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HomeMy WebLinkAbout251 W 1 St (3)CITY OF SANFORD PERMIT APPLICATION Permit Date: JO -- Job Address: 2 5 / W es S— ; -S+ Se60s-1 }'-L Description of Work: :j�e-'Iac v\s frasc�a, �v-h4E-Ws ctn'k- Orb x.'14 Historic District: Zoning: Value of Work: $ 10, oco ' Permit Type: Building i/ 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: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: (Attach Proof of Ownership & Legal Description) Owners Name & Address: ck n C'O C i r -e e ` u "A{? IOC C -tr a,-, 8 c) err 3 a' I q I Phone: �40) 370 " 7.5 )- Name Contractor Nae & Address: cc S} EE � tJ t3`sq. ") C /� 0 1.0 n5Y s U C4;0#') Cc s x' CCZA ,. O r'1 • O r,o X 16 8 4 f A tica mUigeS,�s 'nc�i5 tI 3X?16 State License Number: CCG 150 215 Phone &(& (k)) 4-(4 Contact Person: 1 qtr e Phone: (41) 9--3 --Q'51'2 Bonding Company: r1 -D 1 o Address: Mortgage Lender: Address: Architect/Engineer: /a Y G Id ; 1C c �S n ;L%-+ tit -5 h -? Phone: C4-0-)) - l /17 Address: ICJ$ Wlyno-re -P8. cu tn4e! EL :5 - >?9 Fax: C/+Cl) AoZ9— /17% 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 pe r verification that I will notify the owner of the property of the requirements soof Florida Lien Law, FS 713. b A) ci/ o 04 Si ature of Owner/A ant Date Signature of Contractor/Agent Date D err✓� �/o�a\� 0 oti e P ' ner%1e is Nam / e Print Contractw/Agent's Name Of Owner/Agent is _Personally Known Produced ID APPLICATION APPROVED BY: Bldg: Special Conditions: ry-State of 7Notary A A. RODRIGUEZ blic - State of Florida cion Expires 17, 2005 ssion# 6M"*r/Ag t isyPei National Nata9tww D wpqw Zoning: Utilities: .�`rjivv'••, Date KATIUSKA DURAN s Notary Public - State of Florida My Commission Bpres May 17,20M Commission 0 DO 103188 ,WMeWnded By National Notary Assn. FD: & Date) (Initial & Date) (Initial & Date) (Initial & Date) 111897 LIMITED POWER OF ATTORNEY I hereby name and appoint �o a\ �o 1©C k'e � i t n ,� ► r . of (ZLS Date: - /3 - boa 4 22 Cf f q2 . to be my lawful attorney in fact to act for me and apply to G y o f Sa ki ffo v -a for a�e - I�oo �;g --�e?)Aa '1 g quN e <5 4 Las G q permit for work to be performed at a location described as: Section Township Range Lot Block Subdivision ,�S 1 Sl re e4 , Sar, Z, 3c,2 (Address of Job) 30' n oo ?0-Pv %air $5 3 omMo lj; 4y cl r c I e (Owner of Property and Address) e iOO 0,r �nJo , j Lad -?t9 and to. sign my name and do all things necessary to this appointment -a-A ocj (Type or Print name of Certified Contractor and License #) (Signature of Certified Contractor) Acknowledged: Sworn to and subscribed before me this Day of — A.D. Q) Notary Public, State of Florida „��" ;., MARIA P. FRANOO MY COMMISSION # DD 032822 a EXPIRES: June 11, 2005 (Seal) Bonded ThN Nohry Publ c Undenvr Nro My Commi csion gpires. W, F-- ' -- ' w i - Euu-r 1-? - -36 "r mum; PernftNo. State of Florida C. OuLaty. Of Seminole T0-'914073707770 P. 002/004 A�OTTCE opC, , ONIMNCEMENT Tax Folio No, The Undersigned hereby Sim noVLC0jhatiW0Y=29*tVW*0muck to em -Wit real property, and in accordancc, with Chapter 713, Florida Statutes; thewbg if, this Notice of CGnunencemeat. 1. DescTiption of property. (loW deact0fion of tbVpVp0t► and street address if avOable) 3c2 411 -4. 2, General description of improve=nt" 3. QvenerinforWAtida a. Name and adOess, 6C.0 c, b. Interest in property 4z. Name and ed 4. Contractor '31 Name and address Phone, ntunber S.— Surety a. Name. and address — Fax number -f y Al=!4fiz b. Phone number FIX nMMWRYANNE WIRSE. CLERK OF CIRCUIT CWRI c. Amount of bond SEMINOLE COWY 6. Mader BK 05451 PG 1100 a. Name and address CLERK'S # 2004142945 IRVE0 W9nV/Fft4 W-? 24 155 PN , DINB FEFS IW b. Phone number Fax jjjjr&AF"J'1 K 7. Persons within the Stag of FjorkkF ai;qp*d,by n.whom nabccs FOROM&C be served as provided by Section F! rovi A. Name and Aftess b. Phone number Fax U=rAW S. Inadditionto himself or bault, qw=,agr4pgdc-q of wfteiva a copy ref the Lienor'sNotice as provided in Section 713.13(l)(b), Florida Ste.. a. Phone number Fax number 9. F-xpiration date of notice of d;ft is I year from the date of recardiftS unless 9, different date is specified) Signature of 0W= Sworn to (or affirmed) and $qbscnW J*fore, e /Z../ cq 7�", 4by of 20' a/ �y PmmllyKnawnXCa, Type of Hfication Produced. 