HomeMy WebLinkAbout111 E Lake Mary BlvdPermit#: Oy- ovao.ZGVO
Job Address: fly A A4ACC tM
Description of Work:
Historic District:
Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date: /NIl94y
y TC/VNNN1' ,
Value of Work: $ J000' &0
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 /Z # of Water & Sewer Lines G # of Gas Lines
Plumbing/New Residential: # of Water Closets _-T
Occupancy Type: Residential Commercial l� Industrial
Construction Type: # of Stories: # of Dwelling Units:
Parcel #:
Owners Name & Address:
Contractor Name & Address:
Plumbing Repair — Residential or Conunercial
Total Square Footage:
Flood Zone: (FEMA form required for other than X)
(Attach Proof of Ownership & Legal Description)
State License Number: CAC& V 174 (e
Phone & Fax: ICA 2V -717 441f d8A Jff-Akontact Person: 9,61rgA4 �seNe�G Phone: J45A -?fY- 7171
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 permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Signature of Owner/Agent Date Signature of C ntractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg: cring:
(Initial & Date) ZZ
Special Conditions:
4.514 4-Gt
rdr
tint Contractor/Agent's N m
Date
Signature of Notary -State of Florida
fPY ,PUB Marsha Pridgeon
�- MYCOMMISSION# DD018714 EXPIRES
N
Contractor/Agent is r oval Known to M �II 18, 2005
c�77 0.
Produced ID ' '..ro°Pc
®0NhWMDUTROYFAIN INSURANCE, INC
Utilities:
(Initial & Date)
FD:
(Initial & Date) (Initial & Date)
NOV-19-2004 10:56 HARDIN CONSTRUCTION CO. 407 352 2244 P.02
-,I:iU1L1;1NG PERI`L'S 24 HOUR` 40TICE REQUIRED 5Tl 1 vj
100 N PARK AV' FOR ALL -INSPECTIONS
�. SANFORD, FL 32771 PHONE (407) 330-5659
--- ------- -----------------------------
Application Number ,p¢-00002640Date 7/20/04
Property Address . . . . , , Ill E LAKE MARY BLVD
Parcel Number . . . . . . . 14.20.30.300-0050-0000
Application description . . . INTERIOR COMMERCIAL REMODELING
Subdivision Name ,
Property Use ;
Property Zoning . . . . . . .
Application valuation 30000
Owner Contractor
-
LAKE MARY ENTERPRISE MCKEE CONSTRUCTION
P 0 BOX 471366
LAKE MOINTROE FL 32747
(407) 323-1150
-------------------------- Structure Information ----------------------
Construction Type . . . CONCRETE SLK WITH FRM EXT -.
Other struct info . . . SQUARE FOOTAGE7965.00
----------------- - _ - -
Permit . . . .-. BUILDING PERMIT - NEW/ALTER ------
Additional desc .
Permit Fee . . . . 155.00 Plan Check Fee .00
Issue Date . . 7/20/04 Valuation . . . . 30000
Expiration Date . . 1/17/05
Qty Unit Charge -Per Extension
BASE FEE 35.00
30.00 4.0000 THOU BLDG PERMIT - ORD 3123-3/10/92 120.00
----9�ecial Notes and -Comments ----------------------------------------------------- -------------------------
NEED NOC
framing -drywall -plumbing rough in -slab
Other Fees . . . .-.____---------------
01-APPLCTN FEE -BUILDING
10.00
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Au", 4 :1i
Oaf—Z&yO
Charged Paid
155.00
.00
.00
.00
1.0.00
.00
165.00
.00
Credited Due
.00
155.00
.00
.00
.00
10.00
.0.0
165.00
FAILURE TO COMPLY WITH MECHANIC'S LErN LAW CAN RESULT IN THE -
PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.
NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED.
NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED.
P
Ogl'ESSjVE
lumbind. inc
November 22, 2004
I, William E. Lawson U, license # CFC 041766, hereinafter referred to as the "License Holder", the
Vice President, of Progressive Plumbiniz, Inc, hereinafter referred to as the "Company", hereby
appoint the following persons as Attorney -in -Fact of the License Holder/Company, in order to (a)
sign and submit building permit applications, (b) obtain building permits, and (c) obtain the certificate
of occupancy from City of Sanford (Municipality) on behalf of the License Holder/Company:
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LICENSE HO LDER _
Sign:
Print Name: William E. Lawson II
Title: Vice President
Company: Progressive Plumbing, Inc.
Mailing Address: 1064 W Hwy_50
Clermont, FL 34711
Telephone #:Telephone 352-394-7171
Fax #: 352-394-1201
State of: Florida
County of: Lake
or
WITNESSES:
Sign:
Print: Kelly L. Wertz
Sign:
Print:
E-mail Address: l3illy&progressiveplumbing com
State of Florida
County of Lake QOVO)4);
The foregoing instrument was acknowledged before me this day of 2004 by
William E. Lawson II who is personally known to me and who did not oath
Notary Signature:
Printed Notary Name: Marsha Pridgeon
Commission Expires: April 18, 2005
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Pro- n+ing'Repre ue86pi3d nUS1DW
POST OFFICE BOX 121126 CLERMONT, FLORIDA 34712-1126 • (352) 394-7171 • FAX(352)394-1201
Lic. # QB -0015460