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HomeMy WebLinkAbout810 Palmetto AvePermit # Job Address: CITY OF SANFORD PERMIT APPLICATION Date: Description of Work: 2 _� 1'� Total Square Footage Historic District: Zoning: Value of Work: S ki'y0 T Permit Type: Building Electrical Electrical: New Service — # of AMPS Mechanical: Residential Non -Residential Plumbing/ New Commercial: # of Fixtures _ Plumbing/New Residential. # of Water Closets Mechanical Plumbing Fire Sprinkler/Alarm Pool _ Addition/Alteration Change of Service Temporary Pole Replacement New (Duct Layout & Energy Calc. Required) # of Water & Sewer Lines # of Gas Lines Plumbing Repair — Residential or Commercial Occupancy Type: Residential Commercial Industrial Construction Type: # of Stories: / # of Dwelling Units: _ Flood Zone: (FEMA form required ) Owners Name & Address: % Contractor Name & Address: Phone & Fax-- Bonding ax:Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer. Address: Rd - Contact Person_ Phone: State License plumber rCelJ18r�11 6 11-5- Phone ls Phone Fax: 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 perm e is v ' tion that I will notify the owner of the property of the require is of Florida Li r Law, 713_ Signature o er/Agent Date ySiature of Contractor/Agent Date (:� Prin edAgent's, N e Prin ntr cto ent's Name ature of Notary -State of Florida Dae Signature of Notary -State of Florida Date �vyr v Anh Thu T Nguyen My Commission D0304015 ur o Expires March 25, 2008 Owner/Agent is -Personally Known to Me or _ Produced IDD( APPROVALS: ZONING: UTIL: FD: Special Conditions: Rev 03/2006 Contractor/Agent is _ sonally Kn to % �Me r _ Produced iD !-/J L !� � / ENG: BLDG: ,I11897 T .INM D POWER OF ATTORNEY Date: y` v;24 .� f I hereby name and appoint of to be my lawful attorney in fact to act for me and apply to e14 p�c�r�/�/ � for a permit for work to be performed at a location described as: Section Lot Block Township Range Subdivision ' (Address of Job) (Owner of Property and Address) and to sign my name and do all things necessary to this appointment. /.S Acknowledged: (Type dr Prim name of and License #) (Signature of Certified Contractor) Sworn to and subscribed before me this Day of A.D. ,2 Notary Publiof Florida (Seal) My Commission Expires: •. �,av a� PAULA SONTOS Notary Public -State of Fbft -My Commission Expires Oct 24, 2M Cwmnission # DD458378 9WWW By National Assn. -' Pennit Number �r�/• { Parcel identification �vurnbetrl;J "%/ Prepared by: _ I iN 10111 oil 11 Ili it ill it fit iI Iii If 1I) iI Iii it III It III 11111 Retarn to: /�l 5,� � , � MARYANNE MORSE, CLERK OF CIRCUIT COURT i SEMINOLE COUNTY 8K 06676 Pg 0668, (1pg) NOTICE Off' C[�14�1R ENCEMENi�` ! CLERK' S # ;�0�i?C)i��E,47 RkC(1WL-1) 04!;(1/8007 10143:: l AM State of C" lcslf \ .1 W - -- Co-waty of alb ---- RECORDED BY L McKinley The undersigned hereby gives notice that improvcment(s) will be made to cerrair: real property, ;Wd in accer lance Wil h Cher 713. Ftfirida Statutes, the fvllcncing information is provided in this Nouw of Co nrrencemenz Description of property (le description of the proper v and street address if available) MORSE �`z, JCWK of 1G3RGWT,jC0URY 4t COUNTY, Rb?RIDA General description. «£improvcment(s) (���_, e — 6f �CiBY RUTY, ' LEFRK 3. Owner i forz�atiou :ane I (-I-d-.J CaG a Telephone Number Vv -7,4q(. �- APR 3 0 200% Address 191 o tr%mbAV-e- AV -e- Fax Non, ber Interest in Propem•: (L5rVvl� 4- Fee Simple Trt1e k?(atder (ifottzer [Rett t�e owner shown abm-e) Namc Telephone Number Address Fax stk.VZA Wtimhn Can � NamelA4krYph Address (jun r 5. Surety (ifs��t-; Name Address 7. Lender t if any) Name Address Telephone Number Fax Number &eo % _;;LZ Telephone Number Fax Number Amount of bond S Telephone Number Fax Number S. Pers ons within the State Offiorida designated b' Owner "pen whom notices or et -ter documentS m2v be served as provided by y 713.13(1)(a)T, Florida St;%trrtcl�. Name Telephone Numt er Address fax `lumber 9- to addition to himselfor herself, 0-ner designates the folio -wing to receive a copy of the Uenor'� No ire a_ Provided in 6;13.73(1)(b), Florida Sianites. Name Teiepbone Number Address Fax Number I 0. Expiration date of riotice of commencement (the exv innion dat- is one .ear from the date of recordirg unless 2 diffie,-ent dame is sprcifi ): brgnat~ir�e at"r weer (Acte: per §713.13( 1)(2). "ovr,ur must st,d� r, d no one else may ba perm{itra to sign in his er [ter ead" to a e sz{bserib�d f re Esc this I<�1.Q- ( i1 6 !� _ `_r___- daY of ----f---- ° `R t Who is r crsonally known :to me OR as identificatio.j. Form R-k,.e:3r�a x0"oAnh Thu T Nguyen y; MY Commission DD304015 'car a Expires March 25.20()a CITY OF SANFORD HISTORIC PRESERVATION BOARD APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS P.O. Box 1788, Sanford, FL 32772-1788 Phone: 407.302.5805 Fax: 407.330.5679 T0: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA Downtown Commercial Historic District Residential Historic District 0 This application is filed in response to a notice from he Code Enforcement Department ADDRESS OF PROPERTY: - Pro e Own r _ Signa e: Print Name: UR Mailing Address: �z99 —S , .� e o ��"� 3 2 -- Phone:©�'2� "® `iD9D Fax: Applicant/A en Signature: ------ Print Name Mailing Address: Phone: I certify that all ird Applicant/Owner:( -cAntainer"in this Fax: is true and accurate to the best of my knowledge. 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. Description of Proposed Work/Application Category: (Check all that apply) C Site Improvements/driveway/walkway 0 Storage shed C Moving structures ❑ Replacement windows or doors ❑ Underskirting C Awnings L New construction/additions c Signs C Demolition yRoofs/gutters/downspouts D AC/Mechanical L Fence s/Gates/Pergo las ❑ Replacement siding/flooring/porch o Paint C 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 recommendyd. Attaafh a�itional pages if n ce ,� A Certificate of Appropriateness is valid for six months unless otherwise noted OFFICIAL USE ONLY Historic Preservation Board Meeting Date: Staff Review Date: Application is Approved Approved with Conditions Denied Conditions: Signed: Date: 7" �3- 71107 —This Certificate must be prominently displayed on the building when work is in progress' C:\D000ME-1\jonesm\LOCALS-1\Ternp\XPGrpWise\HPB=Certificate of Appropriateness Application.doc /