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HomeMy WebLinkAbout3512 S Orlando AveCITY OF SANFORD PERMIT APPLICATION Permit # Job Address: 3S I J- 5. 6 c-ia Description of Work: r t Historic District: Date: Value of Work: S 46 q12 _ lin I Permit Type: Building L-- 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: Construction Type: _ t # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Zoning: Parcel #: /I ' ,2/a -3D - 3 Dh - O I N O " O UQ U j ( Attach Proof of Ownership & Legal Description) i Owners Name & Address: D. Sr.Er t i 1 w pr. CC1 v I ) t; v S S . C-m \t 1fCbr-, AvEO.. O-4A qt'% 6'0 17'2S Phone: 'fdi .1123 27/1 Contractor Name & Address: R .- qav /,16 O L-. (Zeu a y Q 'L ) JZ'7.7.2 State License Number: IBC DO ; l / Phone & Fax: 'Fb ? 35 QS S ?4 % / Contact Person: &0-1, r-1. Al t) r S Phoae: -62 7 Bonding Company: Address: s Mortgage,Lender- Address: Architect/Eagioeer: Phone: Address: Fax: Application 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 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: 1 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 there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. Acceptance 9{IC STA Own /Agent is -2ersonally Known to Me or f roduced, ID ` —P L! 44i%=,e_ APPLICATION APPROVED BY: Bldg. Initial & Date) of the property of the requirements of Florida Lien law, FS 713. Date Siinature of Contractor/Agent ;„vmito E. Vkl**' Zoning: Print Contractor/Agent's Name 5g •... Con /Agent is _ ersonally Known to M of,T uced ID L Guys Initial & Date) Utilities: ffg Initial & Date) (Initial & Date) Special Conditions: lv' Wi NOTARIZE Intl 11111111111111111111110111111.11111111111111111111111 Permit Number_ MARYANNE MURSE, CLERK OF CIRCUIT COURT SEMINOLE COUNTY Parcel Identification Number /yoyoc)o SK 06502 Pg 12221 Qpg) CLERK' S # 20061813641 Prepared by: Ga 11 Mo r r 1 S RECORDED 12/01/2006 M3708 PN 1260 Saratoga Ln. RECORDING FEES 10.00 Geneva, F1 . 32732 RECORDED BY t holden CERTIFIED COPY Return to: D . R and G , Inc.' MARY NNE 0 Seft 1260 Saratoga Ln. CLERK C!R0 T SEMIN TY,. LO IDA;- Geneva, F1, 32732 i3 rY 11 NOTICE OF COMMENCEMENT 0 '2006 State of . F Lo r 1 da . County of! Semi no 1 P The undersigned hereby gives notice that improvement(s) 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. 1. Description of property (legal description of the property, and street address if available) 35r;:_i•c lOM U Swc :1 % Wd' &o`- R6r 3vF (3 eg /aNT.eG W h S4I v* N: f S Cz ec, zt Al E ly Sf y,Qt iPC lJ6 I . 2. General description of improvement(s) re\-0C 3. Owner information Name.sab4 ar"- t-ccl ve' e`c`!S Telephone Number, `fo7.3 9 :z?' Address3S0- S. ©rto• naAo Avti- Fax Number S0w1"4c.•-Jt1. Sr-1 %1 3 Interest in Property: 4. Fee Simple Title..Holder.(if other than owner shown above) Name. Telephone Number:. Address Fax Number 5. Contractor Name D. R and G, Inc. Telephone Number ; 407 327 5636 Address umber 407 349 1398 1260 Saratoga Ln Geneva, F1. 3Z Z 6. Surety (if any) Name Telephone Number, Address Fax Number Amount of bond $ 7, Lender (if any) Name Telephone Number Address . Fax Number 8. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by §713.13(1)(a)7., Florida Statutes. Name Telephone Number Address Fax Number 9. In addition to himself or 66rseil, 0ivner designates the following to receive a copy of the Lienor's Notice as provided. in §713. 13(1)(b), Florida Statutes. Name Telephone Number Address Fax Number 10. Expiration date of notice of commencement (the expiration date is one year from the date of recording unless a different date is specified): v ? p Date Signed Signature of Owner Note: per §713.13(1)(g), owner must sign ...and no one else may be permitted to sign in his or her stead." V- Sworn to and subscribed before me this day of 9 47.0 by '`'7 13 r/OK hl 11 11% 0 who is /,-personally known to me OR [_produce d•' • • as identification. : ' p zq Signatu Af no _ to appear t el w) goD1VpZ 1 ST Form Revised: 3/ 98 ' `' "' fit.