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HomeMy WebLinkAbout605 Willow Ave4% CITY OF SANFORD PERMIT APPLICATION Application # : v �aq�l Submittal Date: .5 las ( Job Address: &Q-5 UJl I JOLO RV8. SaLPb9 " R- 31'171 Value of Work: $��a��0. (afl Parcel ID: 05_Iq--3Q-,a1q(3--(304-D080 Zoning: Historic District: Description of Work: �!' C7 1 QSL �o�( hl Q1g.S . Square Footage: ........................................................................................................................ 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 # of Gas Lines Plumbing/New Residential: # of Water Closets Plumbing Repair - Residential ❑ Commercial ❑ Occupancy Type: Residential P4 Commercial ❑ Industrial ❑ Occupancy Use Group(s): Construction Type: # of Stories:1_ # of Dwelling Units: Flood Zone: (FEMA form required) ................................. ................................................................................. Property Owner: . • �(� • • �•� )') �g Contractor:- Top �lll/'A9 0i- a ►h (l U Ro 0,t�w. Address: LU05 Li l I IOU) 44,JE- Address: 3a.4L SQzl 52"708-c-2903 Phone: r7 mmaa�-mail: Phone: 46q-b-g(D aState License Number: V1Y_)'5-Q_(g '7 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 of permit is erification t at I will not the owner of the property of the requiremenA�oorida Lien Law, 713. LkA A5 Signature of Owner/Agent Date, Signature f Contractor/Agent 10 Date "Ph�� sEdG✓A , �' 1iIt, 16a nt Owner/Agent's ame Print ontractor/Age is Nam S a i,07 Signature of Nota -State of Florida Date SignatuMState DEBI(. P ON E e = Y COMMISSION # D 459661HE DEBORAH K PLYBON MY COMMISSION # DD 459661 aJp EXPIRES: September 4,20W Bonded Thru Notary Public Underwriters Owner/Agent is _ -Produced ID APPROVALS: ZONING: Special Conditions: Rev 02/2007 UTIL FD: Contractor/Agent is Produced ID _ ENG: EXPIRES: September 4, 2009 Bonded Thru Notary Public Underwriters Personally Known to Me or BLDG: POWER OF ATTORNEY Date: uU00JE, do hereby authorize to pull the��. I,� permit for► • ! Type of permit Signat e State of Florida County of 2�?= IAAF - Personally known to me or produced ID on �' ,day of, 20_0 job address seal DEBORAH K PLYBON := MY COMMISSION DD 459661 EXPIRES: September 4 2009 Bonded Thru Notary Public Underwriters NOTICE OF COMMENCEMENT Pen -nit No. Parcel ID: &6—) 3©:-586 -0306 -0030 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. 1. Description of 'bj �tj OF �� 2. General description 3!- a 3. Owner Name and ac (legal description of the property 1111111111111111lilt limp milli alIllilot lam 11111111 MARYANNE MORSE, CLERK OF CIRCUIT COURT SE141NOL.E COUNTY EK 06706 Fig 1728; (Ipg) CLERKS a # 2007078226 RR-'DRDl<D 05/85/Rc)07 03:320:5;? FN RECORDING FEES 10.00 RECORDED 9Y T Saith street address if available) P�3 I � I i5 (t�D� (>�i IICr� fig• prove ent: a. Interest in property b. Name and address of fee simple titleholder (if other than Owner) 4. Contractor Name and address: 5. Surety a. Name and address b. Amount of bond 6. Lender Name and address: 7 CERTIFIED COPY MARYANNE M.OR5E CLERK F CIRCUIT COURT S MIN E T , RIDA BYE Drtlu I y CLERK �f1n aW ■ ■ C FAAA7 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 of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) ad" Signature of Owner Sworn --K to (or affirmed) and subscribed before me thisS7` day of / i , 20 017 by js-le-�3 E G� U-�<-- v d s IT Personally Known or Produced Identification Type of Identification Produced &1 p rCdl c.,_.. ,C ��--� Signature of Notary Public, State of orida DEBORAH K. PLYBON Commission Expires: '� q MY COMMISSION # DD 459661 EXPIRES: September 4,20W :1j.. P.. •,E eF �,o,, Bonded Thru Notary Public Underwriters [HIS INSTRUMENT PREPARED BY. NAME 1� ADDR. X52 i 2