4P 4,41" MWU S So" P 1,6 My CommWW DDOM19 WIARY,ANN-E IWORSE Signature of ataxy Public t ���res, FebmarY 10, 2006 GLERX OF CIRCUIT 001_q r4 Covirnissiot Expires. 1,9 -0&'THIS INSTRUMENT PREPARED BY: afth NAME: ADDR. SEP: 1 42004 WATERFROff GATEMY t�� CITY OF SANFORD HISTORIC PRESER VA TION BOARD APPLICATION FOR A CER TIFI CA TE OF APPR OPRIA TENESS P.O. Boz 1788, Sanford, FL 32772-1788 Phone: 407 330-5672 Fax: 407 330-5679 In addition to a Certificate of Appropriateness, a building permit may be required. Check with the Building Department. 407 330-5660. A Certificate of Appropriateness may be required for projects that do not require a building permit. i ms L ernncate must ne prom 1. General Information on the building when work is in pro Property Owner: &loco Y n OL .a-- Property Address: A- ZI '> Vee 3l� Mailing Address: J l.Om/n ,.r.c UXoPhone Number: d dG'n `3,2 61 `/ Fax Number: Agent: C62)tlo &4,44o ��tS 1' �Q Phone Number: Address: CO3 4r* 64,,-t S1,,-,, f Fax Number: Downtown Commercial Historic District: ❑ Residential Historic District: ❑ This application is filed in response to a notice from the Code Enforcement Department certify that all information contained in this application is true and accurate to the best of my knowledge. Applicant: Date: Owner: Date: Please use the attached criteria checklist as a guide to completing the application. Incomplete applications cannot be reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at 407 330-5672 to make sure your application is complete. A Certificate of Appropriateness is valid for six months unless otherwise noted OFFICIAL USE ONLY Historic Preservation Board Meeting Date: Staff Review Date: Application is Approved Approved with Conditions Conditions: Signed: (V-� Date' R/ lIo l F:\SHA_ENGUHistoric Preservation Board\# Certificate of Appropriateness. doc I . Denied 2. Description of Proposed Work Application Category: (Check all that apply) ❑ Site Improvements/driveway/walkway ❑ Storage shed ❑ Moving structures ❑ Replacement windows or doors ❑ Underskirting ❑ Awnings ❑ New construction/additions ❑ Signs ❑ Demolition "oofs/gutters/downspouts ❑ AC/Mechanical ❑ Fences/Gates/Pergolas ❑ Replacement siding/flooring/porch Paint ❑ Other Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building, where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is recommended. Attach additional pages if necessary. ( \ 3. Documentation: In order to be reviewed by either the staff or the Historic Preservation Board, applications must be complete. The documentation listed below must be submitted with the application form. 11 copies of all drawings larger than 11" X 17" and 1 1 copies of all photos must be submitted. Paint: Color samples of all colors must be submitted. Fences/Gates/Pergolas/ Sheds: • A site plan of the property showing the location of the fence, gates and/or pergola. The plan must show the property's dimensions. • A picture of the proposed structure. This can be an elevation drawing, sketch, brochure or photo of an existing shed, fence, gate or pergola provided that the dimensions are included. • A description of the materials that will be used in the project. • Photos of the yard(s) in which the structure will be placed. (11 copies of each photo must be submitted). New construction/additions • Elevation drawings to scale of each facade indicating proposed alterations or additions. Drawing must clearly depict the existing building and the proposed changes. • Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed addition, location of all exterior ground and roof mounted equipment.. • Description and/or samples of materials to be used. • Where applicable, drawings and site plan of other improvements such as fences, walkways, lighting, decks, etc. • Photos (11) of existing structure. Awnings/ Signs • Sketch or elevation drawing of the building facade with proposed sign/awning. • Dimensioned drawing of awning/sign. • Sample of colors. Site Improvements/driveway/walkway/AC/Mechanical Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed improvements. Description and/or samples of materials to be used. Note: AC/Mechanical equipment must be screened by shrubs. FASHA ENG\Historic Preservation Board\ -Certificate of ADoroariateness.doc 2.