HomeMy WebLinkAbout101 Stone Hedge Cti, rR
Permit # : 0 S
Job Address: INlI
Description of Work:
Historic District:
i
CITY OF SANFORD PERMIT APPLICATION
2LDate:
la C6u +,Sa vA4, Ftr
Zoning: Value of Work: S lD"jfl Oa
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: —r'z= 0
Construction Type: 1 # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 0 _-2_L:1-
Owners Name & Address:
Contractor Name & Addr,
61
Phone & Fax:
Bonding Company: _
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
So 1- 0oo o- 15o, (Attach Proof of Ownership & Legal Description)
Phone: vIT
Nwt, Vic• is 7
State License Number: doe O S''2) 1/
p gagContactPerson:Q1•I
1-Fa_ NJ aA,5 Phone: 7 77T-a Oc g Phone: 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. N TICE:
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
it is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. Npafure of
Owner/Agent Date Signature of Contractor/Agent Date D na,
YYI D IrI I -= e_ C.I j c` Print Owner/
Agent's Na Prin ontractor/Agent's Name Sit Date
Signature of Notary -State of Florida Date p w
Expires June 19, ZOt)8 EBBIE BLANTON
Owner/Agent
is Pliy Known qWe or Produced ID N
4Jt.Q rr,,,, ,, APPLICATION APPROVED
BY:
Bldi;Q^ Qt h 01 L3) 6ng: Initial & Date) Special
Conditions: D
Con ct
smy
C 9PI1n9Qnt1 l l1 p EXPIRES: Februay 25.
2W7 1 •e00_3-
NOTARY FL Notary DwOuM AMC- GO - Initial & Date) Utilities:
FD: Initial &
Date) (Initial &
Date)
POWER OF ATTORNEY
Date: P - 1-0 5
I hereby name and appoint ,l`Q,v,,e-- C.C. Qa e ,5 of
NAAS WORK, INC. to be my lawful attorney in fact to act for me and apply to the
Clb p—<4LAX%t-a Building Department for a Roofing Permit
for work to be performed at a location described as:
Parcel No.: 33- \Q-v- 50- 000O-
Legal Description:
6+ 1501 Ak&-;-A1Ar caS. P%e- a- P\cv+
Pota,e,sssIro
Address of Job:
I'D 15i QnP_%1edfig eDV-r%
r
SQc v-'ar-6 FL
Owner of Property and Address:
0nA,ma e GO12n.1101 -e-*On9-he e.COv- Sa n-qvrd 1=L
and to sign my name and do all things necessary to this appointment.
Patrick G. Naas #CCC057818
Name of Certified Contractor nd Contractor's License Number
gnature of Certified Contractor
State of Florid
County of
The foregoing instrument was acknowledged before me this ZV day of
2005 by PATRICK G. NAAS who is personally known to
mekoroduced 0 as identification and who did
not take oath.
cs O
No y ublic - State of Flori
My rommission Expires:
L -* '°r°° w. m
V- oft"
n DD31405
J ur* 10, 20 v
4ermit ivumoer
Parcel Identification ' "
1 S
Number
Prepared b DIaaa P
y.gl5lt)eS-rc`t "ws 6+reefi vu
r te sP vc s r-•3a Rctum
to: q1S Oee-t, C j1-ru 5 Street 4a.
nt S Pam nos 3 1 SF NOTICE
OF COMMENCEMENT State
of not % C, County
of Sevin: nA le - HE
HWSE, CLERK W CIRCUIT CGUiT QLE
CGUM 05598
PS 0750 RK'
S 0 E 105616666 W
D 81/31/ 81:18:3'S PIO WINS
FEES 14.0 WB
8Y D Thomas IN
coe'
CRC
PLANE01 M
o R CXV- ,
t, E • EQK
The
undersigned hereby gives notice that improvement(s) will be made to certain real property, and in accordance; with
Chapter 713, Florida Statutes, the following information is provided in this Notice ofCommencement, 1. Description
of propertylegal description of the property, and street'address if available) a. (-O - 1501, =
ee; YID ea
Los,
P I-d6e a , P lad [3vo 3 a, Pag 55 1A-Td r
e5S : 161 5me COLL r-t) 59^b r48 ,.1=L pc c el *
33- 19-30- 5bq- 00o0- 15o ) 2. Genernl description
of improvement(s) 3• Owner information
Name ('O11ct,,r -
2—e— 5okon Telephone Number 40---)-D-1-g0/`F Address 10 1
fA60e huge- C-OLCI t-Fa.x Number a3a,KPmv4, FL
Interest in Property. 4, Fee Simple
Title Molder (if other than the owner shown above) Name Telephone Number
Address Fax Number
Contractor 6 1 /
Nae
7 ! Nam pa, Address41SWe
C'` S rF A- [- 4-c,vtwv *e riOfi Surety (if any) Name
Address Telephone Number7''
Fax
Number
t4D7--7'-(-
5)3a- Telephone Number Fax Number
Amount of
bond S_
7. Lender (if any)
Name Telephone Number Address
Fax Number 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. Name Telephone Number Address
Fax Number 9.
In addition to
himself.or herself, Owner designates the following to receive a. copy of the Lienor's Notice as provided in §713.13(
1)(b), Florida Statutes. Name Telephone Number Address
Fax Number 10.
Expiration date of
notice of commencement (the expiration date is one year from the date of recording unless a different date
is specified): Date Signed Signature
of
Owner (Note: per §713.13(1)(g), "owner must sign ...and no
one else may be permitted to sign in his or her stead."
to and subscribed before
me this a'Z day of J0,LQ .h t . 2005 by who is _personally known
to me OR as i d cn
ti fi cation. oAM a was 1
c2 iu e, e QN4.0-m c°
nmre0000setoSignature
of
Notary (
notarial seal must appear below). e a 3air mf400)4324IMi FlOitda Notary Assn...0form
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