HomeMy WebLinkAbout3105 Rudder Cir (2)CITY OF SANFORD PERMIT APPLICATION
P` rmit PS -2 Date: _ I I "� • .
Job Address: 105 LL der Cl PCJ e—
Description of Work:
Historic District:
Zoning: TI.L" i Value of Work: $
Permit Type: Building t/ Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/AIteration 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 N/ Commercial Industrial Total Square Footage:I UQ4
Construction Type:tbW-b1K# of Stories: I # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 06 -X -.3
Owners Name & Address: 60—
Contractor
]
Contractor Name & Address:
(Attach Proof of Ownership & Legal Description)
Phone:
State License Number:
Phone & Fax:''`` Contact Person: Phone:
Bonding Company: R JA
Address: w
Mortgage Lender: N A
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 the property of the requirements o r _
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APPLICATION APPROVED BY: Bldg: Zoning: Utilities:
FD:
O -
(Initial & Date)
(Initial & Date) (Initial & Date)
(Initial & Date)
Special Conditions:
111897
LIMITED POWER OF ATTORNEY
I hereby name and appoint
of
Date: I1AL��C)u
7!7r, -O- to be my lawful attorney
in fact to act for me and apply to C'_ �V n for
a �P- C ue> permit for work to be performed
at a location described as: Section (L C, Township_ Range
Lot Block Subdivision
0
(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
L� Day of L2, V A.D.
Notary Public, State of Florida
(Seal)
My Commission
Expires G1/Vim",
SHERRIE L. WICHOLSON
Notary Public, State of Florida
My comm. exp. Oct. 5, 2007
Comm. No. DD 255515
Permit Number ;
Parcel Identification Number
., Prepared by:
PmPaM BY & &latrans 'T'rs:
rt P. Balky
P.O. Box 950521
Return to: t,Ww Mop, Florida 32195.1w'
MARYANNE MORSE, CLERK OF CIRCUIT COURT
SEMINOLE COMITY
BK 05504 PG 1543
CLERK'S #1 2004170719
RECORDED 11/04/2004 12:1757 PM
RECORDING FEES 10.00
RECORDED BY S O'Kelley
CERTIFIED COPY
MARYANNE MORSE
CLERK 0 CI COURT
SE OLE C U LORIDA
NOTICE OF COMMENCEMENT BY
pU
State of
NOV -- 4
County
The undersigned hereby gives notice that irnprovement(s) will be made to certain real properly, and in accordanc,
wilh Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement,
A R
1. Descriptio of property (Ie, @I descriplion'bf the prope and street address if av5ailable
�G:: G �� 2p5 `FCS'; �� e nl (� ' c3�P��� �Ci�s SGY,�osc� Ncr'�S�
(Os b f C� C c e
2. General description of Improvement(s)
3. Owner Information
Namef.j�ol��4,of Telephone Number LlD7 S g_S� qv0�
Address 1aC^U��6 c���J�,3X,)3��v\� '\?J�1 Fax Number
sGvo�c� �`( �%3 Interest in Property:
4. Fee Simple Title Holder (if other than owner shown above)
Name Telephone Number
Address Fax Number
5. Contrctor
Name .1e� Cco�S� rOCNiav� co �C— Telephone Number Yoh 3 L/9 -006 �
AddresS?n1(Dj Ci ;L)Fax Number
Luke r x-10 _3 e/�
6. Surety (if any) U 3 lots
Name j Telephone Number
Address �- Fax Number
Amount of bond S
7. Lender (if any)
Name Telephone Number
Address Fax Number
i
8. Persons within the State of Florida designated by Owner upon whom notices or other documents may be
served as provided by §713.13(1)(a)7., Florida Statutes.
NameAddress �— Telephone Number
Fax Number
9. In addition to himself or herself, OVI(ner designates the following to receive a copy of the Lienor's Notice ;
provid in §713,131)( Florida Statutes.
Aa dTelephone Number Ll0 �- 3YCl -CCG C
ddress ress �11�j� U Fax Number
10. Expiration date of notice o)commoncementthe expiration da
( p le is one year from the dale of recording
unless a different date is specified):
Dale Signed Signatur of Owner Noe: per§713.13(1)(8), "owner
must sign ..,and no one else may be permitted to sign ii
his or her stead, -,17- "4
Sworn to and subscribed beforg me chis day of , 20�_ by
who is personally known to me OR _produced
as identification.
Marcena BaWy
r My commission DD1 2J 61 Si nalure' of Nolary (notarial seal to appea elow)
oExpires May 30, 2006