HomeMy WebLinkAbout428 S Summerlin AveCITY OF SANFORD PERMIT APPLICATION
Date:
Job Address: ____ 428_S __SUPMER N—AS1F
Description of Work: RE—ROOF RESIDENTIAL SHINGLES TO SHINGLE NO STRUCTURAL CHANGE
Historic District: NO Zoning:------ 'Value ofWork: s 4,146.00 -------
Permit F" -pe: Building -XX __ Electrical
E'lectrical: New Service —4 of AMPS
Niechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
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/New Residential 4of Water Closets Plumbing Repair — Residential or Commercial ---- ----- --
Occupancy, Type: Residential Commercial Industrial Total Square Footage: X
0
,,_'oiistructionTvpe: It of Stories: 1 H of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 30-19-31-525-0000-0650 (Attach Proof of Ownership & Legal Description)
Owners Name& Address-E.L. PIVEC
428 S. SUMMERLIN AVE. SANFORD, FL 3277-1----- Phone: 407-3 2-4132
Contractor Name & Address: A & B ROOFING COMPANY., TNr_
3905 MOORES' STATION ROAD SANFORD, FL State License Number:
Phone S. Fax 407-322— 1324_,1377____ Contact Person: RUTH phone —9417
9-417 407-322
uon(ting, N/A
— -------- - -----------
,10ortgage Leader:
Address:
Architect/Engineer:
Address
Phone:
Fa x:
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.
QWj`1-E .R'S &FFIDAVI A 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 LMPROVEMENTS 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 dic puiu;tc ,7;
this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal a
Acceptance of permit is verification that I will notify the owner ofthe property of the requirements of Florida Lien Law, FS 713.
I
/0
Signature of
Date Signature of Contractor/Agent Date
cr
C�' G.F. BOHANNON
f,: -b FA N b �____b,,
-Print OwnerlAgeni's Name Print Contractor/A e is Name
.gna_ ",'
State of Florida atur,-ofN'a -State off Date S ignature of Not 4d' -S
Bftsrl� Meeks
My C"MMOM DD332913
ExPk" June 27 2006
0 IsPersonaliv Known to Me or Contractor!Agent is_Personally Known to e'or
ID Produced ID -
APPLICATION APPROVED BY: Bldg:
Special Conditions
Zoning: —_
(initial & Date) (initial & Date)
Utilities: FD:
(Initial & Date) (initial & Date)
9
CERTIFIED COPY
N0171CtF, O CnVi 1rv1 rNCENirNT MARYANNE MORSE
CLERK O- CIRCUIT COURT
SEMI "OLIN .. , FLORIDA.
ui Seminole By
!'r�X f0_iO i1 (C;nnll-lcte'pttrccl 11) U) 30-19-31-525-0000-0650 DEPu ct: RK
The undersibncd hereby infornls ni1 conernlcd that improvenients will be made to cerwirt rul property, and til ticcardmce with )tctlori
1113 of the Vioridu Stnrttt.es! the Following inl'on»ation is stand,in this NOTICE OF C0lvttvCI:NC1'sh1'I TIT.
0:;_ri;;t :n cF.pt'l�erty; LEG LOT 65. + N 29.35 FT OF LOT 66 FORT MELLON PB 3 PG 69---iff8_21-2007
PAD : 428 SUl`M9ERLIN AVE.
C??t;c: a1 !c;;crintion of improvements! RE—ROOF RESIDENTIAL SHINGLE TO SHINGLE NO STRUCTURAL CHANGE
E L PIVEC
stir., .��-•------, —"• ' _-
-428 S.` SUP24ERLIN AVE. SANFORD, FL 32771-2256
OWNER
Ou;',:r's interest ill site of llle Improvoment:
MARYANNE MORSE, CLERK ph CIRCUIT COURT
1'cc S:n-,Pla Title huller: (if oihe� than owner) Nnme: N/A as ntrntrlt G CCIIINT, v
BK 06604 Pq ibVj, (ipq)
RECORDED 02/28/8007 08:17:08 AM
:c
,ontror; A & B ROOFING C0 INC.
2�
RECORDED BY L McKinlay
3905 MOORES, STATION ROAD SAWORD, FL 32773 `—
N/A
:�.dc!rc5s:
I ,r c of Person wi1hln iha Strtte of l'lorlda clesignnlcd by owner upon whorl notices or other docunicnls my bo served;
AdilrC:S:
In addition to hiulself, owner designates the following person to receive n,copy of the Lionor's Nollcc ns provided in Section 71 �.) �(I)(P),
Statutes. (Fill in tit Owner's OP lon) t
Address.
Cxpirntiorl date oI Nolice of Commencement (llle expiration date is I ym- from t)le c)nte of wording unloss n different. ditto is spcciFled.)
T ;, inwoment prepnrcd by! (Owner)
Sworn to find subscribed befort me Ihis d;�y oti
1: fic JANICE R. ANDERSON
`,,,;3905 MOORES' STATION ROAD
SANFORD, FL 327.73
2000
who ishtrn,hrsouttlly known to nw. or i:n v:_
(1`ypo ol'Went ilicnlkill)
No it ,'ttt�l'c i n ir5ion 11 nntl l'sxpirrl!ion)
My commission M332913
i„ Expires June 27 2006
A & B ROOFING COMPANY, INC.
3905 MOORE'S STATION ROAD
SANFORD, FLORIDA 32773.6524
(407) 322.9417 '
FAX (407) 324.1377
I 1TZ ?� '• �1• • • a
I hereby
name and appoint JAMES ANDERSON
of A & B ROOFING COMPANY,
INC.
to apply
to CITY OF SANFORD
for a Rn0F Cermit•-
And to act in myall matters concerning the same.
LOT 65 + N 29.35 FT OF LOT'66
Legal Description; FORT MELLON PB 3 PG 69 PAn A-28 9UNMERLIN AVE
Parcel ID# 30-19-31-525-0000-0650
Owners name & address: E. L. PIVEC
428 S SIZIMERT TN ACS'
SANFORD, FL 32771-2256
Property address: 428 S. SUNMERLIN AVE.
SANFORD, FL 37771-2256
G.F. BOHANNON
CCC 1326255
LICENSE #
The forgoing instrument was acknowledged before me this 21 st. day
of FEBRUARY ,20 07 by G.F. BOHANNON who is personally known to me
or has produced KNOWN as identification and who DID IDN take an oath.
tiCafARY P(1BLI TERE6AJOHNSON
,'y's
MY COMMISSION # DD 343250
EXPIRES; August 12, 2008
Bonded Thru Notary Public Underwriters
My Carudssion Expires: AUGUST 12,2008