HomeMy WebLinkAbout1104 S Scott AveCITY OF SANFORD PERMIT APPLICATION
Permit #
Job Address: "04 S. 'Zic•4
Description of Work: Q6Q0,f-
Historic District: Zoning:
Date:
Value of Work: $ 413'4"'-
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:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:'
Owners Name.& Address:
i1 VA t • Sat va ' Atall Irv,
Contractor Name'& Address: i IvI-AU 'A •s c_
lPhoue-& Fax:- A*-7. bS7. S-M 407. LSIAA36 ,Contact Person: _
Bonding Company:
Address:
Mortgage Lender:
Address:
ArchitecUEngineer:
Address:
Attach Proof of Ownership & Legal Description)
Phone:--4o`1.44%..pl} G
IQK—
iteLicense , `N`umtier: U-G QA%'147 imta
li Uria. CC --Phnne- AQ 1 % II 47. 5`713 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. 1 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 applic this
county, and there may be additional permits required from other governmental entities such as of
Notary -State rfl
otify the 0"er of the property of the r (—
Date Flori
a Date r/
Agent is Z Personally Known to Me or roducedID
APPROVED
BY: Bl 10l 1Zoning: Initial &
Date Special
Conditions: Initial &
Date) that
may be found in the public records of districts,
state agencies, or federal agencies. H,
FS 13. I
1orE
65 n —
r- Date-- ' Noel
r Contractor/
Agent's Name DEBBIE
BLANTON MY
COMMISSION # DD 188491 a
ent gXPIRE MAJR Kr 2 o
I4ftittCffd/
1" ro:I1No1s'tSE:'6W-A°' 1l'-
l3.7 Utilities: Initial &
Date) FD:
iv /
S Date
orgydsa
o Initial &
Date) e:-
41ss
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: /Q• a • Muffik, Sbw%3 N c.
Ro.6-s A115
J Id a¢ RRW 'rL- 3Z-11 1-
Owner: gm4m ' bdyit
name
License M (AC OA'614 1
Project Information
11.4. S - ScA A 55*01;;00
address
4 a`1.4G a . 043t
phone
Permit M O5- 39
Subdivision:
LM-6:3
I, AND4w < Mae*A, 0- , 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 accordopce with the applicable codes and standards.
Contractor:
IA
printed name
STATE OF FLO A
COUNTY OF
This instrument was acknowledged before me this / 0 day of -4 , 20S by the
above referenced individual, Pa AcUrc.1,J 3 M ,.-_ r r Q.,,Tho acknowledged that he/she is a
duly licensed contractor with I , and w o acknavY ed that
he/she was authorized to execute this document. He/she is ei ersonally known to me or
produced as valid id ion.
WITNESS my hand and seal this )u day of V-Q h , 20o <-.
E BIE BLANTON
SION # DD 1aMolQD: February 25, 2007
Not°rY OiacouM Assoc. Co.
THIS NNSTRUMENT PREPARED BY:
NAME: M
ADDRESS: Z M
a+k r 3279-,
RxAvt, /- 1ipJ fllf ,
State of Florida
SEAUNOLE Coutay
nORIEVVs NAMM CNrlIf:E
NOTICE OF COMMENCEMENT
Building & Fire Inspectior
1101 East 1 st Stret
Sanford, FL 3277
County of Seminole
Permit No. Tax Folio No. (PID) 3p - / 9- 31- 5 a -7 - 0 000 - 0 P ;Lo
The undersigned hereby gives notice that improvement 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.
DESCRIPTION OF PROPERTY ( gal description of the property and street address)
404- S . Sr-O n S ri /'L. 3ZT1
I,Zz Mo. v CIr Se I 19
GENERAL DESCR/I PTION OF
OWNER INFORMATION
Name and address 15mn,s
K OF CIRCUIT COURT
CODUTY, RORIDA
w
Interest in properly (Fee Simple, Partnership, etc.)
NAME AND ADDKESS OF FEE SIMPLE TITLE HOLDER. (IF OTHER THAN OWNER)
CONTRACTOR
Name and address
SURETY (Bonding
Name and address
AT MLArr J S&4 1kc
P,o,q A15
I , . Pa.1t A% L 37,`19 U
MIARYANNE ICIRSE, Ct,ERit W CIRCUIT CWT
Amount of Bond BK 05590 PG 0958
CLERK'S # 2005012305
LENDER
REtxINUEU 61/2412M Wi57r51 PIA
RkUUNDINS FEES M60
Name and address RECORDED BY t holden
Persons within the State of Florida designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes:
Name and address
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as
provided by Section 713.13(1)(a)7.,Florida Statutes:
Name and address:
In addition to. himself, Owner Designates of'
To receive a copy of the Lienor's Notice as
Provided in Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement
The expiration date is 1 year from date of recording unless a different d-atcjs specified.) A
Signature of Owner
SW o t subs efore me this
tk)
Day ofkpLMyCommissionExpires: + alf
SHEILA NINTON
Notary Public, State of Florida
My Comm. expires Jan. 29, 2006
Notary Public No. DD087704
e foregoin ins e tt was acknowledged before me this 'Ch day of 2 tK by
S (Name of person acknowledged), who is pers nally known to me or who has
produced (Type of identification), as identification and who did/did not take
and oath.