HomeMy WebLinkAbout3000 Mellonville Ave (3)77 -V a^:rat
03'� 38q
Permit #
Job Address:
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Mfgl*vi.;//v Abx--
Zoning:
Date: S -.?7 43
Value of Work: S
Permit Type: Building Electrical %C Mec ampal Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS— A ditton/Alteration X Change of Service Tempot'ary 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: I&S'T
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Ad/dress:
.5e,,t P. f7i rr
Contractor Name & Address:
W
Phone & Fax: 1167.3ZZ 1SAZ
Bonding Company: N/A
7-;e>4-
x�C'/eve!
E/P�Tri c
(Attach Proof of Ownership & Le al Description)
.1�,47W/ Z 3277.
Phone: Sol-2,1'Ql
S�tate License umber: ``��9 _
Contact Person: j;/,w y Phone:
Address:
Mortgage Lender:__—
Address:
Architect/Engineer: /" /Q • 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 i.he
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 ofthe �require, FS 7
Signature of Owner/Agent Dateignature 0<ontra r/Age Date
Print Owner/Agent's Name Print Contractor/Agent's Name
.Se • 3
Signature of Notary -State of Florida Date Signature of Notary- tate of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID 6�4-v
fL�
APPLICATION APPROVED BY: Bldg: Zoning:
(lnitial & Date)
Special Conditions:
r�Contractor/ s <l'ersonally Known t. �r
Produced ID
Utilities: FD:
(Initial & Date) (Initial & Date) lrrit ate)
9�7`ha
BARBARA HURLERMy J
CommNo. CC 990570enanv ltnawn t'I WIff .
NOTICE OF COMMENCEMENT
Permit No. 0 3 -1q? Tax Folio No.
State of Florida
County of Seminole
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chaptea 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1
F)
3
Description of property: (legal description of the property and street address if available)
3cc1D Inellahu:!/tv Aae , j,an kird FC 3 z 7 73
General description of improveMe'nt: Arial COW ASA 39 Wb/277l1 --""WAV 414*10 �'or
(.) C,krtt" l koS
Owner informatioif
a. Name and address Sari f or(J 4 rpcxr`C 4uT-,ori tf � I 2e d C/eue (and J31u4
Sz7 -7 3
b. Interest in property
c. Name and address of fee simple titleholder (if other than Owner)
4. Contractor
r' Name and address
Ni ---Phone number 0 0-7
5. Surety
a. Name and address
b. Phone number _
c. Amount of bond
6. Lender
a. Name and address
nfd-rd Vec,Tric. Zr2i. So �Rwk -pi,
Fax number
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
8. In addition to himself or herself Owner designates
Fax number
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 unl ss a different
date is specified) T)aAa (?Wos
Sign e o Owner 'AA
Sw to (or affirm d) and subscribed before me this r3D� day of 20� by
— CERTIFIED copy
MARYANNE MORSE,
Personally Known L�/ OR Produced Identification CLERK OF CIRCUIT COURT
Type of Identification Produced SE INOLE OU N . F RIDA
DEN1TV .LERK
Mn D. Gifford �y
Signature of Notary Publi e of Flonda MQI 3 0 20�
MY COMMISSION # DD103515 EXPIRES
' ^:• 7u 24, .2006
H
Commission Expires: SONDEDTHRUTROY FAIN WSURANCE,INC