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HomeMy WebLinkAbout1601 Terrace DrCITY OF SANFORD PERMIT APPLICATION Application# : t��,5 ( Job Address: J l 00 Parcel ID: Description RECEIVED Submittal Date: 7 Value of Work: $ .7, 400 Historic District: '� Square Footage: I /5 Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑ 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 Plumbing/New Residential: # of Water Closets Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ # of Gas Lines Plumbing Repair —Residential ❑ Commercial ❑ Occupancy Use Group(s): Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required) ............................................................................. ... .................................. Property Owner: l� Contractor: Address: . _0 03 Add s: S + !r<C( 74 it 3 - a/ Phone: E-mail: P o� State License Number:C&CL2Y56 7 V 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 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 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 manage 1pa gistricts, state agencies, or federal agencies. Acceptance of permit is verification that I will notify the owner of the property of the (Q Si re of Owner/Agent Date Print Owner/Aeent's KATIE BALLINGER Notary Public - State of Florida My Commission Expires Mar 27, 2011 Commission III DD 842325 amded Thmunh National Notary Assn Owner/Agent APPROVALS: ZONING: UTIL: Special Conditions. Rev 02/2007 of Fljrridtf Lip 4aA, FS 713. Name Signature of Notary -State of Florida Date f/ �l BILA ."r.^.. r+RY COMMISSION # DD629096 Contractor/Agent isPfREeCl�r 2�g Me or Wit: Notary Discount Assoc. Co. Produced ID. FD: ENG: BLDG: 1 C o wKoe.� VJ'-;I.(Gol Permit No. Parcel ID: D Z ?zQ • S • DAY ' D Ofd State of Florida 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. 2. General description of improvement: 3. Owner Name and address: a. Interest in property THIS INISWRIT as &W fee simple titleholder (if other than Owner) 4. Contractor Name and address: &It tl-c i 111111 ill it ill II IF it 111 11 III If ill If ill it 111111& it 11114111 MARYANNE MORSE, CLERK OF CIRCUIT COURT SEMINOLE COUNTY BK 06721 Pg 1530; Qpg) CLERK'S # 2007085084 RECORDED 06108/2007 05:35:5-6 PM RECORDING FEES 10,00 RECORDED BY H DeVore �®� 5. Surety a. Name and address b. Amount of bond 6. Lender Name and address: 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. In addition to himself or herself, Owner designates _ 713.13(1)(b), Florida Statutes. 0 of to receive a copy of the Lienor's Notice as provided in Section 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) i _ C Signature o wner Sworn to (or af>cirmed) and subscribed before me this day of J � - , 20 Z� by Personally Known ✓" or Produced Identification Type of Identification Produced F � Signa e o of 2-�Z State of Florida KATIE ggLLINGER Co / is n I pir WN� •. Notary Public - State of Florida My Commission Expires Mar 27,2011c Commission # DD 642325° Bonded Through National Notary Assn.