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Permit #:
Job Address:
Description of Work:
Historic District:
9 P-s
Zoning:
CITY OF SANFORD PERMIT APPLICATION
Value of Work: S 1 LI-Ts
v
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 P", Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Bonding Company -
Address;
Mortgage Lender:
Address:
ArcbItect/Engineer:
Address:
Contact Person: Phone:
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. 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 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 of it is verification that 1 will notify the owner of the propel
Signature of Owner/Agent Date
Print Owner/Ag Name \\\\\\\\\\Ai 10/1!,/Obi
of Notary rate of Florio0 Dm
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Notary Public Corti #
DD0100625; Owner/
Agent is _ Personally 4nOW1110 M r Produced
ID '•. O plZ05t.'b•'•• Q•. APPLICATION
APPROVED BY: Bldg: ! \\nieg: — Initial &
Date) Special
Conditions, of
the requirements of Florida Lien Law, FS 7 3. y -
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tore o Contra r/Agent Date A\\
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rnln< AM 0/ and-2.Ir' Print
Contracto s Name y ti of
Notary -State of Florida = NOtary Public DeCw
misom #DDD100625; _ 0
4plIGC4 b .•' Contractor/
Agent is _Personally Known to Iv0,0J x \ Produced ID ',
i F OF 9.0 0` Il111\\ 0
Initial &
Date)
Utilities: Initial &
Date)
FD: Initial &
Date)
POWER OF ATTORNEY
LANIER, JACK DOUGLAS, the "principal," of P.O. BOX 180546 CASSELBERRY FL. 32718,
herewith appoints Mark Chapman 123 Matanzas Rd Debary Fl. 32713, Wally Martin 2718 Candlcxwod
Ct. Apopka Fl. 32703, Mark Hurwitz 30748 PGA Dr Mt. Plymouth Fl. 32776, Donald Henderson 1942
Stanton Street Deltona Fl. 32738 Tom Hardin 199 Summer Club Dr. Oviedo Fl. 32765,Donald John 4082
Lake Bluff Dr. Mascotte, FL 34753, Pat Perkins 620 Prince Lane Oviedo Fl. 32765. Ray Cullen 211
Mockingbird Lane, Winter Springs, FL 32708, Andrew McCloud 435 Green Springs Cr Winter Springs
F132708, Roy Templeton 31 David's Lane Apt# 307 Winter Springs Fl. 32708, Maurice Shelton 4233
Meeting Place Sanford F1.32773 and Joseph Dunlap 1421 Border Drive Winter Park Fl. 32749 Jack
Kramer 2229 Fairglenn Way Winter Park, FL 32792, Joseph Graham 2101 Highland Abilene, TX 79605.
Keith Reece 1652 Silk Tree Cr Sanford Fl 32773, as their attorney in fact, to act in place and stead and
described herein; THIS IS A DURABLE POWER OF ATTORNEY THE RIGHTS HEREIN SHALL
CONTINUE DESPITE THE INCAPACITY OR DISABILITY OF THE PRINCIPAL
To act for me in the regard to the following:
OBTAIN PERMITS AT THE BUILDING DEPARTMENTS
This power of attorney shall be in effect from 1/1/05 through 12/31/05
L6 N&KV6-
JACK
MUGLAS, As Principal STATE
OF FLORIDA COUNTY
OF SEMINOLE J.
DOUGLAS LANIER personally appeared before me and acknowledged the execution of this power
of attorney for the purposes set forth therein. Dated:
1-4—Cis 41
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Permit Number
Parcel Identification Number 'ZS b'1(51C%zOLC_-x:A b
Prepared by:
Jacyln Lanier
Collis Roofing, Inc.
Return to:
Collis Roofing, Inc.
P.O. Box 180546,
Casselberry, FL
NOTICE OF COMMENCEMENT
MARYANNF Mt7RSE, CLERK OF CIRCUIT COURT
SEMINOLE COUNTY
BK 05569 FOG 2elesl
CLERK'S 0 2005002195
RECORDED 61/83 M5 11128136 AN
REMRDIN6 FEES 10.00
REMRDED BY L Mr_Kinley
CERTIFIED COARSE
M A, ANNF M
CLERK OF CI CULT OR1DA
SEMI LE
BY nEPUTY LERK
State of Florida
County of Ste; no JAH - 5 2005
The undersigned hereby gives notice that improvement(s) 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.
1. Description of property (legal description of the property, and street address if available)
r1'bi-CA , V1_ - 3Z'1-1 I 19 FT v4- Co} 2 Y_ (.Q TQ_ Z
2. General description of improvement(s) /-Va"ar-, o,P sa"(-\ GA P(1 I OJ 5
Re -Roof
3. Owner information
Namewkx Ca-r r\jLS Telephone Number
Address l,)-n C9j19-nCXeQr C>Y . Fax Number
lCn (JC f j, K , 52:7 4 U Interest in Property:
4. Fee Simple Title Holder (if other than owner shown above)
Name N/A Telephone Number
Address Fax Number
5. -.n 6ontractor
I N,v Name Collis Roofing, Inc. Telephone Number 407-327-3655
Address Fax Number 407-327-3656P.O. Box 180546 Casselberry, FL 32718
6. Surety (if any)
Name N/A
Address
7. Lender (if any)
Telephone Number
Fax Number
Amount of bond $_
Name N/A 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 §713.13(1)(a)7., Florida Statutes.
