HomeMy WebLinkAbout1150 E Airport BlvdIR
11
Permit # : 0� ' O
Job Address:
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
7 b(A
Date: 10-- � `�y
9 --)-?'3
Zoning: Value of Work: $ 345,00, d a
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 —yL Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
Owners Name `gi Address: l+sarC'
L-. 1/�'v-XC-C a1"4 P.A -i t
V�`� .'ter 31 ✓��� j ., p of/'y1 Phone:
Co tractor Name & Address: �..J� ���i� r 1 A!21Ae-i 1 ni C3 C✓aV,,L l ( e+,* C(, L/%
3 r 1 v State Lice�Nber: 6l
Phone & Faxy40'-34C-F(kXU, gJ7-34q'-rrC+� S Contact Person: �' Phone: �(Cii
Bonding Company:
Address:
.n qr
Lr," nder/:::� __ (V , / ( A o, -L �C
Address: V O &- )( LLy g (C�.4 ��vy4 �� �3 (vi (cr QV '1 l (0
Architect/Engineer: Phone:
Address: 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 dist
s, state agencies, or federal agencies.
-4.. A 'd --1061
Acceptance of�bs,uesrdTcat/i
/77 ,_/l1
Sig `e �ver}
P ' Owner/Agent's N;
Signature of Notary to
'd
Own gent is
Produced ID
APPLICATION APPROVED BY
Special Conditions:
L ANtify the owner of the property of the requirem da Lien
/ ate Signa=ofCoc Ager
PrilOntractor/Agent's Nar
t
da DENISE BURTWAte Signature of Notary -State o
MY COMMISSION #DD036264
EXPIRES: July14.2005
Bonded Thru Notary Public Underwriters
Contra r/Agent is
7roduced ID A=
�ori ng: Utilities:
(Initial & Date) 1 (Initial & Date)
713.
Zy—C) t(
Date
Date
DENISE BURTON
MY COMMISSION # DD036264
'Uj�npEXPItR�E�eV 14.2005..
mvru uarYlQuhl�a 4inderwrlters
FD:
(Initial & Date) (Initial & Date)
v
111897
I hereby name and appoint
of
101rr Q 0 • •.2 ; • 11111111 • c
.'5 mss.C-
Date: /'Z 9 0 c/
to be my lawful attomey
in fact to act for me and apply to G'r o'� S� .�-� for
a permit for work to be performed
at a location described as: Section Township Range
Lot;_ Block Subdivision �.— C(1414
(Address oof+ Job)
(owner of Property and Address)
and to sign my name, and do all things necessary to this appointment.
(Signature of
Acknowledged:
Sworn to and subscribed before me this
Connector)
License #)
Cf- ® 2l 717
Da of O �G�-- A..
— y D�{ MARY ALVAREZ
Notary Public; State of Florida
Notary Public, State of Florida My comm. expires Apr. 20, 2008
No. DD 312263
(Seal)
My Commission Expires:
T HIS'NS��tLIMENT PREPARED BY: Btalidln &Fire Inspection,
NAME: = a 9 P
ADDRESS: i 5� ! j SEI11I.tioLE CUOr� rz' 1101 East 1 st Stree
it()RIDA'S NAIU AL criorr.:r Sanford, FL 32771
NOTICE OF COMMENCEMENT
State of Florida County of Seminole
Permit No. Tax Folio No. (PID)
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.
DESCRIPTION OF PROPERTY (Legal description of the property and street address)
Lec�L Tc� S toy` �- - C_ 11 1 � � v� �-�� � A t-o(Z1 .0 s�-o
GENERAL DESCRIPTION OF IMPROVEMENT
nrn�'1i,rACl1 fitODM nrnnr
Itlltl�asn ■ xs.. �� '
OL CIRCUIT COURT
OWNER INFORMATION 0 MOLE FLORIDA
Name and address i C. )acG C n4/h�� C 2L, -g
o C%
r O r E �G �T'()—� rrl tilFRrr
Interest in property (Fee Simple, Partnership, etc.) ` '— O C -o V-) �c r_ -s nr% fin
%Owl LUnn
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER. (IF OTHER THAN OWNER)
M; d.ta,-%d M C)C-� G q(q-p— P - o, (3 c>-.,, (0'4 s Q)KI(Ahotn�C�,-, QjIc -7 3f2/4-
I- C.) Ck f\
fz4o
i_oar 3 o v 4 G'44 n 0 `F (0 -- O6 -ya
CONTRACTOR
Name and address
U1��
SURETY (Bonding Company)
Name and address
Amount of Bond
LENDER
Name and address
4,1( 5-6 oc t
111111113 owls, Imiles
CLERK OR CIKUIT GClilitT
SEAINVLt WA N1 ,
BK 05497 F`G 0404
CLERK'S 0 2(:)04166892
RECBRDED 14/28/ 09113045 PA
(� RMOIIG FM 10-00
RECORDED BY s O'Kelley
Persons within the State of Florida designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes: 1
Name and address �e,
'I I � C, N � G- M p 0 l
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as
provided by Section 713.13(1)(a)7.,Florida Statutes:
Name and address: W I 11, mow\ Cky,y)
In addition to himself, Owner Designates of
To receive a copy of the Lienor's Notice as
Provided in Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement
;The expiration date is 1 year from date of recording unless a different date is specified.)
GLOFMADWMMER
* MY COMMISSION t DD 121264A"'V! .
� ---�
EXPIRES: June 28, M ---!
aJ��av�o�a.
150ndedTtnBWgMNouiy5m1res Signature of Owner
rn to insubscribed before me this 904k Day of Dc+D er, �.0 C
My Comrndssion Expires:
lotary Public nn
The foregoing insttun
rent was acknowledged before me this r� � day of !� Ve [) , k&Jby
FR re *- QA 4A(;%- (Name of person acknowledged), who is personally known to me or who has
nroduced r v rS Q c& _ _(Type of identification), as identification and who did/did not take
oath.