HomeMy WebLinkAbout1101 13 Str-
Permit #
SJobAddress: If L Z-,> r
Description of Work:
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
Value of Work:
Date:
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS
Mechanical: Residential Non -Residential _
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
of Water & Sewer Lines # of Gas Lines
Industrial
Construction Type: /_ # of Stories: # of Dwelling Units:
Parcel M
Owners Name & Address:
Plumbing Repair - Residential or Commercial
Total Square Footage: t,3
Flood Zone: (FEMA form required for other than X)
Attach PfDotf`Ownership & Legal Description) Phone:
Contractor
Name & Address: KILL-A1'I21V-LL Y (?,prJ 1-r-r -Crane S State
License Number: e e C C7S S Phone & Fax:
O7. -q 6C GG / Contact Person: (:; Phone: Bonding Company:
Address: Mortgage
Lender:
Address: Architect/
Engineer:
Address: 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. 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 managemen4stricts, state agencies, or federal agencies. Acceptance of
permit is verification)at
I
will ctify the owner of the property of the requirements fi E w, FS 713. Z Z-
Si ature
of Owner/A t Date Signa Nre f ontra cttor/Agent Date Print er/
Agent's Name Prix Print
Contractor/
Agent's Name Signature of
o GEORGE BRIDGES,
JR.'I Si
Date
T'9La191y-
COMMISSION # DD
013?'2 DEBBIE BLANTON XPIRES: June
12. ?005 MY COMMISSION# DD 1SM1 Owner/Agent
is Known to Me or _ Cor Tac t is 5Perf8>3'd1iyM ElNaor p
O
llk -
t7 Produced ID Pr•VN0ap1pyoAPPLICATIONAPPROVEDBY:
Bldg:
Initial & Date) Special Conditions:
3 C/
107 Zoning:
Initial &
Date)
Utilities:
FD:
Initial & Date) (
Initial & Date)
111897
LD=D POWER OF ATTORNEY
I hereby name and appoint
PH
Dau- V .
to be my lawful attomey
in fact to act for me) and apply to for
a - permit for work to be performed
at a location described as: Section Township_____ Range
Lot Block Subdivision
Address of Job)
Owner ofhWaty and Address)
and to sign my name and do all things.necessary to this appoin
rrvpe or Print name of Certified contractor and Licm !
COWTaCwt)
Ac)mowledged:
Sworn to ccantehd subscribed before me this
Day of 6 t:>-cam. A.D.
Notmy Public, State of Florida Q
Seal)
My Commission Expires:
Shv " D. Leonard
MY Commission DD271431
w Expires Decemoer 19. 2007
11111111111 DIED 11111111011110 111111WD®11i111311
Permit Number
Parcel Identification Number
Prepared By: _ ocq-
c.1
V.AV-<->
Return to:
t ht l 4,r : •ham -
NOTICE OF COMMENCEMENT
State of--Flerida -
County of -Semi-tole--_
MARYANNE MORSEL CLERK W CIRCUIT COURT
SEMINOLE COUNTY
BK 05607 FIG 0858
CLERK'S 0 2005021869
RECORDED @E/@9/ceM 1112sleg AM
RECORDING FEES I& W
RECORDED BY L McKinley
k cERTIFIEGl.
MARYANNE IVIORSE
CLERK- F. CIRCUIT COURT
EMINOLE OUNTY. FLORI[
ov
FEB
The undersigned hereby gives notice that improvements) will be made to certain real property, and In accordance with
Chapter 713, Florida Statutes, the following information Is provided in this Notice of Commencement.
1. Description of property: (legal description of property, and street address if available)
Church Building
1101 13th St. Sanford, Fla
2. General description of Improvement(s)
3. Owner Information
Name Full Deliverance Church of Jesus
Address 1101 13th St.
Sanford, -Fla.
4. Fee Simple Title Holder (if other than owner shown above)
Name
Address
K ll Pn"j-CColxUctck&S
5. Contractor-
j S ;)r 1 - C---'
NameR S
Address
6. Surety (if any)
Name- N/A
Address
7. Lender (if any)
Name N/A
Address
Telephone Number
Fax Number
Interest in Property
Telephone Number
Fax Number
407) 843-8129
Telephone Number or).
Fax Number
Telephone Number
Fax Number
Amount of bond i
Telephone Number
Fax Number
8. Persons within the State of Florida designated by Owner upon whom notices or other documents may be
served as provided by Section 713.13(a)7., Florida Statutes.
Name Telephone Number
Address
N/A Fax Number
i
9. In addition to himself or herself, Owner designates the following to.receive a copy of the Lienor's Notice as
provided in Section 713.13(1)(b), Florida Statutes.
Name Telephone Number
Address Fax Number
10. Expiration date of notice of commencement (the expiration date Is 1 year from the date of recording unless a
differer date is ecified):
4 o
Da Signed Signature of Owner [Note: er Section 713.1 (1)(gj, "owner must
sign ...and no one else may be permitted to sign in his or her
stead.")
Swnto and subscribed before me this day of Ftbr=N, 20 by
i r% A _ lJ li n- I—--
who is personally known to me OR produce
as identification.
Signature of Notary (notari seal to appear below)
Form Revised: 3198
TAWNYA YVERE BM
MY COMMISSION 4 DD IM2
y EXPIRES: August 3, 2006
Bmded 71vu NOW PuW UndwmftM