HomeMy WebLinkAbout104 Mayrose DrCITY OF SANFORD PERMIT APPLICATION
Permit #: 0(0- 33 3 `t
Job Address: log
Description of Work:
Historic District:
Date: !!Z - 25- - O6
6 - :V 10'i i oc+ Total Square Footage
Zoning: Value of Work: S 3T On . 66
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary 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
Construction Type: — — # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
Owners Name & Address: CL+kA_Q "a Y C>iD0_. Les LLC
o . , - ` + ! 3 6TPhone: 0:7 - Sf f7 ' 3 k / 0 Cont.
actor Name` Address: W CGkS \<uJ %r`S to i
3o ( Ker LA B W - n' ems 5 04r.255 State License Number: Ig C 3 Phone &
Fax: 4 07- G qt .S - 34 AV Contact Person: Phone: Bonding
Company: Address:
ri
Mortgage
Lender: /y'f Address:
Architect/
Engineer: Phone: Address:
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, ctc. OWNER'
S AFFIDAVIT: I certify that all ofthc 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 appfcable t1this property that may be found in the public records of this
county, and there may be additional permits required from other governmental entities suchlas watq management dislAts, statSMncics, or federal agencies. Acceptance
of permit i' vcrificat' i ha I will i y he owner of the property of the I
Signature
of Owner/Agent ate Robert
0. Mc i?cx t I'1 etw mama r ea Men kix:iPrint
Owncr/Agent's Name .01
rt
ZS aG Si
nature of Notary -State of Florida Date 4e
hKaren S Sherman My
Commission DD306877 er
Expires April 05. 2008 Owncr/
Agent is Personally Known to Me or Produced
ID APPROVALS:
ZONING: Special
Conditions: Rev
03/2006 UTIL:
FD: ii&
n4pts g(Florida Lien IAa)f, 0 7 i
Nhoi
taturcofCont ZTE
SC P
A t Contractor/Agent's me tprSStONF jg%•;
N Signature
of Notary -State of Florida ate p s #
U0507298 Contractor/
Agent qponally Produced
ID Kn
w • . *2XX ENG:
BLDG S1,
00
POWER OF A7 Y'ORNIEY
Date: 2&- G 0
I hereby name and appoint Ja r o l ' 4a—e-
Of W e tk- S 2 0 •r5 a . to be my lawful attorney
In fact to act for me and apply to the SC4+oy
Building Department for a F C r oo permit
For work to be performed at a location described as:
Section Township Range Lot Block
Subdivision
4WD L LC.
Owner of Properly and Address)
and to sign my name and do all things necessary to this appointment.
a,r ;2,( "fi 'Cj w 1- rl
Type or Print Nime of Register or Cert6ed Contractor andCowactor's License Number The
foregoing instrument was acknowledged before me this 2-(o day of , cam_ of 20 o i• By-
w'"'G'Pp q's Who
is personally known to me/who produced As
identification and who did not take oath. State
of Florida County
of SW,444 Seal
Notary
Public, Orange County, Florida GailL. Fredrick r
F commission * DD183026 Expires
March 15, 2007 JA
p $OIId2d rhTa 1L1
IItlt SOsiding ..1IIC.
p (
t
Ka,.vid Ned e3 5, r. ,, yS I'L- 3 J 70)
1 YtP YCG bIC.:.
LV,
r'fCr J
13.;1 Dee., NOTICE
OF COMMENCEMENT Permit
No. State
of Florida County
of Seminole Tax
Folio No. 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. 1.
Description of property: (legal description of the property and street address if available) I
r- r :, . 2.
General description of improvement: z - r la i r go 3.
Owner information a.
Name and address 3
b.
Interest in property r c.
Name and address of fee simple titleholder (if other than Owner) 4.
Contractor a.
Name and address b.
Phone number _ 5.
Surety a.
Name and address 2
vy— 5 `. 0 W161Tea '
Siren 4G7-
tags—'Z(, -n IVIA,
1-. 3a
Fax number
Stij i
IaKI1ritU GUNY
b. Phone
number Fax number CLERK c. Amount
of bond 6. Lender
a. Name
and address A' b. Phone
number Fax number 7. Persons
within the State of Florida designated by Owner upon whom notices or other ocum n may be served ps provided by
Section 713.13(l)(a)7., Florida Statutes: a. Name
and address b. Phone
number Fax number 8. 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. a. Phone
number Fax number 9. Expiration
date of notice of commencement (the expiration date is l year from the date of r 9rding unless different date is
specified)4 r. • _ Signature of
Owner Sworn to (
or affirmed) and subscribed before me this a c" day of S a h i m r , 20 C , by t7. MC:
t?ccr.e( f Il ti l p 1 N 1 1111IIp Wi11 t1fi INN Personally Known
OR Produced Identification MARYANNE MORSE, CLERK OF CIRCUIT COURT Type of
Identification Produced SEMINOLE COUNTY BK 06424
Pg 09421 (lpg) CLERK'S #
2"6155412 Karen S
Sherman RECORDED 09/27/2006 12: 29:45 Pig Signature of
Notary Public, State of Florida=°4 -My CommissionDD3l1 itRDING FEES 10.00 Commission Expires: +.,, '
Expires^0105.2ookECORDED BY 0 Hayford
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: Wee_k5 QoO, r!5 Co
13o I Qu r\
License #:-
W,,wjer SRY,rN::s l. 3 7Ui5
Project Information
Owner: )C.+i. lug.j grrJQe:r i lei Permit M
me
O Ma!, ?_vSe 1) r Subdivision:
address
Lot #:
phone
I, N6rr)Ir Mo 5--S , affiant, hereby affirm that 1 am the duly licensed
contractor of record for the above referenced permit, that all the foregoing information is true
and accurate, and that the dry -in, flashings at the above referenced address or lot has been
installed in accordp*n**'cl with the applicable codes and standards.
Contractor:
IH@ 1-0 Id 1"wdc c
printed name
STATE OF FLORIDA
COUNTY OF Jc 1M i r o 1e
This instrument was acknowledged before me this 7 day of , Eby the
above referenced individual, ,who acknowledged that he/she is a
duly licensed contractor with , and who acknowledged that
he/she was authors ed to execute this document. He/she is her personally known to me or
produced INL, 3z2 .$-5 7 4 as valid identification.
WITNESS my hand and seal this 29jj1 day of
g #DD507298 c . Q