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HomeMy WebLinkAbout108 Hughes Avew Permit #: Job Address: 16 , Description of Work: Historic District: 00 Zoning: Permit Type: Building Electrical Electrical: New Service — # of AMPS CITY OF SANFORD PERMIT APPLICATION Date: OZ 2 9 © S r - Value of Work: $ 3sS neo , Mechanical Plumbing Fire Sprinkler/Alarm Pool _ 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: /3 %Q Construction Type: / # of Stories: 00' # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: Yl / f •'+ - Owners Name & Address: i / Attach Proof of Ownership & Legal Description) Phone: 9,7 I • a Ga 6 5'X G Contractor Name & A`ddress:.S tu f r Ce/r5ol%srs G9'y-Cf T.e. 9.Z % /ma nState License Number: QAW~ I%!C 9 72 Phone & Fax: .Z Contact Person: liii t>"tffaAv Phone: 4;017,10-11WI7— V/72 Bonding Company: Address: Mortgage Lender: Address: Architect/Eagineer: Phone: Address: 1-0— G 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 it is ve that I will notify the owner of the property of the require in Florida Lien Law, FS 713. iffi;catjon S of ner/eegntt(/ f Date Signature of Contractor/Agent Date Mture/ Jam^ i am n- of P2'- O gent's Name Print Contractor/Agent's Name A.--bs- Signature of Notary -State of .da Date Signature of Notary -State o rida Date Owner/Agent is _ Personally Known to Me or Produced ID j ZS0 - Z86--13'-Q2 i APPLICATION APPROVED BY: Bldg: Special Initial & Date) NOrry Pdft->;* 01 FWft Canlni tEON Dill; 28, 20 COmttl t # DD 38M 1ftd By Nalotlel k%" Atltlli. Contractor/Agent is Personally Known to Me or. Produced ID -qq l Oct4D f% Zoning: Utilities: FD: Initial & Date) (Initial &Date) (Initial & Date) 0 ., KATRiCf NICHOt.: +ALL0%VAN N; NOlan `rhlk :ate ut Fkrnda My commission EXDires Dec 28, 2M Commission # DD 382405 Bonded By National Notary An THIS INSTRUMENT PREPARED BY. NAME: X; / -r Ys,., r ADDRESS: State of Florida Permit No. SE1111NOLE COuwy nc uinas N.nn.iw„ ci r irT NOTICE OF COMMENCEMENT Building & Fire Inspectia 1101 East 1st Strt Sanford, FL 327 County of Seminole Tax Folio No. (PID)/ The undersigned hereby gives notice that improvement will be made to certain real ro ert and accordance with713, Florida Statutes, the following information is provided in this Notice of Commencement Chapter DESCRIPTION OF PROPERTY (Legal description of the property and street address) GENERAL DESCRIPTION OF IIMPROVEMENT OWNER INFORMATION Name and address 1 1 / T .F- _ - Interest in property (Fee Simple, Partnership, etc.) NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER. R. CONTRACTOR Name and address SURETY (Bonding Company) Name and address Amount of Bond LENDER Name and address Persons within the State of Florida designated by owner upon whom713.13(1)(a)7., Florida Statutes: Name and address- OTHER THAN 01 fill N I IDDIII IDBDllDDII MARYPAW S MINDtE-r.ett' CLERK OF CIRCUIT COURT BK -05577 p'G 0g56 CLERK'# S N 2(a05005676REOFM91/11/M 12s21r3 PN1EMODINBFEBmN RECURDED BY t holden or other documents may be served as provided by Section ersons within the State of Florida Designated by Owner upon whom notice or other documentsrovidedbySection713.13(1)(a)7.,Florida Statutes: may be served asJameandaddress: % t addition to himself, Owner Designates To receive a copy of the Lienor's Notice as of ovided in Section 713.13(1)(b), Florida Statutes. spiration Date of Notice of Commencement he expiration date is I year from date of recording unless a different date is specified.) n vwllar t ubscribed before me this / 1i3 Day of U a r My Commission Expires. ' D 00(o UTM D. CHACON ary c / COMOWSSION ! DD 169117 006ROR0TEFiBopEDn*0 EC j foregoing instrument was acknowledged before me this pA a""C°"'"AW J O day of duced ',A - Qum ofperson acknowledged), who is personal] _to me or who hasoath. (Type of identification), as identification and who did/did not take AFFIDAVIT REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS Company:License #: Owner:l%a / name phone Project Information Permit #: Subdivision: Lot #: I, , affiant, hereby affirm that I am the duly licensed contractor of record for the above referenced permit, that all the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address or lot has been installed in accordance with the applicable codes and standards. Contractor: signature printed name STATE OF FLO COUNTY OF JThisinstrumentwasacknowlededbeforethisdayof , 200 by the above referenced individual, r An-t , who acknowledged that he/she is a duly licensed contractor with and who acknowledged that he/she was authorized to execute this document. He/she is either personally known to me or produced as valid identification. WITNESS my hand and seal this day of Ja h , 2 S Notary Public DEBBIE BLANTON MY COMMISSION 8 DD 188491 EXPIRES: February 25, 2007 1.4MOO_ pTARY FL Notary DjxouM ASWC. Co.