HomeMy WebLinkAbout2420 Willow Avern
rmit H :
b Address: a4;L0 w' P law 'e-
CITI' OF SANFORD PERMIT APPLICATION
Date: / >-- / 5- 6 4
scril tion of Work: Rt -r'o' l— h r n3 Total Square Footage /7 S of -
istoric District: "zoning:
v5 Value of Work: S 3T•
rmit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/ALtrtn Pool
ectrical: New Service - 0 of AMPS Addition/Alteration Change of Scrvice Temporary Pole
echanical: Residential Non -Residential Replacement New Duct Layout & Encrgy Calc. Required)
umbing/ New Commercial: k of Fixtures H of Water & Sewer Lines 4 of Gas Lines
umbing/New Residential: # of W( Closets Plumbing Repair - Residential or Commercial
cupancy Type: Residential Commercial Industrial
instruction Type: q of Stories: H of Dwelling Units: Flood 'zone: (FERIA form required)
veers Name & Address: IGht FJ `
nlraclor Name & Address: W Le
one & Fax: -Tt
ceding Company:
dress:
rrtgage ).ender:
dress:
chilec"..agincer.
dress:
Phone. y V 7-
7 0' 00
L'
Stale License Number: Jt=rr (2( 5-
Contact Person: Her (4, A dh ns Phoac: 7 V%— Xi!L— 0 3o
Phone.
Fax:
plicalion 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
lance of a permit and Wad all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate
mil must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS. TANKS, and
t CONDITIONERS, etc.
NER'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
istruction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
ICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YoU INTEND TO OBTAIN FINANCING, CONSULT WffH YOUR LENDER OR AN
TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
TICE: In addition to the requirements of this permit, Were may be additional restrictions applicable t h property that may be found in the public records of
county, and there may be additional permits required from other governmental entities such as w inagemerht districts, s agencies, or federal agencies.
eptance of permit is verification that I will noti the owner of the pro rty of the requirement o FI hda Licn S 7
Signract/Age
gent D Sic of Coin et g t Dale Zu
e, A4, PrinNapq _
Print Contractor/Agent's Name V.
Sigy(>>pGfTolary-StatsVofFlorida ACAPAs!k,/ to ?
s; Owncr/
Agent is X eraorhall Known tr M Produced
ID il DD500874 ROYALS:
ZONING: UTIL: Ic vial
Conditions: 03no06
of
Notary -State of Z•
tZ.0G Date
nt
is Pcr nally Known to Me or ID
C ENG:
BLI)G: S)
IPOWER OF ATTORNEY
Date:
1 hereby name and appoint /VA. r-o /j {moo Q e S
Of Ind c, g to be my lawful attorney
in fact to act for me and apply to the 5ar,4,I
Building Department for a permit
For work to be performed at a location described as:
Section Township Range — Lot Block
Subdivision
F6
Owner of Property and Address)
and to sign my name and do all things necessary to this appointment.
d r5 v- vr.l' Z /oW l C 00.i
Type or Print Name of Rdgister or Certified Contactor and Contractor's License Number
The foregoing instrument was acknowledged before me this *day of of 20 e C
By a V- S r4l P ty 2 ll
Who .is ne so___ na1Lti]mww t_o me/who produced
As identification and who did not take oath.
State of Florida
County of
Notary Public, Orange County, Florida
tirP.,, eGail L. Fredrick
o ,,, ;mission # DD183026
Upires March 15, 2007
iUA. Soaded Thru
Aslaatc Hoadia8 Co., Iac.
Seal
NOTICE OF COMMENCEMENT
State of r L
County of 5 !m : h: i
The undersigned hereby gives notice that improvement(s) will -be made to certain real property, and in accordancewithChapter713, Florida Statutes. the following information is provided in this Notice of Commencement.
i 1. Description of property ("at description of the property. and street address if available)
Leg S l2 0 4: (_ort : 5 "1
Pacrelu'J 31 - (CL 3i - 52-t0 - 0000 - 015 2.
General description of improvement(s) P (
5 P61 6 CV _
3Z3 44(1 3.
Owner inf rmation S Name ' +
v y mc-
V r m Telephone Number Address
r { 3 p u; t.l..c: ire !W Fax Number Interest
in Property: C u: 61 Z.i*7- 4.
Fee Simple True Holder (d other than owner shown above) Name
Telephone
Number Address
Fax
Number 5.
Contractor. y CJ Telephone Number ''f0 —(e9!r-• Name
WCrr s /" Address ( `
JiFax Number
Fax qt ?r;
r'3 r 6. Surety (
i any) Telephone Number Name Fax
Number Address Amount
of bond 5 7 a.
9.
Lender (
if
any) f\j
0 „ 1 b—
Name 'vAddressTelephone
Number
Fax Number
Persons within
the State of Florida designaled y o ner upon whom notices or other documents may be served as
provided by §713.13(1)(a) Telephone Number Name Fax
Number Address In
addition
to himself or herself. Owner designates the following to receive a copy of the Lienors Notice a provided in §
713.13(1)(b). Florida Statutes. Telephone Number Name Fax
Number Address ommencement (
the
expiration date is one year from the date of recording 10. Expirationdateofnoticeofcunlessa
different date is specified): Tt , -DO
Cp , Date Signed
Sigrtat of
Note: per §713.13(1)(ill `o mer must sign ...
an o one else may be permitted sign in his or
her stead. vo Sworn
to
and subscribed before me this l j day of by who as
is
Fo m
Rovised. 3195 THIS INSTRU1 &
ENT PREPARED BY: 1 t
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CERTIFIED COPY'_
MARYANNE
MCRSE CLERI
OF,CIRCUIT
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