HomeMy WebLinkAbout1106 Sanford AveCITY OF SANFORD PERMIT APPLICATION
Permit.# : 'E - l Date:{i IB ra
Job Address:11Q 6Ay<-
Description of Work: Re - Ron
Historic District: Zoning: Value of Work: S !00
Permit Type: Building Y Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool _
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pofrr
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 _X Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: e`S- 1 t{ - 3 0 - !S:A 6— 120 1- 400 12 (Attach Proof of Ownership & Legal Description)
Owners Name&Address: 309R Aylor- L,&,%LA5 Wine
C4A tsc ,1 L e ,,, Phone:
r
Contractor Name & Address: AJv-ry
rIV04. pia.$ai State License Number: C.CCOS"1t-1-11
Phone & Fax: 401 ' 79- (111 \- Contact Person: R1.1 rL Phone:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
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 ofthe 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 di 'cts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of th Lien La F 713. oentsda
c`
aay0
N - Signature of Ow/Agent Date Signature of Contractor/Agent Date S
rit Owner/A am` (\\ t Contractor/ANams c,., :, .D
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date rD ia7 p
la vw
rw. Owner/
Agent is Personally Known to Me or c _ Produced
ID
a0a APPLICATION
APPROVED
BY: Bid A Zoning: Initial & Date)
Special Conditions:
a . =tt:
rn O G G-
O Contractor/Agent ' _
Personally Known to Me or r Produced
ID
n NO y Initial & Date)
Utilities: FD:
Initial & Date) (
initial & Date)
Power Of Attorney
Date: - I c 0 6
I herby name and appoint of Advantage Roofing Inc.
To be my lawful attorney in fact to act forme and apply to the G;+y Sw
for a roofing_permit for work to be performed at a location described as:
Parcel 1D#: I `l - 3 0 - SA c> - 13 o X — 0 o -10
Legal Description: Lo4 'j, of s,,,A
Address of Job: A A v , .
Owner of Property and Address: _ Pv% c c..
A/y\ i
And to sign my name and do all necessary to this appointment.
Contractors Name: Typed: Thomas Ringler. Advantage Roofing, Inc.
State License#: CCCO52477
Signature of Certified Contractor:
Acknowledged before me this day of Jc, ,n 'Z.pO (P
By Thomas Ringler
ID Or Personally know to Me
Notary Signature•4_ 9' < seal
My Commission Expires: 3 -014- Z-')c)
NOTARY pUBLIC•STATE OF FLORIDA
Rose Smith
Commission TDD411If
Expires: 1M-. 24, 20
Bor:ucd 77uu Ad?.Wc Bonding Co.,--
i I 111111111111111111111111111111111111111111111111111111111 11 III 11111
Permit Number
Parcel Identification Number .21 • I K -10 . $AL,
Preparedby: —Svj,",
Return to: 6ci ,j
NOTICE OF COMMENCEMENT
State of R o "ill
County of SC n^j Nof4r_
MARYANNE MORSE, CLERK OF CIRCUIT COURT
SEMINOLE COUNTY
BK 06075 PG 1376
CLERK'S # 2006004353
RECORDED 01/10/2006 11121136 AM
RECORDING FEES 10.00
RECORDED BY D Thomas
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 theA property, and street address if available). rt,Y
2. General description of improvement(s)
3. Owner Information Pi.,cV_ NC-
NameSvo $ Telephone Number C\ E
Address
ti (" LAF'J"5 wv) Fax NumberGtnssJ&r-S T FL, Interest in Property;
a
200 4. Fee Simple Title Holder (if other than owner shows above)
Name Telephone Number '
Address Fax Number
5. Contractor
Name
u I
Address (' •0 P r c /L. l r\ ,
Qd%A
6. Surety (it any)
Name
Address
7. Lender (if any
Name
Address
Telephone Number y-7- b 719 h-7-4
Fax Number
Telephone Number
Fax Number
Amount of bond $ _
Telephone Number
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 Uenor's Notice as
provided in 713.13(1)(b), Florida Statutes.
Name Telephone Number
Address Fax Number
10. Expiration date of notice of commencement (if expiration date is one year from the date of recording unless
different date is specified):
Date Signed Signature of Owner'(;: per 713.13(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 Cell 20 0 by
AciArY Rober+ Cs. who is personally
known to me OR _ z produced as identification.
SEAL .: ROSL E,`I
Signature of Notary' Cr.Mj551c11199 Bor.;
Inc. 23,
20 (0104)
J
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: AliwAw. R,Xnn, License M Ccc.o53.1-0 l
Project Information
Owner: I c.c.c J av n 4-- Permit M
name
1106 S'A - 4 Qv Subdivision:
address
Lot M 1.
phone
1, fuss, 6a,11:S) , 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
r
v : n O 0- i-C4
printed name
STATE OF FLORIDA
COUNTY OF
This instrument was acknowledged before me this day of , 20 , by the
above referenced individual, , 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 personally known to me or
produced as valid identification.
WITNESS my hand and seal this day of
Notary Public
20