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Home My WebLink About1112 Orange AveCITY OF SANFORD PERMIT APPLICATION Permit #: ' ,0 GO - 13(D V Date: ) V Job Address: It 1 Z 01P_ VOr N C-Z Description of Work: '0—C, (,'}C-"> A_— 'AjV e,;5,CLS 1` r ] c t'r'u-tJ r-4@1 5 historic District: Zoning: —Value of Work: $ J? Z U '— Permit Type: Building _ Electrical Mechanical Plumbing Fire Sprinkler/Alann Pool Electrical: New Service - # of AMPS Mechanical: Residential Non -Residential Plumbing/ New Commercial: # of Fixtures _ Plumbing/New Residential: # of Water Closets Addition/Alteration Change of Service Temporary Pole Replacement New (Duct Layout & Energy Calc. Required) of Water & Sewer Lines # of Gas Lines Plumbing Repair - Residential or Commercial _ Occupancy Type: Residential Commercial Industrial Total Square Footage: Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: Owners Name & Address: 7-2S`f 1-1/0SI Contractor Name & Address: t sroa 4V45 vK Phone & Fax:. Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer: Address: Attach Proof of Ownership & Legal Description) I-.i^V0 roV4yVUnk . t-LG t C 11n ter® 1Wr_Wacffr_ c 3 V 7,6S State License Number: CC-'C'_I 7oC?9 (r / 33" 6 Contact Person: 041 Ci " Phone: t'o7 ' 019-2 Phone: Fax: Application is hereby made to obtain a pennit 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. N TICE: 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 permit is verification that I will notify the owner of the property of the requirements of Florida Lien w S 713. Signature of Owner/Agent Date 'Vignature of Contractor/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Owner/ Agent is _ Personally Known to Me or Produced ID APPLICATION APPROVED BY: Bldg: initial & Date) Special Conditions: ft 1 \1 s Name Date Signature IS , o to Date MY COMMISSION # DD *4280 EXPIRES: November12,2006 ontracto * A6n, is"" 'Fcrrsoiito Me or _J\ Produced ID 03 - C. Ina 3 Z Zoning: Utilities: FD: Initial & Date) ( Initial & Date) (Initial & Date) ov a J'A ts, 1 0 p ease —) % 1.1d,h5 CITY OF SANFORD DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing Public Works Acknowledgement A. Sidewalk Closing B. Street Use/Closing 1. Walkways - Protection - Width 2. Barricades - Protection - Width 3. Fencing - Protection - Width - Height 4. Curb Protection/Sidewalk Protection/Street 5. Storm Sewer Protection C. Dust Control Police Department Acknowledgement A. Traffic Control -4 , ion _ 30a d S / V B. Crowd Control/Security Utility Department Acknowledgement A. Water, Sewer - Capped off, Sealed B. Water for Dust Control (Meter) Engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: r a- c4txp- - 6AL-. raid Additional Comments: Q e sll s.+ n Gz S-- U C- l k V C 02/15/2006 14:52 4073022540 Feb 15 2006 1:14PM HP LASERJET FRX J,1%k>(-P SANFORD PD PAGE 01 p.1 ease rat' r% 40 3w 4ol)-34a. -M CITY OF SANFORD DEMOLITION Building Division Acknowledgement A Permit Application B. State Forms C. State Statutes/Cootractor Licensing Public Works Acknowledgement A. Sidewalk Closing B. Street Use/Closing 1, Walkways — protection — Width 2, Barricades — protection — Width 3. Fencing — Protective — Width • Height 4. Curb Protection/Sidewalk Protaction/Street S. Storm Sewer Protection C. Dust Control police Department Acknowledgemmt A. Traffic Control X',. 