HomeMy WebLinkAbout2789 Flightline AvePermit # : 0S- k A(
Job Address: 2 1 4bel F
Description of Work:' Ken- GFV 1
Historic District: 1110 Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date:
umcane 68,mA,-e PA
Value of Work: S ? 000--
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool _
tv Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
N A` Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
A' 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: UON) WOOF
Construction Type: tN 5# of Stories: 1 # of Dwelling Units: 1 Flood Zone: (FEMA form required for other than X)
Parcel#: (A0- LU- Z:;0I- ----;0U-- V100-U(
Owners Name & Address: Sal, as D Ai rgor4 A
Clevelanrdf lvd.sk 2 Contractor
Name & Address: IbET'1V R C Gri' { f V C Phone &
Fax: WK;n :T,,i - 7t;A7-ib VWi - Contact Person: Bonding
Company: tJ I Address:
ty J* Mortgage
Lender: Address:
N / 0% Attach
Proof of Ownership & Legal Description) Phone: -
el State
License Number: CGC O591 Z 2- Architect/
Engineer: N ^ Phone: IV /^ Address:
N /A Fax: _ IV / A 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. 1 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 %4ork 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 permit is rifican n th i 1 ' no i e owner of the property of the requirem nts of F ida Lien Law, FS 713. atur
wliceffAlfthl Da Signature of ontrac o Agent Date Print
Owner/ ent' ame Print Contractor/Agent's Nam Signature
of otary-State of F i Date Signature of Notary -State of Floridar- rrrrr, Ann
D. G18or WCOMMISSION#
DDIC3515 E)0S KARIE
S. CLEARWATEg+ 7u
2006 MY COMMISSION # DD 07»5J5 ner/*"
jfl rwx toMeorContractor/Agent is Personally no a o XPIRES: November 27, 2WS Produced
1 D _ Produced ID I-WO-3-WTARY FL Wary service & BoraKrg, IN APPLICATION
APPROVED BY: Bldg: Zoning: Utilities: FD: Initia
ate) (Initial & Date) (Initial & Date) (Initial & Date) Special
Conditions:
t'A
Permit No.
State of Florida
County of Seminole
MARYANNE NURSE, CLERK OF CIRCUIT COURT
NOTICE OF COMMENCEMEIINOLE COUNTY
BK 05645 P6 0526
2005041274
RECORDING FEES 1&69
RECORDFM BY L McKinley
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.
of property: (legal description of the property and street address if available) o? W El G h+ I in c Avpnve,
i.L .Tsar Imo: O(o-ZD-31- 3c r-Olc c- Do 00
2. General description of improvement:
3. Owner information
a. Name and address
b. Interest in property
c. Name and address
4. Contractor
Name and address
Q/ 880 L -r
Phone number
5. Surety
a. Name and address
if other than Owner)
Dq
Fax number
kNNCERTIFIEU 1
MARYANNE MORSE
CIRCUIT C.OUft
OCRAINrAr rnUNTY. FLORIDA
b. Phone number Fax number
c. Amount of bond
6. Lender
N ( a. Name and address
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 &a-} htr dr v w of
tk nr Cans-kyuc4'%0tJ C-o" . 1 i ic , to receive a copy of the Liego-r's Notice as provided in Section
713.13(1)(b), Florida Statutes.
a. Phone number 3f(D - Cv-1-7- CDy (p'P Fax number - -
9. Expiration date of notice of commencement (the expiration date is 1 year from the da f recording a 'fferent
date is specified)
ignature ofl5wner
Sworn to (or affirmed) and subscribed before me this q4A day ofJ44MI4 , 20 d , by
r
Personally Known L./ OR Produced Identification
Type of Identification Produced
THIS INSTRUMENT PREPARED BY:
Tgnature of Notary Pu-blicjvte of r1brida NAME V-01LE CG TF.-P—
Commission Expires:
ADDR. Z46D
Ann D.Gifford
MY COMMISSION a DD103515 EXPIRES P FiF1Gtt, FL 32i7
July 241006 OAL .r3F,?I fL CpnibiRt C- tC J
XV BONDED TNRUTROY FAIN INSURANCE INC