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HomeMy WebLinkAbout490 Lake Mary Blvd09/13/2007 13:23 4073668976 RELIANCE PAGE 03/03 0-31q(o CITY OF SANFORD PERMIT APPLICATION Application N: /�}} Submittal Date: Job Address: � /%fW 6 (401 Value of Work: S 00, 00 Parcel ID: — '—�(Q -2C2--5o14 sD��pp7' 7,oninR; Historic nl9trict: Description of Worlt: 5 C w tA L f tee,a,4 J f Square Footage,• ............ 1.l.........l ........l................l............ ............... s.......... .....I .................. i..• Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbing go"' Fire Sprinkler/Alarin ❑ Pool ❑ Sign O Electrical: New Service - # of AMPS Addition/Altcration ❑ Change of Service ❑ Temporary Pole ❑ Mechanical: Residential ❑ Non-Residcntial ❑ Replacement ❑ New ❑ (Duct Layout & I*nergy Cale. Required) Plumbing/ New Commercial; N of Fixtures # of Water & Sewet.J.ines # of Gas Lines Plumbing/New Residential: to of Water Closets Plumbing Repair — Residential ❑ Commercial Occupancy Type: TlesidentiaJ ❑ Commercial Industrial ❑ Construction Type: 9 of Stories: tl of Dwelling Units: Occupancy Use Group(s): Flood Zone- _ (FEMA form required) .................... ............................................................................................. Property Owner. Contractor: ��kaAOleo �.. -Y itML,74 elIn Address: a Address: �z q (0 0 1�,1 _ U /00y &;-Coo '71-10vice o---- 307 ?L Phone: Jr. -mall: Phone: �tate License Number: C eS9/ Bonding Company: MortgAge Lender: r - Address Architect/Engincer: " Address, Phone Address: Fax: Plan Review Contact Person: Phone: Fax: E-mail: s,. Application iv hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation hes commenced prior to the Issuance of a permit and drat all work will be performed to meet standards of oil 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, otc. �j(iR'S AFPIDAVI'f: 1 certify that nil of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and znnin& WARNING TO OWNP,R: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYTNG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMML•NCEMENT MUST BE RECORDED AND POSTED ON THE.105 SITE BEFORE THF, FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LFNDFR OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE; In addition to the rcquircments of this permit, there may be additional restrictions applicable to this prop that maybe round in the puhlic records of this crnml'y, and there may be nddiNonal permits required from other govcmmentnl entities such as water mamaTient istricts, state agencies, or federal agencies. Acceptance , ermit is ve 'fication that I will notify the owner of the property of the i �01 Si store of 0kynct/AgOf Date Signature o Conti GI✓b 0 Prin wner/Ag is Namc rill tracto A Signnturc of Notnry-State of Florldn Dntc Six o atm .. �s PAMELA WOODY r°' Y °� MY COMMISSION #DD378996 ?�'� EXPIRES: DEC 13, 2008 �4, Own / �pilbd�omt Ir iipllhit9 wmq Co trac'fo9fR to uccd ID APPROVALS: ZONING: UTIL: FD, Special Conditions: Rev 07,07 of of Dnic Sharon L E99ert I� gs mission p�g44A20 0212612011 suny now, to Me or ENG: BLDG• LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: � �� �� I hereby name and appoint: an agent of: (Name of Company) �- O to be my lawful attorney-in-fact to act for me to apply for, receipt for, sign for and do all things necessary to this appointment for (check only one option): ❑ All permits and applications submitted by this contractor. C7 The sped permit and pplication for yN ork toVedtc���� Expiration Date for This Limited Power of Attorney: License Holder Name: C 'eO /— lJ / rl��� State License Number: Signature of License Holder: STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this�day o , 200 -7 , by who is ❑ personally known to me orChas produced cc�-.