117 Hazel Blvd; 17-2088; FENCEJLL 1 1Oa 3
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $
Job Address: 1 B \rd Historic District: es No
Parcel ID: -a O -- G' tr Residential Commercial
Type of Work: New Addition Alteration Repairr Demo Change of Use Move
Description of Work: )9O I
TLL
1 w 1 1
14 " Ga-\-e 6LA A i - to the io ce4e_ Plan
Review Contact Person: T, _k C. CA k XGti DC y
Title:
0CCO"w— t Phone:
1 -- x
Fa `:
Email: -rAcia QY'1c S l X- encg•COIN Property
Owner Information \ f
r Name
J' a (yi P 1 4 ?-e-v-) ' Phone: Ivy 4 — V FS-77 Street:
1 &726\ 4-C - Resident of property? : Cwed Q_ 0 City,
State Zip: so (4vd F IrL 1]_
i-)
fin
n
Contractor Information '`\ /;
n Name (
1
rf J _J(t re.r)c (W Phone: -qccg gD Street: So
o-h(-\doe MLM-CkaQ Fax: k Frg-',S(oL —A 76t _- City, State
Zip: "' ( Q 1e.5, State License No.: 7s 3 Name: Street:
City,
St,
Zip: Bonding Company:
Address: Architect/
Engineer
Information Phone: Fax:
E-
mail:
Mortgage Lender:
Address: 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. 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. FBC 105.
3 Shall be inscribed with the date of application and the code in effect as of that date: 5" Edition (2014) Florida Building Code Revised: June
30, 2015 Permit Application
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.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
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.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
1991Ile
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Print ntra or/Agent's Name
Signature of Notary-Stat ri ia iaFrankenfleld Date
aQ NOTARY PUBLIC
g -STATE OF FLORIDA
a Comm# GG063882
N E 9 Expires 1/18/2021
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas[] Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No #` f Heads
4X
APPROVALS: ZONING: - - 0 UTILITIES:
COMMENTS:
ENGINEERING: FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Ok to install approx.2 linear feet of 6' high
privacy fence and 2. gate(s) as shown on
plan. Fence shall be constructed with
finished side facing outward.
Revised: June 30, 2015 Permit Application
11111111111111111111111111111111 # 11 fill
THIS INSTRUMENT PREPARED BY:
Name: MOSSY OAK FENCE, LLC
Address: 271 SOUTHRIDGE INDUSTRIAL DRIVE
TAVARES FL 32776
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number
i I, F1L 1' - bEa7J l I!_!Lc ':_a)U;d I 'r
CLERK O : 1:i;:_:L1'): i CJ .1%,..
CLERK'- 201.7068f 85
1;' j! L "?I_i a. , I• _ - -^, 1_,.,, -•i`;
r r r t ;l li'
T.
E DCIRD :N .i FEES ::i. _ _ _
r
Parcel lb Number.) Q Off/— 1 —50`% '&-20
The undersigned hereby gives notice that improvement vdll be made to certain real property, and in accardance with
Chapter 713, Florida Statutes, the foliovirg information is provided in this Notice of Commencement.
GENERAL DESCRIPTION OF IMPROVEMENT:
Fee Simple Title Holder {rf other than owner) Name:
CONTRACTOR:
1 Name. MOSSY OAK FENCE, LLC
Address_ 271 SOUTHRIDGE INDUSTRIAL DRIVE TAVARES FL 32778
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served
as provided by Section 713.13(1)(b), Florida Statutes.
Name:
Address:
In addition to himself, Owner Designates
To receive a copy of the Lienor's Notice as Provided In
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a
dlfferant date is specified)
WARNING 7'0 OWNER_ ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I. SECTION 713,13,.
FLORIDA STATUTES, AND CAN 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 08TAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalties of perjury, 1 declare that I have read the foregoing and that the facts stated in it are true
to the b7F off myy kno-IAw//P{/7dg/e/and belief.
Janees Sig a;u.a LAvmr's anraac Nemec
Fj,ids statute 7t3.'.3(1 Xg): - Tha •7^nor must sign the notice of ammencomant and no one Me may be perreitted-to sign In his cr her stead;
State of , (; ( County of
The foregoing instrumert as acknowledged before me thisZ day of
by ( of , C, % J Who is personally known to me
Name of person making
statementP produced:
r`
OR who has produced identificationQ e of identification
ot""r Pup,- JENNIFER RAPP KEO ENEter°°(+
W COMMISSION t FF 044604
EXPIRES: December 10, 2017 Noury signature F .
rFOFnoa c BorbedThrulludgONotary Sovim gV
i
Limited Power of Attorney
Date: `-Li-I
I hereby name and appoint: llLo 6 021 an agent of Mossy Oak Fence to be
my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for:
The specific permit and application for work located at:
I l -7 -a 2 d /J( V-d Sa a i vd
License Holder Name:
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF IC
71
The foregoing instrument was acknowledged before me this`ay of
201-1 ,by C rG,2&x MLi er Is personally known tom or
produced identification and who did (did not) take an oa -
Signature "'?Xav
Print or type name tmr Shannon Frankenfield
Notary Public - State of
Commission No. Expires:
a o, NOTARY PUBLIC
STATE OF FLORIDA
Comm# GG063882
wr 19lib Expires 1/18/2021
J
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