HomeMy WebLinkAbout550 Don Knight LnPermit #:
Job Address:
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date: A a I l r'4:7-
oyN+ Lane. SanPrixo( P ` 3@-7-73
Zoning: Value of Work: $
Permit Type: Building &**" Electrical mechanical Plumbing Fire SprinUer/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
Occupancy Type: Residential Commercial Industrial _
Construction Type: # of Stories: # of Dwelling Units:
Contractor Name & Address: S nnn Q 'QZ!, OLtAl-1 -e-T
Plumbing Repair — Residential or Commercial
Total Square Footage:
Flood Zone: (FEMA form required for other than X)
Slate License Number:
Phone & Fax: Contact Person: F Call t- L i b,--la 4y,-e- Phone: y6'7 e/ 1-7- N b0 8
Bonding Company:
Address:
Mortgage Leader:
Address:
Archilect/Engineer: Phone:
Address: 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 of pcnuil ' Zcafion
that I tq th ner of e p prty of the requirements of Florida Lien Law, FS 713.
TQe
4 SignatA of Owner/Agent Date Signature of Contractor/Agent Date
All- P int /Age is N
Vim ' 4byw
WN O W gr lure of Notary -State of Florida Date
Z a
j 2U'5
0 s a Owner/Agent is/_ Personally Known Me or
Produced ID
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is _ Personally Known to Me or
Produced ID
3 • ZZ -0S
APPLICATION APPROVED BY: Bldg: Y/ r r I ' zoning:
Initial & Da (Initial & Date)
Special Conditions:
Utilities: FD:
Initial & Date) (Initial & Date)
7 ice®®®®®
l
M NOTICE OF COMMENCEMENT
MABENINOLIMLE Ct
SE CIIUGiTY
r AK 056543 IP6
0-6 1` Permit No. Tax Fd3L$W S 0 2*1
N State of Florida
N'
County of Seminole RECMIMS FEES It
J BY D Thai
4 The undersigned hereby gives notice that improvement will be made to certain real property, and in accc
C`S Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
C
4 $ r 1. Description of property: (legal description of the property and street address if available) Of Q
Zn f1 '
538 Oon 1Gn nIn - l_1,nc. 5nn _ Ft_ 3a-7 -73
2. General description of
3. Owner information
a. Name and address cJG.n n r e, 0 , -L A_ , a-\,-...._
b. Interest in property _
c. Name and address of fee
4. Contractor
I. Name and address Son (J, k r pgr A Av-, h enk,- ; 4,, 1,
900 Red c e_Vetanyl SI.,ri s nr-, tL 3z- b. Phone
number yo7 i 585-gcxzt Faxnumber ,4cn 5785-y 5. Surety
a. Name
and address /V //4- 6F CIW.
UIT MUU 07 147740
ice
with
AAA 2,
411)
b. Phone
number Fax number I ! c. Amount
of bond i 6. Lender '
a. Name
and address I b.
Phone
number Fax number I 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 ' r : L Z) o cl ,
77 2i 1 1 b. Phone
number 110-7 585-40oo Faxnum er yo7 S78S-NbqCi 8. In
addition to himself or herself, Owner designates'P 6-,Pn H . C my-PJ I I of H," i
n sc. rho .1c 4eA cw e, P Ajo receive a copy of the Lienor's Notice as provided in Section 713.13(
1)(b), Florida Statutes. I I 7 a.
Phonenumberj3ZZ S - c/o 1Faxnumber 9. Expiration date
of notice of commencement (the expiration date is 1 year from the date of recording unless' differenrt date is specified)
I Van& C.rws Signature of Owner
i of PAmWsttod Sworn to (or
affirmed and subscribed before me this z z-day of/-}iQL H , 20I , by ilyn Cre-,-JS '
I I Personally Known V
OR Produced Identification TPof Identification Produced
4, n J
JACQUELWE C'JCKcRHAtA NO0lIN-STATE W' °
F OAIOA of Notary Public . State
of Florida COMMISSION A 01-11100603 EXPIRES 03h9i:006on
Expires: / BONDEO TMRU
LW-1101ARY1