HomeMy WebLinkAbout711 E Airport Blvd (4)6�
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CITY OF SANFORD PERMIT APPLICATION
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Permit No.: =I 1� ko"
Job Address: %// /---. A/ gd2n h`%
Date: S
77
Parcel No.: 2 - -30 505- 0000 -p(y p (/ (Attach Proof of Ownership & Legal Description)
Description of Work: -, --- . v / / .42.,
Type of Construction: �yo Flood Zone:
Valuation of Work: $-J b� L ZyOccupancy Type: Residential Commercial Industrial
Number of Stories: Number of Dwelling Units: Zoning: /2-( Total Square Footage: (r 00
Owner: A k'if . V I -L kL-
Address:
City:
State:
Phone No.: 1( 0-% - 33 d - 2 ff SS Fax No.:
Contractor: 0 L4%
Address: SO ,041 0 IF , el t
Zip:
City: (� 0V / State: Q Zip: �0F State License No.: _(f-CCOYd'/77
Phone No.: "(00- 2 Z .- %7S Fax No.:
Contact Person: /I -,PSA H ¢ f j� A ZAj Phone No.:
Title Holder (If other than Owner):
Address:
Bonding Company:
Address: --
Mortgage Lender:
Address:
Architect:
Address:
Phone No.:
Fax No.:
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.
o
Signature of/Ownerr//Agent Date i o Contractor/Agent Date
ft"a 6 f PC- A2/f1-f4. 4EDAva
,ri A nt's ame
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of Ngo � Jq,to NF1(:,0
MFILA G. COPELAND
* * kl / 004,tMISSION # CC 946986
N c '.RES: July 16, 2004
FOF
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9TR��� 5•=•-e. firm budget Wary Services
Owner/Agent is V Personally Known to Me or
Produced ID
Print Contractor/Agent's
of Florida
Date
/ C.�ZC§�t�40TARY
1ENNIFER BAKER
'141> Comm E. 5/29/04
o. CC 945339
Per<Onz!ly f✓v¢oum I Other I.D.
Contractor/Agent is - Personally Known to Me or
Produced ID J -f 33 0 _ y 2 0 - 21 - y _ o
APPLICATION APPROVED BY:l i� 7
Special Conditions:
Date: .3 ---R- 7 •-- �;
r-
Iloll 111n11nm1111moln1un1e111111111111111Nil I11o1111111111111n
Permit Number
MARYANNE MORSE, CLERK OF CIRCUIT COURT
Parcel Identification Number SEIINOLE COUNTY
H 04623 PG 1943
Prepared by: C ERK' S # 2003061926
r
IRWORDED 05/14/2003 03114102 PM
Return to: r e A'\ F(_- 4 t 1 ,q e C oLNr/cam RE MIRDING FEES 6.00
RWORDED BY L McKinley
3Gi So f'cxr liwa� cn7r cf , (�� 6�%-1 CERTIFIED COPY
7iwIARYANNE MORSE
J� g D�
1 CLERK OF CIRCUIT COU
NOTICE OF COMMENCEMENT SEM E COUN LOR
State of E
DFPI ITY Cl FRK
County of �' eA, tl\ b A AV a a
The undersigned hereby gives notice that improvement(s) will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of -property (legal descrlptlo6 of the property, and street address if available) �.
2 o -�0 - 5050000 0(00 'r-� <
2. General description of improvements)
3.
Owner information
V n n
Name AA h s•
I=e It (A
Telephone Number y6%390 — ZrSS
Address 7// .
/4 to ✓ oh / /311J,
/
Fax Number
r X27 J
Interest in Property:
4.
Fee Simple Titl Holder (if other than owner shown above)
Name
Telephone Number
Address
Fax Number
5.
Contractor
Name �
n v c
n
x/07 9;_ of S
Address 3 r� o
l �C `' � `" �j' C -e (C
Telephone Number -
C Fax Number
0
do r=i 32foc
6.
Surety (if any)
Name
Telephone Number
Address
Fax Num er
Amount of bond $
7.
Lender (if any)
Name
Telephone Number
Address
Fax Number
8. Persons within the State of Florida designated by Owner upon whom notices -or other documents may be served.
as provided by 713,13(1)(a)7, Florida Statutes.
Name Telephone Number
Address Fax Number
9. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as
provided in 713.13(1)(b), Florida Statutes.
Name Telephone Number
Address Fax Number
10. Expiration date of notice of commencement (the expiration date is one year from the date of recording unless
different date is specified):
13 -
03 X11 �� f/
Date Si npd-
Signature of Owner Nota per 713.13(1)(g), "owner
I.;",;�. I SNEIIAG.COPEIAND must sign... and no one else may be permitted to sign in
�!SSION A CC 946986
# � * his or her stead."
v
i;. S: July 16, 20041c
Sworn "`
tbscfibed'LJ � �— day of
known to me OR produced
zz
um
PAY P"
of N ary L SHFILq G. C p D
`MISSION q
� yrnr� CC 946986
rFeFrP''' S: July 16, 2004
__.__. .. "•`.9adgerNotary�Service�s
20 y 3 by
who is personally
as identification.
NOTARY e my:..,^r
PIRAc
L r''^ t' -L ^40139
I Pcrs�r�.+.ly F:non�r I l Other 1. D.
r
.. LI1?11TED POWER OF ATTORNEY
S�I�D3
DATE
I hereby name and appoint INC�yne W c!�: S 5e— 11 S
o r A N G Go nstu o f/0 n to be my lawful attorney
in fact to ac,c for me and apply t.o' Cilv 0 CN,Oto1-j for
a �� pQ� �n� d permit for work to be performed
ac a location described as: Section 12— Township, 2(n
Range �� Lot 505 Block OQO)Subdivision
and to sign my name and do all thins necessary to h's appo n�nent.
• g� �e. U��S 2S
C� Uri
Type or Print name of Ceftified Co ense
Signa e of Certifie. Contra r
,acknowledged:
Sworn to and sCbscribed before me this
Day of -4 A•:D. 19 9003
JENNIFER BAKER
Notary Publ%cjkcat/ef Florida
o MyComm Exp. 6/2�
No. CC 946139
PersonallyKnovm I) Other l.D. Il a Ll1I' e
My omm s s i o" n EScp r
n•
AC# 0 5 2 4 8 4 1 STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L02081203048
The RESIDENTIAL CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2004
HEDAYAT, ARMAN
ANC CONSTRUCTION INC
3450 PKWY CENTER CT APT 6071
ORLANDO FL 32808
JEB BUSH
GOVERNOR DISPLAY AS REQUIRED BYLAW
KIM BINKLEY-SEYER
SECRETARY
AC# 0 5 24161 - STATE OF FLORIDA
DEPARTMENT OF' BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L0208120
Z, 156039 IM
Tne KUUrIVU CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31,, 2004
HEDAYAT, ARMAN
ANC CONSTRUCTION INC
3450 PARKWAY CENTER CT APT 607-I
ORLANDO FL 32808
JEB BUSH
GOVERNOR DISPLAY AS REQUIRED BY LAW
KIM BINKLEY-SEYER
SECRETARY