HomeMy WebLinkAbout2410 Elm AveCiTY OF SANFORD PERMIT APPLICATION
Permit # : / / /
Job Address:
Description of
Historic Distr
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 #:
Owners Name & Address: (w r0 if !
igejahylo . F1 35-So9
Contractor Na & Address: `1w
eel , fJC1
Phone & Fax:=li Z 1
Bonding Company:
Address:
Mortgage Lender:
Address:
Arehitect/Eagineer.
Address:
Date:
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:
of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Attach Proof of Ownership & Legal Description)
V io Co e_e;,uz Dr-
State License Number: OZ
Contact Person: 4!5b 4L4_-4?U 571ANA00e: 101
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.
OTiC : 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 then; may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of permit is verification will notify the owner of the property of the requirements 9,f Florida Lien Law, FS 713.
3_pe
S er/ Date S' lure of ontractor/ ent Da
1 &H,+AJ S b A 04-e .a S i %Zfk 772:-P
PrifthOwner/Agent's Name ` ?
Q 5
Print Contractor/Agent's Name' Joy Flhid
on #DD330714
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1
0 + Signature of Notary-S is of Florida Pan+ Ift" Signature o tate of Florida j. `, RBonJu 20, 2008
1% 'P `
i•r p E
i•' OWi1Q/Agent is Per.n_nally Knnwn to Me or
Produced ID
y ..a
APPLICATION APPROVED BY: Bldg:
initial & Date)
Special Conditions:
0010W 1Z, 209Y
Contractor/Agent is _ Personally Known to Me or
Produced ID lZrr.44g,010, D l.$ X__ 1D/o
p
Zoning: Utilities: _
Initial & Date)
FURN
initial & Date) (initial & Date)
Al
POWER OF ATTORNEY
Date:
I hereby. name and appoint :S60/0 ppiee000
of A on'Si'QUC'i i O Seeur Ccs L to be my lawful attorney
in fact to act for me and apply to the -Se wi f,mo It CoU. Pj'Lk 4
Building Department for a permit
for work to be performed at a location described as:
Section Township Range Lot Block
Subdivision
2141 b rr 1 &el . 50J0ed
Address of Job)
ui lir. a1to Lo 2t?iru DeID 3 0 1
Owner of Property and Address)
and to sign my name and do all things necessary to this appointment.
a
Type or Print ame of dertified Contractor and Contractor's License Number
istn a of C& ied Contractor
The foregoing instrument was acknowledged before me this day of 20
by
who is personally known to me/who produced Ai"./ P74 G # C-Tr- 3 90 -760
as identification and who did not take oath.
State of Florida
County of
Notary lic, O ge County, Florida
JOY Farhid
TM •=Ommii6MD330714
20, 20p8BondedUri
awdW cb..
Seal
THIS INSTRUMENT PRE RED BY:
NAME: c-Mwn? Lhiei> i
ADDRESS: _ SEAIINOLE COUNTY
ILORIT..WS 14nn:wu CHOICr
Building & Fire Inspection
1101 East 1st Strei
Sanford, FL 3277
State of Florida
Permit No.
NOTICE OF COMMENCEMENT
Tax Folio No. (PID)
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.
DESCRIPTION OF PROPERTY (Legal description of the property and sheet address)
IIX
GENERAL DESCRIPTION OF IMPROVEMENT
NARYA" WWv CLW OF CIRCUIT COIRIT
WITII LE COMITY l
Q K 0n6 n Cif 189 CLERK'
S 20050_-4F.AP7 RECORDED
W0412M 89e51:12 AN OWNER
INFORMATION RECORDED BY L NcKialsy Name
and address hV_C- i N i 1 CERTIFIED COPY 2V
g MARYANNE MORSE Interest
in property (Fee Simple, Partnership, etc.) CLERK
IRCUIT COURT or
NAME
AND ADDRESS OF FEE SIMPLE TITLE HOLDER. (IF OTHER THAN OUENOWN CkgRj It MAP
fl A mor CONTRACTOR
am
address s6okWql oP
MJO i F BccD?8 (p SURETY (Bonding Company) Name
and address Amount
of Bond LENDER
Name
and address 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 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 .1--
of
To
receive a copy of the Lienor's Notice as 1,
vtd. in.gicction 713.13(1)(b), FloridaStatutes. iAatliovDate,
of Notice of Commencement t
gxjirikon gate is 1 year from date of recording unless a different date is specified.) Sifg_
na of Owner 44O
S_ rn
totand subscribed before me this Day of +ei ruCc E , My
Commission Expires: 77 dgar My
commission DD256M T.1f E*res ocww 12, 2oo7 Notary
Public S 711
e for instrument was acknowledged before me this day of u DOS by D
e oi! iui ICI rJ (Name of person acknowledged), who is personally kJngmaLtax=qr who has produced (
Type of identification), as identification and who did/did. not take and
oath.
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
WIRP License M
Project Information
o
Owner: (4) l ti C) WK) I (IN 5 Permit M C)S-/ 199
name
a-I 1 D I rr1 i . S • Subdivision:
address
c G y eq(n 7 I Lot #:
phone
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:
signature
6g
printed name
STATE OF FLORID
COUNTY OF
This instrument was acknowledged before me this _ day of rnG rc,k , 20 0-`by the
above referenced individual, , h pg., , N n , ; -a , , who acknowledged that he/she is a
duly licensed contractor with N A-? Co, s -'F- , and who acknowledged that
he/she was authorized to execute this document. He/she is either personally known to me or
produced IhN bS v- l4 • (p7lo- d foV _ as valid identification.
e/-p'I.I/IIIJ3 /
WITNESS my hand and seal this _ day of / C(/ , 20 61-
bk&
Notary Public
DEBBIE BLANTONQDMYCO&IN"ISSION # DD 186491
EXPIRES: February 25, 2007aRYFLNotDiscount °r Assoc. Co.