HomeMy WebLinkAbout1102 Locust Ave (2)CITY OF SANFORD PERMIT APPLICATION
Permit #: (2 (0 — 9 (P Date: VIGIO&
Job Address: - LoCoi94 J+-
Description of Work; Re. - R.•
Historic District: Zoning: Value of Work: $ H !q 4 O
Permit Type: Building A Electrical Mechanical Plumbing Fire Sprinkler/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 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 #: I& O P — 0O 0 0 (Attach Proof of Ownership & Legal Description)
Owners Name & Address: U; Yo, Ltw,/ Grww S->< nix+. S (Aa w
14411 NW 11 h'1" S. Phone:
Contractor Name&Address: AANN ft4u %= Aaa46%1na. &403 U
State License Number:
Phone & Fax: 4,31- `1L- h'11 Contact Person: 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. 1 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: 1 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 ofthis 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 t .
ssQ dfcation that 1 wi notify the owner of the pi
nature of Owner/Agent / Date
Jmeia-
Pri t caner/Agent's a . ,
n
t 7
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bld : Zoning:
Imtial & D e)
y of the requirements of Florida t'
Lawj6711—
0& —"N %/--7 06
Signature of Contractor/Agent Date
i10mCL5 i-tit') /ew-
Print C n ractor/Agent' e
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID
Initial & Date)
Utilities: FD:
Initial & Date) (Initial & Date)
Special Conditions:
NOTARY PUBLIC -STATE OF FLORIDA
Rose SIDith NOTARY PIfBllC•ST?,TE OF FLORIDA
Commission;DD411199 Rose SIDl l
Expires; bL4R. 24, 2009 Commission iDD411199
coded T ,ru 02n,ic Bondir , :o.. lac. ExDireS' MR, 24, 2009
Boaded T7: a :ula :tic Bonding Co., 1::..
Power Of Attorney
Date: Zo b
I herby name and appoint -Tu A; o y;l of Advantage Roofing Inc.
To be my lawful attorney in fact to act for me and apply to the C;:h oll- Svc,.-- -,A
for a roofing for work to be performed at a location described as:
ParcellD#:
Legal Description: (.-- 1 -931 K 1-
Address of Job: I I o 2 L oCV 4 Av,
Owner of Property and Address: .); x.,,. LCAVtt--n-` 144 71 NW 1-141+
k
1-
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 J—e—aay of Jan Zdo (-
By Thomas Ringler
ID Or Personally know to Me
Notary Signature: seal
My Commission Expires: • d ' Dc
NOTARY PLBUC.ST.TE OF FLORID'
Rose Smith
COMMisslon fi DD411, " ?
L.
ENP,;res: ALAR. 24
utttic Bonding Co., ,.,,.
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: AAyw.X t., L.•y,,b License M GU.os a ywi-)
Project Information
Owner: Permit M
name
Itoi I_ot-v4 Ay+- Subdivision:
address
Lot #:
phone
1, Su s-L.L d R; ),L j , 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: I1 0
signature
printed name
STATE OF FLORIDA
COUNTY OF
This instrument was acknowl ged before me this day of Jam__ , 2001"y the
above referenced individual,CA 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
WITNESS my hand and seal this
as valid identification.
day of , 20
ry Publics_
w
D2 -8B11= etANT N
3. Fabre & UD 16uSgt
11111 is Ile 11 eel II p1 U oil 11 IN 111111111 N1 g1III 0 1111111111 Iasi Permi^^
Number Parcel
Identification Number 1 4t- Prepared
by: 7TU 541'N, a c I'c.V Return
to: ( vi 0 A IN, NOTICE
OF COMMENCEMENT State
of f=19,: AV\ County
of se nnolst- MARYANNE
MORSE, CLERK OF CIRCUIT COURT SEMINOLE
COUNTY BK
06075 PG 1377 CLERK'
S # 2006004354 RECORDED
01/10/2006 11i:21t36 AM RECORDIND
FEES 10.00 RECORDED
BY D Thosas CERTIFIED
CONY MARYANNE
MORSE CLERK
OF C r, nolr IT
COURT CThe
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 the property, and street address if available) La -
I 1 1`31 k 13 SHly 2. General description of improvement(s) Fez -
Rw-A'- 3.
Owner ' formation — OO
NameI i' i u Sty h C? n Telephone Number Address
q 4-7/ M W. I -jq'4'5
1
Fax Number - C 0 (d S -f-/ S 3 Micc1>
76, FL, 5 30 5 Interest in Property. 4. Fee
Simple Title Holder (if other than owner shows above) Name Telephone
Number Address Fax
Number Z5. Contractor
Aav-I-,,,, 9Av9-t,'ny T-&, Name Telephone
Number Address GKo-
3 P., fin,- Fax Number 6. Surety (
if any) Name Telephone .
Number Address Fax
Number Amount of
bond $ _ 7. Lender (
if any Name Address
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 1 9. In
addition to himself or herself, Owner designates the following to receive a copy of the Lienor'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 digned
Signature of Owner (Note: er 713.13(1)(g), "owner must sign ...
and no one else may be permitted to sign in his or
her stead." to and
subscribed before me this 7 rh day of C,n , 20 4 by O LiGZ
6 1-t en 5 who is personally known to
me OR `% produced as identification. NOTARY '" ' iC-
STATE OF FLOR1DA Signature of
Notary..WELRose Smith Commission = DD411199
Expires: ! LkR.
24, 2009 Sunded Tluu .`.::
a.:tic R::: ii ; Co., Inc. 23-20 (
9ro4)