Day ofC' 075 nivisjn 1A},-,166 i
My Commission Expires:
NotAry PubV
The foreg ing instrument was ach!,-Medged before me this day Of
na " known to
Ily
s
e2uvo (name of person acknowledge rsonally to
c f �e("
(ns P;Fr
s
.0
me or who hip produced (type of Iden cation as identif; 3a
and who did J lid not take an oath:
SEMINOL E COUN7Y
FLORIDA'S NATURAL C DICE
Limited Power of Attorney
Date: 01
I hereby name and appoint /a-kiI N riU%G4
Of Rdf-6,4 09��'�S (Name) to be my lawful
(Company Name)
attorney in fact to act for a d apply to Seminole County Building and
Fire Division fora -ey-00 - permit for
(Type of Permit)
work to be performed at the location described as:
Parcel ID#:
Address of Job: �.s',L�a%e Air �ar.
Property Owner:_ 1?&PA r
and to sign my name and do all things necessary to this appointment.
C 'foo GH{ cc ( 0,2 ;V0
(Cont actor's Company and License;
(Signature of Contractor)
Acknowledged:
Sworn to and subscri ed efore a this day of
Notary Pu lic
a A Keeling
(Seal)MY Commission DD&%M
or r. Expires December 09, 2000
My Commission expires on: d r
A. D. m