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Home My WebLink About609 8 Ste-. �j CITY'OF SAN ORPERMIT APPLICATION Permit #: 0 _ w Date:4 7h F Job Address: �Qq 57 Description of Work: 7)emokk 5 F R Historic District: Zoning: Value of Work: S 1000 Permit Type: Building —Y-- 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 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: ywk OGI tnyo T- Phone: Contractor Name & Address: o�� >ft?dtt bn f!! /X liA j State License Number: Phone & Fax: Contact Person: Phone: 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: 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 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 requiremen of FI a Lie ^ w, FS 713. -7117111-5 Signature of Owner/Agent Date Sig re of Contractor/Agent fbate ? . J` Print Owner/Agent's Name Signature of Notary -State of Florida Owner/Agent is _ Personally Known to Me or Produced ID Bldg: (initial &kp2Z,oning: (Iate) Date APPLICATION APPROVED BY Special Conditions: (Initial & Date) Utilities: FD: (Initial & Date) (Initial & Date) a rint s ame v 3 ry-State of Florida Date PL a. re w' tv is Personally Known to Me or c ov�Contractor/Agent c ID �_ —AEe,&oduced (Initial & Date) Utilities: FD: (Initial & Date) (Initial & Date) Release and Hold Harmless Letter of Authorization to Participate in the Seminole County Community Development Block Grant Demolition/Clearance program SEMINOLE COUNTY GOVERNMENT PHONE: (407) 61i5-7384 PLANNING AND DEVELOPMENT DEPARTMENT FAX: (407) 6tA-7366 1101 EAST FIRST STREET DATE: 04107/03 SANFORD, FL 32771 We, _ Augusta and Anselmo Godinho (name) Who reside at 1882 Rex Cour, Lon wood FL 32750 (address) Do hereby authorize Seminole County and its authorized employees and agents, to enter upon and demolish nd cle-ar structures and debris from the following property: Parcel 1D# 2S-4340-SAG-1fl09-0060. Len Lots 6 + 7 Blk 10 TR 9 TOWN of Sanford PB 1 PG 62 and 23-19-30-5124009-0080 Lots 8 ' +-10131k 10 TR -9 -A-C'MartigirAdd PS -1 PG- 2- (legal desc�iptit5n ofi �rroper<y), further described as Single -Family unit at 609 W 8 St. Sani'ord FL 32771 (street address) We represent that we are the legal owner(s) and hold title of the foregoing property anti that we have full authority and right to grant the permission given by this documcrit. We also recognize and agree that funding for this program is entirely granted by the Community Block Grant (CDBG) and that We will release, indemnity and hold hannless Seminole County, the Board of County Commissioners, Officers, employees, and agents From and againsi: any and all liability, claims for personal injury or death, and loss or damage to any property of any kind whatsoever arising out of or in any way connected with the permission given by this doct,ment. nt Name Signature (Witness) Signature (Witness) BARBARA McGYLL —� rizff .1 A L1ffd5&0%-J^ L�L-Z Print Name Print Name State of Florida, Seminole County W1TN S: Signed, sealed and delivered in our pr Signature (Owner) Signature Owner) AUj LMO GODI13Hd AUGUSTA GODYNHO Primo a P� a � ignature fitness) ignature tress) GAIL CiiApMA11 Print Name r PrBARBARA Mr.GMT, i The foregoing instrument s acknowledged who ersonally wn to and who (did) (did not) take an oath. n AlftPtmgr B. Stedweit Commuda * W mat 71 r � llQ"Ue a=NH•s eo.. tm me this day of j by------- (Name), y(Name), me or who produced (type of identification) as idttntification ird ptary FJOW,, in and for the and lorida (Seal). L;1pd\tcm=1CD1PROIECTS\Clcwmce\20022003.Lmas and Authoriai6ons16098WSiOodint.oLcmmfAuthorizatio FomL9.doc The foregoing instrument s acknowledged who ersonally wn to