HomeMy WebLinkAbout2903 Sanford AveCITY OF SANFORD PERMIT APPLICATION
1,
Permit # :v
JolrAddiens: -:
Description of Work:
Date:
3Z-7 .77
v
Historic District: Doing: Value of '
I -,
Work: $ "
a O S V H>
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole
MechapicaL Residential Non -Residential Replacement New (Buct Layout& Energy Cate. Required}
Plumbing/ New Comrmercial: # 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 Types #.00ff Stories; # of Dwelling Units: Flood Zono: (RE1titA form required for -other than. X)
Parcel #°Q C_j00 oy a (Attach Proof of Ownership & Legal Description) f
Owners-Nam'e'& Address =-
Phone:
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architect/Engineer:
Address:
Phone:
Fax:
Phones
Application is hereby made to obtain'a permit to do the work and inatattafions ag indicate& l certify that no work or installation has commenced prior to the
issuance ofa permit and that all work will be performed to meet standards oeall laws regulating construction in this jurisdiction. I understand that a separate
permit must be wvreO for FLJ CTRICAL WQxK, RLUIviATNG> SIGNS, WELLS, PpQLS> FURNAC S,130IL RS, HEATERS, TANKS, al?d.
AIR CONDITIONERS, etc.
OWNER'S AFFIDP_VIT% [certify that all of the foregoing information is accurate and that all work. wilt bedone in compliance witlratt 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 he 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. n
O
pis of emut'.is verification that -I. will notify the owner of the property of the requirements of Florida en Law, FS 7I3: Signature
or OwnerlAgent Cate Signature of Contractor/Agent Date yoo
C Zriot
O er gent's N P ' on actor/Agent's Name 3
9 7
p ignature of N taryState of Florida Date Signature of Notary State of Florida Date T
Z
DEBIE BLANTON t]
M`{ COM O''SION' 188491 Z
t7 tD Owner/Agent is Per ally K go%w'n to °r A/
D oZced gen1 ona_ty o
w 0 Produced ID_-S'f` i7 L'Gt/ /c-L" ID e bruary (7 i I / J L N „
1.800-3-NOTARY FL Diary, iscoun oc. O
ION
APPROVED BY: Bldg: Zoning Utilities: FD:- 1 (
Initial &
Date) (Initial & Date) (Initial & Date) (Initial & Date) Special
Conditions:
r --
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
C n ire •c sCompany: License
P
Project Information
Owner: Cz-M-1 Permit #:
name
3 Sa/T\/VID V e -- Subdivision:
5_1q 69-
a ` ss 77
Lot #:
phone
I, , 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
scoe c22
printed name
STATE OF FLORIDA
COUNTY OF
i
This instrument was acknowledged before me this J day of 2065, by the
above referenced individual, JAAL 1 , who acknowledged that he/she is a
duly licensed contractor with , and who acknowledged that
he/she was authorized to execute this document. He/she is eitheryor-sonallyffd—w ,me or produced
as vali n- Iification. WITNESS
my hand and seal this day of F-e p , 20 0 S7 DEBBIE
BLANTON MY
COMiF':3SION # DD 188491 EXPIRES:
February 25, 2007 1-
800-3-NOTARY FL Notary Discoun_ "A'O" °
h,
Be it known that f 'C' IV%-e WG Has all power needed
pertaining to permitting for Michael Fleming, Fleming Brothers Roofing Co.,Inc.
License#RC 0067429 For:
Jobsite:
c1 a3 5wr, CG-
Signature
Michael Fleming
Printed name
STATE OF FLORIDA
COUNTY OF =-*Y\ k)C1'14
t. {
This instrument was acknowledged before me this ` day of e
2005 ,by the above referenced individual, Michael Fleming , who acknowledged that he is a duly
licensed contractor with Fleming Brothers Roofing Co., and who acknowledged that he was authorized to
execute this document. He is personally known to me
XXX or produced as valid identification.
Witness my hand and official seal this S day of - 2005
Notary Publi
ppr " ichard J Fleming
Printed Name: " y Commission DD188336
My commission Expires °i" ExPires April 19 2007
Permit Numecr
Parcel Identification Number
Prepared by;
T n G
Co lS 2 ry
Rctum to; 3
NOTICE OF COMMENCEMENT
State of F
County, of
H 11111111111111 loll
MARYANNE MORSE, CLERK OF CIRCUIT COURT
SEMINOLE COUNTY
05618 RG 1421
CLERK'S # 2005027721
RECORDED 02/17/2005 12:05:28 PM
RECORDING FEES 10.00
RECORDED BY t holden
CERTIFIED COPY
MARYANNE MORSE
CLERK Of CIRCUIT rril l
SEMINOt Ej,0I NTY, FLORIDA
BY
The undersigned hereby gives notice that improvement(s) will be made. to certain rca.l prope ffl)ln 9cowirdancce;
With Chapter 713, Florida Statutes, the following information is provided in this Noticc of Commencement,
1. Description of prop y (legal des ription of the property, and street address if available)
a q C) 3
2. General description of improvcment(s)'
3, Pwner information j c-
T9 `r Name r'I ® J Telephone Number
Address U :' Fax Number
Interest in Property: f17.U'
4, Fec Simp e itle older if other han the owner shown above)
Name Tel.ephon querAddressFaxNbc
S
Contractor 00
Name KW10/;v• / Telephone Number
Address jfq( j0Fax Number t
i 4 e,,,.l 3 6.
Surety (if any) Name
Telephone Num r - Address
V/ Fax Number _ Amount
of bond S 7.
Lender (if any) Name
Telephone Number t I
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 §713.13(1)(a)7,, Florida Statutes, Name
Telephone Number Address
Fax Number 9.
In addition to himself.or herself, Owner designates the following to receive a. copy of the Lienor's Notice as provided
in §713t13(1)(b), Florida Statutes. Name
Telephone Number Address
Fax Number 10.
Expiration date of notice of commencement (the expiration date is one year from' d)e date of recording unless
a different date is Speciftcd):
Date
Signed Signature of Owner (Note: per §711 I (1)(g), "owner must
sign ,..and no one else may be permitted to sign in his
or her stead," Sworn
to and subscribed before me this day of 20 0-5 by 1
e y-,I e Y'c c=1 who
is t/ _personally known to me OF, p as
identification, Saoitiag/
delo °npni4lPa 9 o`yoiiodlsr 900Z `
h l A S3 13 a
669Lt
t 00 4 NOISSI J 11 Form
Rc i,ScE; 3/04 y01 V1At01 38WI and' vs r
roducca--'
NIA-- Sig * '
i ' N( 6 I I CtiR I
1ra
mush. r el ). . EXPIRES:
May 14, 2006 9"'
OF FI VI, Bonded Thru Budget Notary Services