HomeMy WebLinkAbout1912 Sanford Ave (4)CITY OF SANFORD PERMIT APPLICATION
Permit # : 102 - Date:
Job Address: l r? ! a- sA r Fv icy A v'-tiva= SA -1Lua , ?L 3 a 7 1 / Description
of Work: / O 00c: e
Historic
District: Zoning: Value of Work: S % !J CFO 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: Mechanical
Plumbing Fire Sprinkler/Alarm Pool 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 Industrial
Total Square Footage: of
Dwelling Units: Flood Zone: (FEMA form required for other than X) to ;
fa.f Parcel#:
4VII ev 1 /a, (d/u.r. 14.,,11. G',.,r.6y i+'A41. ry /hn.K NwM Pw.+K(Attach Proof of Ownership & Legal Description) Owners
Name & Address: Tv Vea: A. Pi N i:
vc7 ZPJACkyPgrf, CQA,;
f /f 714
Phone: Contractor Name &
Address: N 4 Phone & Fax:
Bonding Company:
Address: Mortgage
Lender:
Address: Architect/
Engineer:
Address: State
License
Number: t// Contact
Person: ll//1j y T 1pf7f& Phone: Jfro 'M 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. I understand that a separate permit must be
secured I'or ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR CONDITIONERS, eic.
OWNER'S AFFIDAVIT:
I certily 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 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 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713 Sign r of
wrier/Agent Date Signature of Contractor/Agent Date cti-i c-
E /C . y 7 e PYi tOwner
Agent`s Nairn Print Contractor/Agent's Name t AIC4 Ignature
of Notary-
ate or F o ' .I,iw.......••• Signature of Notary -State of Florida Date A. DECKER FZ
17QMBERly CO,.WDD
M575 ErtpMea 21712COO 11
Owner/Agent is
Personally Know 5W)432 s
tllrrtd d ttwr- Inc Contractor/
Agent
is _Personally Known to Mc or Produced ID Flalda
Produced ID APPLICATION APPROVED BY:
BI Zoning: nilial Date) Special
Conditions: Initial &
Dale) Utilities:
FD: Initial &
Date) (Initial &
Date)
I•
AFFIDAVIT.--
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
17
Company: /V +9 - License #:_ - -
Project Information
Owner. K . -. :. Pennit #:
Subdivision:-IAwFas
Dh=
I, , affiant, hereby affum that I am the domed 19'4011V ER
of record for the above referenced permit, that all the foregoing information is true
and accurate, and that the dry. in, (lashings at the above referenced address or lot has been
installed in accordance with the applicable codes and standards.
cvffe-<_
sipamm
J' r'. W. . j }s
prima name
STATE OF FLORIDA _
COUNTY OF -
This instrument was acknowledged before me this day -of by the
above referenced individual, c'r , whoa owledged that he/she is a
duly licensed contractor with—' :' —. - - — - - =- - , and, who acknowledged that
he/she was a_uthorized-.to:ezecute.this..document. He/she erp sonallyknown to- a or
produced as vali en .
WITNESS-my-hand and seal -this day of- - — -200L.
a..............
0.....jECKERKIMBERLY * D0o2595 s- blic
e
NWO2=
400— I Y lWN32Ine
inio iivamWnLrii rncrnnnf LVDID11THME KWS'Ej MeW I}f` CK-CUIT Cti41RT NAME
all/W:'t •U'/%-- MINBLE CWUWTY NOTI
E OF COMMENCEMENT PK
rE.>'67 Pstr'i] 8 ADDR.
f 7 Zi G & Sr CLERK'S 0 2006W9257 J
REDIiDEM 01/19/2006 11:01:44 All I&
tM State
Permit
Florida
Tax
Wj11t NB_FE'ES RECCIRDED
BY t holden 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. of
property: (legal description of the property and street address if available) 2 ,
4 "0,Cb A 41 f .. 2.
General description of improvement: 3.
Owner information a.
Name and address I
G-i. stC ' J'G GG , •C19't % /`—G- r/O fL b.
Interest in property c.
Name and address of fee simple titleholder (if other than Owner) 4.
Contractor a.
Name and address b.
Phone number Fax number 5.
Surety a.
Name and address b.
Phone number Fax number c.
Amount of bond 6.
Lender a.
Name and address b.
Phone number Fax number 7.
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes: a.
Name and address b.
Phone number Fax number 8.
In addition to himself or herself, Owner designates of 713.
13(1)(b), Florida Statutes. to
receive a copy of the Lienor's Notice as provided in Section a.
Phone number Fax number 9.
Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date
is specified) ature
WW Sworn
to ( affirmed) and ubs ribed before me this day of , 200 (p , by CERTIFIED
COPY. Personally
Known OR Produced Identification MARY . NE MORSE Type
of Identification Produced L CLERK . IRC 11T COURT SEMIN
I LORI E Signature
of Notary Public, State of Florida nc 7j;. Commission
Expires: s_. ':' " t ,