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HomeMy WebLinkAbout201 S Maple AveCITY OF SANFORD PERMIT APPLICATION r' t _�71. �r Application # :� rES 1 Submittal Date: `�T Job Address: `MiS. C Value of Work: s � �� 00 T Pa reel ID: 'r � �' I —,W29 / Zoning: Historic District: Description of Work: _2kt_®racy &6q D/ e /V t r- lyat& e Square Footage: ...............�7E .......................................s................................................................ Permit Type: Building lectrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm [3 Poo l 13 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 # of Gas Lines Plumbing/New Residential: # of Water Closets Plumbing Repair- Residential ❑ Commercial ❑ Occupancy Type: Residential MV/ Commercial ❑ Industrial ❑ Occupancy Use Group(s): Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required) } .. � ,/................................. .............................. PropertyOwner:••S��//•••"v/�� •� � •-•••••••••••••••••••••••Contractor:•"( •• •• 1t'ell ti Address: ' 6'' hQy4KIAddress: f FL Ye?7-7 3,47®/ O Phone: T� '� E-mail: Phone: 4Z7 State License Number: C4.eC Bonding Company: Address: Arch itect/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: 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 addi to the this county, an ere may I is !anotify is ermit, ts equi`e the Agent thee may be additional restrictions applicable to this property that may be found in the public records of d from other goLemmental entities such as water management districts, state agencies, or federal agencies. of the 67 Signature htiit er/Agent's Nam \ // �`�� E • TF/////"'4_5 12 Siature ofNotary �te o• ti9�aa�y /�+ • O Date • ° 'Ol , *� � D . N VV i � • 1 Owner/Agent is Aaly 'it5t{�to' _ Produced ID APPROVALS: ZONING: jl�I�tpPF�L: FD: _ Special Conditions: Rev 02/2007 , FS 713. Date • V t 5PS0,429a °. Q Date �c. 7 • y,�. 6 'r a'1�"' .sicj c; "Q Contractor/Age _ Personaily Known �r Produced t2lV? ENG: BLDG: 145.00 ��fv'7 vW Ff� o ". - © f Nv v SIG 1, 1 "1 � -_ n S Fi c3 + f IIIIIIIill11111111111IIIIHIIIIIIIIli11111i�1111 1111111111 s e, ! Tax Folio No. State of Florida County ofe+�` P 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. 1. Legal descriptio of propert (include street address, if available): rA Z - e.7 ilk '%`C>~ T' le' tote General description of improvement: �9 � .��tG�I � �� � �, ��d �r.��. CERTIFIED COPY T e� MARYANNE I` &R 3,1� 2. Owner information — name, address, and phone CLERK OF CIRCUIT COURT SEMINO C UN� . FLO` BY EPL) Fov 3. Interest in property: 4. Name and address of fee simple titleholder (if other than Owner): 5. Contractor - name and address: MARK ORMAN CONSTRUCTION 700 Woodling Place, Altamonte Springs, FL 32701 Phone number: 407-629-6640 Fax number: 407-209-3560 6. Surety -,name and address: r MAY -),2 2 2007` . r;j d, {; ay {C7 7. Lender - name and address: 8. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(i)(a)7., Florida Statutes (name and address): Phone number Fax number _ 9. In addition to himself, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number Fax number 10. Expiration date of Notice of Commencement (the expiration date is 1 year from the date of recording ur*ss a different date is specified). Signrt>g Date S to nd u e�ibecL f e me this .22 AI day of 20 0 1 _'Inj TNS� �UME T PREPARED g Y; NAME t alic /�1� • . , ,,,y�rADDR, 00 1/,00 llllll I I I1111