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HomeMy WebLinkAbout2885 Mellonville AvePermit # Job Address: Description of Work: Historic District: CITY OF SANFORD PERMIT APPLICATION Date: I t- a • bca lf' up roof Zoning: Rx - 1 Value of Work: $ 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: AS Construction Type: CbnrAK# of Stories: �_ # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: Owners Name & Address: Contractor Name & Address: (Attach Proof of Ownership & Legal Description) Phone: State License Number: Phone & Fax: A' w Contact Person: Phone: Bonding Company: N A Address: s, Mortgage Lender: ry /1 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: 1 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 Qa xa ignature f owner/Agent Date rwt tnt aC MTKIrxi pa oa nt Owner/Agent's Name _�;` -3- W S n ur f Notary- ate of ida Da e Zm_a Wn�u�51o o Owner/Agent is /personally Known to Me or a Produced ID APPLICATION APPROVED BY: Bldg: (Initial & Date) Special Conditions: of Notary -State of Florida Date t -q L Date �C.ntractp�dAgentis-_-C_Pes..Known to Me or _ Produced ID Zoning: Utilities: FD: (Initial & Date) (Initial & Date) (Initial & Date) (� b ` oN c o x n r CD CD O cnv —^r <n cnoo O C)Q Z 111897 L=ED POWER OF ATTORNEY I hereby name and appoint of Date: (� 1 C-l�O(4 W1 J U) Y) to be my lawful attorney in fact to act for me and apply to C ;4 Ok for a V permit for work to be performed at a location described as: Section ' Township 2 Range Lot Block Subdivision (Address of Job) of Property and and to sign my name and do all things necessary to this appointment. Acknowledged: Sworn to and subscribed before me this I Day of Lnu A.D. Notary Public, State of Florida (Seal) My Commission C41 (7 JAC, Expire SHERRIE L. NICHOLSON Notary Public, State of Florida My comm. exp. Oct. 5, 2007 Comm. No. DO 255515 ilei W lid it iwl U Iwo R ULI U3 [SJ e 4x.1 :a r .1-1 . Permit Number_ Parcel Idenlificatlon Number jn&-,U-31- �Oy©olC) -yt30 NARyANW MORSE, CLERK OF CIRCUIT C11URT SEMINOLE COUNTY Prepared by: BK 05504 PG 1541 CLERK'S 4 2004170727 REWDED 11/04/2M 1207M RM Robert P. Way RECORDINt3 FEES 10.00 lay i REMRDED BY S O' Ke11ey (� P.O. BOX 95M 1 Return to: Laky Maq, Plovida 32795-082 � CERTIFIED CORY MARYANNE MORSE I CLERK 0 tP^UIT COURT SEM LE C FLORIDA' NOTICE OF COMMENCEMENT Bpi' ' UTY CLERK State of County of NOV 4 2004: The undersigned hereby gives notice that with Chapter 713, Florida Statutes, the fol 1. Description of prope ty (legal d 2. General description ofaprove 3. Owner Informatlor}, Name�oz,oc Nic e > Address l-vec� C 4. Fee Simple Title Holder (if other Name Address, 5. Contra for Name�?, Ccs} rc�c Address + C,�0g 6. Surety (if any) Name Address �- 7. Lender (if any) Name Address 8, Persons within the State of Florida served as provided by §713.13(1)( Name �...- Address 9. In addition to himself or herself, Ov provide in §713.13(1) b) lorida Namel�(4�:�a Address 10. Cxplratlon date of notice of com unless a different date is specified) it AlA"t% Date Signed Sworn to and subscribed before me this who is personally known to me 0 as identification. ,W Marceno Bailey -�My Commission IF dF Expires May 30, mprovement(s) will be made to certain real property, and in accordano Dwing information is provided in this Notice of Commencement, A k iteblh�,d�e�dd� s if availa-�jl``���� ncnt(s) 1-c /'d V'--( :�'D773 Telephone Number ACU 5 _ c)c) Fax Number Interest in Property. j, ,., �n l an owner shown above) ll Telephone Number Fax Number kC)" 60-�7Y'C-- Telephone Number /i cL& 0'(0 Fax Number 1-16) 7- 2419 -006 t �I � Telephone Number Fax Number Amount of bond 5 Telephone Number Fax Number designated by Owner upon whom notices or other documents may be 3)7., Florida Statutes, Telephone Number Fax Number ler designates the following to receive a copy of the Lienor's Notice tatutes. Telephone Number ci07 94-/ 7-37G� Fax Number /J, =1, nencement (the expiration dale is one year from the date of recordin, -jignatu're of owner [Notq: per §713.13(1)(g), "owner must sign ...and no one else may be permitted to sign it his or her stead," day of �%UZ� , 20_L by _produced �az,�g � �/ �c�.� Signalure of Nolary(notarial seal to a pear below)