HomeMy WebLinkAbout2588 S Sanford AveZ'
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CITY OF SANFORD PERMIT APPLICATION
Permit #: (/J — / '^
Si4
9 l / / -
Date:
0JobAddress: c d dv v 110/ Si¢ • w 41/ w
Description of Work: z'I'L,
Historic District: Zoning: Value of Work: S DDidlo
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:
Of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: ('(Attach Proof off Ownership & Legal Description)
Owners Name & Address: i R'ei O s GIRitI a4 0 eJ. i{YJ /c1 E i i4sr//.CJ/
Phone:
Contractor Name & Address:
State License Number: ``
Phone & Fax: { Contact Person: ,j%C Phone: 70,7 - Z :>
Bonding Company: Ald
Address: '
r
Mortgage Lender:
Address-
Architect/Engineer:
Address:
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 permit is verification [ha
wfllQthvownorof
ope of the requirements of Florida Lien Law, F 713.
i to ofOwner/Agentate Si atu of Con traccttor/Agent Date
PjiuLDwrier/Agent's Na Pri tractor/Agent's Name
azure of Notary -State of Florid to Signature of Notary -State of Florida Date
sr
f BARBARA A SMATHERS DEBBIE BLANTON
r.: MY COMMISSION 11 DD 290611
eis(O'n ljpf fr IVv#1 t S W9tnegentis _ Pe Ily Kn EXPIRES: May 17, 2008 Co acto
EXpIgES: FebruaryroducedIDBalledThuNotaryPubkUndenwBeProdced 25, 2007
I-M MOTARY FL Notary Discount Assoc. Co.
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:
M
Tsy
i
Pennit Number
Parcel Identification Number
Prepared by: a jq t'ry, A,
sty,, -73. Retum
to: Si
irt NOTICE
OF COMMENCEMENT State
of--1021W,4COUnty
of morn\e WMW
WMWt CLERK OF CIRCUIT COLT SEMINOLE
COUNTY EIK
05599 P6 0191 CLERK'
S * 2005617116 RECORDED
WSUBM 89sES119 AM REWRDINS
FEES IlLee KMRDED
BY L "inity The
undersigned hereby gives notice that improvements) will be made to certain real property, and in accordance with
Chapter 713, Flvrida Statutes, the follorwing information is provided in this Notice of Commencement. l .
Description of property (legal description of the property, and street address if available) 2.
General descriptionof itnprwcmeot(s) g &— Poor 3,
owner Information Name
AgJZ i Lstf- (JSr'Q. /'—/V , elophone Number Address ' .
5/aI 1 0If /I UE ,ax Number Interest
in Property: 4.
Fee Simple T Ue Holder (if other than the owner shown above) Name //
Telephone Number Address
Fax Number Corttraclor
ltiameR///
A it ppi"r t/'tC• Address
i P s- w y 1VW 5r 54tvFV.-
2+3 W. Surety (
if any) Dame
Address
H
ir
Leader (if any) CERTIF
EVICORY-% MARYANNE
MORSE CL
RK OF, CIRCUIT COURT SEM
OLE COUNTY. FLORIDA 0EIRWY
tLE1 st
i ;
flF RR jjL
Y ` Ot'`` 20 tt1
Telephone
Number Yd % 3 A;? Fax
Number Telephone
Number Fax
Number Amount
of bond S Name
Telephone Number Address
Fax Number 8.
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served
as provided by J713.l3(I Xa)7.. Florida Statutes. Name
Telephone Number Address %
V % Fax Number 9.
in addition to himself or herself, Owner designates the fotloa9ng to receive a copy of the Lienor's Notice as provided
in §7)3.13(lxb), Florida Statues. Name
Telephone Number Address &/
Fax Number 10.
Expiration date of notice of commencement (the expiration date is one year from the date of recording unlcsc
a different date is specifiod):
Date
Sign S• nap a of Owner t 713.13 l s1 De+' 1 § (xg), "owner must
9 ...and no one else may be. permitted to sign in his
or her stead." Suvrn
to and subscri ed Wore 0 tthis who
is ,personally known to me as
identification. . roan
Rni-d: 30% day
of N . 20 _ b; 7)
Notary (
notarial seal must BARBARA
A. SMAI HERS MY
COMMISSION # DD 290611 EXPIRES:
May 17, 2008 m000k . •
P B Med 71uu Notary Public Ur4ernmsn
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
COMPANY: AVmAiv w -T;
SUBDIVISION:
PERMIT NO:
AFFIDAVIT
LICENSE NO: C.L° e— / 3 a &.(/ .S
PROJECT INFORMATION
ADDRESS: 426 d f7I/+
LOT:
1, k1 *"A&d1t C' 4(affiant, hereby affirm that I am the duly licensed contractor of record for the above reference
permit, tfiat all of the foregoing information is true and accurate, and that the dry -in, fleshings at the above referenced address/lot has
been installed in accordance with all applicable codes and standards.
CONTRACTOR: /, r o :,,
Printed name
STATE OF FLORIDA
COUNTY OF S!/m 6—V lE-
This instrument was acknowy gdged before me this / day of f4/'' , OS by the above referenced
individual, . `f l/MR-1'-' who acknowledged that he/she is a duly licensed contractor with
A? l I ft,4-" and who acknowledged that he/she was authorized to execute this document. He/she is
either personally known to ifie or produced as valid identification.
WITNESS my hand and official seal this day of r-e h O 1
Notary Public
Printed
My Col xpir
7DiscournMYCOMMI;;SIMI
EXP;RES: Fe7
1-800-3-WTARY FL Notary Co.