HomeMy WebLinkAbout2747 Carrier Ave.11
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Permit #: v W
Job Address:
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date:
Value of Work: $_1(A 1_506
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 X Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel 4: 1 Ap- o4 _")
1- --')U- WI U—
I -7U(,) (Attach Proofof Ownership & Legal Description) I
Owners Name & Address:
( X11
i
1 ADD CL�el�a. ct %3(Vrit,
3,277 Phone: (-il)-1)
STS — C{ -DIC)
Contractor Name & Address:
State Number:
^^'' '' p
CCC 1M 6 q
/
Phone &Fax(gd
ys�
,,/License
Contact Person: LiScitl oAk
Phone4 `)uso-ipl-3
Bonding Company:
Address:
Mortgage Lender: N /A.
Address:
Architect/Engineer: Nf/A 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 the property of the require of Florida L n La
N io-Ja-os
W
u Sig�natureofOwner/Agent Date ignsture:ofContractor/Prge_; ate
I�S t j_ ,1, , 5
Z �(-1L/X
o Print Owner/Agent's N Priontractor/Agent's ame
j5&34J !&
r7 `" Signature of Notary -State o Flo ' ate "&,. J_
v Signature of Notary -State of Florida Date
cz2-�
N
0
Owner/Agent is Personallyw Known to Me or
Produced ID
9IPLICATIONAPPROVED BY: Bldg:
Special Conditions:
(Initial & Date)
Contractor/Agent is Personally Known to Me or
Produced ID
Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date)
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uneic7vrea
AFFIDAVIT
REGARDING ROOF DRYIN AND FLASHING INSPECTIONS
Company:ll.�!' ' .1 ■ !'
Owner:
l�l�i.i1:i � � • �
name
address
phone
License #: _CM Oji ag4S
Project Information
Permit #:
Subdivision:
Lot #:
I, l A(� 0. 1 "ec, , affiant, hereby affirm that I am the duly licensed
contractor of record for e 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:
r— signature
printed name
STATE OF FLORIDA
COUNTY OF O Cant Q
This instrument was acknowledged before me this a day of , 200S, by the
above referenced individual, C 1kodc9S , who acknowledged that he/she is a
duly licensed contractor with lstocl�os ��,ts 120o�' t � , and who acknowledged that
he/she was authorized to execute this document. He/she is either personally known to me or
produced as valid identification.
WITNESS my hand and seal this day of 10 �✓ , 20 �.
Notary Public
.V* Lisa Marsh
My Commissan DD357961
or ti Expires September 26 2008
POWER OF ATTORNEY
Date: 10- ID- C)�
I hereby name and appoint _! )Q& `ink
of _i `D_ C S n2(S 6)0&20, to be my lawful attorney
in fact to act for me and apply to the CL'u or J A ryi�b (d
Building Department for a j%e - cod permit
for work to be performed at a location described as:
Section Township Range Lot Block
Subdivision
Q19-1 AV56- -U73
(Address o Job)
�ff�d f;r�-1- A,-1-h.I -t ►- Utz.. 0moo 22s Nmb)Qd PAflc 6-dte, N.T.
(Owner of Property and Address)
and to sign my name and do all things necessary to this appointment.
Type or Print Name of -Certified Contractor nd Contractor's License Number
LSignatnre of Certfi� ontraator _�
The foregoing instrument was acknowledged before me this day of 20 QS
by L;
who is personally known to me/who produced
as identification and who did not take oath.
State of Florida
Co f O ca -a2
o
I wi
Notary Pu lic, Orange County, Florida
,OWX Lisa Marsh
MY Commissar DD357pe1
-q p Expires September 26 2008
Seal
THIS INSTRUMENT PREPAA"tE Ok COMMENCEMENT
r NAME
Permit No.R L Tax Folio No.
State of Florida .,) '' �}
County of Seminole ��=�1�.U� <j �lZ 3
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 providedin this Notice of Commencement.
1. Description of property: (legal description of the property and street address if available)
n ---�►-'xr-n- rv;%r,- 1 -if Y-� a -1L1 l Pat,
2. General description of improvement: - -
3. Owner information
a. Name and address '—)a n Ob(u- At 46)f i
327'
b. Interest in property 'i '
c. Name and address of fee simple titleholder (if other than Owner)
4. Contractor 2M4� P r
a. Name and address Q uo S 1 S t e fkP VI . �I �Y1QS pkk _
b. Phone number ' t -L0"7 - t oSD - h013 Fax number
5. Surety CERTIFIED CUA
a. Name and address Isi g•.V n'NINI ,t•° x __
4Yq �,a
b. Phone number
c. Amount of bond
6. Leader
a. Name and address (�
Fax number
b. Phone number Fax number
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(l)(a)7.; Florida Statutes:
a. Name and address L LX" DoJ- -1 Air-:poy }
b. Phone number85 2 Fax number lt4lf)
8. In addition to hiTasel herself, Owner designates !% Y� of
to receive a copy of the ieno o ice as provided in Section
713.13 1) , Flon a Statutes.
a. Phone number _-VD 7 - Fax number
9. Expiration date of notice of commencement (the expiration date is 1 year from thee of recor ' g unless a different
date is specified)
y� CC' f f eSiL{�2►'1�' O� Erni n iS't'rc�;•`i"� Ort
Signature of Owner
Sworn to (or affirmed) and subscribed before me this /o2 day of eQc4415e /' , 20 Z>e by
IIIIt 1111111111 MME IBM
Personally Known k1— OR Produced Identification
Type of Identification Produced NNYMW WNISI=j CLEW 1F CIWJIT LWRT
S�tAI1V(11.E (�f�.�dTY
' BK 0594E, iris, 1328
CLERK'S S 11 20051762!72
Signature of Notary Public, Stat o lorida RM)RDED 10/12/2A)0.5 1211606 PH
Commission Expires: REWRDINS MS 10.;W
REUIRMD BY t holden
;fie',,,, Ann D. Gifford
i+t~•
4: ,r MYCOMMISSCN# DDIC3515 EXPIRES
,aye. July 24,.2006
�, ` BONDED THRU TROY FAIN MIBURANCE INC