HomeMy WebLinkAbout117 Rabun Ct (3)CITY OF SANFORD PERMIT APPLICATION
Permit # : Os _
Job Address:
Description of Work: J /0 f Y/1 LX1 lyt-WC
Historic District: Zoning:
Permit Type: Building &,-- Electrical
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets _
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
Parcel 0:
Owners Name & Address:
Address:
Date: ! / l 76 c? 0 2(X/
Value of Work:
Mechanical Plumbing Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Ca1c. Required)
of Water & Sewer Lines # of Gas Lines
Plumbing Repair— Residential or Commercial
Industrial Total Square Footage:a %
of Dwelling Units: Flood Zone: (FEMA form required for other tban X)
of Ownership & Legal
Mortgage Lender: &Pf
Address:
ArchiteeVEngineer: Pbooe:
Address: Fa::
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 mast 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 time may be additional permits required from other govemmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of IZZ fication that I will no a owner of the property of the requirements I ride Lien Law FS 713.
Vvv 3 z 1(o 3 GJ
ignature of Owner/Agent Date Signature of Contractor/Agee Date
6
t er/Agent's N Print Contractor/Agent's Name
Signature of Notary -State of Florida
F
Nate Signature of Notary -State of Florida Date
f;•
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ppZ57
tktobar 30, 200T
Owner/Agent is _Personally Svie
Produced ID
APPLICATION APPROVED BY: BldA--I- C a
Initial & Date)
DEBBIE BLANTON
Con c Y CO6Pdietitfati}MCB6w6ttoM
EXPIRES: Februa 25 2
r-o0.3-NOTARY FL Notary Dhsmura Assoc. Co.
Initial & Date)
Utilities: FD:
Initial & Nate) (Initial & Date)
Special Conditions:
E I
C.0
Y i•!JflNOTICEOFCOMMENCEMENT
Permit No. Tax Folio No. y
State of Florida
County of Seminole
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.
1. Des i `etion off operty: legal description of the property and street address if avail 1
jj '
IFI
2. General description of improvement: - Vr *1 Uawac .1AV.RR04ANE MO
3. Owner information
a. Name and address V2 Ta r) +Y ex Z*`G
b. Interest in propeity _
c. Name and address of fee simple titleholder (if other than Owner)
2005
4. Contractor
La. Name and addr ss S l
e
Phone number `f - Fax number 540 7 -- 5Y T
Surety loitllAlfl A 1BIAAAB1iBBBiA BBlBiliil®
a. Name and address
b. Phone number Fax n
L-
c. Amount of bond nWrMSF,59 for- 17--21 1
6. Lender CLERK' S 0 2065848,488
a. Name and address P1 RMORDED WUPRIP M M AW3 DN
REMMINE FEES 10.00
b. Phone number Fax nMdKBiDED BY L McKinley
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713. 1(7.: Florida Statutes:
a. Name and address
b. Phone number Fax number
8. In addition to himself or herself, Owner designates of
receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes.
a. Phone number Fax number
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different
date is specified)
Signature weer
worn to or affume_dj and bscnbed before me ffiLCV day of GL , 20 &- — , by
Pi i rC A7 J .
Personally Known OR Produced Identification
IlypeLIdentificatio
Produced
Bwbwe Fedd
My mnMwior, D0257263
M Expires OmW 30, 2007
Signature of Notary Public, State of Florida HIS INSTRUMENT PREPARED BY:
Commission Expires: NAME 'lk7p'
ADDR. per,. rvL!5!t 70
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: Szk&A e. r 1 `IP% License #: C c-00(/7%s
Cfo - PL_
ccnw Le 37o7. r
Sheer Information
Owner:
IJ o"ra r Sheer Permit #: name
7
Att{r C, wrf: Subdivision: paddress
qg7 - Cad B - ? oah Lot #: phone
I,
J Vtlefl M t 00(/ , 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:
Z" &A sipatu
a(
d/ Mf,I)eK printed name
STATE OF
FLORID COUNTY OF
This instrument
was acknowledged before me this oP day of %ham , 2 by the above referenced
individual, , 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 F171,:-
P, !p - 31 11- f ) I as valid identification. WITNESS my
hand and seal this c) ' day of LC1 ' , 200 S' 5.= 1
Notary Public
DEBBIE BLANTON
Z MYCOMMISSION # DO 1 M%91 EXPIRES: February
25. 2OU7 I-M3-
NOTARY FL NoWy Dismxvt Assoc. Co.