HomeMy WebLinkAbout608 W 20 Stw,.
Permit #: U.0
Job Address: 44
Description of Work:
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date:
Value of Work: S I ' .70Uy Permit
Type: 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 7cornmercial
Closets
Plumbing Repair - Residential or Commercial _ Occupancy
Type: Residential Industrial Total Square Footage: gep Jow
Construction
Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: (
Attach Proof of Ownership & Legal Description) Owners
Name & Address: S lt'1-91- .-7 —/5 44 Z L49E:7 —7
C ( 1 1'i Z a> S % /9 I ti Phone: 7 — / Z ) 7.fy r
Contractor
Name & Address: Phone &
Fax: Bonding
Company: Address:
Mortgage
Lender: Address:
Contact
Person: State
License Number: Architect/
Engineer: Phone: Address:
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 constriction 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 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 ibis
county, and there may be additional permits required from other govemmental entities such as water management districts, state agencies, or federal agencies. Acceptance
of permit is verification that 1 will ljfy the owner of IV prorty of the requirements of Florida Lien Law, FS 713. Signalu of
Owner/Agent Date Signature of Contractor/Agent 15,Te
od z, n I> q 21' z P Owner/
Agent's Name Print Contractor/Agent's Name r Signature
of
N61ary-Stale of Florida '+' Date Signature of Notary -State of Florida r' J #
DD 15Si&1 L obruary
25. _^07 rprr:vrtA:
c. t- Date
Date
Owner/
Agent
is - P rsonally V io a Contractor/Agent is _ Personally Known to Me or Produced ID
li I 1 3 I ea _ Produced ID APPLICATION APPROVED
BY: Bidy"'t), Zoning: initial & Date) Initial &
Date) Special Conditions: P
L4% ov
Utilities: FD: Initial &
Date) (Initial &
Dale)
w
NOTICE OF COMMENCEMENT
Permit No.
State of Florida
County of Seminole
Tax Folio No.
The undersigned hereby gives notice that improvement will be made to certain real property, and in accorjW4FMtb COPY
Chapter 713, Florida Statutes, the following information is provided in this Notice of ComniencementjVIARYANNE MORSE
CLE!j OF CIRCUIT COURT
1. Description of property: (legal descni tion of the rope and.street address if available) `F IroUNTY. FLORIDA
i h 4i ;' •• FJ•i+i / -7.- \:i mil ( %' - \I \
2. General description
3. Owner information
a. Name and add
2 7 / .:.
b. Interest in property
c. Name and address of fee simple titleholder (if other than Owner) NI=
4. Contractor ,
a. Name and address (%G(J/9 hNiRYANNE MNIRSE, CLERK OF CIRCUIT CItT
b. Phone number Fax number i I 1Pq)
5. Surety
a. Name and address RE[ WFD 82/9912M 19:53t 19 AN
b. Phone number Fax number RE130M 01 L WKINIfy
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 whompotices 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
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 date of recording unless a.different
date is specified)
l Signature of Owner
c
tiv6t -t .-r 7 iL-•e.
Sworn (or a ed) and subscribed before me this day of , 200 , by
Personally Known OR Produced Identification v-1
Type of Identification Produced F-1,j L, 3 13 I o-7 THIS INSTRUMENT PREPARED BY:
p
NAME
ADDR.
Signature of Notary Public, State of Florida r ' i r• °f' ' Sta-.7 , s. /L '77.2
Commission Expires:
3:
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: License M
Project Information
Owner:
name
POCO apt`` f address
phone
Permit
M Subdivision:
Lot
M I,
c- 9 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. ow
ne-' (/ srgna`•wc '7J,/
printed
name STATE
OF FLORIDA COUNTY
OF This
instrument was acknowledged b fore me this ' day of Fe-3 , 20 0(q by the above
referenced individual, EQA-Q--- , who acknowledged that he/she is a du
n rac or w>! M , and who acknowledged that he/
she was authorized to execute this ocument. He/she is either personally known to me or produced
r-l> L— CI R • 3 113 3 as valid identification. WITNESS
my hand and seal this _ day of a-Alk- , 20 0(.? pFEB'
BW, ITON IdY
CC- • ''`J OD IE5481 Notary Public r -:•
z-nor,. v .-,•....ti •
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