HomeMy WebLinkAbout2018 Sanford AvePermit ii
cM Or SANFORD PrRMIT AI'PLTC��TfON' • . :.I 2 kt t ,+ " .,t ; l
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Date:~
,
Job Adc•ess: G' V
&scription of Worir.
Historic District: Zoning:
Vallee of Work: S S ji U (/
Permit Type: Building Electrical Mechanical Plumbing fire Sprinkler/Alarm r
Electrical' New Service - It of AMPS AdditiordAlteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacemeflt New (Duct Layout &_ Energy Chli.., Required)
Plumbing/ New Comnicrcial: ii of Fixtures it of Water & Sewer Lincs ii of Gas Lincs
Plumbing/New Residential: ii of W,,atcr Closets 1'tutnbing repair— P,-csidcntial or Commercial
Occupancy Tyle: Residential � Commercial Industrial 'Total Square Footage:
Construction Tyne: It of Stories: ii of Dwellillg Units: Flood Zone: (FEMA form required for oth.eu- than X)
Parcel ii: (Attach Proof of Ownership & Legal Description)
Owners Name & Address:
20 l� �y4,� Fb IZf 4A�FD2_ Phone:
Contractor Name &''Address: `A� �� C, 2a O t Ca �...._.__......._._..._
0 o r-2 IV� 51�� �D � C l 3Z7-7 1 State License Number:
Phone& Fax: Contact Person: - -Phone:
[lording (
Address:
\•lortgagc
'kddFess:
Architeeb
Address:
Application is hereby made to obtain a permit to do the work and installations -.indicated. I ccrify that no wore: or installation has comntencui prior to Ih(
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 sepanle
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, l fEATEM, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate turd that all work will be done in compliance with :ill applicahlc. laws rr.};ul.(ting
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAT' M, ULT 1:N 1`Ot11:. i'f,.YTNG
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO oBTATN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCI-ME14T.
Nn'1_I(i s In addition to the rc(Iuirctncn;; of this pcnuil, there ntay be ndditional icstrictions applic:tblc to thi;: property that maty be linind in the public rccordi of
this county, and there may be additional hermits required Rom other governmental entities such as water nt:matcmcnt districts, slal(t al;cncic. or fcdc.r:tl ngrncic':.
Acceptance of perrnit is verification that I will notify the owner of titc property of the requ469��,
FTSi�nnlure of Owner/Agent )n Uau:
Print OwncpgkgeiA's N
a
Si3'.rfatur'c JI Ijrotn
/ ® r iviy L-Ommt6+slon CC985428
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�'foi a E*ires December 09 2004
O""n fAgcnt NoMkil to �t or
-- Produced ID
Print "c or- gent' :un(,
ie of o4prN ti
I' t: ahilU" i Ang Date
2 My C ission 985428
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ov nd� Expir ecember 09 2004
C'nn;rtctin/A' :- i; I rrsnn: ii t'nown to iNlc or
IYudu(•cc a)
APPLICATION APPROVED BY: Ill(IL1 � � .0 Ing: �—
Inival S Oatc; (Initial ,l Datcl
Special
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(Initial f: U:ttc) (h>;tial L Dat'.
1
WYANNE NORSE, CLEW OF CIRCUIT COAT
SEMINOLE COUNTY
BK 05472 P6 0115
CLERK'S # 2004153753
-7
RECORDED 10/118/21W PH
1�fgj,,CL. or,
RECORDED' BY S 01 Kelley
,V U A 4Ly
,11r 1. acd hcvcby ;L%'(:; 110:*
cc -LllIt iprOvUll;it will bo 111.dc Lo ccvzal
OCOI)crty, ;II
d iWiccordwico witl
;llaptcr.01.1' z Is
713, 1�10V (h, SUILULG., t1Ir, follo"'116'r '11f " 16011 provided in tabs loticc of coll1111cliccluclIt.
1. . Dc,,Crjl)Lioll Of property: (legal description of the Pr0PG1*t.111 ;incl street adclress11 1
c.
.f' j1j)IOVG111 lit:
Z. Gclicral dr,"C11PLIO11 0
owlicr hiforillition
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a. N;1I11c;1l1C1,1ddrc, --
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b. lntcrcst "I P1,01)crLy
c. 's of i .
iblilc and z'ddlc-
4.. contractor
zi. Namc wid
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b. Pliolic nwnbcr _,L6j - _:Y,�_7
5. Surety
'Iddrcs:;
b. 1?1101lc munbcr ,
c. A11101111t 0f bond
6. Lender
r., -I -x awnbcr
b. Tho,101111111bcr 110111 Iloticc, or Othc17 doc,1111cilts luny ,lorldZI dc:-,lj,,Ir.tC6 by ov"I'Cr upon V,
'111d address
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b. ).'hone nuinbcr�. Ala actditioll Lo
L cl:;prov1dill ScCtiOJA
cc,�/c -,I copy Of 1.11C LICIlor's
to 17C I
Ilorida St,-,.tLlLcs.'
Fln"V, datc of rccol-61113 wiles". a diffcrlcut
1. I yc"r from
)?jjojIc Pmit
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Po, Linda A Keeling
n CC928
MyCommissionCC9 Expires December 09 2(KW IA,11( by
.1 'lop 260
YOC - - - Q7.;�--
33.3— 30 -
personally 1(;10\1,111
POWER OF ATTORNEY
Date.
I, Andrew J. (Andy) Adcock do hereby authorize Ruben Birch
To pull the R e r o o f permit for Z D 1 N 8 AVE
(type of permit) (address)
Signature
'40Y NitLinda A Keeling
My Commiss" CC985428
f4)" r/ Expires December o9 20o4
i
i
Notary Stamp
Cly known me or driver license # , of State of Florida, County of
�j �� day of �L�'Tp (3 2 )2004.