HomeMy WebLinkAbout2430 S Myrtle Ave (3)t CITY OF SANFORD PERMIT APPLICATION r7
Application #: l/ l I ` ,/ Submittal Date:
Job Address: 3 v S _ �Y R7'1 ' /Ty Value of Work: $
Parcel ID: ? /nn�i� 3 0 — �' 3 `h—;0� 0o0--0 `t/O Zoning: n Historic District:
Description of Work: P2 .+,.SI J �t✓ V � c w lookA' fe A'AlSquare Footage:
........................................................................................... 0............................
Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbin Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service — # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑ Non -Residential 0 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 )�l— Commercial ❑ Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
................p.......................................................................................................
Property Owner:;r �/,�e-boR A'tJ Contractor: rlE/► 4 Y , e /C,�-C. %yLti'ri
Address: g�-i`�iN /�V� ��1127L+f^e��+- Address:,
'I� / /s�C-' !//g 4. O/�J A'
Phone: E-mail: Pone: ?7=31411 State License Number:ir �a *� 7SYZ
Bonding Company:
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Mortgage Lender:
Address:
Phone: Fax:
Phone:
Fax:
E-mail:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 i is verification that I wi n ify the owner of the property of the
requirements o da Lien Law, FS 713.
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3%/o `7
Signature ofer/Agent Date
_
Signature of Contractor/ gent Date
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Nei 1b � r,
er/Agent's Name
Prin tra r/Age Y Name
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Signature of Notary-Siato of FloridaDate
Signature of Notary -State of Florida Date
'M'=Fe&bniary25,20II "IDM 1tMY
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ced is PersoIl nown3o Me or
_ Produced ID � (�, �I/! �'> � ��oG.. 9i!- �2 - U
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Contractorr
_Produced ID
APPROVALS: ZONING: UTIL: FD:
ENG: BLDG:
Special Conditions:
Rev 02/2007
NOTICE OF COMMENCEMENT
Permit No.
Parcel ID:
State of Florida
County of Seminole
The undersigned hereby gives notice that improvement 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.
11111111111111111111111111111111111 IQ 111 11111111111111111111
MARYANNE MORSE, CLERK OF CIRCUIT COURT
SEMINOLE COUNTY
BK 06618 Pg 1202; O pg )
CLERK'S # 200703G549
RECORDED 03/09/2007 01:41:35 PM
RECORDING FEES 10.00
RECORDED BY J Eckenrath
2430 S m` il: LE Xi-) SPrN F0Vb K L. 32.7'11
1. Description of property: (legal description of the property and street address if available)
aTS 41 *.42r F FAIJKLIN TF RR( -E . Pl i 8CvK 3 P� 79 05,Em r wol-a coQ c,c-sy
2. General description of improvement: ( 0,0c'"% t-5,,7-4>
3. Owner Name and address:
a. Interest in property 0 W 0-A ERS
b. Name and address of fee simple titleholder (if other than Owner)
4. Contractor Name and address:
5. Surety
a. Name and address
b. Amount of bond
6. Lender Name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes:
a. Name and address _ u1A
In addition to himself or herself, Owner designates of
to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes.
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a diff nt
date is specified)
Signature of Owner
(or affirmed) and subscribed before me this day of 1 , 20 07 , by
Personally Kno n or Produced Identification _
Type of Identi catio Produced tl(i�'ip �Ik
MARYANNE i'fI2,,, Anh Thu T Nguyen
�°1 R OF CIRCUIT Cord
"l" 04E COUNTY. FLOEI ' commission DD3oa015
ublic, State of a i ik ,w/ ExpfresMarch 25, 2008 IRIS INSTRUMENT PREPARED BY:
Commission Expires:D-IEPQTy CLERK -fie„ NAME�IY1-'�--
MAR 9 2007, ADDR.