HomeMy WebLinkAbout130 Sand Pine CirCITY OF SANFORD PERMIT APPLICATION
Application #:0 7 — 2 3s Submittal Date:
Job Address: 13V ---- '� 71411L C-1 a t'..\?z Sa,,1 „" SL Value of Work: $ 0 0.6
Parcel ID:
Zoning:
Historic District:
Description of Work: r lJTcv: d�- t C--6yq:-l-S r Oy o Square Footage:
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Permit Type: Building . Electrical Mechanical ❑ Plumbing Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service — # of AMPS Addition/Alteration 19' 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 ❑ Commercial ❑
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
........................................................................... ................
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Property Owner: 0-T kit 1...K' VJ N C - *A C -c-- Contractor:�-b Q c�� b LL '�)6 «- A -Z -D
Address: /30 Address: Z 3 Cf
Phone: E-mail: Phone: 4-61- Vt D State License Number: C BC,/ ZS 1457
Bonding Company:
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Mortgage Lender:
Address:
Phone:
Fax:
Phone: Fax:
E-mail:
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 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 permit, 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 of permit is verification that I will notify the owner of the property of the requirements of Florida Iii Law, FS 713.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name Ppqt Contractor/Agent'Ze
Signature of Notary -State of Florida Date Signature of Notary -State of Florida ate
Owner/Agent is — Personally Known to Me or
Produced ID
APPROVALS: ZON
Special Conditions:
Rev 02/2007
UTIL: FD:
ON M ghAlW Sr
A �f?H#Riloelery t
ContractoEt—Known to Me or
Produced ID
ENG: BLDG:
f n
OTICE OF COMMENCEMENT
Permit No.
Parcel ID: '�_�,a 3c,- / Ci - Gt �' j Xc6 .
State of Florida Y
County of Seminole
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.
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MARYW E MORSE, CLERK OF CIRCUIT COURT
SEMIN[Y.E COUNTY
EK 06715 Fq 01271 Q pq i
CLERK" S # 2*0071_r82232
RFMRDE'D 06/04/2007 04:02:2-4 ;%
REMRDING FEES 10.00
RECORDED BY T SaithRZIF�PD' COPY
77-4
007
CLARK U� t k'.=,DA
1. Description of property: (legal description of the property and street address if available) Y1 Z6
eel 4z 1,
2. General description of improvement: e6z'-r.qt7
3. Owner Name and address:
a. Interest in propertyL
b. Name and address of fee sii
Contractor Name and address:
5. Surety
a. Name and address _
b. Amount of bond
6. Lender Name and address:
r4m
(if other than Owner)
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
of
8. In addition to himself or herself, Owner designates
to receive a copy of the Lienor's Notice as provided in Section
713.13 (1)(b), Florida Statutes.
9. Expiration date of notice of commencement (the expiration date is 1 ye the date of recor ing unl s a different
date is specified) l
ignature of Owner
Sworn to (or affirmed) and subscribed before me this day. of --?n� 20
by
Personally Known or P oduced Identification
Type of Identification Produced -q q
ow Notary Public State of Florida
PHIS INS�.T REPAR Michelle L,Laverde
My Commission DD504545
Signature of Notary Public, State of Florida NAME �'►o, ti Expires 01108/2010
Commission Expires:
ADDR.1 3