HomeMy WebLinkAbout1219 Myrtie AveCITY OF SANFORD PERMIT APPLICATION
Permit N
Job Address: AV
Date:
Description of Work: 6 Total /Square 'oo aagge
Historic District: \rC Zoning: Value of Work: S ^.I l ,/
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkier/Alarm Pool
Electrical: New Service — H of AMPS Addition/Alteration Change of Service Temporary Pole _
Mechanical: Residential Non -Residential Replacement New (Duct layout & Energy Calc. Required)
Plumbing/ New Commercial: N of Fixtures N of Water & Sewer Lines N of Gas Lines
Plumbij g/New Residential: N of Water Closets Plumbing Repair — Residential or Commercial
Dccup Iacy Type: Residential Commercial Industrial
Construction Type: N of Stories: N of Dwelling Units: Flood Zone: (FEMA form required)
j
DwnersName & Address:
Phone.
contractor Name & Address: n'e) 14 Con '.
y1
Sta I'nsc/N'umber-
hone & Fax: y l " - 6 )1a Contact Person: S7 Z`L, L7t7d Phone:
3onding Company:
ddress:
Mortgage Leader.
ddress:
rchitect/Engineer: Phone.
ddrew: Fax:
pplication 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
ssuance 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
vomit must be setarred for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
UR CONDITIONERS, etc.
WNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and dim all work will be done in compliance with all applicable laws regulating
onstruction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITII YOUR LENDER OR AN
TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
40110E: 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
his county, and these may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
Wceptanct: of permit is verification that 1 will notify the owner of the property of the requireme o Flori Lien aw, FS 7 IA.
1-06
St reSignatureofOwner/Agent Date ' naof ton(ractorAggeld Date Print
Ownaftenu's Name Signature
of Notary -State of Florida Date OwncdAgent
is _ Personally Known to Me or Produced
ID PROVALS:
ZONING: (PUTIL: pecial
Conditions: ev
03/2006 Prin
Co (r r Ag Name SiL1W.
800,3-WTARY tar-
pD18846t Date
EXPIRES:
February 25, 2W7 t
FL NO Y DISCOU 4 Avoe. CO- Contractor/
Agent is _ Personally Known to Me or Produced
ID am
ENG: BLDG:
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
TO: THE HISTORIC PRESERVATION BOARD OF THEPITY OF SANFORD, FLORIDA
0 Downtown Commercial Historic District Residential Historic District
0 This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PR TY: Ial
Property Owner ,,/
Signature: Print Name: e.1ao J
Mailing Address: 3 GAU
Phone: 14Q-7' D 3 Q ? Fax: D -7 -0 S Z
Applicant/AgentGS
Signature: Print Name: .S'tC A-G OaG
Mailing Address: /&,3 - a'a
Phone: qo'J 2%2 - ( 2.> FaxXJ
1 certify that all information contained in this application is true and accurate to the best of my knowledge.
Applicant/Owner: 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)
o Site Improvements/driveway/walkway 0 Storage shed 0 Moving structures
o Replacement windows or doors 0 Underskirting 0 Awnings
o New construction/additions o Signs 0 D blition
O Roofs/gutters/downspouts 0 AC/Mechanical [YFences/Gates/Pergolas
o Replacement siding/flooring/porch 0 Paint 0 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
r9com ended. Attach additional pages if necessary.
J
s' s1
A Certificate of Appropriateness is valid for six months unless otherwise noted
Historic Preservation Board Meeting ate:
Application is Approved
Conditions
Signed:
OFFICIAL USE ONLY
Approved with Conditions
Date:
Staff Review Date:
Denied
9•/-Ae'nz-
This Certificate must be prominently displayed on the building when work is in progress***
Requirements for Certificate of Appropriateness Application
r i ° i ODUK I, roges 50-04,
Semino(e County, Florida
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LI(M) NOD' 10' 44. 5' E 49.87' 50,00'(P)
L2(H) N00' 16' 3B. 3' E 49, 92' 50. 00' ( P)