HomeMy WebLinkAbout730 Upsala Rd (3)9OPermit # : CAD
CITY OF SANFORD PERMIT APPLICATION
Date:
Job Address:
Description of Work:
Historic District:
ra
Zoning:
I
91A. 6 K
Value of Work: S
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 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 Commercial bidustrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than \)
Parcel q:
Owners Name & Address: -1 %" vkAI "O 2
1 -4 O V p5 W -C- rA P<! SQr-vv —z4-O
Contractor Name & Address: 7"11Z
L 3 z `7`7
L 3Phone &Fax: -770
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
R 10W-Pffmml
Attach Proof of Ownership & Legal Description)
1- (A-01 F-P50 k- Z- PA-9-,NPI - VIJ C* VJZC:A
Phone: -1 0
State License Nur bell: C C 0 Z Z50
Contact Person: lti , CO L1Li'hune:
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 for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, ctc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be dome 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 Wrrii 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. 10-1
Acceptance of permit is verification th• I will notify the owner of the roperty of the
nt:
Signature ofOwncr Agent Date
1 SM0 rtiin
Print Own g s Name
PDSignatureNotay-.S'Ia1AU-Iorida
S
Special Conditions:
fift fik0 )09Wo talc or
Initial
Signature of Notary -State of Florida, Date
DEBBIE BIANTON
MY CONti11RSiON # DD 188t91 Contractor/
A enters a oual.)no vn INc Produc
d ID` Utilities:
Initial &
Date) (Initial & Date) FD:
Initial &
Date) i
9
NOTICE OF COMMENCEMENT
State of Florida
Q pp _ County of Seminole
Dd Y P.•. (iIn il-t No. Tax Folio No. (PID) _
Tile undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chaptcr
O V 713, Florida Statutes, the following information is provided in this Notice of Commencement.
DESCRIPTION OF PROPERTY (Legal description of the property and street address)
z l -7 3 0 1,1(2S>a. cr_i-:::> EP z -i . 03V ast
NN,
N1 oU t G
GENERAL DESCRIPTION OF IMPROVEMENT Y1 C pr,ri
Interest in property (Fee Simplc, Partnership, etc.) r" 1,2 W t=-,t—
NAME AND ADDRESS OF FEE SIMPLE TITLE 11OLDER•(IF OTI.1L•R TI.1AN OWNER) _
CONTRACTOR
Name and address l4GOL Ploo-4
Roe) e L-- e o r ri']__ --a, -n—r r
q TFIR Ill " oil if of; if 1111111111 amit II ill II1111 I'll I fill
SURETY (Bonding Company)
Name and address MAIRYANIVI; Miws _ ri FQu t)- RCUIT COURT
SEM1Nill E CUP -1 tTk-
Amount ofBond BK 060713 PG 1763
CLERK'S #1 2006005719LENDER
Name and address RELORDED 01/12/2006 06:16:47 AM
oval
ssssssssss sss*sss*ss,*s*ssssssss*ssssssss sassssss sssrr.*sss*sarssssrsssrsssw**.s sss.*...
Persons within the State of Florida designated by Owner upon whom notice or other documents may be served as pro-, 1ded
by Section 713.13(lxa)7., Florida Statutes:
Name and address
ssssssssssssss*sssssssssssssssssssssss*sswsssssssssssssssssssssss sssssssss s**sss*ss•:ss*+
In addition to himself, Owner designates of
to receive a copy of the Licnor's Notice a;
provided in Section 713.13(l)(b), Florida Statutes.
ss**sss***ss**ssssss****+s*********sss*sss**s**ssssssss******ss**sssssass•s*ssssrassss.s***
i
Day of a.n
My Commission Expires:
T —
zC
The foregoing instrument acknowledged acknowledged before tare this _ day of Mtru1L , i4 1
1 NI S l C k M (name of person acknowledged), w s rso me
or who has produced (type of identification) as and
who did / did not take an oath>
AFFIDAVIT
REG ING ROOF DRY-IN AND FLASHING INSPECTIONS
Company: o oo License #•
90 0 ;: ",CA,
t '
Project Information
Owner: `T M 0 it - Permit #;
fname
3 o v PS J #-- Subdivision:
address
y c -7- 3 3Z - bo S Lot #:
phone
I, D IeOC aff ant, 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:
r signature
oUL
printed name
STATE OF FLORIDA
COUNTY OF
This instrument was acknowledged before me thi \ ` day of , 20 _, by the
above referenced individual, 4,—K co L, who acknowledged that he/:;he is a
duly licensed contractor with oP oA an"iQ acknowledged that
he/she was authorized to execute this document. He/she is eithe rsonally wn to me or
produced as valid id ti ication.
