HomeMy WebLinkAbout297 Upsala RdPermit # : NF ffol it
Job Address:
Description of Work:
Historic District: /D Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date: I L l 1/ 2/ d
of Work: $ 7 ZU s/py
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 Total Square Footage: 33
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: ;
Owners Name
Contractor
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Number: 7!rn
x
Phone: 5W
Application is hereby made to obt& 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.
OWNER'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
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 pemvt, there may be additional restrictions applicable to this property that may be found in the public records of
this county, and then: may be additional permits required from other governmental entities suc}y"ater management districjf, state agencies, or federal agencies.
Ui6
io
the
owner o the propez Date
11
of
Notary -State of Florida ier/
Agent is _ Personall Known to Me or Produced
ID 4—— APPROVED
BY: Bldg: Initial &
Date) Special
Conditions: Date
Zoning:
ty
of the requi en of FI n Li 13. 1z/
iZ o Signature
of Contractor/ ge ( Date Priontractor/
A ent's Na a\\ r %.s
yz •'1
Signaretuof Notary -State
of Florida` . 1Date6' : ; Z VC Contractor/
Agent
is_ PersonallytSe,or,
S6
p Produced ID ,.:' • ' e., „r • \\ 10 O Utilities: ///
Fll•1i 11)
lo\\\\\
Initial & Date) (
Initial & Date) (Initial & Date)
IMPROVEMENT
TV -IS IN , NT PREPARED BY-
Lo r 4 J c 1`It!idccl—
ADDRES
c do SEMINOLE COUNTY
FLORIUA'S NATURAL CHOICE
NOTICE OF COMMENCEMENT
State of Florida
Permit No.
Building & Fire Inspections
1101 East 1 st Street
Sanford, FL 32771
County of Seminole
Tax Folio No. (PID)
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.
DESCRIPTION OF PROPERTY (Legal description of the property and street address) 3.3— —,30 —j-
GENERAL
OWNER INFORMATION
Name and address --,-ro,t/n,
MARYANNE'MOF I;,`
XE OF CIRC111T COURT&
M(YIF INT//E Rme._
By
DEPUTY C:ERK
A:Co _ n •nnRl
y ,A
A11ty
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER. (IF OTHER THAN OWNER) c Q
CONTRACTOR %'
R rtpe and address ,n ) _ _ C
SURETY (Bonding Company)
Name and address /
Amount of Bond
LENDER
Name and address
IIIIIIININIIINIIIIIINIIIa111111111111N1111111111111111
SENINME COUNTY
HK 06514 Pg 05161 Upg)
CLERK'S # 2006194605
RECORDED -12/ 12/20K 88141139 A14 REC)
RDINO FEES 16.09 Persons
within the State 7fFlorida designated by Owner upon whom notice or other documents may be served as provided by Section 713.
13(1)(a)7., Florid Statutes: ' /,, Name
and address %l/X/1me Persons
within the State of Florida Designated by O provided
by Section 713.13(1)(a)7.,Florida Statutes: Name
and address: In
addition to himself, Owner Designates Provided
in Section 713.13(1)(b), Florida Statutes. upon
whom notice or other documents may be served as To
receive a copy of the Lienor's Notice as Expiration
Date of Notice of Commencement30— The
expiration date is 1 year from date of recordiniunlessadifferent date is s ecified o
a subwndbed ld'ore Notary
Public, State of Florida Ir-
Signature
6f,10w4 this
i,I Day of My
Commission Expires: of
1MY
comm. 9)0ree June 20, 2010 No
The
forego' g in rum t w s acknowledged before me this 1 \ day of , by Q
N , }eI 7%wlS (Name of person acknowledged), who is personally known to me or who has produced
L /i e oaf identificati s identification and who did/did not take and
oath.