HomeMy WebLinkAbout520 Valencia St (2)CITY OF SANFORD PERMIT APPLICATION
Permit # : 5z-7
Job Address, 526
n
4
Description of Work: /-
Historic District:
Date:
r. o-Y•_`t-er r e ,mil _ 3Z l
1 ,
Zoning:
C I
rwa Total Square Footage
Value of Work: S ( Ul aao0 • D b 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 Construction
Type: # of Stories: # of Dwelling Units: Owners
Name & Address: L—° 94- Phone &
Fax: I o D Contact Person: Bonding
Company: Address:
Mnrtasoe
Lender• A
dd—t- Architect/
Engineer: Address: _-
Flood
Zone: (FEMA form required) Phone:
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 issuance
of apermit 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. SM
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 permit, there may be additional restrictions applicable to this property that may be found in the public records of this
countymaybe rLwillitotify ired
from other governmental entities such as water management districts, state agencies, or federal agencies. Accep v ,
cation the owner of theproperty of the require ofFI a Lin Law S-- -ate NAY-r7Cv
INNI,
L• . PtAriff-
Kotaryptateof o '
a ate Signature of Notary -Stag aty 7 6 +° c ao N DAF6EYWE ADCOCKNOTARY
We, STATE OF
FLORIDA MY C m. Expires
DEC. 2, 2009 ent is to Me
Dr Contractor/Agent is a°e. o, ueed ID _ Produced
ID %
9ROY APPROVALS. ZONING: UTIL: FD:
ENG: ////lll tlN\\\ Special Conditions: Rev03/
2006 E
5.00
A1897
41'-
MUTED POWER OF ATTORNEY
Date: c) It 1 1 6 1p
I hereby name and appoint
of _ Co-t. / %o o F' O w-C.- to be my lawful attomey
in f ct to act for me and appl to 6 n_ r for
2a _ ' permit for work to be performed at
a location dese ibed as: Section Township _ Range Lot
Block Subdivision 1
L 73-g -7-7 Address
of JobI
I— !
AL Owner
of Property and Address) and
to sign my xame and do aL dhings necessary to this appointment. o
Type
or Prat name yf Cer4ed Contractor and License #) gnat
ae of CC1 ti*AT=tracoor) Acl;
nowledged: Sworn
to and subscrib4before me 's Day
of A.D. Z oo Notzry
Publi, Sra:e ofFlori -- DAFNEY FAYE ADCOCK Se
l) } NOTARY PUBLIC, STATE OF FLORIDA 1
MY
Comm. Expires DEC. 2, 2008 COMM,,
N DD378600 My
Commission Expires: t
AFFIDAVIT
REuARDING ROOF DRY N AND FLASHING INSPECTIONS:
COMPANY: qnwi'
LIC IENSE NO: LC. L O Z ZSO
SUBDIVISION:
PERMIT NO:
PROJECT INFORMATION
ADDRESS: 5Zo
I Well
I Alt" — affiant hereby affirm that I am the du licensedYduty
contractor of record for the above reference permit, that all of the foregoing
information is true and accu,-ate, and that the dry -in, flashings at the above
referenced address/lot has be installed in accordance with all applicable codes
and standards.
CONTRACTOR:
PRINT. NA E)
SIGNATURE)
STATE OF FLCRIDA
COUNTY OF _ 'v
This ins-trument was acknowledged before me this day of
by the above referenced individual,
SPz)-c-'e why knowledged tha he is a duty licensed
contractor with - , a who acknowledged that he
was authorized execute this documenVflle he is either personally known to
me or produced — as - valid
identification.
WITNESS my hand and official seal this day of
DAFNEY FAYE ADCOCK
NOTARY PUSUC. STATE OF FLORIDA
MY Comm. Expires DEC.2.2008 Nota PU lic
COMM. N DD376609
Printed Name: E
My Commission Expires: i i.
14 r- 00_
bo % State ofFlorida
tt 17 Permit No.
NOTICE OF COMMENCEMEN
ounty of Seminole
Tax Folio No. (PID)
11ce undersigned hereby gives notice that improvement will be made to certain real proV : y, and in accordance ; ith Chapter
7 .r 713, Florida Statutes, the following information is provided in this Notice of Commcnce mt.
DESCRIPTION OF PROPERTY (Legal description of the property and street add: s)
1V
GENERAL DESCRIPTION OF IMPROVEMENT
OWNER INFORMATION LNeandadress
o i rJ ,
interest in0operty (Fee Simble, Partnership, etc.)
NED"Coex
VIA ANNE ._!gRSEZCERKCIRCUIT; COURT
IEM1 COU FLORID
1
1(''
y1OIL
5 Za V e..C"w—
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDE"F OTHER T:: W OWNER)
CONTRACTOR
Nd addross SURETY (
Bonding Company) Name
and address C.
tl-- zo Ic rt`,Cv I
IIIHNp1pINpINN1
N iIgiNNIgINp N t11M MARmw
lopmg -r-WRL'UITWIRT Amount
of Bond SEM MILE l.'UlA N LENDER
BK 06413 Pq 1099) Qpg) Name
and address CLERK'
S # 2006150278 RED)
tNIx:D 09/19/M 11e06t04 A14 RECI)
N01146 FEES 10.00 s#
s#i#f}}i+}###}#+#y}#fi#si#siti#+s#i++####i+ti+i•############ # # i ss i+ss####+#. til_fi tt t I rKinler Persons
within the State of Floridadesignated by Owner upon whom notice or other d,: sments may servcc IS provideo bySection
713.13(l)(a)7., Florida Statutes: Name and
address sss}s:
s+ssii+#sss++ss+s#++t+}++i#+is++ss+si+si+its+ii+ts++ss#++:ss++sis}s}is#sr•+####+##+ In addition
to himself, Ownerdesignates _ of to receive
a c goy of the Lienor's 1` :-tice as provided in
Section 713.13(l)(b), Florida Statutes. NOTARY PUBLIC,
STATE OF FLORIDA MY Comm.
Explree 06C. 2, 2008 COMM. A
00378609 to The
me
this
lea My Commission
Expires- (Z_ of V "
It' `
2 was acknowledged
before me this day of , i'9— _ by A, (tip (
name of on aclrnowl•: ;(:p, is person,:; y me or
who has produced (type :`io— .anuitcaUon and who
did / did notes