and who (did) (did not) take an oath. n AlftPtmgr B. Stedweit Commuda * W mat 71 r � llQ"Ue a=NH•s eo.. tm me this day of j by------- (Name), y(Name), me or who produced (type of identification) as idttntification ird ptary FJOW,, in and for the and lorida (Seal). L;1pd\tcm=1CD1PROIECTS\Clcwmce\20022003.Lmas and Authoriai6ons16098WSiOodint.oLcmmfAuthorizatio FomL9.doc DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing Public Works Acknowledgement A. Sidewalk Closing B. Street Use/Closing 1. Walkways — Protection — Width 2. Barricades — Protection — Width 3. Fencing — Protection — Width - Height 4. Curb Protection/Sidewalk Protection/Street 5. Storm Sewer Protection C:. Dust Control . Police. Department. Acknowledgemen t. A. Traffic Control B: Crowd Control/Security Utility Department Acknowledgement A. Water, Sewer — Capped off, Sealed B. Water for Dust Control (Meter) Engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: Additional Comments: D�� 1-111, <0-+ DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing Public Works Ackpowledgement 1 5 . Sidewalk Closing B. Street Use/Closing 1. Walkways — Protection — Width 2. Barricades — Protection — Width 3. Fencing — Protection — Width - Height 4. Curb Protection/.Sidewalk Protection/Street 5. Storm Sewer Protection C; Dust Control Police Department. Acknowledgement. A. Traffic Control B.' Crowd CoritroUSecurity Utility Department Acknowledgement A. Water, Sewer — Capped off, Sealed B. Water for Dust Control (Meter) Engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: Additional Comments: I -IF 1o3 7-17-203 1 1 : 3fiW4 FROM DEMOLITION Building Division Acknowledg6went A. Permit Application 8 State Forms C. State Statutes/Contractor Licensing Public Works Acknowledgement A. Sidewalk Closing B. Street use/Closing 1. Walkways - Protection - Width 2. Barricades - Protection - Width 3. Fencing - Protection - Width - Height 4. Curb Prote gjowSidewalk Protection/Street S S S w Protection P. 3 - form o er - C. Dust CogtrR Police ]Department Acknowledgement. A,, TOM Control B. Crowd- ControMcarity- Utility Dapartment Acknowledgement A. Water, Sewer - Capped off. Sealed B. Water for Dust Control (Meter) Enginetring & Planning Acknowledgement A. Historic District B. Zoning issues Address of Job:. Add itignal Comments. EO 39Vd Gd GdOJNVS ODSZZOELOP 90:80 E00Z/8i/L0 DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing Public Works Ackpowledgement A. Sidewalk Closing B. Street Use/Closing 1. Walkways — Protection — Width 2. Barricades — Protection — Width 3. Fencing — Protection — Width - Height 4. Curb Protection/.Sidewalk Protection/Street 5. Storm Sewer Protectidn C. Dust Control• ' Police Department Acknowledgement. A. Traffic Control B: Crowd Coritrol/Security Utility Department Acknowledgement A. Water, Sewer — Capped off, Sealed B. Water for Dust Control (Meter) engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: Additional Comments: f7)K- D, `,w6fl 7/Z 1/0 3 DEMOLITION •e Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing ' Public Works Acknowledgement A. Sidewalk Closing t ; B. Street Use/Closing 1. Walkways — Protection — Width 2. Barricades — Protection — Width 3. Fencing — Projection — Width - Height 4. Curb Protection/Sidewalk Protection/Street 5. Storm Sewer Protection _ C; . Dust CoiRtrp.l ' Police.Department.Acknowledgement, A. Traffic Control B: ' Crowd ControUSecarity, Utility Department Acknowledgement . Water, Sewer — Capped off, Sealed B. Water for Dust Control (Meter) Engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: (�'j T"*' <s+ S T •v• Additional Comments: r. e 0 = j66 0. #* al it 14a,