HomeMy WebLinkAbout302 Beverly Ct (2)Permit # : 5
Job Address:
CITY OF SANFORD PERMIT APPLICATION
Date: 066 / !, / 6
Description of Work: ►` We a tJ s h NS ! el
Historic District: Zoning: Value of Work: S 0 v t s --o -�d
Permit Type: Building t Electrical Mechanical Plumbing Fire SpriuUer/Alann 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 #:
Owners Name & Address:
(Attach Proof of Ownership & Legal Description)
Phone: 7u / a;F C T, 4 r✓� /
Contractor Name & Address: JILL S 'f t+ 1-f' l- W K 1 ? e Qr fro f-- I IBJ <j
State License Number: C 6 ,' ! /
Phare & Fax: V6 1 (0 % Z �4 Contact Person: /a v�`� Phone:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address: Fax:
Application is hereby made to obtain a permit to do the work and 'installation 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 pennit, 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 requ;ntsFlorida nenLawFS713.
Signature of Owner/A t Date Sitractor/Agent Date
/Agent's Name Print 'orm actor/Agent's Name
dA4-dog /� _7-Q �/44�/N
JS� of Notary State of Florida D S e of Notary -State of Florida Date
��' Saundra ompson
a My Commission DD036543
dor wo�P Expires June 25, 2005
Owner/Agent is Personally Known to Me or
_ Produced ID
APPLICATION APPROVED BY: Bidga f /a h 1 d./) /LonjJng:
(Initial & Date)
Special Conditions:
t#IDEDEBBIE BLANTON
XPIA
COMM 1AHy f . or
ES: February25, 2007ARY FL Notary Discount Assoc. Co.
Utilities: FD:
(Initial & Date)
(Initial & Date) (Initial & Date)
Permit No.
State of Florida
County of Seminole
NOTICE OF COMMENCEMENT
Tax. Folio No.
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 provided in this Notice of Com c IMMENT PREPARED BY:
1. Description of property: (legal description of the property and street address if availabME
Ann >r �
2. General description of improvement: AA°6d
3. Owner information
a. Name and addresstr'�c�� civ a � r� ,> �? O 2- P jle e C, SF C%44(l7rx
b. Interest in property
c. Name and address of fee simple titleholder (if other than Owner)
4. Contractor
a. Name and address (_ (, 714 Tie U) Iq *r�e iC fit 6 f /.Al �
b. Phone number 0 ! 0 Fax number Z
5. Surety
a. Name and address ifBFi1FD
b. Phone number Fax number CtMK 7F CIRr 11T Qai
ya
c. Amount of bond SEi� E U
6. Lender
a. Name and address
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(1)(a)7., Florida Statutes:
a. Name and address
b. Phone number
8. , In addition to himself or herself, Owner designates
Fax number
Of
.13(1)(b), Florida Statutes. to receive a copy of the Lienor's Notice as provided in Section
713
a. Phone number Fax number
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different
date is specified)
,
Signature of Owner
Sworn 4 (or affirmed and subs 'bed before me this
a
Personally Known % OR Produced Identification
Type pf Identification Produced
/ day of /0�° ,200 ,by
I IN If 116 11 1111 11 661 11 111 11 111 1111111111 19 11 1111 1611
Votary Public 9tate o Florida
Expires: 5 e ►ce, Saundra L Thompson
VY 't
My Commission DD036543
pp Expires June 25, 2005
MARYANNE MORSE, CLERK OF CIRCUIT COURT
SEMINOLE COUNTY
BK 05475 PG 0648
CLERK'S # 2004135359
RECORDED 14/07/2004 11:40:04 AM
RECORDING FEES 10.40
RECORDED By t holden