HomeMy WebLinkAbout211 W 20 StCITY OF SANFORD PERMIT APPLIC:ITION
Permit #': �� 17d .5' Date:—a.
fob Address: ra A 1 \A)-
Description of Work: Fe Wc.\vnta Total Square Footage
Historic District: NO Zoning: Value of Work: S tj i
Permit Type: Building Electrical Mechanical Plumbing Eire Sprinkler/Alarm Pool
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 or Commercial
Dccupancy Type: Residential Commercial Industrial
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FENIA form required)
owners Name & Address:
contractor Name & Address:
'hone & Fax:
3onding Company:
\ddress:
4ortgage Lender:
kildress:
\rchitect/Engineer:
l• \ddress:
Contact Person:
Phone:
State License Number:
Phone:
Fax:
Phone:
\pplication is hereby made to obtain a permit to do the work and installations as indicated I certify that no %vork or installation has commenced prior to the
ssuance 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
mnnit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
UR CONDITIONERS, etc.
)WNER'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
onstruction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
-WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
1TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
IOTICE: 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
his county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
weeptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713 -
Signature
t3.Signature of Owner//Agent Date Signature of Contractor/Agent Date
�.-01r•r /�. �Oh�iO�
Prin er/Agent's a e Print Contractor/Agent's Narne
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
got"' DEBBI L
MY COMMISSION # DD629096
EXPIRES: February 25, 2011
Owner/Agent is 'P 0' 1 Not AssocContractor/Agent is _ Personally Known to Me or
Produced iD a Produced ID
d'PROVALS: ZONING: UTIL: FD: ENG: BLDG:_
0 pecial Conditions:
_ev 03/2006
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PLAT OF BOUNDARY SURVEY q
for
LORI ANNE and GERALD MONROE III
Legal Description
THE EAST 5 FEET of LOT 3, ALL of LOT 4, AND the WEST 30 FEET of LOT 5, BLOCK 2, HIGHLAND PARK,
according to the Plat thereof as recorded in Plat Book 4, Page 28, of the Public Records of Seminole County,
Florida.
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CAP (/33e2)I, 85.00
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SCALE: 1"=30'
SURVEY NOTES:
1) The street address of the above-described property is 211 WEST 201" STREET.
2) The above-described property lies in a Flood Zone X.
SURVEYOR'S CERTIFICATE
This is to certify that I have made a Survey of the above described property and that the plat hereon delineated
is an accurate representation of the same. I further certify that this Survey meets the Kinimue Technical
Standards set forth by the Florida Board of Land Surveyors pursuant to Section 427.027 of the Florida Statutes.
REVI5IONS: / / CERTIFIED CORRECT TO:
R. BLAIR KITNER - P.L.S. NO. 3382
Post Office Box 823, Sanford, F1. 32772-0823
(407) 322-2000
PROJECT N0: C)0- 521 SURVEY DATE: If OCT08ER ZOOG