HomeMy WebLinkAbout205 Hays Dre-- . termit #: U%r 3317
Job Address: 'Z 0-�
Description of Work: `Ile _'Kn
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CITY OF SANFORD PERMIT APPLICATION I 11
Date: SC A- e rv, kr g r `� ; pia t,(
Historic District: Zoning: Value of Work: S .6'000
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 —11— Commercial Industrial Total Square Footage: 19 S2
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 & Address: Itvf r li n
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1 8At 5 D f' Phone: 1G/✓ � Q :,Z — 3:3 9 2A-0- 7;3R 7
Contractor Name & A/+ddress: RL 144 i o h
AVC ( State License Number: C8 )Ari//e_.��
Phone&Faz: Iv?) 0-21at4 11-,S24 Contact Person: IT/yi, I�IPh ,Phone: Lk7'2 "q� „(a(,
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Bonding Company-. A ' Sc;, r
r.Address: '7 ,0 W. C (' SS ;r -L � �0
Mortgage Lender:
Address: -
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: Iawrz regulating
construction and zoning. WARNING TO OWNER- YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT W 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 requiremen f Florida Lien L; 'S 713.
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Signature of O tw er/Ag nt Date Sign cure of Cpo�ntractor/ ent Date
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P int wner/Agent's N me Print Contractor/Agent's Name
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S nature o Notary -State of Florida .�;� o ora -State of Florida Date / - ---
r MY COMMISSION It CC 962528
a= EXPIRES: December 21, 2004
Bonded -Nu Notary Public Underwriters
Owner/Agent is _ Personally Known to Me _Personally Known to Me or
_ Produced ID �(, (��030 Q n�SZ2l� _ Produced ID
APPLICATION APPROVED BY: Bldgtg.
at
Special Conditions:
Utilities:
(initial & Date)
FD:
(Initial & Date) (initial & Date)
A_
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
State of Florida
County of Seminole
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.
iption of property: (legal description of the property and street address if available)
2. General description of improvement: e nd rc i Cedilla Vt p4l r
3. Owner information I
a. Name and address crit L. rd
')"o N — orc� tL CERTIFIED COPY
b. Interest in property WIARYANNE MOW
c. Name and address of fee simple titleholder (if other than Owner) BLUK OF CIRCUIT CnI,
4.
Contractor
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a. Name and address 2CJ
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C ' Ai,4L, Ave SAyj
a rJZ
b. Phone number (kt-Ig 13 ,1 a - i l 0 t"l
Fax number 40i = -A a E
5.
Surety
a. Nameandaddress WAC�oV�A ZnS
�(ii 8!i H 9!1 I I�Q!
HHNi!WHNiif,®i!H.i0HN,,N0U!,U
b. Phone number [ i�>'."3 t R!;PAENT PRFRARFf)
By: Fax number
_
c. Amount of bond
CLERK OF WNLUIT CUURT
MARYANNE MORSE1.
'
6.
Lender NAVAE ���x�� Ni�.1;�r'•ru
–7— BK 05467 PG 0460
a. Name and address ADDR.I
j,
o
b. Phone number
Fax nu@ifDING FEES 10.00
7.
Persons within the State of Florida designated by Owner upon whom notfffA31WE&lft dlohe4dents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes:
a. Name and address
b. Phone number
Fax number
8.
In addition to himself or herself, Owner designates
of
to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes.
a. Phone number Fax number
9. Expiration date of notice of commencement (the expiration date is I year from the date of recording unless a different
date is specified) ff
Si afore of Owner
zi
S orn to (or affirmed) and subscribed before me this day of , 20 f��/ , by
Personally Known OR Produced Identification
Type of Identification Produced 1) L-,4+6 6 3 61)& 5-6 0 5-67o2 �
N�,
Y. VELERUII. HENRY
MY COMMISSION # CC 962528
ignature of Notary Public, State of Florida EXPIRES: December 21, 2004
Notary Puni�unde
Commission Expires: wdters
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