HomeMy WebLinkAbout123 Anderson CirCITY OF SANBORD PE gT APPLICATION
Permit ------
Date: _Z 6 U
Job Address:/ %31i "Z. c- ,_ I n
Description of Work: Q !'G.Qa f luj, Z e S Historic
District: Z0"1°g= Value of Work: $ 21 Permit
T X
ype:
Building 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 Cale. 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: 2 ro Construction
Type: CG/br # of Stories: _ I # of Dwelling Units: _L Flood Zone: FFAdrorm required for other than X) Parcel #:
Owners
Name &Address: (Attach
Proof of Ownership & Legal Description) Phone:
Contractor
Name & Address: Star
lcense Number. CCC 6 Phone &
Fax:Contact
Person: Phone: 3 S—s86 BondingCompany: Address:
1 Mortgage
Lender: Address: ,,
11
ArchitecVEngineer: N d Address:
Phone:
Fax:
Application
is hereby made to obtain a permit to do the work and installations as i issuance
of a permit and that all work will be performed to mndicated 1 certify that no work or installation has commenced prior to the eet standardsofalllawsregulatingconstructioninthisjurisdiction. tins I understandthat a separate permit must besecuredforELECTRICALWORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACESBOILERS, 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. WARNINGTOOWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TOYOURPROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOURNOTICEOFCOMMENCEMENT. 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 theremaybeadditionalpermitsrequiredfromothergovernmentalentitiessuchaswatermanagementdistricts, state agencies, or federal agencies. Acceptance of permit is
verification that I will notify the owner of the property of the requirements of Lien La 713 j/Z Signature or
Owner/AgentDateSignatuntractor/A ent / Date ZP- Lner/Agent's
NamehCPaf ( Z l 10
P t Co rac or/Agent's Name qq J iNt of
Florida a
j,y p SignatureofNotary -State of Florida , Dd%mela M Murdock a n Expires November
01 2006 ,V _ i44 Owner/Agent is _ Personally
Known to Me or Produced 1 D X
APPLICATION APPROVED BY: Bldg:
Zonin Initial Date) g• Special
Conditions: My
Commission
OD148M gyp
dr Expires November_
01..2008 Contractor/Agent is Apersonally
Known to Me or - Produced ID Initial & Date)
Utilities: Initial &
Date) FD:
Initial &
Date)
01/22/2U04 09:54 FAX 4076297808
It 002/003ORLAP*0 TI'?LE
CMa Na;7PL7:t3
nm d rn `T1:1.:; (. I ::»
UsDgwji snof1ta oiendwomDo*,00cri
5ET MEMNT STATEMENT
A.
1. FAj rHA 2. J FatlIA 3. I ] Cony, l)rdrae.
6. File Number. 7. Lvov; Number, R. Mortgage IM. Case 4:
0037551033 094 49829783
V. ('. V. IIIS.
1S8 „„ wo hvwn tat. Ux LlNnn'Y!n
aMMIX Ddd a:nO ny 1qe eedemvA Ie17 N n lbmr mn bA 70C.m T 4PIRHdt
A`m ADDRESS OFBOEL'tOWHR: 5NADIESAM1N J. BAKER
FI, AND ADDRESS OF SELLER:
ETARY
40 EAST NIARIETTA S IRLLT Fib POINTS PLAl.A ATLANTA OAOFHOUSING, AND UFXAN 1)$VELOPt NT
P. nA.41 AND ADDR)35S OF LENDER:
a ELLS rARCrO 101a MORTOAOE INC.
C, PROPERTY LOCA [ION;
123 ANDEPSON CLR 5AN I= FL 32771
PLACE Or SETTLEMENT:
EL SE'J?L NTETr'T AG.CNT: 2699 Lee Road Suite 475 Winter Park, !•'I. 32799
Otl,ado'1 We and Ab>trut of Flori lna 407b29-7B04 Conitact;
Di4HUT, IN ENT DATE:
L 5E'rrUME1vT.DATB: O1R3RU04
01,23/ZOU4 _
ant GROSS AMOT)7`tT DUR TO bELLRj_ : ,
100, GROSS MOUPU DU t'xvn vvtuw ^ 97 Z66.00 401. Co=iwk Klee rite
Si zoo.uu
101. Con:r Ict sales rice 402. PettaoUal property
102. Pers00AJ PrOpeTiy - 1 02.57 403. 103, Settlement ahar us to bnn owfi lirtie 74U0
104. ESCROW FOR Ri'r.A1RS
4 070.00 404.
405.
Ad enkc f4i items paid by 3ellcr 111 advanocto5.
1d ustmcnts for items paid b L• e err in cc
406. CitYttvwn taxes
106, Citv/tnuii texas 407. CoUritY tcDm
107. County vexes 40Asaessmcaty 106.
A -rncuts _ 409.
109.
410.
110.
411.
ill.
412.
112.
62
o tU 57 246.00 RA
taorn Brwer 13Y OR
IN BEHALF O ONVER : AMOVjjT 0_ EDTJCTIOP1sINDUETo5>cLLER 20U. ANI
5 r 10Z-L00.
00 Sol. Exeess d veil' ouro instmWord 2U1. D7o3iteteaniest:non 60 )26,00 502. StWemam chat ea to seller line 1400 5.3x2.c3 20i. vriaci
aatouat of new to a 503. J:
d lA s lnkrn sub eat to 303. Exist.
L1ng 1aa;i(s) taken_ subject to 504. Payoff
ofAretrnort aee loan 204. 505,
Payoff
of $Mond mortggc loan 205. _ _ 206.
CREDIT
FROM NF14.MI 570.00 506. 207. 507.
IM
508.
209.
509.
Ad
ustrn,
a,as for it=y a rdd by Soler is rdvmco Adju0mt nt, for items wtpaid by Solltt in adyum 210. City/
town tares 65.49
510. City/
town taxes 511. Countytaxes
01/01/2U04 to 01/23/2004 6'.4S 211. Co
taxis 01101r2004 to 01/23/2004 212. As:.
esmnentS 512. Asaessme=
6 213. 513.
714,
S14'
515.
1215
216.
220. Tntal
Pald By/Fur Borrower 61 761.49 516. S2
6.
447,92 300. CASH
AT SETTLEMENT :F'ROM'70 B 600. CASH AT SETTLEMEO SE 301. Gross
Amo(Int duo from borru er line 120 62.738.57 601. Groan amount duo to aellrr line 420 57,25(.00 302. Lces
amountr paid/for boaDwcrQipc 22U) 61 76-1.49 602. LCRN redtutlons in Mt. due seller Will 520 6 417.52 M. nrr
977.08 703. Can XIlTo From Seller 50,816.08 SUBSTITUTION FORM
1099 SELL15 t STATEMENT. The Information contained in Blocks E,O,H and I on line 401 (or If 401 is asteriked, line
403 and 404) is Important tax Informatlon and Is being furnished to the Internal Revenue Service. If you are required tofileareturn, a negligence penalty or other sanction will be Imposed on you if this item is required to be reported and the IRS
determines that it has not been reported. settlement agent
with your correct taxpayer Identification number. If you do not