HomeMy WebLinkAbout806 Magnolia AveCITY OF SANFORD PERMIT APPLICATION
Application # : (� � � � � J -D Submittal Date: 1- 27.0
Job Address: �6 i?9arN0%%a�� ayt,1 Value of Work: $ so a, G
Parcel ID: Zoning: Historic District:
L� r vyp.lw
Description of Work: -� `� /- % 0/rl % dY, 7'N G i, �� .� �o %� Square Footage:
0
........................................................................................................................
Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service - # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑ Non -Residential O Replacement ❑ New ❑ (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: It 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):
Construction Type: bi 1" # of Stories: --)— # of Dwelling Units: Flood Zone: (FEMA form required)
.................................................................................. . . .. ...... 0............
Property Owner: Mak 1,4yf4Al Contractor:
Address: pd �Ct/a r� NOi �. Ql dly.( Address: 0) l/
Phone: E-mail: Phone:: State License Number: CCC 0AZ SO/
Bonding Company: Mortgage Lender:
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Address:
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. 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. 1F 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 agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requiremen Flori ten Law, FS
Sign f Owner/Agent Date gign ontractor/A
.ALS O
t' N 5on o nt's Name
-.07
tgnature e o public State of Florida ate ignature of No t of Florida Date
Paul A Nsen
My Commission DD516629 MY COMMISSION t# DD629096
o; w Expin35 02/0912010 EXPIRES: F�,,,a
04` ry 25, 2011
J ' ` "OTARY _ FI. Notary DL-4mmt Asx Co.
Owner/Agent is P rsonally Known to Me or
`Produced ID� (L.
APPROVALS: ZONING:
Special Conditions:
Rev 02/2007
UTIL: FD:
Contractor/Agent is
_
Produced ID
Personally Known to Me or
ENG: BLDG:
LDU,D POWER OF ATTORNEY
Date:
I he:7 _,.by name 4;.1d appoint U A, C
of to be my lawful attorney
in f:: -.L to act for :._ae and apply e r p /0' al for
a permit for work to be peef'ormed
at z -,cation des:,.,Hbed as: Sec :..:;n Township Range
Lot Block Subdivision
ASN' I/ b
(Address of Job)
M I,1'4,q 6k L/.� 27 7
-� waer of Property and Address)
and sip my il':�me and do al::
,s necessary to this appointment.
-0/
C ca o2 2S
(Type or Pri, namne of Certified Contractor and License #)
?,pature of dettified Contractor)
Acl.Owledged:
Sw.. n to and a;, .)scribed before me this
Day ofc A.D.
Not, y Public, Stz, of Florida OW Notary Public state of Florida
I
Pain A Olesen
My Commission DD516629
(S�,aad Expires 02/0912010
M'ommi sic -,Expires:
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/11"'O Y Orf VzW h►g6 acr,
)TILE OF COMMENCEMENT
State e:' Florida County of Seminole
' Permit No. _ Tax Folio No. (PID)
T1te undersigned hereby gives notice i' at improvement will bemade to certain real"property, and in accordance orifi. Chapter
713, Florida Sty -rtes, the following i; J; ;rmation is provided in this Notice of Commencement.
DESCRIPTION OF PROPERT':` {Legal description of the property and street address)
"`` GENERAL D. SCRIPTION OF _'APROVEMENT
!�Q
. ,)
;F OWNER INF,)RMA
Name and add.:. -ss
AJ1V La
Interest in pro > arty (Fee Simple, P+:• trtership, etc.)
t..r
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NAME AND ;'.DDRESS OF FE!_-
_
CONTRACT ..)R / /
Name and add, --ss
SURETY (Bc :.ding Company)
Name and adds ,�ss
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Amount of Bos d
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LENDER
Name and add .ss
6 Wei qWe"I"
TITLE HOLDER (IF OTHER THAN OWNER)
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Persons within ie State of Florida & gnated by Owner upon whom notice or other documents may be served as p -ovided
by Section 713.13(lxa)7., Florida St. Acs:
Name and add; -ss
1?,l In addition to �irnself, Owner des' , :sates
�x
{fj
.:. _ to receive a copy of the Lienor's Notice as
;r•
provided in Sc,:;tion 713.13(1)(b), ` orida Statutes.
Expiration D. to of Notice of Co-.-, mencement
.-.1 (The expiratic, date is 1 vear frort:. date of recording unle_cc a different date is crwnifim,l
;•, '
Signaturet6f Owner z®4*' ` -Notary Public State of Florida
r}
Paul A Olesen
f rc Q �•1y Commission DD516629
=A, s scribed o this --- —Day of e�4�4 i�Y �''�n ! es 0
-:! c y r 2r'09I2010
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My Commission Expires:
LIJ
N tary Pub ti,.
