HomeMy WebLinkAbout3880 Moores Station Rdi -
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CITY OF SANFORD PERMIT APPLICATION
Permit # : as " 3) V Date: 11-3-04
Job Address: ,3 80 Nkmee5 SVlbc. i do Read
Description of Work: FWIOICe .5rUr M 1100t'
Historic District: Zoning: RValue of Work: $ , �, o 0c)
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 — Residentialor Commercial
Occupancy Type: Residential V/ Commercial Industrial Total Square Footage: '30142.
Construction Type:lfitK # of Stories: I # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 04 ^ 2.0 - 31- 3 - 042. A " CX= (Attach Proof of Ownership & Legal Description)
Owners Name & Adddrresss,�ffiE
'� 'r G C
Fed Qael b `r Phone: 7g7
Contractor Naame & Address: Rn AQ ',A U Y\STY U C, Cw- C C> I V-1 C
3 So$�� �G\Cp ul lc►C n_] State License Number: C.C.C' C)S 7 0C)GI
Phone & Fax: w Contact Person: Phone:
Bonding Company: N A
Address:
Mortgage Lender: /A
Address: A
Architect/Engineer: N 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 1 will notify the owner of the property of the requirements of F a w, -FS 7-1-3---_
h PAo l 1.3- b+� `�
S nature Owner/Agent Date ature of C or gent Date
as Dtane rsws
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=a 1�'�et-Presider+tk n�' Admin�s�ra�iCn. SAA c s 1
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Ye int Owner/Agent's Name ractor/ t' ante
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Awnatu
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y i c S'gn ture of Notary -State of a D of Notary -State of Florida Date
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ZsOz Owner/Agent is
/personally Known to Me or Contractor/Agent ers�nown to Me or
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Vom _Produced ID _ Produced ID
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APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:
0
e
11I897
LEM TrED POWER OF ATTORNEY
Date: � � I L� l ot-I
I hereby name and appoint
of to be my lawful attorney
in fact to act for me and apply to of for
a j ,p - C C u T permit for work to be performed
at a location described as: Section Coq Township— Range C
Lot Block Subdivision
(Address of Job)
Dq' PU4 J\jI�
(Owner of Property and j
and to sign my name and do all things necessary to this appointment.
?� CC
(Type or Prin
jAm-uamfCWiffed4ontqctor =4 peense #)
Acknowledged:
Sworn to and subscribed before me this
y Day of tl 10 V A.D.
Notary Public, State of Florida
(Seal)
My Commission Expire L
—(/-
SHERRIE L. NICHOLSON
Notary Public, State of Florida
My comm. exp. Oct. 5, 2007
Comm. No. DD 255515
Permit Number_ ;
Parcel Identification Number 0q -2
Prepared by:
Prepared By & RAftrn
Robert P. Bailey
P.O. Box 950821
Lake Awry, Florida
Return lo:
NOTICE OF COMMENCEM
State of C-
C o u n ty
,County of � ry--\"Y,U\e,
neat to a� a atata >�t a ala at ala a a� a aai a taa � � � ea nil
Uu C)
NARypNNE MORSE, CLERK OF CIRCUIT COURT
SENINBLE CIAMTY
BK 05504 PG 1540
CLERK'S # 2004170716
RECORDED 11/04/004 18 1747 PH
RECORDING FEES 10.00
RECORDED BY S Q'Kelley
CERTIFIED COPY
MARYANNE MORSE
T CLER OF CIRCUIT COURT
INOL NTY, FLORIDA
BY lrY CLERK
The undersigned hereby gives notice that improvements) will be made to certain reaallnperNAag iA ccordana
with Chapter 713, Florida Statutes, the folliowing information is provided in this Notice of Commencement.
I R
1. Descript' ,n of , -property (I, gal descriplion'bf l rop y, and street address if available)
iw 'dame e �1 e ��
\-,
2.neral description of Improveinent(s)
�QCcr-)�
3. Owner Information
Name �6�6 (C ��ROWAJ
Address
4. Fee Simple Title Holder (if other
Name
Address
5. ContrK'A
Name C'D
AddresS? 0 -\�,o 0A S-0
5 if y)
l
6. Surety an �C
(
Name
Address
7. Lender (if any)
Name
Address
8. Persons within the Slate of Florida
served as provided by §713.13(1)(
Name
Address
9. In addition to himself or herself, 0,
providen §`713.13\(1)(b), F)orida
Name-. C��Jed
Addressr�A\j, C1�r
`C
10. Expiratlon dte YnoTlc���e of con
,unless a different date is specified
Date Signed
Sworn to and subscribed before me this
-
who is , personally known to me O
as identification.
PY Marcen
My Con
%C tidy Expires
04' I Telephone Number L(0 -T
3t� Fax Number
Interest in Property:
an owner shown above)
Telephone Number
Fax Number
w, C VC Telephone Number �--tC1- 3<-kC`.C)UCo C
'C& 0 -CL fu Fax Numberk,�U--1_ 3L1�� C) (D 5
Telephone Number
Fax Number
Amount of bond S
Telephone Number
Fax Number
designated by Owner upon whom notices or other documents ma; be
3)7., Florida Statutes.
Telephone Number
Fax Number
ier designates the following to receive a copy of the Lienor's Notice
tatutes.
Telephone Numberg07. 9,V-7-3 7CU,�-
Fax Number Z,,/U.7 31-1 oos
)n`cce-�ment (the expiration dale is one year from the date of recordin,
SignatuPe'-of Owner No(e: per §713—ffT-�F9-), °owner
must sign ...and no one else may be permitted to sign ii
his or her stead." t'ii�/l
day of �l1 e� , 20_L2_ -'l- by
_produced
Baaey /%/'✓i'o rte, /� _ /" .
iissionD0121781 Signature of Notary (nolarial seal to pp .ar belov.
ay 30, 2006