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HomeMy WebLinkAbout2004 Jefferson AvePermit # : Job Address:.hPLV Description of Work: Historic District: CITY OF SANFORD PERMIT APPLICATION Date: 4-L. -3..2-7-71 Zoning: Value of Work: $ V 250(2 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) Parcel #: Owners Nam�e & Address: IOD1 Aa ImPh?n AIBP Contractor Name & Address: a% -471 ,05 F0. Phone & Fax: *7-x% 3'7 qy% Bonding Company: Address:' Mortgage Lender: Address: (Attach Proof of Ownership & Legal Description) Iferd ff(— a Phone: 70'7— 3a it — q v2� _�GI:IL'i i'i� SSIl7v7l,�, Dr �% State License Number. C l'C Q,5!7 S a a 9�1G_VP •5r/Contact Person: Phone: 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 districts, state agencies, or federal agencies. UUOU.uo.dHY ance of pe 't is verification that I ill notify the owner of the property of the requirements f Florida i a 713. : r•.•.C.......M. 'r atllA/l A/VI �� c r y� Signature of Owner/Agent Date f Signature o ontract /Agent Date of r; Q G .Z : to o . ©'I-�,. dv�sh c�ir�sfian X111 It�� 4 a P :Z # � U Print Ow / gen ' Na Print Co / s Na U.: j Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date ;> � i AJC • r�(�.�� � : QQ ��'�J� ;I � /rib : came • p �25: ;''Nua'S ; Owner/Agent is �Personall Known to Me or �,, a� w-----..•w«•w Y Contractor/Agent is Personally Known to Me or cH141P : _ Produced [D _ Produced ID "•'•••••••------- APPLICATION APPROVED BY: Bldg ljn�gqli& ate Special Conditions: Utilities: (Initial & Date) wo FD: (Initial & Date) (Initial & Date) Permit Number Parcel Identification Number— Prepared umber—Prepared by:�� t 188111111 II 16111 ill II III it IIS 11 ill 11 lilt II 111111111 it III 11111 C'm4,-Q`l Return to: Contractor NOTICE OF COMENCEMENT State of FLORIDA County of MARYANNE MORSE, CLERK OF CIRCUIT COURT SEMINOLE COUNTY BK 05487 PG 1212 CLERK'S # 2004161487 RECORDED 10/19/2004 10:35141 AM RECORDING FEES 10.00 RECORDED BY t holden The undersigned hereby gives notice that improvements) will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, fee following information is provided in this Notice of Commencement. 1. Description of property (legal description of the property, and street address if available) 2. General description of improvement(s) t,ejw,r 3. Owner information Name (Rco-, s L.4y-".--- VvtiSl*- Telephone Number j ;% c4l l Address &a \ PAWIQS-t-E.o A -U4 Fax Number Interest in Property: 4. Fee Simple Title Holder (if other than the owner shown above) Name Telephone Number Address Fax Number 5. Contractor Name: All Ways Professional, Address: 427 Gaston Foster Rd. Orlando, FL 32807 6. Surety (if any) Name Address 7. Lender (if any) Name Address Inc. Telephone Number (407) 737-4474 Suit E Fax Number (407) 306-0257 fiEu OOPS Telephone Number MARYANNE ROMs Fax Number 9LERK OF CIRCUIT COURT Amount of bond $ ff"DU 9.00TY. HQWA Telephone Number 2004Fax Number OCT 17 ZOO 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(l)(b), Florida Statutes. Name Telephone Number Address Fax Number 10.Expiration date of notice of commencement,(the from the date of recording unless a different date specified): Date Signed Y^ 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.") expiration date is one year is Sworn to and subscribed before me this :(day of (x!( 20 CSS by who is _Personally known to me OR - oduced as identification. /� '/M/N/...............................N///.` C. CONNELL /DAVID o�wAv a„' ,. Comm# 6DO33M e� '^s 6/20/2008 •. _� .' (800)432.4254: ;,ry Assn.. Inc ' ........... .........a sea.i, must appear 4