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HomeMy WebLinkAbout2210 W 1 StCITY OF SANFORD PERMIT APPLICATION Permit # : - J -s Date: Job Address: t D � / Description of Work: jet J�oo f— Y/!�1 r �� 210 f;<,v Z/:'S¢/C /✓1//u/ f%CLi i r�� �,� �,✓g (� f Historic District: Zoning: Value of Work: $'7Q J Permit Type: Building Electrical Electrical: New Service - # of AMPS Mechanical: Residential Non -Residential Plumbing/ New Commercial: # of Fixtures Plumbing/New Residential: # of Water Closets Occupancy Type: Residential Commercial Construction Type: # of Stories: Parcel #: e�2 tD � — —3 d —3,90 3,90 " Owners Name & Address: /) q 1// -d Contractor Name & Address: / ) , , % // _.. rn Phone & ax' Bonding Company: _ Address: Mortgage Lender: Address: Mechanical Plumbing Fire Sprinkler/Alarm Pool _ Addition/Alteration Change of Service Temporary Pole - Replacement New (Duct Layout & Energy Calc. Required) # of Water & Sewer Lines # of Gas Lines Plumbing Repair - Residential or Commercial Industrial Total Square Footage: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) O"- 6000 — 22 (AttachP oof of Ownership & Legal Description) Phone: %Z State Lice/nse /Number: L e —e'aJ71K cea1 Contact Person: {-2lt// /, rte/ A?/L Phone: �P — f -7) 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 ofthe 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 pe t i erifica ' n thaat I will notify try of the property of the require nts of Florida Lien Law, FS 71 . Signature of Owner/Agents Date Signature of Con c r/Agent Date t Owner/Agent's Name P ''"t Co ractor/A ent's Name \ / -Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date Rebecca R. Doud ebecca R. Doud A oS �� ommisI,sion #DD20167 gSip❑ #DD201672 Owner/ • XKW*9 Contractor/tib' �TfYltno o _ Pro¢fGed [ c_ rn Produced ID = :'= Ex fres. f1pr -uet�ded Th - goFF�oQ: Thiu Inc. 9 ...•oP: on e Atlantic BondingCo., FOFF� Atjantic Bonding Co U APPLICATION APPROVED BY: Bide: �oi� lgJ I Utilities: FD: Ini al ate) (Initial & Date) (Initial & Date) (Initial & Date) Special Conditions: I—RNESr ftaft I Sultdor "Our Nam* 9tenda For Quefity" C"00: I381111 f?44M - Rex' (3r161 ►rr.-3736 1,000 C. INDUBMAt flit.. $uku K oRmor CIM FLfaROA 3.2763 'FULLY LICANUV d MURF..0 DTATP CiRTrPtcrs acc uVatoot • C9 CO21M r►'+rw. or*&I-Vuhri a.com 40-0 322 7369 P. 01 .._ its " �C•—.�� —�1�f9--C�G�=� PRC.POSaLSUBWTTED7'0,DATE; 14 2 32-71 1 C'C7i h S aaa �-���c i Fv Wh ite Drip Edgy+_ WFHERr"lNv5J8MiTSpEC;F'f�A71(;il��,h,ly�E$�IMp'T'E',SF^.�cl -••-- -- 1 'raw offerlrltietg rll t Maul all aliablis off aitr, Clow.job title thorousNy, Baud Mvgwt round for umkla..• Z. RapWd A lady rottod w#W dachift aua d utast-oa ds. Eacasesive fiiaoiaa and a111 Minuirn weals Will be Jaz 3. X1I V1. I lit %it Derr a yia, (Moob Iba& C'aurAy Cada - Bvtw than 30I# for Rs mdfi.) 4 I'nAdl e31 new painbd alf maam trip . Compal to all even salad raoa with alttd* roof cement S Itow) Vishay maewAlbim in all %-Wloyrs - cetrout to lhi4elr ower L"Witaminleg-Gail>irosTua► CZK `,Valley. b. Far rah stew leatd boa a fad go9ce z oks ot>, all 9xictins y9ob oared pipet, Peat to raaafth oaleer Vvuaing 7. Replace (—)keys 1+Iayli ,eti. Chi Mo y. $. Iwo air lttlhb_s td MUML* - A.,il ariglac, ts>mgx realant) - 30 1@ s+ "ufl aturoz was-Wy 9. NSM ail al"4" Willi 1 IA" ra*&S mile, 10. laull (---) leaghe of t'idw Veat IavWl (3) off-cidip rewiv. J. Sk! ltaloaull 43# bas slwi4 drat -int, orad Slaasle-Ply wl' SDS cold vvvew A&ftive -12 'Year MMMArturft, wurTlarty. 12..aLll waleriaolt wwd and wait iasMlod is prapmiy:Mlied in accurdwce wigh c-jrmt u&%!►>:rt:s. ytute, and County C'o&s wd Spaeaaifiesbana. ALL MONVY IS DUX UPON CO141inETION Of WOX& !r'ama mains check FIFW# a, tCANIST A9097 Toad Coact of all Warit; Pkaa: nxnoa+e vei+icier frrxu �istrwsry bcfx�e 7;U4a.ea► thy: i�ty of jub; at><i rr,rnc>vr- ashy itecrm on rwatl sf +� Rlxaiczsr red eh*,k Heat dl1 fllCrwws wv wcuv:, khatt rtuV fall or bm"a off dLw to baling rAwrA'rale vrtlile rttir6se{t, we are not r*n wwible. Tf neA a'nuaft on th.4 P'apo.osl, (JgPW Iv 1r*,nprV -, far; rvrwvtl of r+yt r=4 alarl and tha haver Lha, is tmte'K.ai+le (i.e ernat4Ctds, bird bate, h-4"# plain. ew.) aas.1 rtyriuM wadwd to the mAjV Lki% ineidir tlat antic a:d aa",k prig to job sloe,. A re-imWlaion ver ndjuslGrroontat ede,ob CCarlpltlaVr: (pr.; 691r'.satnHitts, air coMklOanl -4 ovatpcsvmu, alwwm, piyc:a< arc ), raat, oic damps to nmeniss'vas 6;e U, ewmamr w0ji s w iaetivarr rnu:is O.a.: dlivr+p ayiI, aidew dU. tatxiiec yae, tri:.), and re-1rat4atkm of anythaka tram accord bar r+erroved to prvgmmlt# rv"p k tarp► roftmi wood ara m (ix,: faaL it. ac*d'!t. Iridl►trp, .