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HomeMy WebLinkAbout1811 S Summerlin AvePermit # : `-' - O` Job Address: S. SuMAA J L Description of Work: Pt'S A V& T ) k i Historic District: Zoning: CITY OF SANFORD PERMIT APPLICATIOr S,w" Re- - Date: CD 9, — Z G — uA�2 S Value of Work: S 2 / © 0 Permit Type: Building X_ Electrical Mechanical Plumbing Electrical: New Service - # of AMPS Addition/Alteration Mechanical: Residential Non -Residential Replacement New PlumbmW New Commercial: # of Fixtures — Plumbing/New Residential: # of Water Closets # of Water & Sewer Lines Fire Sprinkler/Alarm Pool _ Change of Service Temporary Pole _ (Duct Layout & Energy Cale. Required) # of Gas Lines Plumbing Repair—Residential or Commercial - Occupancy Type: Residential Commercial Industrial Total Square Footage: Construction Type: RE ROOF # of Stories: �_ # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: 3 [ - 19'31 -5a)4 - m - eDCM p q ` ^ (Attach Proof of Ownership & Legal Description) O.vners Name & Address Su m Ae a I,,N hi vet �4A, -D t ?24:7 ' - -3(-Tio Contractor Name & Address: Central Florida Roofing Professionals - 952 W Charing Gross Circle Lake Maty FL 32746 State License Number: CCC132664Q Phone & Fam 407-5744856 & 407-330-5083 Contact Person: Michael Torres Phone: 407484-2633 Bonding Company: Address: Mortgage Lender. Address: Arehihct/F.rrghneer: 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 race 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, BEATERS, 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 ori 'en Law, FS 713 mature of Owner/Agent Date Signature of Contractor/Agent Date I er/Agent' ame Priv VS ignadr 9' N tyt lorida Date :4 ` My Commission DDI 31894 o Expires July 05, 2006 Owner/Agant is Personally Known to Me or Produced IDT:T1 %I %, �A,�.J t C APPLICATION APPROVED BY: Bldg: (Initial & Date) Special Conditions: Zoning: Michael E. Torres rrrPriv retractor/Agent' e - afW C2 Signature of Notary -State of Date N; •N.M.q........... .IN.. .. ... �t. r NIA SHAY EVAN �/ Commission it OD0148100 Contractor/Agent is K Personally or Expires 915!2006 Produced ID Bonded through 1d0043Y�2S�) Florida Notary Assn., lne. ............................................. i Utilities: FD: (Initial & Date) (initial & Date) (Initial & Date) -- -... - -.-. e -.j AFFIDAVIT REGARDING �t NG ROOF DRY -IN AND FLASHING INSPECTIONS Company: C& NtML R focd; ltc�f'optl s License #: CCC 132 '/m qS U1. CHARS un ass CR. PL 3z}gc Project Information Owner: qc. ' Q name g� SS�?ef?i;►1 AVE, address phone Permit #: (b 6 —'L? - Subdivision: ZZ Subdivision: Lot #: R1 k 6 I, /"IsFE� �� �aRR� , affiant, hereby affirm that I am the duly licensed contractor of record for the above referenced permit, that all the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address or lot has been installed in accordance with the applicable codes and standards. Contractor: signature ,4 r 4-J (. F . - ooe-�5 printed name STATE OF FLORIDA COUNTY OF Spic -c xJoL E This instrument was acknowledged b fore me this day of Oc;�a E -n , 2. 0 , by the above referenced individual, P1.C>M , who acknowledged that he/she is a duly licensed contractor with (�N�ot P. ��N , and who acknowledged that he/she was authorized to execute this document.fie/she is either personally known to me or produced FL DP,' -,m5 Uc-E,A�s&- as valid identification. WITNESS my hand and seal this day of , 20 i Notary Public Permit Number C 6 -- aa� Parcel. Identification Number 31- 19 -31, 5�4--06aZ-<Xco Prepared by: jai F —-,;-j& 5 cv,C � sC Return to: � p Lt0 a �r L I:� L 37—T4C MARYAWE K tt,�e LIERR W GIRWIT C"T SENIWI_E C t lTY BK 059-59 PG 0478 CLERK'S # 20(6181738 R lWD 101191`c)m5 te%16109 F REG#3RDINE FEES 10. 00 REWRDED BY t holden -/,CERTIFIED COPY YWAP,YMBNE Alffiff 1GI FRi )i CIRCUIT COURT SEMINOQ G`JNTY. FLORIDA State of County of Si°iAt o e The undersigned hereby gives notice that improvement(s) 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 (le al description of the property, and street address if available) S - SUA4E4 v t c N' j+v, S- y -PL 327 -7- ( -37-W Le-� S its t W-6 t P3 -Ft- 7- BLV_ C 6?64A-A,Z 2. General des ription of improvement(s) 3. Owner informati Name i� ek Telephone Number ymT -320 -01041 Address Ig I 1 S,,,- c .4u A-Ve Fax Number 14(p7_2 G. g- y J 31 S" Az J L Interest in Property: 4. Fee Simple Title Holder (if other than the owner shown above) Name Telephone Number Address Fax Number 5. Contractor Name Central Florida Roofing Professionals Telephone Number 407-574-4856 Address 952 W. Charing Cross Circle, Lake Mary Fax Number 407-330-5083 b. Surety (if any) Name Telephone Number Address Fax Number Amount of bond $ 7. Lender (if any) Name Telephone Number Address Fax Number 8. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by §713.13(1)(a)7., Florida Statutes. Name Telephone Number Address Fax Number 9. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in §713.13(1)(b), Florida Statutes. Name Telephone Number Address Fax Number 10. Expiration date of notice of commencement (the expiration date is one year from the date of recording unless a different date is specified): 54- Date Signed Signature of Owner [Note: per §713.13(1)(g), "owner - must sign ... and no one else may be permitted to sign in, his or her stead." Sworn to and subscribed before me this _ day of S,2:� , 20JYby 1,.11r 4' r1 ,rte ile who is personally known to me ORCt produced / /�ye (3 LrOJO as identification. k >) r-\` v*� Laura J Torres :4 ` My Commission DDI 31694 Form Revised: 4/98 of Expires July 05, 2006 of No (notarial seal must appear below)