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HomeMy WebLinkAbout126 W Woodland DrCITY OF SANFORD PERMIT APPLICATION Permit # : os— — 113 3 Date: Job Address: i zCo IAA • iA rso r- L—ta--i i Description of Work: R 03r ` - \ e,Q M'r-r, Historic District: Zoning: Value of Work: $ JA , f o 0 Permit Type: Building --%Z 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 #: 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 of Dwelling Units: Total Square Footage: Flood Zone: (FEMA form required for other than X) Attach Proof of Ownership &„Legal Description) Owners Name & Address: W L-JS Ea-c t-L. Ohl gt, LA0 A rJ• rJt,'C'I \.E /\1 M 1 ZCd V. • JliOo 4 L e.. ip S ANA t_p 3 2 Phone: AA Contractor Name & Address: Phone & Fax: Bonding Company: Address: Mortgage Lender: Address: Architect/ Engineer: Address: Contact Person: State License Number: 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 management districts, state agencies, or federal agencies. Acceptance of p .t .s verification that 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713. 1 — Oc Mgnaiure or OwnuTtAgent Date Signature of Contractor/Agent 8 Fs2 i t'Jul= O Print Owner/Agent's Name / Print Contractor/Agent's Name DEBBIE BLANTON MY COMMISSION N DD 18W1 Ws& lill i09Ar TARY FL Notery lhscoum Asaoe_ Ce APPLICATION APPROVED BY: Bldg: Date Date Signature of Notary -State of Florida Date Contractor/ Agent is _ Personally Known to Me or Produced ID Zoning: Initial & Date) (Initial & Date) Special Conditions: I Utilities: FD: Initial & Date) (Initial & Date) r.;:-. ,fie:, i. . .vts•:ac:.., M.,a,: r,` ,. yF, aP NOTICE OF COMMENCEMENT Permit No. State of Florida County of Seminole Tax Folio No. 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. i-1. Description of property: (legal des 'ption of the property and street address if available) tt0'ti'l E c zC- © 2. General description of improvement: 2 EM -, s CD ti 'A NJ\ s A e 2 e I 3. Owner information a. Name and address At_I5G;-cZ_1r 1_' r IN, rl b. Interest in property p of ti e=jS==_ C. Name and address of fee simple titleholder (if other than Owner) fl! Contractor a. Name and address Ct') Lk i to y b. Phone number Fax nub r 0550Z,1i L Surety CLERK'S it 2005O L 01 SO a. Name and address _ al=rnFM 01 /22/ MUM AN RECORDING FEES ILSO b. Phone number Fax nuAWWED BY L McKinley c. Amount of bond a- 6. Lender 1 l a. Name and address !; _ ,,, cS -r g -- I k'A S 1 • 1`,,r.r. s t Ai Z C'S 6 7(1 Z 1 '? (a 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 713.13( 1)(b), Florida Statutes. to receive a copy of the Lienor's Notice as provided in Section 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) e er Sworn to ( or affirmed) and subscribed before me this day of , 200n_ ' by A IPAL)). n 0 " CERTIFIED,_COPY Personally Known OR Produced Identification MARy..kNNF MORSE Type of Identification Produced E L ,4 s C " 5"S= ° S 3- a ' ' CLER OF CIRCUIT ,COURT SEMI LE COUNTY. , FLORIDA PHIS INST UMENT PREPARE .BY uTY ERK Signature of Notary Public, State of Florida BY: Co ire . NAME L3F 2-t Git,k7 t ZO ZOlhar DEBBIE BLANTON ADDR. U JaN MY COMMISSION # DD 1W91 4 1 VU 7 N EXPIRES: February 25, 2007 f7 t-SM3.140TARY FL Notary Discount Assoc. Co. T- 1 j