HomeMy WebLinkAbout700 E Airport Blvd (9)CITY OF SANFORD PERMIT APPLICATION
Permit #
Job Address:
la - 1.1 W
Description of Work: WT T 1
Ilistoric District: "Zoning:
Z-D-0t0
Value of Work: $szoo . n
Permit Type: Building Electrical Mechanical Plumbing A— Fire Sprinkler/Alan 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 & Sewcr Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair - Residential or CommercialiM
Occupancy Type: Residential X Commercial Industrial Total Square Footage:
Construction Type: # of Stories: Z # of Dwelling Units: — Flood Zone: (FEMA form required for other than X)
t^
Parcel #:
e _ 1 (
Attach Proof of Ownership & Legal Descripli )
Owners Name& Address: 1I I D:1i U \),U-a& knA. -7M r Q1Q ii Xin na
Contractor Nam & address:
Slate License Number:Q C A
Phone & Fax:4tn^-t"ly 1' L Contact Person: impyn Phone.
Bonding Compare: `
Address:
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address: 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 for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNERS AFFIDAVIT: I certify that all of the foregoing informalion 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.
addition to the requirements of this permit, there may be additional restrictions applicable to this ropeny that maybe found in the public records of
nd there may be additional permits required from other governmental entities such as water na ent districts, slate agencies, or federal agencies.
t1 of permit is verification that I will notify the owner of the property of the r it Is to da en La FS 713. e a en •
O
42a WiregnatureofOwner; Agent Date lure of Contractor/Agent Date 7c
E '
nt OwnedAgent's Name Print Contractor/Agents Na e E
Co
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gnalure of Notary -State of Florida Date Si natu otary-State of Florida Date ve.e a„U a
s
F •. o, •
s` wn - /Agent is _ Person411y Known to Me cfr Contractor/Agent is _Personally Known to Mc or Produced
ID - L- i iYl LL11A -JAUn5) _ Produced ID APPLICATION
APPROVED BY: Bldg: Zoning: Utilities: FD: Initial &
Date) (initial & Date) (Initial & Dale) (Initial & Date) Special
Conditions: r`
erHarvey L. Bt ker My
Commiallon DD304324 a
np' Expires Vmch 28.2006
MV 14101INVIVI M rnr-rmmr-u oi.
NAME i1-'c 61 , C AMTS)
ADDR.NOTICE OF COMMENCEMENT
Permit;Zza, ) L 4 I y op- L 1Z Tax Folio No.
State of Florida
County of Seminole
CERTIFIED COPY
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordalllATttYi NNE MORSE
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. CLERK OF CIRCUIT COURT
SEMJN . FLORIDA
1. Description of property: (legal description of thtproperty and street address if available)
2. General description of improvement:
3. Owner information
a. Name and address
b. Interest in property (N.,Q si
c. Name and address of fee simple titleholder (if other than Owner)
4. Contractor 2V kjc i ' - i
7 . Name and address V Zy e AAe '
b. Phone number
5. Surety
a. Name and address
is
b. Phone number _
c. Amount of bond
Lender
a. Name and address
Faxnumber ern
z
v Fax
number r "n ,may zw 0
a owb.
Phone number Fax number CD 7.
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served • z provided
by Section 713.13(1)(a)7., Florida Statutes: W a.
Name and address I jp b.
Phone number Fax number 8.
In addition to himself or herself, Owner designates NN,. =- 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 I year from the date of recording unless a different dateisspecified) Signature
of Owner Sworn
to (or affirmed) and subscribed before me this day of qua p , 20 0( by Stnrivc mo n-1-5 Personally
Known OR Produced Identification Type
of Identification Produced n( (0 n N
ry ar
Po •• TERRA APPLING Signature
of Notary Public, State of onda *' °fO Public - Stole of Florfdo Commission
Expires: = o-' n 0n sJul29,. F,;,.
omm"Slon # DD By342309
I
tided `bnonoiNot°ryAssn. 7 r