+c). w�-AEAs:fJYPAMOSCTOrIORMS) aNPWTeA1AL:'•COMP LETEINAJQ R�Ah1C$dV1TNTHQAi�t7Vfa. �ECIFsCAT!OWrn,ff317t+E r tJtA >✓� .r :�f _ �..1.__.:. '.' ....i�.___ - . t}UL6Ari!Y iS Wd TH PA'tiWJ!WrS TO 09 I11ADe Ad FOLLOWS Any eitwatocs or ati isrions ffflm ObO,,* xV*CJnC300n* wttl Wcame an Metra rharge over and move o-ornetcv Ow"r to cwrry f,r1!. Toon ado tens av--r- r•,seteaswv insurance. Owner fe ony legal tees for col4vion of any work aot paid for w+it"'O .3Q day from: cornpiehon. All oboe Is guaebnIowi I ,o years.roetf materlbl cnrrieu slandnartl moanitfacYt►rb w,a►rswty wff+C3Rtt�c•aoc',r1Ar�lE; _ E-"�"' �y ] c�.4.; y� - --_-.�.•,.�.�_�_ __.___.�._ NOTE: '1 HIS "OPO4AL MAY BE MTl+pRAWN BY JS IF Pig.[ ACCEPTED WI rMIN "CHsI�'rV i3Q) L).AYS ACCL" PTANC%CrM PAMP08AL PF+FABdv�a,�t+Cl':IPCCIrICATbN9rnrnCC+r+0171CNdAgprsATlga.�GTCRY�hD�RE Av�GG pTEu.YOU APE AV7,- 0A1ZE0t'3W TME MrCA4K AS SPLWOMIEp. PAVMIENTS IMlL,, 6110 MAOC AS OUTLINJO Aho'�E. r J " �N a�e C:5- 3273 DN P� b ,,I e,Z SEIvANOLE COLIRTTY FL01C1 AA'S NATURAL GM010 E NOTICE OF State of Florida Tax Folio Na � permit No. The undersigned hereby gives notice that improvement will be made to certain 713, Florida Statutes, the foiling information is provided in this Notice of Com OF PROPERTY (Legal description of the property DESCRIl'1ZON _11 % T MARYANNE MORSE, CLERK OF CIRCUIT COURT SEMINOLE COUNTY BK 05495 PG 0253 CLERK'S # 2004165630 RECORDED 10/26/2004 1111006 AM RECORDING FEES 10.00 RECORDED BY t holden County of Seminole l property, and in accordance with Chapter - -- 09t'11fIE;D 00" street address) traaa+vrn�r*� xa..� GLERK OF ClRCILT �O GENERAL DESCRIPTION OF IMPROVEMENT OWNER INFORMATIONi _' l c� Name and address Interest in property (Fee Simple, Partnership, etc.) NAME AND ADDRESS OF FEE SIMPLE TITLE1�0LDE (IF OTBER THAN OWNER)____— i CONTRACTOR Name and SURETY (Bonding CompanY) Name and address Amount of Bond LENDER • Name and address i may be served as provided persons within the State of Florida designated by Owner upon whom nonce or documents y by Section 713.13(lxa)7., Florida Statutes: Name and address In addition to himse14 Owner designates provided in Section 713(l)(b), Florida Statutes. Expiration Date of Notice of Commencement (The expiration daze is 1 year from date of recording unless a X Of receive a copy of the L9enoes Notice as is specified.) Signature eoof,�0) zn= sub ed before a this _ ��y of ()C&6,Z_ e My Commission Facpirr Notary Public The foregoing instfu nt was acknowledged before the this a3 day (name of person acknov me or who has produced (t and who did/did not take an oath. 1-121Rebecca R.. Doud �o�PpY Pu�GC+ Comm,�si 0D201612 W Apr 09, 2007 r $ended Thru `9rf pp F��Q�dm Co., Inc. po At^Ic 0 61— i by dged), who is personally known e of identification) as tnenttfication 3 AFFIDAVIT REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS Company:%LY License #: CC—e'of'6 J 01 420 ©.Ci l: Z7K 3 /Project y Information Owner: �A%�� L / Permit #: name 2-2-/o l(/, Subdivision: address Lot #: phone I,t��GJ 7 iT- _l-P"�GfL , 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: STATE OF FLOR�1IJnDA COUNTY OF \,�c� ,nno This instrument was acknowledged before me this day of U , 20()Vy the above referenced individual, n e 1 S, L� , who acknowledged that he/she is a duly licensed contractor with Se -4e>- 11-2- 664k_f , and who acknowledged that he/she was authorized to execute this document. He/she is eit rsonally know toe or produced as vali tific`aTion. WITNESS my hand and seal this day of , 2004V otary Public DEBBIE BLANTON MY COMMISSION # DD 188491 E EXPIRES: February 25, 2007 OTARY FL Notary Discount Assoc. Co,