-! The for oinf nstrument was ack ;::;wledged before me this day of i"%%ter-�,�>1 CERTIFIED COPY E
l
:r
Lar✓ z'G-� (name of on acknowledged), who is personally t , NF MO
z
U. me or who �_ produced C ., (type of identification) as ident : ff fjF CUIT UR
di ! did not take an oath; S 1 0
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DUTY tLER
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HISTORIC
WATERFRONT GATEWAY
AT
CITY OF SANFORD
HISTORIC PRESER VA TION BOARD
APPLICATION FOR A
CER TIFI CA TE ' OF APPR OPRIA TENESS
P.O. Boz 1788, Sanford, FL 32772-1788
Phone: 407 330-5672 Fax: 407 330-5679
In addition to a Certificate of Appropriateness, a building permit may be required. Check with the Building
Department: 407 330-5660. A Certificate of Appropriateness may be required for projects that do not require
a building permit.
I nis cerurtcate must oe prominenuy atsptayea on ine ounaing wnen worK is in progress.
1. General Information
p
Property Owner: //"( Ly�? Property Address: 0 ` 'MaSNO�I
Mailing Address: x'06 ,%%%14&I;/; � A"t Phone Number:
/
S//�h!`o•( too
P? 7/ Fax Number:
Agent: �o► 0�/�"''fi oo k" y �/ Phone Number:
1J 4 �i .1 GtN /GV� r/ � Fax
7/
Address: 4d ili-eW� �t , Fax Number:
yo7 17 5ff�
y�7 J�?�
❑ Downtown Commercial Historic District: Residential Historic District:
❑ This application is filed in response to a notice from the Code Enforcement Department
I certify that all ' formation contained in this application is true and accurate to the best of my
knowledge.
Applicant: Owner:
Date: -2V,07 Date:
Please use the attached criteria checklist as a guide to completing the application. Incomplete
applications cannot be reviewed and will be returned to you for more information. You are
encouraged to contact the preservation planner at 407 330-5672 to make sure your application is
complete.
A Certificate of Appropriateness is valid for six months unless otherwise noted
OFFICIAL USE ONLY
Historic Preservation Board, Meeting Date:
y
Staff Review Date:
Application is Approved Approved with Conditions
Conditions:
Signed:
FASHA ENG\Historic Preservation DoardVJCertificate of Appropriateness.doc 1.
Date:
Denied
2. Description of Proposed Work
Application. Category: (Check all that apply)
❑ Site Improvements/driveway/walkway
❑
Storage shed
❑
Moving structures
❑ Replacement windows or doors
❑
Underskirting
❑
Awnings
❑ New construction/additions
❑
Signs
❑
Demolition
Roofs/gutters/downspouts
❑
AC/Mechanical
❑
Fences/Gates/Pergolas
❑ Replacement siding/flooring/porch
❑
Paint
❑
Other
Completely describe the entire scope of work: all changes in material, color or location to the
exterior of the building, where on the. property the work will occur and how the work will be
accomplished. For large projects, an itemized list is recommended. Attach additional pages if
necessary.
0/( kJW17 ro k c � W,'7"
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3. Documentation: In order to be reviewed by either the staff or the Historic Preservation Board, applications must be
complete. The documentation listed below must be submitted with the application form. 1 I copies of all drawings larger than 11" X
17" and l 1 copies of all photos must be submitted.
Paint: Color samples of all colors must be submitted.
Fences/Gates/Pergolas/ Sheds:
• A site plan of the property showing the location of the fence, gates and/or pergola. The plan must show the property's
dimensions.
• A picture of the proposed structure. This can be an elevation drawing, sketch, brochure or Ohoto of an existing shed,
fence, gate or pergola provided that the dimensions are included.
• A description of the materials that will be used in the project.
• Photos of the yard(s) in which the structure will be placed. (11 copies of each photo must be submitted).
New construction/additions
• Elevation drawings to scale of each facade indicating proposed alterations or additions. Drawing must clearly depict the
existing building and the proposed changes.
• Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed
addition, location of all exterior ground and roof mounted equipment..
• Description and/or samples of materials to be used.
• Where applicable, drawings and site plan of other improvements such as fences, walkways, lighting, decks, etc.
• Photos (11) of existing structure.
Awnings/ Signs
• Sketch or elevation drawing of the building fagade with proposed sign/awning.
• Dimensioned drawing of awning/sign.
• Sample of colors.
Site Improvements/driveway/walkway/AC/Mechanical
Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed
improvements.
Description and/or samples of materials to be used.
Note: AC/Mechanical equipment must be screened by shrubs.