HomeMy WebLinkAbout2216 Hartwell AvePermit #
Job Address: e1 14
Description of Work:
CITY OF SANFORD PERMIT APPLICATION
Date: I o7UO.S
Historic District: Zoning: value of Work: SY,010n. ne
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:
Construction Type: _ # of Stories: I # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
r /
Owners Name & Address: '34/V /Llli -1- ES a 2 14a h6ft h2Z /)Am
Phone:
Contractor Name AddreApza )Q & // lam 1%ot/ — /girl A-i ! _1 .
V. d State License Number:
Phone & Fax: Contact Person: ,SI%/%/G Phone: $U% -Z„ 7
Bonding Company:
Address:
Mortgage Leader:
Address:
Architect/Engineer: 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, then may be additional restrictions applicable to this property that may be found in the public records of
d there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
of p it is verification that M notify the owner of the property of the requircmen of Florida Lien Law, FS 13.
ignature of Owner/Agent Date na of Contractor/Agent Date
rint Owner/Agent's Name Print ctor/Agent's Name -
i ature of otary-State of o a Date Sigy tun otary-State o on a to
DEBBIE BLANTON
MY COMMISSION # DO ltiWiP
EXPIRES: February 25, WurnAgentis —_Personal] now` Me or J / , Con g kik Fe Ana Known to Me
roducedID 1. rl io'7 G% GYO'0 _ °'s xwantAswe•Co.
NM /
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APPLICATION APPROVED BY: Bldg O b oning: Utilities: FD:
initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:
6 %t'J
s1
THIS INSTRUMENT PREPARED BY.
NAME: Building, & Fire lnspect°oI
ADDRESS: d g ulm 1101 East 1" Stre
3 a+oK4 Sanford, FL 327:
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit No. Tax Folio No. (PID)
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter713, Florida Statutes, the following information is provided in this Notice of Commencement. /
OF PROPERTY (Legal description of theproperty and street address)yL T,7 /(a GENERAL
DESCREMON OF DMPROVEMENT „+ A
OWNER
kName
and address ' Interest
in property (Fee Simple, Pmtaership, etc.) er W! o
r NAME
AND ADDRESS OF FEE SIMPLE TITLE HOLDER (1F OTHER THAN OWNER) CONTRACTOR
Name
and addres . i
SURETY (Bonding Company) Name
and address Amount
of Bond Wmaw CMWT SENIMXE
COMM LENDER
BK 10155571 F`S 1361 Name
and address CL E RK a S 0 21IW5802976 RECW=
011SUM5 11i11%36 M py
PersonswithintheSateofFloridadesignatedbyOwneruponwhomnoticeorotherdoc=ea ti" I y Section 713.13(1)(a)7., Florida Saun=: Name
and address i#
t##iif###tilt!!##t;;#t#####ift##;#ff;#iiiitsi#•i#i##;#it;rt#;rt##i#####rtt######t#itt#i##tii•#is- Persons
within the State of Florida Designated by owner upon whom notice or other documents may be served as provided
by Section 713.13(lxa)7.,Florida Statutes: Name
and address: In
addition to himself, Owner Designates ° f To
receive a copy of the Lienor's Notice as Provided
in Section 713.13(1)(b), Florida Statutes. sii!•
slsill+ii#iiiiii;rt#i;iiiii##ii;;;i#i##;i;#i###rt+Y;#f#1F####ii#y[;####rt######;#f;rt#+R!##t##ii#f Expiration
Date of Notice of Commencement The
expiration date is I year from date of ret o unless a different e is specified.) Xo
a U /IE •-,do 5 Signature
01 owner Sworn
to and anbacnib ore me Day of • " a My
Commission Expires: ?• t'=_ vtary
Public ! "? s,''• The
fore instrument was before me this day of pro
ms1 -9 (Name of person acknowledged), who is p filly ]mown to me or who has Type
of identification). as i entification and who did/did not take