� — as identification and who did (did not) take an oat (Notary Seal) R SUZANNE K. ADAMSMY COMMISSION # DD264589 EXPIRES: November 03,200 7 (Rev. 3/27/07) (rj Z 69/1 ✓1 �° /� 14 J'q tQs- not or type name Notary Public -State of 00 Commission No. 0,0 2 6 c/ 9"9 My Commission Expires: IV 9 O7 Sep 13 07 02:02p PETROLEUMITECHNICIRNS INC ©04/113/2a07 t 3_?3 4073668976 C NOTICE OF COMMENCEM Permit No. 0(0 1,D'I '? Parcel ID; `I •:_� ,) a a State of Mori& County of Stmirrul( Tlw undersigned 1,rreby gives notice that improvement real property. Arm rt! a.-cordanc.e with Chapter 713, Flo% information is PTO: Ided in this Notice of Commeneeme 1. iDcscription of -; operty: (}c al dLesscri ))tion of the pro; oval %Ar j - General description cif improvement: 3. Owner Informai inn u. Name -1r(d address: b, lnir.rest in inoperty; a A , c, Name .wd ;rddress of fee simple titlelio)der REL IANCF I be made to certabl STatutC5, the followjug and street Address if other than owner) ___. . 1P I m 1106Tn. Natnc ::n i •:.d.dxess: e �m b. Phone .Number: 4 6 0 Io __3 C q�) (e, S. Surety 1- cl$ 3 i, y q 5`1 iAIM MouinaIIIIfW1iMa81IW'nil 11611 PAGE 02/03 MARYANNE MORSE, CLERK OF CIRCUIT COURT SENINOLE COUNTY SK M17 Fig 1545; (ipg) CLERK'S !# 2`007133277 RECORDED 09/13/2007 02-.53:2E PM RECORDING FEES 10,00 RECORDED BY T SaIlth,.. RTIVIED COPY N1 i. MORSE y�ARYA�IN� OURT CLERK OF CIRCUIT 0 ORIDA SEMIN L-E�NTY, F B DEPUT CLERK CP StI G3200 a. Natnc sr.:i address: b. Amour:; of bond S C, . Phone :Netrrbcr! G. Lender a. Name end t:ddress: � b. phos,( +,-saber; ` 7. Persons within 1t State of Florida designated by Owner upon whom notices or other documents may bC Served as provided by 5cettot1713.13(I )i a)7•, Florida Statufcs; �1'Iai11C nail Addl4r�: b. Phone Nttrnber; $, In addition to hi n.4ei f or herself, Owner desigrtate5 Section 713.13(:) (br. Florida 5taures: a, Name nn(l address: _ b. F1ioric Nuirber: 9- 1_',xpirutior) ttat( of11otice ofcornmenCcment (the sPecifred) -.— _ WARNING TO OWNER: ANY PAYMENTS MARC COMMENCEMEN 1" ARE CONSIDERED IMPROP FLORIDA STATUTES, AND CAN RESULT IN YOI NOTICE OF COMNIL.NCEMENT MUST BE RLCC INSPECTION. IF YOJ INTEND TO OBTAIN FINA BEFORE COMMI-NGING WORK OR RECOROIN The foregoing instr:rnent was aclwow)edged before me _._ f a,smt of person) as for Sigmmha-c of Notary r'ut�Sw,ff t'idn Commission Expire following person(s) to receive a copy of the Licuor's Notice As provided in date is I year from the date of recording unless a different (late is Y THE OWNER AFTER THE EXPIRATION OF THE NOTINGE OF 7 PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, t PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A DED AND POSTED ON THE JOB SITE 13EFORE'THE FIRST 'INC;, CONSULT WITH YOUR LENDER OR AN ATTORNEY YOUR NOTICE OFCO MENS', NT igpature OwKer or Owner`s Authoriacd 0 f.(icer/Ualrctor/Partncr/Manager Signatory's Title/Vfficc Q �^ Z-- day of 2O.Ll by ROAII Z type of authority ...e.q. officer, ntit.gl'ee, nttOrMs (,tame of party on behalf of whom instrutricnt was executed), F0ter r�� PAMELA WOODY MY COMMISSION •#D037889s EXPINES: DEC 13.2008 " BenneGtnrough ISt Stale Insurance