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Home My WebLink About3760 S Orlando Dri ` CITY OF SANFORD PERMIT APPLICATION Application #: � / y � Submittal Date: Job Address: aAuc) ()l�(V1Ac) D(' . S . Value of Work: S V. X11 ,(-1 0(-) Parcel ID: 1, -)n -,Jo -'JC)C) - aaa-0 P, - C) Zoning: Historic District: Description of Work: �C�S�C1t� r c a{lam �`l "-� `1�i1 (� �C:(� F( 2 Square Footage: ...................................................................�1:........................................... Permit Type: Building ❑ Electrical ❑ Mechanical W�, 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 # of Gas Lines Plumbing/New Residential: # of Water Closets Plumbing Repair- Residential ❑ Commercial ❑ Occupancy Type: Residential ❑ Commercials Industrial ❑ Occupancy Use Group(s)-.6100k C(1`vN l Et"1C,2 Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required) .....................................(....,.....i....................................e....................................... Property Owner: i�C Arc �'t.i \e 1 Contractor.l VI Address: .�� Ca$y�J Address: 12ab fleAd �71L�crx�ma C- �(DK `l3\�.3t'k�x�u�� ,� 3 n Phonek2N)3`)q -uI1$ E-mail: Phone. `�I\S^tate License Number: Bonding Company: n�� Mortgage Lender: 6\ `M Address: Address: Architect/Engineer: Address: Plan Review Contact Person: 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 ofthis 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 will notify the owner of the property of the Owner/, K,I'va" IV M,MICHELLE LYNN LAVOI MYCOMMISSION # DD 480173 EXPIRES: October 11, 2009 Bonded Thru Notary Public Underwriters Own Agent is Personally Known to Me or jz Produced IDSL D r iUA r L1'" 4 s APPROVALS: ZONING: Special Conditions: Rev 02/2007 UTIL: FD: Date Agent's L 5 8�D igna we of Notary -S to of Florida Da y'n`"'t., STEPHANEY STRAHM :° •• Notary Public - State of Flmlde 1101 Comn"mr EWreaApr 12, 2011 Commission 0 00 662766 Contractor/Agent is 1$Fr q> National Notary Assn. Produced ID ENG: BLDG: City of Sanford 300 N Park Ave Sanford, Fl 32772-1788 (407) 330-5656 or (407) 330-5660 BEFORE ME, the undersigned notary public person personally appeared Patrick Barger, who being duly sworn and says that she or he is the President of B&G Refrigeration Company, Inc.,whose address is 3230 Kline Road, and the License Holder, whose license number is CAC1813635, appoints the following person(s) to apply for, sign for and obtain permits and pertinent documentation on his behalf and his customers behalf for the information listed: Company Name: License Holder: Licenser Number Address: Appointed: Fl Drivers: President B&G Refrigeration Co., Inc. Patrick Barger CAC 1813635 3230 Kline Road Jacksonville, FL 32246 Robert Bethel Print Name: dc 0\'A f A C� SWORN TO AND SUBSCRIBED BEFORE ME, byR-A -1CC ' 6 PnQ-(,— who is personally known to me or produced as identification, and who did take an oath this 77 day of ,2493. a007 Copy Provided to: 'jl/zoo o a Public: Sta f Florida My Commission Expires: "EYP°'% STEPNANEYSTRAHAN� 's Notary Public . State of ilorida '_ .0ninde8ft Expires Apr 12, tat t Commfasion as DD 662766 ..,.a Bonded Tft* National Notary Assn. �� ._ N • . IINIi11NlNNIII>I�iiIIMNMiOiiNNNq�1�NiNNNNp1181 THIS INSTRUME !lT PREPARED BY: (�^ Building & Fire Inspection- ,A n Name: n� �`f i 1� E� ' 1101 East First Stre rt r Address: \ n� Sanford, Florida 327717.1 S E1k11 NOL R State ofFlo a ;!£' zl� ` = ' Urx ' ' ' County of Seminole_ m NOTICE OF COMMENCEMENT "C? 4r Parcel ID Number (PID) �\ ^OT 3��-��-G�� ) rig 1:� r• The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance witwi r� Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. i DESCRIPTION OF PROPERTY (Legal description of the property and street address)-lquo War'An CAj )s'5� . n r� C 3bt� -� S U ut c�'E� GENERAL DESCRIPTION OF IMPROVEMENT �~v1S A\ 4, Teri r,P -"1.'�-', Af-xN nnr-A. OWNER INFORMATION Name and address: i (oc" �_. '� (YN%-n X31 • l9 is • { t �o i�;+ L,yly Q I DcA Uuyye n,CO QAOr f Eck (��J a C 1A0.n g- I- Ito" Pr's,, rr, rMITPArTnP - - Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section 713.13(1)(b), Florida Statutes. crr Name an address: 'E ' Cr Iaddition to himself, Owner Designates �IZC>`flYl� ��j. of 1�(1C,e2r 1r 1 To receive a copy of the Lienor's Notice as Provided in Section 713.13(1)(b), Florida Statutes. Expiration Date of Notice of Commencement -•. (The expiration date is 1 year r from date of recording unless a different date is specified.), STATE OF FLORIDA 'x� COUNTY OF SEMINOLE rrl C7 Signature of Owner The foregoing instrument was acknowledged before me this J'Fd day of Apri , 20 (� � by i� er17 Who is personally known to me x' Name of person making st ement <• ' OR who has produced identification type of identification produced •Tj CERP-FIED COPY. (SEAL) --- _ MARYANNE MORSE cpURT CARLA NARCISSE Notary Signature ' SEMIN COUNTY. FLORIDA MY COMtv11SSION # DD 492133 EXPIRES: November 17, 2009 Bonded Thru Notary Public Underwriters BY C' --CRY B REFRIGERATION ,. i 3230 KLINE ROAD JACKSONVILLE, FLORIDA 32246 (904) 620-0081 (904) 620-9816 FAX May 9, 2007 City of Sanford 300 N. Park Ave. Sanford, Fl 32772-1788 (407) 330-5656 (407) 328-3859 Fax RE: Permit Application and Notice of Commencement To Whom It May Concern: Please find attached our permit application for an a/c change out we are doing for a RaceTrac inside the city and the Certified Copy of the Notice of Commencement. I have not enclosed a check for payment due to the fact ,that when I called to see if we could mail in the permit, I was not able to get a cost of permitting this job. If you could please notify me at the number above, we will gladly pay over the phone with a credit card or mail you a check for the amount due. If you are in need of anything further or have any questions, please give me a call at the number above Monday — Friday from 8 am to 4 pm. Thank you for your help. Best Regards, p t�'J Jeanne Copeland Permitting Department B & G Refrigeration Co, Inc.