HomeMy WebLinkAbout302 S Oak Ave (4)Permit #
CITY OF SANFORD PERMIT APPLICATION
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Date: le-za-o4
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Description of Work: _O Srce- 1'GI-yAi-e 4!Ku Total quare ootage
Historic District. Zoning: Value of Work. S C%
Permit Type: Building Electrical
00,
Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS ..:500QAkN.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
Deeupancy Type: Residential _X Commercial Industrial
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FFMA form required
wuers Name & Address:
M tepw
t Q p ZVZ
r
Phone:
ontraclor Name & Addr
State ease Number:
hone & Fax: Q Phone:
3ondiug Company:
ddress: . /XjQLtti 4"L Mortgage
Leader: ddress:
rchitect/
F.ngineer: Phone: ddress:
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 ssuance
of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 understand that a separate Permit
must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, IiEATERS,'TANKS, and UR
CONDITIONERS, cic. WNER'
S AFFIDAVIT: 1 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 caning. 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 WITH YOUR LENDER OR AN ATTORNEY
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 govemmental entities such as er management districts, state agencies, or federal agencies. acceptance
of permit is verification that I will ratify the owner of Uhc property of the uiremenls o 'da Lien Law, FS Signature
of Owner/Agent Dale re of Contractor/Agent \al TTr Print
Owner/Agent's Name Pr' ontractor/Agent's N e ../ sy 16 F#o OJ _ GRIC
a
m•aI Signature
of Notary -State of Florida Date Signature of Notary -Stale of Florida D50
e
w
D
298 ;
Q V
Owner/
Agent is _ Personally Known to Me or Contractor/Agent is _ Personally Known to Me Produced
ID Produced ID L S 1 h \\ d'
PROVALS: ZONING: UTIL: FD: ENG: BLDG: pecial
Conditions: ev
03R006
roylmlNov x1low aINNIN0H1111NVY1NN16411M1 THi UMENT
PREPARED Y: F M
NCEMENT NARY NORSEv
CLERK OF CIRCUIT COURT NAME e -
W] SMINOLE COMITY Permit No.
u c S T& p" 1174; ilpg)
State of
Flori RECORDED 10180/M 02120132 pN County of
Se i RECORDING FEES 10.00 The undersigned
hereby gives notice that improvement will be made to certain rea pi pro rtrtyandhn° tc%rdance 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) 2. 3.
Ge
ral
descrii tion ofimprovement: L Dwner information
a. Name
and address .444 /// 09 J Wee Al e— V 3 d
Z S u ,Oaky b. Interest in
property c. Name and
address of fee simple titleholder (if other than Owner) 4. Contractor //ff
a. Name and
address,7N,CiZs0 3o r C'e' b. Phone number
Fax number 5. Surety a.
Name and
address b. Phone number
Fax number c. Amount of
bond 6. Lender a.
Name and
address 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)(a)7., Florida Statutes: a. Name and
address 8. 0 b.
Phone
number
Fax number 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 _ Expiration date of
notice of commencement (the expiration date is 1 ye from the to of recording s a different date is specified)
Signature of Owner
Swom to (or
affirmed),pqd spb nre bed before mefihts t) day of OL-bo6 er 20 O L , by f"!N0`e 0 /"
CERTIFIED COPPPersonally Known
OR Produced
Identification Type of Identification Produced
A 5Ile TEO/ CLERK 4 F a
OF
TURT
SEMINOL ' Y.
0RIUq DD507298 0
Signa a of
Notary Public,
State of Florida j y' oQ n CAE
Commission
Expires:C•AO`
A Berson & Son Electric, Inc.
201 S. Grant St.
Longwood, Fl. 32750
407-339-9208
POWER OF ATTORNEY FOR
KNOW ALL MEN BY THESE PRESENTS:
Harold Anderson, hereinafter referr Pj INC 4A., inth_e ounty of
does appointwful attorney
In fact.
In principals name, and for principal's use and benefit, said attorney is
authorized hereby:
1. To fill out electrical pen -nit, sign for Anderson & Son Electric, INC. and
Harold Anderson, and pay for an Electrical Permit in the
Cl - d y %5-a . lr-ro Z
2. And n thing other than expressly granted in number 1, above.
All that said attorney in fact shall lawfully do or cause to be done under the
authority of this power of attorney is expressly approved.
IN WITNESS WHEREOF, I HAVE HEREUNDER SET MY HAND AND
SEAL THIS DAY OF
Signed, sealed and delivered in the presence of: William Gladden, R.
Dec 06, 2006Expires•
a R Atlantic BOr4ina Co., Im.
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