HomeMy WebLinkAbout625 Sarita St (5)CITY OF SANF'ORD PERMIT APPLICATION
Permit #: ()1-20.5-7 Date: C l to -1 l G y
Job Address: 625 Sarita St
Description of Work: roof new .addition 4 sg shingles
Historic District:
Zoning: Value of Work: S 1 .,2 -1 -4fl0
Permit Type: Building X Electrical
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential _
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets _
Occupancy Type: Residential X Commercial
Construction Type: roof # of Stories:
Mechanical Plumbing Fire Sprinkler/Alarm Pool
_ Addition/Alteration Change of Service Temporary Pole
_ Replacement New (Duct Layout & Energy Calc. Required)
_ # of Water & Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial Total Square Footage:
_ # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel a: 01-20-30-504-1200-0140 (Attach Proof of Ownership & Legal Description)
Owners Name & Address: Patricia McCaffery 625 Sarita St., Sanford, FL 32773
Phone: 386-717-5283
Contractor Name & Address: DaVld Lundherg 1709 Hnwp1 1 Branch Rd-,
Winter Park, FL 32789 State License Number: (=11155941
Phone& Fax407-672-0001 407-647-933(2ontactPerson: Davi d T.unr3hPrq Phone: 4(17_(72 01
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
Fax:
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 permi e fic tion t t 1 . ti e'ow f th pr perry of the requir ent f Flori ien Law, S 713.
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Sign re of Owner/Age ' Date na re of ontractor/Agent Date
TaR 1kQ m "J)-,M-TtJ
Print vner/A ent's Name Print C ntractor/Agent's ame
Signature of Not State of Florida Date yl(j/f/�SQZ ignature of NotaState of Florida Date
V ti't`s W .,0,1 Ph- Notary Public State of Flnfdda
Nota Public State of Florida s
Notary Wendy R Benson
41^ Wendy R Benson X q Commission QUA'
Oymer/Agent is ' Pe so ally ndwn to MerorMy Commission Q "" ontractor/Agent is _Persona ly Known to Me 7H
Produced ID Expires67112120Q Produced ID
Expires 07 212t)L!�
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date)
� 430°
LIMITED POWER OF ATTORNEY
Date: April 29, 2007
I hereby name and appoint Liza Denton
of David Lundberg Building&Roofingo be my lawful attorney in fact to act
for me and apply to City of Sanford for a Roof
permit for work to be performed at a location described as: Section: 01
Township: 20 , Range: 30 , Lot: 504
Block: 1200 , Subdivision: 0140 ;
Addressofjob: 625 Sarita St
Name and address of owner of property: Patricia McCaffery
625 Sarita St., Sanford, FL 32773
and to sign my name and do all things necessary to this appointment.
Signature of certified contractor
David C. Lundberg CCC1325941
Print name and license # of certified contractor
STATE OF FLORIDA
COUNTY OF ORANGE
he for oing instrument was acknowledged before me this 92 � day of
200%, by David C. Lundberg who is personally known
to me (X 5, or who presented ( ) , as identification,
and who did ( ) or did not ( X) take an oath.
Notary Publi ' signature
Notary's stamp: l�7��0�g3
�° Notary Public Sate of Ffgnde
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