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HomeMy WebLinkAbout519 E 1 St (3)sll CITY OF SANFORD PERMIT APPLICATION Per # : I 1 Date: Job Address' , 3 a ' 7L `7 ^, Description of Work: Y1 S-G2 } n e-UJ -,-)e y- O i G r _ it UVl Chi S Historic District: Zoning: Value of Work: Permit Type: Building Electrical )_ Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical: New Service - # of AMPS Ot) Addition/Alteration Change of Service Temporary Pole Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required) Plumbing/ New Commercial: # of Fixtures _ Plumbing/New Residential: # of Water Closets Occupancy Type: Residential of Water & Sewer Lines # of Gas Lines Commercial X Industrial Plumbing Repair - Residential or Commercial Total Square Footage: Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other. than X) Parcel #: 0- - 3 i 5 5 — ` © ^ DO 1 d (Attach Proof of Ownership & Legal I Owners Name & Address: 1.0U-tti Contractor Name & Address: t t - A A-0mnn Phone & Fax: t-i (]-1 "-T( 8V --1,5 Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer: Phone: L_} on - 3 a 3^ H q5 C) 44 State License Number: L- c)(p D 17 el Contact Person: Q V)t 'g'rL>,( Phone: LIP"'I - 55 1 - t7 Uq R Phone: Fax: Address: 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 issuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate permitmustbesecuredforELECTRICALWORK, 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 constructionandzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICEFORIMPROVEMENTSTOYOURPROPERTY. 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 prop2La e public records of this county, and there may be additional permits equired from other governmental entities such as water managems, or federal agencies. Acceptance o ermit is to%fcat' ' n that I l otify the er of the property of the roireents of Fl rida n Signature of Owner/Ag Date Signature of Contractor/Agent Date rtra, Dip\(f7 `, C Signatylo o Notary -State of F onda c Date igJ ature o Notary to e of Florida to t n / —- FLORENCE A. DE GRAVE .Pus c USANAN D. SCHAFER i. MYCOMMISSION # OD 16426i' EXPIRES: NqyB Br 12 7'i' Y COMMISSION # DD 080203 s o 11 tCK e or Contractor/Agent is Personal * , fl i bo Me EXPIRES: April 20, 2006 OW11RrQ85Bondi? #fd ig1Y` t a roduCed ID G d C ^ Produced ID sr P BondedThru Budget Services po 9 Y APPLICATION APPROVED BY: Bldg: ONO ADZoning: Initial81 [ e) Special Conditions: Initial & Date) Utilities: Initial & Date) FD: Initial & Date) s THIS IPISTIt U%JENl t'rttrHi NOTICE OF COMMENCEMENT Permit No. S;pS Tax Folio No. State of Florida ---- —"— County 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 fol owing information is rovided in this Notice of Commencement. 519 E 1 st S, - Sctnr6 , F(` as rI 1. Description of property: (legal description of the property and street address if available) LQ Q A 1( S S+S 51 (LESS 0 )oQa4- N 1/2 © S4 Ad ran S + 6 I©5-F+ S//z o - Uac S+ 2. General description of improvement:' 1 3 Owner information a. Name and address 0- c> D b. Interest in property c. Name and address of fee simple titleholder (if other than Owner) 4. Contractor a. Name and address L' 1 ( 4 --,) p We S+ r P I+a YYl pr-)AQ h. . Phone number 09- rl gg - 35C) D Fax number L4 O rl- 5 Surety a. Name and address b. Phone number Fax number c. Amount of bond 6. Lender 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 of to receive a copy of the Lienor's Notice as provided in Section 713. 13(1)(b), Florida Statutes. a. Phone number Fax number 9. Expiration date of notice of commencement (the expiration date is 1 year from the -date of recording m-166)s a different date is specified) Signature of Ownpt" Sworn to (or affirmed) and subscribed before me this r L1 day of 20 O by Personally Known. OR Produced Identification BK 0.5590 r-,G Type of Identification P uced C-j:!) f C CLERK, S ## 200 0- 12@1@3 REt IItD D 01/214/20 11e4: 4 AN CERIEDGOPYRECURDINBRiESI& QMARYANNEMOR"T, RELVWD BY t holden Si re of Notary Public, State of Florida (CEP OF Cl 111.11I r' Commission Expires: S'EMf OL C N _;_(' )bA- Iof" aY'OB. FLORENCE A. DE GRAVE B} _ MY COMMISSION # DID 164280 ( I EXPIRES: November 12; 2006 nT4>F FF ° eOP Bonded Thru Budget Notary Services N , 2 •4! 005