HomeMy WebLinkAbout2407 Key Avee '
Permit #67- 9,
Job Address:
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date: //— l
Zoning: Value of Work: S . iY—fX21 op
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: 1( # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: J — �// (Attach Proof of Ownership & Legal Description)
(Owners Name & Address: 7 ' ��//
P- 2 a Phone:
Contractor Name & Address: 7lLY /_1V , ___ I
GJ/P",J State License Number: /t CGl1C1 La (o
Phone & Fax: / / Contact Person: Phone: ��
Bonding Company: n-('
Address:
Mortgage Lender: A/41
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 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 permit is verification that I will notify the owner of theroperty of requirement f Florida Lie ezw,
- fo � 4�
XSigal,en of wner/Age.[ Date Si atuc'ofContractor/Agent
Personally Known to Me or
-Qq
"11110111111011'",
` A
APPLICATION APPROVED BY: Bidg: t' lcib I I OZoning:
(Initial & Date)
Special Conditions:
Agent's Name
Date
��- Y, �y
DEBBIE BLANTON
MY COMMISSION # DD 188491
ContrL _EXPM9& itd6taq�5id0ft or
nwy G, rJnt , nl�rnnt neeM r:n
Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date)
THIS INS E PREPARED BY:
NAME: i 'r—=v=
.: Bui'ding & Fire Inspectoi
(Eh�ro
A DREySS: N��
Coin11e)` East 1st Stre
,s Sanford, FL 327'
NOTICE
State of Florida
OF COM IAlENCEMEN
County of Seminole
Permit No.
Tax Folio No. (PID)
The undersigned hereby gives notice that improv
be
713, Florida Statutes, the following information is
went will made to certain real prop and in accordance wish Chapter
provided in this Notice of Commencement,
DESCRIPTION OF PROPERTY (Legal desc
npaon of the
property and street adds ss) i
"
i
GENERAL DESCRIPTION OF IEW"ROVIIEMENT
k OWNER L'r'Fv^+Iu"vLiTTtDN
\ Name and address
,Le I2ctit e j,�
J /' r
Interest in property (Fee Simple, Paris hip, e�tC.)FOR
NAME AND ADDRESS OF FEE SIMPLE
TITLE HOLDER (IF OTHER � F CIRCUIT COUR7
CONTRACTOR
E� '
e and addr s � _
SURETY (Bonding Company)
Name and address
"" 1111116 f it �l;f 11111111 Il I[t li Illi Ilii fl til g®
Amount of Bond
-
MARYAN E MORSE, CLERK OF CIRCUIT
LENDER
SEMIND E COUNTY
Name and address
BK 0 500 PG 0862
CLER 'S # 2004168433
Persons within the State of Florida designated by ownerupon
whom notice or other dom menu ali$rOwNy $ecdon
713.13(1)(a)7.,Florida Statutes:
RECORD D BY t holden
Name and address
Persons within the State of Florida Designated by
provided by Section 713.13(1)(a)7.,Florida Statutes:
Owner upon whom notice or other currents may be served as
Name and address:
In addition to himself Owner Designates
or
To receive a copy of the Lienor's Notice as
Provided in Section 713.I3(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement
(The expiration date is 1 year from date of recording
unless a different date is specified-)
i
Signature of Owner
Swooirn/�D and ubscribed before me this
"L
Day of UU
/ U My Comnnission
Expires -
Notary Public
Atih Thu T Nguyen
The foregoin trtua t V; s owledged before
me this` day of My Commission DD:
y
(Name of
rnvduced
ersoa acknowledged), who is ers0 Expi s March 25r 2(
g )� P y known to me or wio
e
J „
(Type of identification), as identifi tion and who did/did ndt-u
Ill If III 11111
COURT
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