HomeMy WebLinkAbout210 Sanora Blvd (3)CITY OF SANFORD PERMIT APPLICATION
Permit # S-IgZ9
Job Address: 2/0 5,77,
Description of Work:
Historic District:
Date: -J 16
V,
Zoning: Value of Work: $ to 6o 6 Q, n e )
Permit Type: Building Electrical Mechanical V/ Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Servige Temporary Pole
Mechanical: Residential V 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
W17c-97
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other then X)
Parcel q: — — O (Attach Proof of Ownership & Legal Description)
Owners Name & ddress: ! O
Phone: —
Contractor Name & Address:
State License Number:
Phone & Fax: - - — Contact Person: - Phiae: y7=?22
Bonding Company:
Address: y
Mortgage Leader:
Address: '
ArcbitectlEngineer. Phone:
Address: 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 per it is verification that 1 will notify the owner of the property of the requirements of Florida Li 3.
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0 0 ^ p iSggnaturc of Owner/Agent Date Signature on tint Date o g
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o a o Print Owner/Agent's Name Print Contractor/Age is N e o, a
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Si turc of No • g tary-State of Florida Date Si store of Notary -State of Florida Date w yy
s:2 Owner/Agent is _ Personal y Known to Me or Contractor/Agent is V ersonally Known o Me or
Produced lD oc-j— 6;;Vp_Produced I -`l •
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APPLICATION APPROVED BY: Bldg: - Zoning: Utilities: FD:
Initial & Da 5 (initial & Date) (initial & Date) (Initial & Date)
Special Conditions:
rmosnamama=Emu mmnoun onISulIm Q
THIS
INSTRUMENT PREPARED BY: NAME/%% ,:,/
1-ZrADDR.
NM
M CLERK OF CIRCUIT CMIRT SEMINOLE
COUW BK
W5653 F*G 1595 CLERK'
S 0 21KI5045466 RECORDED
W18 .W- W 1211E'5 RM RECORDING
FEES I& M RECORDED
BY D Theen NOTICE
OF COMMENCEMENT STATE
OF FLORIDA TAX
FOLIO NO. o7D 1-,J GtSO.E00 - 038'0 PERAUT
NO. COUNTY
OF SEMINOLE The
UNDERSIGNED hereby gives notice that improvement will be made to certain and real property,
and in accordance with Chapter 713, Florida Statutes, the following information is provided
in this Notice of Commencement. DESCRIPTION
OF PROPERTY (Legal description and street address) L CAI Z: , 71 Al -le F Sann
ra I,Lis 1 + 0 lea p 2-I2-B11 -PG Q Q10 %n a, -,St /-?lyen/ General Description
of Improvement , -i P_ Xiir Ql i' env Jr,?&e774 li i' %rc3/ OWNER INFORMATION Name
and Address
Interest in Property (
Fed Simple, Partnership, etc.) NAME AND ADDRESS
OF FEE SIMPLE TITLEHOLDER (if other than owner) SURETY (Bonding Company)
Name and Address
CERTIFIED C06 r
Pi rRK
OF
CIRCUIT COURT Amount of Bond
SZtP LO RIUA LENDER
BY CLERK
Name and Address
MAR 16 2005
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 or to receive
a copy of Lienors Notice as provided in Section 713.13(2), (
b), Florida Statutes. Expiration Date of
Notice of Commencement . 2' 7 The expiration date
is 1 year from date of recording unless. a different date is specified.) SignaLre of Owner
Sworn to and
subscribed before me this day of YPv. Dlaria I.
Flores otary Public RL
25. 2DOS My Commission Expires a C ^ ,goo Od:S Bonded
ThrL Atlantic Bonding Co.. ILL , /
The foregoing instrument was
acknowledged before me this day of walle!? _ d 00c'- , by r
har l es e u I bt-- rfse)n (name of person acknowledged), who is personally known tome or who
has roduce .L Orl Ve/S ,Zx'ee"7S-r--- a of identifica+ion identification and who did (
did not) take an oath.