HomeMy WebLinkAbout114 Woodfield DrCITY OF SANFORD PERMIT APPLICATION
Permit # : O - 10(, r `
1/
Date- I -1 %- 0.6J
Job Address: I y W o0 4 1, e /d .b '
Description of Work: rC ro,% -F I n 3le S
0
Historic District: Zoning: Value of Work: S -5 000
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: J0 S
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FE A form required for other than X)
Parcel #:
T (
Attach Proof of Ownership & Legal Description)
Owners Name & Address: v I s iF be- b , !JP AD, -re
1 11 Y3 Y 4& 04 wotxP F (• 3 a 15 v Phone:
Contractor Name & Address: W ePK S P—w t I-r co .
l nl %iPr4 State License Number: E C d 0 a
Phone & Fax: Y01 bdu— a& k 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. 1 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 a lic
this county, and there may be additional permits required from other governmental entities soh as
Acceptance of pe verification that I will notify the owner of the property of the r
Si
l 1
re of Owner/Agent Date
Is L-..r o•-e
nt er/Agent' me
Si of otary-State f lorida Da
Owner/Agent is I fPersonally Known to Me or
Produced ID
APPLICATION APPROVED BY: Blgt .O ng:
Initial & Date)
Special Conditions:
to this property that may be found in the public records of
r management jlisttie% state agencies, or federal agencies.
of Florida Iliervt*, FS
I- lq-Ds
Date
e
Print—Contractor/Agent's Name
e.)1)
Signature - e f Florida Date
DEBBIE
BLANTJMyCOMMISSION # r,
Contract /A l*in tRPruQFNnYFt-! '-
Initial & Date)
Utilities:
4es
FD:
Initial & Date) (Initial & Date)
Lynn Jennings
COMMISSION # DMY
D201397 EXPIRES
May 11, 2007
h`' SONM THIU TROY FAM INSUWCE WC
FRCVM : HAROLD HODGES FAX NO. 4078629030 Oct. 27 2004 07:23PM .PI
THIS INSTRUMENT PREPARED 8Y.
NAME: Chris 1 g or e
ADDRESS:: /,a, Building & Fire Inspectio
T:
SuvotE Coutv7Y 1101 East 1 St StreTl.)Nl1.Mi \.1il:ltnl f.HCTIt7y"
Sanford, FL 327;
State of Florida NOTICE OF COMMENCEMENT .
Permit No. County of Semir ole
Tax Folio No. (FID)
The undersigned hereby gives notice that improvement will be made to certain teal713, Florida Statutes, the follow
p this Notice of
n real PrO and in accordance with Chapteringin#'ormation is provided in
nV cry rTD"r%%,T
L + S`5 OF PROPERTY (legal description o£the property and street address)
S?+-o tGultw tJ,l 1S+ 4dJ
GENERAL DESCRIPTION OF IMPROVEMENT
ov
OWNER INFORMATION
Name and address &.1(s 1v .r- 4 NAM-L , , 40o
Interest in property (Fee Simple,
tiI3 1 w >
1ARYAN1&
r aE • 0CIRCUIT COURTF l
Z 3 — VZ
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER, (IF pR,e,N OWNER)
Name and address
Wei k s
SXTRETY (Bonding Company) ..
Name and address
e,, - ._...rn_-
v..u, va arva{4 --
LENDER
Name and address /
N
oAs within the State of Florida designated by Owner upon whom notice or other113.13(1)(a)7., Florida Statutes:
Jame and address
IINDue UlUUl011W11111tDOW1®UW )112 , MARY>
9M NUR6t9 CLERK OF CIRCUIT COUNT SENINULE
CULWY BK
05583 PIS 0280 CLERK'
S # 218056168498 RECORDED
01/18/2M 11s36t37 AN as
provided by Section ersons
within the State of Florida Designated by Owner upon whom notice or other documents may be served as rovidedbySection713.13(1)(a)7.,Florida Statutes: lame
and address: i
addition to himself, Owner Designates of
rovided
in Section 713.13(1)(b) Florida Statutes. To receive a cOPY of the Lienor's Notice as xpiration
Date of Notice of Commencement he
expiration date is 1 year from date of recording unless a different date is specified.) 9
Signature`
o Ovmer and
s cribed before me this now of y
Commission Expires: Lynn 3enn'Ings ub
C +_ MY COMMISSION # DD207577 VMS May
11, 2007 BOND
RU TROY FAIN RiSURANCE WC ie
foregoing instrument was acknowledged before me this A"
o. n J day
o -i' Name
of person ackn wledged), who is >versonally (mown to me or who has oducedd
oath. (Type of identification), as identification and who di id not take
POWER OF ATTORINEY
Date /—/,1— 05
I hereby name and appoint 'tea IroLP 71oaiass of Weeks Roofing Company
to be my lawful attorney in fact to act for me and apply to the SAH f.-J
Building Department for a roofing permit and to sign my name and do all things necessary to this
appointment.
Property Owner's Name: hg, rc
Address of Property: /1'f wood-l-lel Jr
Legal Description:
1!
Margaret L. Pow , Roofing Contractor RC0029823
The foregoing instrument was ackrowledged before me this 1 '7 day of
20 0.5' , who is personally known to me.
State of Florida
County of bf4fdQf
Notary Public, State of Florida
Gail L. Fredna
J A
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: e ., 5 Ro X1 ilck CO, License #: PC D D 1419 a
1bv1 r
W%niev Sor, r T FL- 3a-) °t
Owner: A ovr if
name
11499 -Hwy 4 3q
address
phone
Project Information
Permit #:
Subdivision: L7 roVe Vl e zy 1 I (.",Sc Lot
M 51 I,
V4r G(I ROd24e5 , 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, an that th dry -in, flashings at the above referenced address or lot has been installed
in acc dance ith the amKcab1d`c-oatsand standards. Contractor:
printed
name STATE
OF FL O COUNTY
OF This
instrument was acknowledged before me this day of , 20 D-by the above
referenced individual, 110, r 0 1 d foal 5ej , who acknow edged that he/she is a duly
licensed contractor with LA) RtA 5 A"'w , and who acknowledged that he/
she was authorized to e e ute his document. He/she is either personally known to me or produced
FD L- &14 - -) Jd to as valid identification. WITNESS
my hand and seal this day of J Qa , 20O Notary
Public