119 Lake Ada Cir 09-1424 (a)NOV 4 2008
� CITY OF SANFORD PERMIT APPLICATION
Application # : j `� (i I Submittal Date: �r <
Job Address: di / 69i`(L6Kj i /1 PIAK l I Value of Work: S
Parcel ID: 3o - S6 I - (p o 0 - v o 7 I Zoning: Historic District:
Description of Work: Uy-ioa CCAPPcA7 ) AS -G gi
iZ - o-1 Square Footage:
.......................................................................................... ...............................
Permit Type: Building � Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler /Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service — N 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 ❑ Commercial ❑
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
.............................................. ............................... ..... ............................... ......
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Property Owner: C i ! V O F n3A A/ PO/%r� Contractor:
/�� ZNC.
Address: Sun /y. �A 21L R t/,c Address: d " 0x S S f L!/J /LP � f� 39LNSI_ 0 � 2s "
SAr,Fotl , Ft, '2.I0 0 .SE RALIS LvIq S N'V
Phone: E -mail: Phone: State License Number:
Bonding Company: lorrttpg Lender: 4AU&
Address: Addr ss: f0 % �/' �% l c ?aj' 3 0
.arch itect/Engineer: �-K ( .-
Address: 7 1 Q
Plan Review Contact Person:
f.
Phone: Fax:
Fax:
E -mail / !1
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, BEATERS, 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
constntction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. 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 ofthis permit, there may be additional restrictions applicable to this property that may be found in the public records of J
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
Signature of Owner /Agent Date
P'?IILL- i'�Ia_o, 11 —L).Ug
Print Owner /Agen 's Name
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S g r ot State of t?NbnFiS V e[oN epua� r1�y �,,
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.S.�Z¢Z£4(008) njgi paPu08 6.'s
E A. BURG ; eooz/9t s9,i x3
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Comm# D00388226: 9CZ9980t]01
o D
;? Expires 5/1512009 cJanSN
tl 311nf '
' - `Bonded thru ( 8001 432. 4�{ ........ .............................n!
oTn %,OwneF(&WImNigety A y Known to Me or
APPROVALS: ZONING:v I ' UTIL: FD:
Special Conditions:
Rev 07.07
of Florida Lien Law, FS 713.
o -ZE, (38
Sign;te o C,bntractodAgem Date
. n \ u . 1
f - 7a-
-
SignarureofNotary -State of I rida NOTMV PUBLIC -STATE OF FLORIDA
Pidde L. Evans
Commission #DD795435
Expires: JULY 31, 2012
BONDID THRII ATl.Ati1'IC BONDING CO., INC,
Contractor /Agent is _ Personally Known to Me or
_ Produced ID
ENG: BLDG: D�
Permit No.
Tax Folio No. J - 1 - SC) ._ S(7 % ' 0�)00 - 66 7 4
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
The undersigned hereby gives notice that improvement
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.
1111111IIIif11 11111 1I I III II1111111111111II111it III I I III Ifill
MARYANNE M010 -- ;, CLERK 01- CIRCUIT GCIJRT
S &MTNI]l.E Ci1111Vi'Y
DK 07087 PA ob27 i { 1 pR)
CLERK" S # 20081 3662
RECORDED 11/04/008 08:44:40 AN
RECORDING FEES 10. ND
RE'CORDI_D BY L_ McKinley
1. Description of property: (legal description of the property, and street address if available) 1910 LC rU S - S-
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