HomeMy WebLinkAbout2018 Chase Avev CITY OF SANFORD PF.RMFI' APPLICATION
Permit // : O
A
Date: /0— 3/ -O G
Job Address: e0al5- l _ti SP_ Ave- o t, /6,en
Description of Work: Xe— Xoo,^Total Square Footage
Historic District: -Zoning: Value of Work: SOG
Permit
Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alanu 11001 Electrical.
New Service — H of ANQ'S Addition/Alteration Change of Service Temporary Pole Mechanical:
Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required) Plumbing/
New Commercial: 0 of fixtures q of Water & Sewer lines N of Gas Lines Plumbing/
New Residential: 0 of Water Closets Plumbing Repair — Residential or Commercial _ Dccupancy
Type: Residential —A, Commercial Industrial Construction
Type: --I-- N of Stories. N of Dwelling Units: Flood 'Zone: (F F.MA form required) Jwaers
Name & Address: A b f /W c. , Wn- ana ( 1te s e Over Phone:
contractor
Name & Address: hone &
Fax: _yf2 3onding
Company: ddress:
Mortgage
Lender lddress:
lrehitectlEngincer:
lddress:
Person:
State
lAccrose Number: 4fcc Phone
Fax:
pplication
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 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 termit
must be secured 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 that 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 VICE
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT W ITFI YOUR LENDER OR AN TTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 40TICE:
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 there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. cceptance
of permit is verification that I will notify the owner of the property of the az
C Q1 -r. 1Si6Wiirc of
Owner/Agent Date Owner/Agent
is Produced ID
d'PROVALS:
ZONING: pecial Conditions:
ev 03/
2006 tat Nolary
Public
S111e of Fbn rP Melinda
Bums -Williams lMy Commission
DD591600 or UTIL: FD:
Juire
orida Li
cn FS 713. for/Age t
Date ign ure ofonlyPritcontr
for/A Name t Sign ure of
NotI. tit lorid>
i01ary
ublie Stei bride Melinda Bums•Winiams
My Commission DD591600
a w ires
09/04/2010 Contractor/Agent is
Personally Known to Me or Produced ID FNG:
BLDG: 0
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: Ie License #: CCC' 132(-7I S 3)(
AsAi, Ave- :5-ir- bo Project
Information Owner:
I I c l'j ,qA' Permit M name
Ori
e4ase Ale, Subdivision: /IlLEEW619 57— address
Lot #:
phone
affiant,
hereby affirm that I am the duly licensed contractor
o record for the a ove 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 accordance with the applicable codes and standards. Contractor:
STATE
OF FLORIDA COUNTY
OF This
instrument was acknowledged before me this day of _al, L200by the above referenced
individual, who acknowledged that he/she is a duly licensed
contractor with «r 77:7C. , and who acknowledged that he/she was
authorized to execute this docume t. He/she 9 eithe ersonally known tome r produced as valid
identification. sr WITNESS my
hand
and seal this day of , 20 Not4 Public Notary
Public State
of Florida Melinda Bums -Williams
My Commission OD591600
F x9trus 09/
04/2010
jH1S 1N STRUNIENT PREPARED 61ft+ .
OF COMMENCEMENT
NAME
Permit No. DDR. / . Tax Folio
State of Florida
County of Semi e
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.
of property: (lega/l description of the property, and street address if available) 1= : Z F'
T 7 Z f %I 40 .5 (.-5 qq_ qS
r /
a • Z C /s 'I s / ice% ; P62 7 1
2. General description of improvement:
3. Owner information
a. Name and address
b. Interest in property
c. Name and address of fee simple titleholder (if other than Owner)
Contractor
a. Name and address ,/. ;-. l 1 t ' r n
13 Ay 1, _ QQ —L
b. Phone number 'R 1 Fax number bi S 1
5. Surety
a. Name and address A
b. Phone number
c. Amount of bond
6. Lender
a. Name and address 4
Fax number
b. Phone number Fax number
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1 xa)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 f-j Fax number
9. Expiration date of notice of commencement (the expiration date, is 1 year from the date of recording unlesyifrrdt°x° m a
date is specified) zo= m o z a
Xroz
1 ^ 0 „„-
vv
Signatureof„ wne .. r, 3
m- m caCo
4 m
Sworn to (or affirmed) and subsc •ped before me this 3 it day of C % I' e r 120 lac m < -
Personally Known OR Produced Identification
WTypeofIdentificationProduced` • .,_ r,
1' , .
rx* w Notary Public State of Florida ? ERT R a
A. ` M_ Melinda Bums Williams '' -wtiN n
Signature of Notary Public, State of Florida X-"' My Commission DD591600
Commission Expires:
Expires09/04/2010
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