HomeMy WebLinkAbout2408 S Myrtle AvePermit # : 01 a_QP
Job Address: a2.40q S _ Vkl *IV t
Description of Work:
Historic District:
Zoning:
CITY OF SANFORD PERMIT APPLICATION -
Date:
Value of Work: $ % : $fo ®t 06)
Permit Type: Building —1-- Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service'– # of AMPS Addition/Alteration Change of Service Temportdry 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 Commercial Industrial Total Square Footage:
Construction Type: T— # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required f0j, (rfher than h)
Parcel #: 2 r j G� �j" S g- l��n!9C9'Q u� Ly (Attach Proof of Ownership & Legal Description)
Owners Name & Address: �I9 c TQ �u1+- f�P �i C`c1 1� L v� t� Ft 1 TLa A V'tP !2,C3 -V-1 2 :L%'% %
/Phone: 46 7,
, ,.Z4 og-A 9
Contractor Name & Address:?,) Ri T� C % iv c') S� \'Q�i1Q r'. 1,A11 C, VL %Q %;Q 'il I 11 a32- 3-Z___
State License Number: Re
Phone & Fax:#D7.3 y'Q5579 SIO%.-t�y /a 2S Contact Person: R`c kl3 �(.bT 5' Phone: y0 %�t?((sj
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 reg -elating
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 iEY BEFO E RECvnLitiG3 YOUR NOTICE
OFCO fENI EINIENIT
.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the pul lic 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 pq-mitysjerif[cation
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Owner/Agent's
of Notary -State of
-Mll notify the owner of the property of the requireme s of Florida Lien Law, FS 713.
;��2 -j�j���%
Date Signature of Contract r/Agent Date
V -d ;Mw'A 5-
- p Print Contractor/Agent's Name
ill 0 )J-5-07
Own Agent is P rsonalk Known to Me or
Produced ID (—cl.D L
TION APPROVED BY: Bldg:
(initial & Date)
Special Conditions:
Date Signature of Notary -State of Florida Date
Contractor/Agent is e, na,
Produced ID V11
SFBN-#-HD629096
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EXPIRES: February 25, 20l 1
I -800 -3 -NOTARY Fl. Notary DiscotntAssac.Ca
Loring' Utilities:
(Initial & Date) (Initial & Date) (hi+tial & Date)
NOTARIZE
.. Permit Numbe
Parcel Identification Number 36 -j y�
Prepared by: Ga 1 1 Morris
1260 Saratoga Ln,
Geneva, F1, 312.732
Ret to: D R and G, Inc
1260 Saratoga Ln,
Geneva, FI. 32732
NOTICE OF COMMENCEMENT
� Iaalaa a®a aa1 a earn 1aa a aal la urer®alal1a7i1191'llf IUI"Ill�lrt �� �"�
MARYANNE MORSE CLERK OF CIRCUIT COURT
SEMINOLE COUNTY i
BK 06594 Pg 0660; (ipg)
CLERK" S",# 2007025298
RECORDED 02/19/2117 08=48109 AM s
RECORDING FEES 18.09 I
RECORDED BY H DeVore
CERTIFIED COPY
MARYANNE MORSE,
CLERK OF CIRCUIT COURT
SEMINO COUfJrty, FLORIDA
13Y_ _�ERK
'FEB , 9 9 2007
State of Ea o r l:da
County of; Semi n�1e
The undersigned. hereby gives notice that improvement(s) 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.
1. Description of property (legal description of the property, and street address if available)
Av,l �" 7j?J
C14` ,. -; .- ^, Y` T e: _ 1•$'l' y�..'"�a -' cciw�l�' i:u i " ": 1`� ES "3 y"� . 7
2. General description of improvement(s)
3. Owner information
Name v 6'. wi_ R.•e. A. Telephone Number. 4%x'7 =j
Address 40` ", %fury rrtVr Av e-, Fax Number
3�"?; interest in Property:
4. Fee Simple iitle._Holder (if other than owner shown above)
Name Telephone Number'
Address Fax Number
5.
Contractor
Name ,. D_ R and G, Inc.
Telephone Number, :407 327 5636
Address 1260 Saratoga Ln Geneva, Fl. 3��S2umber 407 349 1398
6.
Surety (if any)
Name
Telephone, Number
Address
Fax Number
Amount of bond $
—7.
Lender (if any)
Name
Address 1 6'
Telephone Number
Fax Number
11
8.
a.11 designated by Owner upon whom notices or other documents may be.,
Persons within the State of Florid
served as provided by §713.13(1)(8)7., Florida Statutes.
Name
Telephone Number
Address
Fax Number
9.
In addition to himself &66rseir, Owner designates the following to receive a copy of the Lienors. Notice as
provided. in §713.13(1)(b), Florida Statutes.
Telephone h pone Number
Address...
Fax Number
10.
Expiration date of notice of commencement (the expiration
date- is .one year from the date of recording
unless a different date is Specified):
Date Signed Signature of Owner Note: per §71.3.13(1)(g), "owner
must sign ...and no one else may be permitted to sign in
his or her stead."
Sworn to and subscribed before me this day of _ 19 ; f)()by
rr Y1 (�-e x r c c
who is personally known to me OR prod
as identification. 1 ,
of Notary (notarial sea0o appear below)
BARBARA A. STEPHENS
;.; MY COMMISSION # DD 585910
*, EXPIRES: May 17, 2008
o<k� Batu rnn, NNW PLd* under wwrs
Form Revised: 3/98