HomeMy WebLinkAbout800 Mersch Rdi
2
CITY OF SANFORD PERMIT APPLICATION
Permit # : 0! - ) 3 a 9
Job Address: 9W /Y>e r"$
Description of Work: A::22—/7V'T__
Historic District: AW Zoning:
Permit Type: Building Electrical
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential. # of Water Closets
Occupancy Type: Residential _ Commercial
Construction Type: # of Stories:
Parcel #: MV— 1 / "
Owners Name & Address:
Contractor Name & Address:
Phone & Fa::
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architect/Engineer:
Address:
Value of Work:
Lines
Mechanical Plumbi
Addition/Alteration
Replacement Ne
of Water & Sewer Lin
Industrial
of Dwelling Units:
Date:
ng Fire Sprinkler/Alarm Pool
Change of Service Temporary Pole
w (Duct Layout & Energy Calc. Required)
of Gas Lines
Plumbing Repair — Residential or Commercial
Total Square Footage:
Flood Zone: (FEMA form required for other than X)
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 appKcable this
this county, and there may be additional permits required from other governmental entities suc# as w#W may
Acceptance of permit is verification that I will notify the owner of the property of the requiregre 6 of
Signature of Owner/Agent
Print Owner/Agent's Name
Signature of Notary -State of Florida
Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Blr MOning: 4it.& ate
Special Conditions:
be found in the public records of
tatp@gencies, or fe0ral agencies.
Date
pVontractor/
Agent's Name
7/33 _,;ate 0 S
Si atureof Notary -State of Florida Date DESBIE
BLANTON n
ent CJAI
Y eSr5 7An1 6 % a or lam •+
rrc . epua Y 25.2007 o.
vr Aawc.Co. Utilities:
FD: Initial &
Date) (Initial & Date) (Initial & Date)
AFFIDAVIT
GARDING ROOF DRY -IN AND FLASHING INSPECTIONS
I
Company: Ler AGI License #: Ci % -,3 /
I
Project Information
Owner: Permit #:
name
f S ` Subdivision:
3o Lot #:
poe
I, N f 1' ( , 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 ac race with the applicable codes and standards.
Contractor:
printed name
STATE OF FLO
COUNTY OF
This instrument was acknowled ed before me this y day of Fe , 200y the
above referenced individual,R b+ dO•r bou , 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 either person o me or
produced as valid identifi
WITNESS my hand and seal this _ day of Fah , 200
L
CDEBBIE BLANTON
Y COMMISSION 8 DD 1 SM91
EXPI>3:::: February 25,2007
Y FL Notary Mwoura Assoc, Co.
JHIS III U ENT PR. P Db9
r
NAME:
c ADDRESS:
d0sell bWd [SE, OLE COUNTY FLOIUAS
NATUNlL CHOICE Building &
Fire Inspections 1101
East 15t Street Sanford,
FL 32771 NOTICE
OF COMMENCEMENT State
of Florida Permit
No. 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 following information is provided in this Notice of Commencement. GENERAL
OWNER
Name
and PROPERTY (
Legal description of the property and street address) OF
IMPROVEMENT Interest
in property (Pee Simple, Partnership, etc.) PSG 14
NAME
AND ADDRESS OF FEE SIMPLE TITLE HOLDER. (IF OTHER THAN OWNER) , and
SURETY ,(
Bonding C077 I
lillt®1®11®igllli(Ii UI®till® Name
and address K
RWOX HORSE, Ct.W Or CIRCUIT MW Amount
of Bond LENDER
Name
and address Persons
within the State of 713.
130)(07., Florida Stal Name
and address BK
0 6 MZ F•S 1901 CLERK'
S V. 2946019103 RECIRQED
P-lulm OL4tP1IIs P" REGARDING
FEES MOO RECORDED
BY D Thomas designated
by Owner upon whom notice or other documents may be served as provided by Section Persons
within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided
by Section 713.1 0)(07.,Florida Statutes: Name
and address: AJOPII,o In
addition to himself, Owner Designates d Provided
in Section 713.13(1)(b), Florida Statutes. Expiration
Date of Notice of Commencement The
expiration date is 1 year from date of recoi To
receive a copy of the Lienor's Notice as of
orn
to a d subscribed bef re me this Day of u.
y My Commission Expires: gnhThu T Nguyen My Commisson
pD304015 Notary Public
Expres March 25.2008 f re
of g instrum t wysac knowledged before me this '3 day of -,y 6 - Al/
t r (Name of person acknowledged), who is personally known to me or who has produced DJ (
Type of identification), as identification and who did/did not take and oath'