Name N/A 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 §713.13(1)(b), Florida Statutes.
Name N/A Telephone Number
Address Fax Number
10. Expiration date of notice of commencement (the expiration date is one year from the date of recording
unless a different date is specified):
CV-Os
Date Signed Signature of Owner Note: per §713.13(1)(g), "owner
must sign ...and no one else may be permitted to sign in
his or her stead."
Sworn to 'su scri ed before me this day ofJ f , 1, a DES by
e ` ik r r Q
who isypersonally known to me OR produced as
identification. 2z= Si
ure of Notary (notarial seal to appear below) CUB "-•
riouv ' •
riL' o°
oe
Coo . O c'
ccNotorYpu"W/ » c Form
Revised: 3/98p1f95 z//'
OFliF' O\pP\\.
CITY OF SANFORD
HISTORIC PRESERVATION BOARD
APPLICATION FOR A
CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407 330-5672 Fax: 407 330-5679
In addition to a Certiflcate of Appropriateness, a building permit may be required. Check with the Building
Department: 407 330-5660. A Certificate of Appropriateness may be required for projects that do not require
a building permit.
This Certificate must be prominently displayed on the building wnen worK is in progress.
1. General Information
Property Owner. STe 166 A't'^/"S-f Property Address: y p U ` % (zero c^
Mailing Address: 2 i 1 9 re,d CrefT' Ui • Phone Number.
Z
t ,+/t e, ( 3yv Fax Number.
Agent: Avdm.l C /oti « Phone Number:
Address: C p. / ,? of -YC C 4-T e f y Fax Number.
Downtown Commercial Historic District: Residential Historic District:
This application is filed in response to a notice from the Code Enforcement Department
1 certify that all information cont ned in this application is true and accurate to the best of my
knowledge.
Applicant: Qcv. C eZ4 Owner.
Date: " S 5 Date:
Please use the attached criteria checklist as a guide to completing the application. Incomplete
applications cannot be reviewed and. will be returned to you for more information. You are
encouraged to contact the preservation planner at 407 330-5672 to _make sure your application is
complete.
A Certificate of Appropriateness is valid for six months unless otherwise noted
OFFICIAL USE ONLY
Historic Preservation Board- Meeting Date: Staff Review Date:
Application is Approved V Approved with Conditions
Conditions:
Signed: C rldlvta- rDate: 151&4
Denied
FASHA EWHistoric Preservation BoardWCertificate of Appropriateness.doc 1.
2. Description of Proposed Work
Application Category: (Check all that apply)
Site Improvements/driveway/walkway Storage shed Moving structures
Replacement windows or doors Underskirting Awnings
New construction/additions Signs El Demolition
rRoofs/gutters/downspouts AC/Mechanical Fences/Gates/Pergolas
Replacement siding/flooring/porch Paint Other
Completely describe the entire scope of work: all changes in material, color or location to the
exterior of the building, where on the property the work will occur and how the work will be
accomplished. For large projects, an itemized list is recommended. Attach additional pages if
necessary. %J fi - kr,4 oC ? `Y O !1 -r, 4 1 ec4 r,4L.
3. Documentation: In order to be reviewed by either the staff or the Historic Preservation Board, applications must be
complete. The documentation listed below must be submitted with the application form. 11 copies of all drawings larger than 11 " X
17" and 11 copies of all photos must be submitted.
Paint: Color samples of all colors must be submitted.
Fences/Gates/Pergolas/ Sheds:
A site plan of the property showing the location of the fence, gates and/or pergola. The plan must show the property'sdimensions.
A picture of the proposed structure. This can be an elevation drawing, sketch, brochure or photo of an existing shed, fence, gate or pergola provided that the dimensions are included.
A description of the materials that will be used in the project.
Photos of the yard(s) in which the structure will be placed. (11 copies of each photo must be submitted).
New construction/additions
Elevation drawings to scale of each facade indicating proposed alterations or additions. Drawing must clearly depict theexistingbuildingandtheproposedchanges.
Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposedaddition, location of all exterior ground and roof mounted equipment..
Description and/or samples of materials to be used.
Where applicable, drawings and site plan of other improvements such as fences, walkways, lighting, decks, etc.
Photos (11) of existing structure.
Awnings/ Signs
Sketch or elevation drawing of the building facade with proposed sign/awning.
Dimensioned drawing of awning/sign.
Sample of colors.
Site Improvements/driveway/walkway/AC/Mechanical
Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposedimprovements.
Description and/or samples of materials to be used.
Note: AC/Mechanical equipment must be screened by shrubs.
FASHA ENGUiistoric Preservation Board\#Certificate of ADDropriateness.doc 2.