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HomeMy WebLinkAbout203 Tyler DrCITY OF SANFORD PERMIT APPLICATION A Application # :—b t/ Submittal Date:6--1,2 3 �67^ Job Address: Q03 T V ter Dr, .SQ h�CC�, FL. 3a773 Value of Work: $ 0 lot, co Parcel ID: %- a�®'l' J�J- f {017 -- OOoZ 6 Zoning: Historic District: Description of Work: Re- r00 � (�� �1/Skj Square Footage: - Permit Type: Building'F( 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 ❑ Construction Type: �— # of Stories: l # of Dwelling Units: _ # of Gas Lines Plumbing Repair- Residential ❑ Commercial ❑ Occupancy Use Group(s): Flood Zone: (FEMA form required ) ................................................................................................... ...... .. R - / �y Property Owner: �-(.i'l.C� GZ jF, Fe p, (tet m Contractor: CSO -rop �\UG<S.Cy� �rG-'dt�l (tel©iicfc Address: -o 3 Tj f P i b r L1 e, Address: lc sz) Q tse. • �� r 0-177.3 FL. 3,2709 Phone: 40Z-5741 7- 71931 E-mail: Phone: y07-6-'1 -7,6i Rate License Number: Ce(-' f .j (o ivZ? 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: 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 o ermi is verifi tion tha I will notify the owner of the property of the requireme is of Florida Lien.Law, F 713. ryry • oC 3107 ignature of Owner/Ageenni ) Date S�iig ature of Contractor/Agent } Date A/ w, �", Q Q >L 1 C� r C s Q( W C t2Q cz l rid6wne Agent's Name Printf Contractor/Agent's Na -5/a 3�© 7 L �Signature of Notary -State of Florida ;24tY'P�c, DEBORAH K. PLYBON MY COMMISSION # DD 459661 -gf EXPIRES: September 4, 2009 ,Bonded Thru Notary Public underwriters Ovine . Produced ]D FL- DL lvSD- �$= SCS= J -O APPROVALS: ZONING: Special Conditions: Rev 02/2007 UTIL: FD: DEBORAH WPLYBON MY COMMISSION # DD 459661 EXPIRES: September 4, 2009 Bonded Thru Notary Public underwriters Contractor/Agent is personally Known to Me or Produced ID ENG: BLDG: POWER OF ATTORNEY Date: 5:b 3/d 7 I, *a) A k/L*Vl,?cA , do hereby authorize �-Ply& J to pull the permit for x.03 `ry lcr8 :SQr)PPt-d, Type of permit job address ' W Signature State of Florida County of Z1)71 -c. Personally known to me or produced ID on day of , 206 7 ;:��'o' • DEBORAH K. PLYBON MY COMMISSION # QQaJ59661 b€ EXPIRES: September 4, 2009 Bonded Tlw Notary Public Underwdters NOTICE OF COMMENCEMENT Permit No. Parcel ID: 07-,2() - 3 /- 505- 01%60-- 00�6 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 infonnation is provided in this Notice of Commencement. IHIM 11111iiHIHIII UINO RIN1111I111►aaii� Ir�iHIM MRY€INNE MORSE, CLERK OF CIRCUIT COURT SEMINOLE Ct NTY Alf 067M Pq 172-9; f 1 pi ) CLERK' S * F007076227 RECORDED 05/25/2007 03::2:52- PN RECORDING FEES 10.00 RECORDED BY T Saith CppY p�R�1F1Ep MORgE RRACIR D1T CCDRl 1Da C`ERK DE p11`IT ,�FVOpR '�— �n 5K2®0� 1. Description of property: (legal description f the property and street address if available) 2. General description of improvement: (`e- 3. Owner Name and address: L i' 1�-- re-uc0-F a. Interest in property n( -) n, Off` b. Name and address of fee simple titleholder (if other than Owner) 4. Contractor Name and address: kyr 7 T 6 5. Surety a. Name and address L Vic% rc I> CIOL- ') .iFGG' . 3 .; 7n 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 maybe served as provided by Section 713.13(l)(a)7., Florida Statutes: a. Name and address 8. In addition to himself or herself; Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(l)(b), Florida Statutes. 9. Expiration date of notice of commencement (the expiration date is 1 year from t date of recording unless a different date is specified) Signature o Owner Sworn to (or affirmed) and subscribed before me this r� day of 2007 by 7}L FG,S�-535 -YS-505-0 ,CINQ't e'er r t'Ajt Personally Known or Produced Identification Type of Identification Produced FL. I,L— K PLYBON NAMTHIS INSTRUMENT PREP jj n �l ,.ey ••. %� al L s�� s:R .= MY COMMISSION # DD 459661 t. 1 /n o - Signature of Notary Public, State 6JFlorida Commission Expires: p q; 6o EXPIRES: September 4, 2009 Bonded Thru Notary Public Underwriters A n r) p M