HomeMy WebLinkAbout121 Tech Dr (2)CITY OF SANFORD PERMIT APPLICATION
Permit #: b - C) D, () Date: .430I aW -3'
Job Address: 1 Q I Te eh a- . Sajc)rd I F I a 1 Description
of Work: Soo 4MI4 3 t Sw%3 Pf I& L Historic
District: Zoning: Value of Work: $ co SDD 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: Mechanical
Plumbing Fire Sprinkler/Alarm Pool Addition/
Alteration Change of Service Temporary Pole Replacement
New (Duct Layout & Energy Calc. Required) of
Water & Sewer Lines # of Gas Lines Plumbing
Repair- Residential or Commercial Industrial
Total Square Footage: 13, (03T of
Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #:
aty -
19 - 30 - 5 5%6- oo o o - o ( tDQ (AUacb Proof of Ownership & Legal Description) Owners Name &
Address: 14ric i l5 --)use F ri t-n on Phone: Contractor
Name &
Address: Uoe, Et2_ cAr i PO BOX y L)ao CA r\,f: x C1 , F(- 3 a-n I State License
Number: G= n/ A 0/ 01 S 0 g Phone & Fax:
u - ;t - (oU -I Contact Person: nrt j Sru nS f Z- Phone: 3 a l - 303-5; ?Sr Boadisg Company: Address:
Mortgage Leader:
Address:
Architect/Engineer:
Address:
Pbooe: 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 mat 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:
1 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. TI : 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 verification
that I will notify the o er of the property of the requirements of Florid S 713. 3 3J O
a. O er Agent Date
S' ctor/Agent Date rci;:f V111f'C 44fm JIOA-v Yl 7- Print Owner/ ent'
s Name Print Contractor/Agent's Name j v /s .
3-,3)- O gnau= of Notary -
State of Florida Date Signature of N woiFJoti DFBBIE BLANTON l,
Nmds CsNNnsrn
MV COMMISSION # DD 188491 Owner/Agent is
wsonally Known to. A4 Cannnksion DDygpontrdctor/Ag t is ffS' x llylf&rtfflN j%2007 Produced ID sr
EtnDkas Produced 46UTNOTARY FL Notary D+scoum Assoc. Co. mbsr 14. 20W- v APPLICATION APPROVED BY:
Bldg:. N li :.L Zoning: Initial & Date) Special
Conditions: Initial &
Date) Utilities:
Initial & Date) (
Initial &
Date) 3tD
W..
NOTICE OF COMNfENCEMENT
PHIS INSTRUMENT PREPARED BY:
Permit No. NARAPG /r==cT/l c Tax Folio No.
State of Florida
County of Seminole AD R yoLo SA o !J7--7
IfFdR jza"Ili4 e
The undersigned hereby gives notice that improvemen 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: of the property and street address if available)
n I Par 1e,, P P> 33 P(-i C G) U ++,
2. General description of improvement: eLrc Tyr c*L-- ZWaN-
3. Owner information
a. Name and address U L3a-7
b. Interest in property
c. Name and address of fee simple titleholder (if other than Owner)
Contractor 9 % ?a M
a. Name and address LI.y e l e cA r ic_ o DUX (4 o go `1 n Ford (, FC. E3
47- In
b. Phone number Fax number
5. Surety
a. Name and address g
b. Phone number
c. Amount of bond
6. Lender
a. Name and address
Fax number a 210 tWn
I
Ile I
I
b. Phone number Fax number
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes:
a. Name and address
b. Phone number Fax number
8. In addition to himself or herself, Owner designates of
to 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)
ture of Own
Sworn to (or affirmed) and subscribed before me this 310 day of rA A (I-L W 20 O 7r , by
Personally Known CERTIFIED COPYORProducedIdentification .
Type of Identification Produced AVIARY ANNE MORSE
r OF CIRCUrIrT OUR
C FLORIDA
Signature of Notary Public, State of Florida
und. cM.nlh
y comn*Ww DD3r 8 DE U CL RK
Commission Expires: ExOm S'^aw 14. 2008 oMQR 3 2005