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HomeMy WebLinkAbout104 Hughes Avef ,4 Permit # : r✓c s // Job Address: m l 1\%i f-Lla l Description of Work: Historic District: CITY OF SANFORD PERMIT APPLICATION Date: Zoning: Value of Work: Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool 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 or Commercial Occupancy Type: Residential Commercial Industrial Total Square Footage: Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) — q Parcel #: '9 1 / / -3/ Owners Name & Address: Sd-S oA o o ©o 3 o Contractor Name & Address: Phone & Fax: Bonding Company: (Attach Proof of Ownership & Legal Description) Phone: State License Number: C-✓� Contact Person: Phone: 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 p6or 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-- lavra regulating construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT N VO4.TA 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 is verificatio that I I tify the owner of the property of the requirements of Florida Lien , FS 713. 9 4_otf Ight-re of Owner/Agent � Date Signature of Contractor/Agent Date Print r ner/Agent's Name ;5e_dy Signature of Notary -State of Florida /-a'pate 40r4lf Deborah L Lyon My Commission DD026294 Expires May 15 2005 Owner/Agent is _ Person Ily Known to Me or , Z Produced ID 0 s:VI-V e-6 APPLICATION APPROVED BY: Bldg: Zoning: (Initial & Date) Special Conditions: Pn Contractor/Agent's Name uy Signature of Notary -State of Florida Date DEBBIE BLANTON MY. CO'MMi;3SION # DD 188491 on ced [D '5� &moo M or i800 -3 -NOT, Y (Initial & Date) Utilities: FD: (Initial & Date) (Initial & Date) gir-14 -/ C) (Y Permit No. Tax Folio No. Notice Of Comment STATE Of� Lb COUNTY OF 4 D C�1� 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 property: (legal description of property, and street address if possible). te4 Wutr�� �� UR(NEU Con R�o 4, fl„ �n �� NARYAJ444t MORSE 2. General description of improvement: r 3, Owner Information: a. Name and Address: j,.e OLS 14mR b. Interest in property: C. Kame and address of fee simple titleholder (if other than owner): b. Contractor: (name and address) S� 11w, �tl. s .Gt�oWR Ns S. surety: a. ar Address b. Amount of bard S 6. Lender. (Name and Address) 7. Persons within the State of Florida (rdesignated by Owner upon whom notices or other documents may be served section 713.3 (1) (a) 7., Florida Statutes: (name and address) 8. In, addition to himself, Owner designates the following persons (s) to receive a copy of the Lienor's Notice as pr 713.13 (1) (b). Florida Statutes: ( name and address) 9. Expiration date of notice.of commencement (the expiration date is I year from the date of recording unless a specified) Sworn o and subscribed before me �i da 'of of(�G� �� ( ignature Of Owner (Signature of Notary Public) ( Owner's Name T (,zv c a -X ©r/i Aotry • Deborah L Lyon -Y ;. My Commission DD028294 (Owners Address) Expires May 15 2005 StAIMOLE COUNTY. FIRM in Section date is rds/s ' .� err 7r Ln rrn o Lo .. CR rW Ln CM mm W�. :.W �.. a x 4 provided by in Section date is rds/s