WITNESS my hand and seal this day of
DAFNEY FAYE ADCOCK'
i
NOTARY PUBLIC, STATB OF FLORIDA
11 MY Comm. Expires DEC. 2, 2008 Notary Public
COMM. N DD378609
tl
POWER OF ATTORNEY
Date:
1, Andrew J. (Andy) Adcock do hereby,authorize, .
To pull the Reroof permit for 47jk- typc
of permit) (,jddrcss) N
CAFNEY
FAYE ADCOCK NVAnypUSUC, STATE OF FLONDA MYComm. Es<pinS DEC. 2, 2000 COMM, #
Stamp
Personally
know o me or driver license of State of Florida, County of day
of GO
Page 1 of 2
Parcel Information 12 January 2006
Parcel:33-19-30-5AF-0000-0260
Property:730 UPSALA RD
SANFORD, FL 32771 5602
Owner:CHURCH SAFEHARBOR CHRISTIAN
Mailing:INC
730 UPSALA RD
SANFORD, FL 32771 5602
Legal: LEG LOT 26 (LESS RD)
NEW UPSALA
PB 1 PG 67
TRY: 2006
TD: S1 SANFORD
DOR: 71 CHURCHES
Exemption
36 CHURCH/RELIGIOUS
Homestead Year Granted:
Amendment-10
Amendment-10 Prior Year Total Re Appraised Addtion Total
and Value 184,457 184,457 184,45
xtra Features
Building Value 48,786 48,118 48,11
Income Value
Total Just Value 233,243 232,57 3 232,57 3
Correct Assd/Admin Value
Classified Value
OH Adjustment
Total Assessed Value 233,24M 232,57 3 1 232,57 3
SALES
ale Deed escription Sale Date ORB Book ORB Page Sale Amt 1 QC
U D ARRANTY DEED 04/01/1989 02058 0463 167,00 1 00
U D UIT CLAIM DEED 05/01/1987 01848 1347 10 1 00
U D ARRANTY DEED 07/01/1985 01655 1195 80,00 1 00
U D ARRANTY DEED 1 04/01/1984 1 01539 1 1496 75,001 I 1 00
Q D ARRANTY DEED 1 03/01/1983 1 01442 1 1511 61,00q I 1 00
LAND '
CODE Land Rate Ag Rate Land Area Frontage D/T Depth Class Value Adj Ovd Reason Just Value
AA 50,000.00 0.00 4.340 0.0 0 184,45 85% 184,45
AA 20.00 0.00 0.350 0.0 0
Total: 184,457 184,45
Q
CITY OF SANFORD PERMIT APPLICATION
Permit # : O V q 3 Date:
Job Address: I'X'70 MA LA IZ OA'J , S A N F06M p t ov2
Description of Work: A-DA 1TjI9+J Orr V fLa%oUL 1U ct;c ffKZ6S
Historic District: Zoning: Value of Work: S 2) OaC • 00
Permit Type: Building Electrical _ (.. Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration 4 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 Commercial Industrial Total Square Footage:
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:tNEriZ s..rsCtQN A'i aN/ft. T ALT`t — I(VIO SfittNe. Cfdt. StiJTH. fSLV(>,
4JrPA%CT+s'0j 6Q6t1N4Li Gt 3'L-714 Phone:
Contractor Name&Address: E12%LF.cTR(C Cb(L?.y104 SoNPoAT LN 'lb SSO , 0tZ%.A4,4o
F(t,Rt i>* *37-EC09 State License Number: Cc, 000 24 IN
Phone & Fax:1167-VS9 -"9b % -47 M - oS(2 Contact Person: 900%400 W Ol,le^I Phone: t4e'7. l 9—W994
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. 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.
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. 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 I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
we""' Tom.AteSignatureofOwner/Agent Date Signature of Contractor/Agent
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg: ing:
mtial & te)
Special Conditions:
Signature of Notary-319Te of Florida
V(tAE l-k--STD t .
Contractor/Agent is Y Personally
Produced ID
Initial & Date)
Utilities:
Jyc' ii,s
ANNE HERSTOL
EXPIRES: November
COMMISSION D3 51549
oaaaedWrWcUndo It.. FD: Initial & Date) (
Initial &
Date)