HomeMy WebLinkAbout214 Meadow BlvdPermit # : 0"')_/0
Job Address:
CITY OF SANFORD PERMIT APPLICATION
Date:
Description of Work: Alf -t Pe d �r_�T�JJ f Total Square Footage----� / --_
Historic District: Zoning: Value of Work: r®{
Permit Type: Building '1*"' Electrical Mechanical Plumbing Fire 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 _
Occupancy Type: Residential V Commercial Industrial
le
Construction Type: 0%. N of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
Owners Name & Address:
Phone -
Contractor Name & Address: v
State License Number:
lt
Phone & Fax: / 0 7, -1 Z Z • ISf Contact Person: Phone: Y__r
Bonding Company:
Address:
Mortgage Lender: .
Address:
Arch itect/Engineer:
Address:
Phone:
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 fedora encies
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Acceptance of permit is verification that I will noti a owner of the property of the requireme of Flofola Lien Law, FS 7
Signature of Owner/Agent Date Sig o ntractor/Agent Da
n
C_)A;ignature
t' N Print o ra for/Ag nt' meW�q� DE13DI>✓ ,,, bD62gp96
My COMM""O" 252011
Feb,"'Y t Assoc of otary- e of Florida Date Signature of No ary-State of Florida oF� to IXpt Fj Nota v0 50°o"�wNSM *
II y� c�
1_900-3`00"
�r0z t,C.J2- �-'t �.i. ger o "; State of Florida
.7, : risen
r qty DD516629
Owngr/Agent is Personally Known to Me or or nod CfxWaet&A]b ttls _ Per nally Known to Me or
✓Produced ID VC— P L_ " -r'o uce
APPROVALS: ZONING:
Special Conditions:
Rev 03/2006
UTIL: FD:
�Opp Notary Public State of Florida
Paul A Olesen
My Commission DD516629
of ao Expires 02/09/2010
ENG:
BLDG
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State GJ- Florida
Permit No.
TICE OF COMMENCEMENT
Tax Folio No. (PID)
County of Seminole
The undersigne6 hereby gives notice -0at improvement will be made to certain real property, and in accordance wit;, Chapter
713, Florida Statutes, the following in*..jrmation is provided in this Notice of Commencement.
DESCRIPTIO N 0 2 Y
Y PROPERT',' 'Legal description of the property and street address)
--CERTIFIED COPY,
MARYANNE ?4ORSE
GENERAL ID, -MRIPTION OF .(,APROVEMYNT �&o --_-eH-PxK 0 CIRCUIT COURT
OUNTY, FLORIDA
OWNER INFORMATION
Name and add: ess - .2 IPA -.4 W
7 -7-
,�X A, 41,0kz r . _21.2 7/ rEB' 0 7 2007
Interest in proy-_,rty (Fee Simple, P�_,,rtnership, etc.)
NAME AND.,,",IDDRESS OF M1, 'SIMPLE TITLE IIOLDER•(IF OTHER THAN OWNER) n
M
CONTRACTOR
Name and addTds Af T
SURETY (Boi Aing Company) it
Name and address
Amount of Boi-A V7
LENDER
Name and adds ess
Persons within i,',xe State of Florida &: ,mated by Owner upon whom notice or other documents may be served as p---ovided
by Section 713. 1 3(lXa)7., Florida St.-.I?c Aes:
Name and add-, ass
In addition to Idniself, Owner desi,,,!.,'ztes
to receive a copy of the Lienor's Noticc as
provided in St, --..tion 713.13(I)(b),
brida Statutes.
Ex I ientratian 11Ae 004
(Th da*igrl We&Eft-of FAtbf r =rdinsz unless a different date is qrprifim
Paui A Olesen
My Garnmission DD516620
Expires 02109/2010 Signature Owner
;
S orn on ld c b this Day of
My Commission Expires:
;NLary P ub I i _-n
and who did / _Iid not take an oatt-j---
-day of , 19 by
acknowledged), who is personally k ' -kown to
��pe of identification) as identif ration
LBff '.'ED POWER OF ATTORNEY
Date: '7
I hei.-e-by name F.qd appoint 4 RII)J1,14
ofoe to be my lawful anorney
in factto act for me and apply tc) lo, A al for
apermit f be or work to performed
at a location de.,v,-ribed as: Seci'ron Township_ Range
Lot.- Block Subdivision
�6 jd tv 9Z t/,i
(Address of Job)
LOL a do W )7z- L, a�
(O*ner of Property and Address)
and to sign my -, tame and do all +.pings necessary to this appointment.
(Type or PriT,,i. name of Certified Contractor and License 4)
7
(Signature of Certified Contractor)
Ac,`,,:aowledged:
Sw,-.;im to and si,bscribed before me this
H-" Day ofd Coyy a"L,
A.D. -200
f
Novy Public, Stwe of Florida "Y Notary Public, State of Florida
Pail! A Olesen
My Commission DD516629
Expires 02/0912010
M3 Commissica Expires: OZLdq / 2OID