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HomeMy WebLinkAbout206 W 16 Stl CITY OF SANFORD PERMIT APPLICATION Ap'plica'tion # : ` Submittal Date: Job Address: 206 WEST 16TH STRFFT Value of Work: $ Parcel ID: 36-19-30-502-0000-007B Zoning: Historic District: z, Description of Work:Re—roof residential shin les & modified bitUMenSquare Footage: l g ................... JQ.....!:�it ............................................. 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 0 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): _ Constr=tion T' e: cf Ston... u Of nrr :. ��::.:g :.r�:`s:. �_ la3uU' Zrj i� (i %ii fi Fvru� rtyuircu I ...•.•.•..•..•.•.••••••••••.•••.••••••.••••••••••••••••.•............................. SARAH L. MILLER 1988 TRUST A & B ROOFING COMPANY INC. Property Owner: Contractor: Address: 212 WEST 16 TH STREET Address: 3905 MOORES' STATION ROAD SANFORD FL 327.71..: .SANFQR1D "FT. 377:Z1 Phone: E-mail: Phone: 322-9417 State License Number: CCC 1326255 Bonding Company: N/A Mortgage Lender: NIA Address: Address: ArchitecuEngineer: N/A Address: Plan Review Contact.Person: 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. 1 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. NOTICF: M addition to the requirements of this permit, there may be iddition.nl restrict ons s-plicable to this property that may be fol.*.nd in the public records of tivs county, and there maybe additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. Amer/Agent is fp it is verificatio that I w' a 'fy the owner of the property of the requirements of Florida Lien Law, FS 713. Known to Me or o _ Produced IDD/YI _ Produced ID APPROVALS: ZONING: CM `, W ature of.Owner/Agent ate Signature of Contractor/Agent Date vim, o r �g. 9 0 �—" ���'Qi, G.F. BOHANNON z Q o o = a rint Owner/Agent's Name Print Contractor/Agent's Name Cn w � w Z b W W Z G� �i �� OU X MX �- ignature of Not e of Florida Dae Signature of Nota -State of Florida to "'UJ Amer/Agent is Persaja11 �5�%%S Known to Me or Contractor/Agent isXX Personally Known to Me or _ Produced IDD/YI _ Produced ID APPROVALS: ZONING: UTIL: FD: ENG: BLDG Special Conditions Rev 02/2007 A & B ROOFING COMPANY, INC. 3905 MOORE'$ STATION ROAD SANFORD, FLORIDA 32773.6524 (407) 322.9417 FAX (407) 324.1377 1 hereby name and appoint JAMES ANDERSON of A & B ROOFING COMPANY INC. to apply to CITY OF SANFORD fora And to act in 'my behalf in all matters concerning the same, L --gal Description: prcel ID# 36-19-30-502- 0wners name & address- THE SARAH L. MIL'L'ER 1988 TRUST 212 W. 16TH STREET SA>ti�'ORn, �T. 'i�771 property address: 206 WEST 16 CCC 1326255__ LICENSE # G.F. BOHANNON 23rd day The forgoing instrument was acknowledged before me s -- who i s p - s Per n Personally know o f FEBRUARY ► 2 0 0 7_1B G. F. BOHANNON or who has produced unTnum� as identification and who DID DID NOT take by me an oath. My Commission Expires : 8-1_2-08__ t }wry IC a ,, TEREBA JOHNSON *: ;. MY COMMISSION # 00 343250 ' WIRES: August 12, 2008 �,4 X0' 90ndad ThtU Notary pbbllc underwriters 11111 II 111 11 Ili II 111 It In It 111111 Ill it Ill 11 1111 If III If'III 11111 NOTICE, Or, CONIMEMENVEN] '' MARYANNE MORSE, CLERK OF CIRCUIT COURT SEMINOLE COUNTY 5::;! o Florici;l BK 06693 pg 0378; Qpgf Cc.:n(NI of Scmin')ICLERK'S # 2007072092 X fG-i0 ii (Co Parcel 11) 11) .36-19-30-502-0000-007B RECORDED _05/15/2007 08:28:01 AM The undersigned hereby int'onils a I I collceriled ilial impronmuIlls NviII be lld Ill accordii cc lvirilvection 11.13 of the hlori du Statutes, llld followlilb illlOr111Qlion 1S SMEQd. ill ill N011C1: 0FRECA00M1}1rQpAire D•_scripdon fpinperty;LEG. W 74 FT OF E 144 FT OF THATPARTOF S :1y. OF LOT 7 W, OF OAK AVE. .`- G C KEELYS ADD TO.SANFORD PB 2 PG 86 PAD: 206 W 16TH ST.' G:n;:a1 s<ri^tion of irnprovcments. Re—roof residential Shingle & Modified Bitumen No Structural Change THE SARAH L. MILLER 1988-TRUST�� `,1,'.;.`.212 WEST 16TH STREET SANF _ vo\� �^® ) — O,crcr's interost in site oC the improvcnl 1'sc Sirnrjle Tide holder; (if olllci than 01 r �l A & B ROOFING COMPANY,INC. 3905_MOORES' STATION.ROAD. SANFORD FL 32773 `a:rcty:(ifany) ii a,nc of Person within the 5tnlc of 1'1orlda cicsipated by owner upon wllonl notices or other docnnlents cony be served! N/A 11. nIddil1011 t0 llilll5dfa owner doignaos the fol101Ylll& par50n to I'eccive n,copy of the l.,ienor'sNolice as provided in Section 7l l.13(1)(f), IOr{C;l'tWllllC3. (hill Ill Ili cjlYii�i"'� �t3iii i Ns:r.c: N/A ,ddress. Cxpirn!ion (late oCNotice of CoiTlmencemellt (t(le expirtltion data is I yens (1.0 he (late 6f recording unless a different, date is sIncificd.) I i•is irisirument prapnrcd by! ncr . Sworn to rind subscribed before rile This di'Y of JANICE R. ANDERSON -.;-,.'.3905 MOORES-' STATION . ROAD SANFORD, FL 32773 who khro p rsonntly kmawn to me qr llns/hnvc provided — ('1`ypa vI'Jdcnlil_lcaliou) Notary 11lll)liC ` IllIlllSSiUlI ii Illld 1S\IlIfi111U11) TERESA JOHNSON MY COMMISSION # DD 343250 EXPIRES: August 12,2W8 •...• •.For c; ,. Bonded Toru Notary Public Underwriters