3,oa r as y0 B. Crowd Control/Security VtiUty Department Acknowledgement A Water, Sewer — Gapped Off, Scaled B. Water for Dust Control (Meter) Engineering & Flanoing Acknowledgement A. Historic District B. Zoning issues Address of lob: 1 I I a-- C Additional Comments: u L+J6trc a. i 5 low R`rf f ease `ems r r. -t-u ) u I 6ep r. CITY OF SANFORD DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing Public Works Acknowledgement A. Sidewalk Closing B. Street Use/Closing 1. Walkways — Protection — Width 2. Barricades — Protection — Width 3. Fencing — Protection — Width - Height 4. Curb Protection/Sidewalk Protection/Street 5. Storm Sewer Protection C. Dust Control Police Department Acknowledgement A. Traffic Control A4. : IfOn.- Sod . a S Y B. Crowd Control/Security Utility Department Acknowledgement A. Water, Sewer — Capped off, Sealed B. Water for Dust Control (Meter) Engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: I a— lJ Additional Comments: Q &.4,5 Il r) q s—-1., ck v C 09 J')s lo q ea.Se elv-rr" -tu ' Id S bep r CITY OF SANFORD DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing Public Works Acknowledgement A. Sidewalk Closing B. Street Use/Closing 1. Walkways - Protection - Width 2. Barricades - Protection - Width 3. Fencing - Protection - Width - Height 4. Curb Protection/Sidewalk Protection/Street 5. Storm Sewer Protection C. Dust Control Police Department Acknowledgement A. Traffic Control X : as Yo B. Crowd Control/Security Utility Department Acknowledgement A. Water, Sewer - Capped off, Sealed B. Water for Dust Control (Meter) gineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: Additional Comments: e- V-1 s; } n q S-- U V C S c)-) 5 low CITY OF SANFORD DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing Public Works Acknowledgement A. Sidewalk Closing B. Street Use/Closing 1. Walkways — Protection — Width 2. Barricades — Protection — Width 3. Fencing — Protection — Width - Height 4. Curb Protection/Sidewalk Protection/Street 5. Storm Sewer Protection C. Dust Control Police Department Acknowledgement A. Traffic Control X-,L . 40n . Sod d S Yu B. Crowd Control/Security VB. Wity Department Acknowledgement ater, Sewer — Capped off, Sealed Water for Dust Control (Meter) Engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: PZQ-0 U `s- Additional Comments: U C. 1LL V'C 44 Permit No. State of Florida County of Seminole NOTICE OF COMMENCEMENT Tax Folio No. 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. 1. Description of prope : (legal description of the property and street address if available) 1 1 12 D M rG-e f/Q_ 2. General description of improvement: 3. Owner information a. Name and add C. b. Interest in property c. Name and address of fee simple titleholder (if other than Owner) ' A. Contractor a. Name and address kc, rc 2 S I UO Afa.514 'n' b. Phone number 5 — 2 G 7 5. Surety a. Name and address e '- UOS'S ,, Fax number — 11001U01!l1Wnoun IN4fliIN11Ml1111111w b. Phone number Fax numberhq& & ; y Fitt p r c. Amount of bond SENtt 1QUWjY 6. Lender Bit Wlb6 lag 0475; Upgl a. Name and address CLERK' S 4lt b6,1t139,- 1 REl; i3lO&D DdIlW W:lh:4i Ph b. Phone number Fax numbertEL'tlIt IW FLU 10.44 7. Persons within the State of Florida designated by Owner upon whom notices dE-b&i"dAUMeM1"y be served as provided by Section 713.13(1)(a)7., Florida Statutes: a. Name and address b. Phone number 8. In addition to himself or herself; Owner designates Fax number 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 r ' unless a different date is specified) Sworn to (or affirmed) and subscribed before me this /"0 day of / & Personally Known OR Produced Identification Type of Identification Produced Si cure of Notary Public, S f Florida MY CWMnWW^ DDM4W Commission Expires: 'a ^' EOms Deownb ' Ct 2W of Owner 20 Q6 ,by P Fps' cOl b A