HomeMy WebLinkAbout2400 Sanford Avex
CITY OF SANFORD PERMITAPPLICATION
Permit # : OS—/
J
Date: I ... 0 [ % a— ` o 1—I
I 1
Job Address: 4 OL7
-7 7 I
Description of Work:
Historic District: Zoning:
Value
of Work: SCI 9 7d
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 losets
Plumbing Repair— Residential or Commercial
Occupancy Type: Residential Commercial
Industrial Total Square Footage: 170 G, -SS/ l S /fo Fii /-FTF— D
Construction Type: � # of Stories: J_
# of Dwelling Units: �_ Flood Zone:
(FEMA form required for other than X)
Parcel #: 3(.—) 9 =- 30 -Sq) ^ O • .
(Attach Proof of Ownership & Legal De ription)
Owners Name & Address: '0 t7 A
. _
Phone: '!b %` t) — % % l/
Contractor Name & Address:
Phone & Fax: 4 b 7 -.3 XL—)
Bonding Company: UIA
Address:
Mortgage Lender:
State License Number. `0 CCC --o
Contact Person: - Phone: ibi- 4
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.
3,77 a
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 rr_I;ulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN VOITR, 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 ty, and there be diuonalp�p¢errm, �equ�r from other governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance o tmrt is verificatyAn that I '1�notify leo/w�r of the property of the requirements of Florida Lien Law, FS 713.
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Sigt►ature of Owner/Agent Date Signature of Contractor/Age Date
1 nr✓IAS 1 Ir eolbL)
Print O r/Agent's Name Print Contractor/Agent's Name
A—
'014111,
Y.°�s'% Hflya Sta o lorida g Notary -State of Florida Date
2° `° = Commission #DD328091 ate Si nature of
IZICHgtio 3. �'GGiJ�w� S6�•
_� •, `�. Expires: Jun 18 2008
0, F�OPO� Bonded Thru DEBBIE BLgNTON
" " Atlant�mnEtiggr &Jnc, Pejsovally Known to Me or on � i com , d
I�sed l(�XPIRES: Feb
Produced ID i' /6 . �1 k i �,� L, F _ 25 Pon4I9IM or
tag rua
1.800 -3 -NOTARY FL Notary Discount Assoc. Co.
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
special Conditions:
1JVg
�a -710
t 1
Notice Of Commencement
.s,rATE Of
COUNTY OF
f}{F, UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter
713, Florida Statutes, the following informaUon is provided in this Notice of Cornroencemmt.
i
I. Dt:* c p6cm of propcxty: Ocgal description of property, and street address if possible).
L Eg Lots 7`I.4 F6 CLr s s to go Ft) Pt)u c- HC-15At5
pI�3 PGS i GLiglIr u COP,
'MATtYANNE MOR -S»
2. General description of improvement: mt pkof CROW R1
3. Owner Information:
a. N and Adds:
aqbo
b. Interest in property: Av U e f L
C. Name and address of fee simple titleholder . (if other than owner):
Uou L
4. C—Tractor. (name and address)
�LL�'_�GLi✓
�• Lt -r
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M
74 r2
v
« i,.o rtti,
m CO W
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'rt
S. may:
CD
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a. riddrrss �
r
LD
2
b. Amount of bond S
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6. Lender. (Name and Address) - I
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may b& served as provided by
section 713_.3 (1) (a) 7., Florida StanAcs: (dame and address)
8. In addition to himself, Owner designates tate following persons (s) to receive a copy of the Lienor's Notice as provided in Section
713.13 (1) (b). Florida Statute ( name and address)
9. Expiration date of notice of commencement (the expiration date is l year from the e orraror-l•.ing unle32 �iffer`ntdate is
yp«ar1«l)� cu. W) la ib
Sworn to and subscribed before me this �� �%Z /— � LX
1s2_day of - 0(�r_A� .,20 0 �I r (Signature Of Owner)
(Signature ofNotary Public) ( Qwncr's Name)
Richard J. Ellison, Sr. `i O o S f� u fa rd '� vz v to c
Commission #DD328091
JA >y.FD rd
N. Expires: Jun 18, 2008 F % �' i 1
Bonded Toru
Atlantic Bonding Co., Inc.
(Owners Address)
THIS INSTRUMENT PREPARED BY;
NAM
A D D