300 Laurel Ct; 18-4090; PLUMBINGCITY OF OCT 0 1 20%
NANFORD PERMIT APPLICATION
BUILDING DIVISION
Application No: 11 0qD
Documented Construction Value: $ 14 3 5?/" / 6
Job Address: J Q D Of Historic District: Yes No'
Parcel ID: 11' 2 d 36 -50' Q C 60- d 01y Residential Commercial Type
of Work: New Addition Alteration Q Repair Demo Change of Use Move Description
of Work: 10 41 ogIAJJI' //-IV %jam/O J Plan
Review Contact Person: Title: Phone:
f .Sy J`rl/c % % / Fax: AMi` q1 7 Email: c-
Property
Owner Information Name
G
Phone:
AIA Street:
7 ti Cl T Resident of property? : U-s City,
State Zip: 1 kald( /' G 32,773 Name
Street:
City,
S1 Contractor
Information Phone:
Fax:
410 %,FS% (9 q1 7/ State
License No.: 01 r 07 T `( Architect/
Engineer Information Name:
Street:
A A City,
St, Zip: K Z7 Bonding
Company: Address: /
V)4T 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: 6" Edition (2017) Florida Building Code
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
Print Owner/A,
v °
0 FOP•',
Signature of Notary -State of Florida DAtf =
FF 9%740
2 A
920,%.O,y- Onded ct"•• dew
Owner/Agent is ersonally Knowl4:l ,Lod,
Produced ID Type of IDy/id i9i38iY@44`d® Signature
of Contractor/Agent Date i1Ri861$
9A/' Print
Contractor/Agent's Name Q
O, 5,.
11 iS •• . Sign•
i ary-State of Florida 'at Fg6o1A0 '
ro°
aeonae SOOContractor/
Agent is Persor l YPUBLIC
n
a'fo•Iecb Produced
ID Type of ID°°°><ei P l !;;t®a e
BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building Electrical Mechanical Plumbing Gas Roof Construction
Type: Occupancy Use: Flood Zone: Total
Sq Ft of Bldg: Min. Occupancy Load: # of Stories: New
Construction: Electric - # of Amps Plumbing - # of Fixtures Fire
Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No APPROVALS:
ZONING: UTILITIES: WASTE WATER: ENGINEERING:
FIRE: BUILDING: COMMENTS:
Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole County, FL
inst #2018111487 Book:9220 Page:1377; (1 PAGES) RCD: 9/28/2018 1:46:44 PM
REC FEE $10.00
THIS INSTR NT R ARE Y:
Name: CN
Address:
o s
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number.
aRTIFIE OPY GRANT MAL OY
CLERK r • THL. CIRCUIT COURT'
AND MP,R ,Li z.
SEMI. OLE COi
C
BY r
UTy
Date
Parcel ID Number.
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.
DESC tPTI OF PROP TY ( age d sc ' on the roperty nd greet addre [v tla I
7 G!i I r peft Wet d os f
4 .GrAv.+
GENERAL DESCRIPTION OF IMPROVEM NT:
AJAI /n1 Y.,/'Y6ltr
OWNER INFORMATION:
Names• %i 6A -C Zvi'/
Address: _,3bb C 4a / t!;f J c„ )Pic11 d Z 7 u
Fee Simple Title Holder (if other than owner) Name: 61• +
Address:
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:
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
different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, 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 OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalties of perjury, i declare that 1 have read the foregoing and that the facts stated in it are true
to the best of my knowledge and belief.
Owner's Signature Owners Printed Name
Florida Statute 713.13(1)(g):' The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead'
State of County of
The foregoing instrum%ytra§)aCJahknowledgedbeforemethis2, day of,
by Who Is personally known to me
7ex e or ers ri:a
OR who has ptaducg04'htificatildir ,tygpf identification produced:
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NotarySignahae
6LIC, VIA
EXCAVATION PROPOSAL Date
Roto-Rooter Services Company
For Service Please Call 1-800-GET-ROTO (438-7086) Ticket No.
C
y 3— Z00 /q Z02 t
General (407) 859.9557 • Fax (407) 857-0419
1404 Gemini Blvd., Orlando FL 32837
CFC #1429187
Proposal Submitted To Work To Be Performed At
Name toNN o Name
Street 9061 Lovvel Street
City 5 ti h a -J City
State f5 (oK f ZIP 3 Z State ZIP
Telephone Number Telephone Number
Roto-Rooter hereby proposes to furnish all the materials and to perform all the labor necessary for the completion of:
Include make and model of materials and necessary labor, and state anticipated contingencies that would materially after the estimated completion date.)
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1. Roto-Rooter will perform the work described above and supply all required materials for the sum oT ZO f.; , 0 -
Customer will make payment as follows:
5O % of the cost ($ (qO
oS1 ) upon execution of this Agreement.
of the cost ($ ) upon the start of the work.
Balance of the cost upon completion of the job.
S 2. The approximate starting date is and the approximate substantial completion date is
j. Neither date is guaranteed. Unexpected conditions or problems could cause delays. A definite completion date is not of the essence.
r
3. Roto-Rooter guarantees that all materials will be as specified above and that all work will be completed according to standard
t practice and in a good, workmanlike manner.
1 4. Customer will provide all necessary easements and rights of way. Unless specifically stated otherwise above, (a) Roto Rooterisnotresponsiblefortheremovaloftrees, sprinkler systems, underground and above ground fencing, rocks, sidewalks ordriveways, or the repair of streets, sidewalks and the like, (b) Roto-Rooter will back fill and grade the excavated area to ground
i level and mound it to allow for settlement, and (c) Customer is responsible for all landscaping repairs or replacements
Customer required following completion of the job. Roto-Rooter is not responsible for damage resulting from poor weather.
ioi ws 5: If we cannot video or inspect the complete sewer line, we will give you a price to repair the section that we believe is causing
the restriction. After we have uncovered that area, we will attempt to inspect the rest of the sewer line. If additional work needs
to.be done, or a complete sewer line replacement is required, we will propose a price to properly complete the work. The price
for the additional work may be significantly higher than the original proposal. If you decide not to proceed with additional work
we propose, you will permit us to complete our work and back fill any excavation.
1f deviation from the work described above is required or customer requests additional or different work be performed, the
parties will agree on an additional charge and sign a new written work description before Roto-Rooter begins the new work.
7. rTHETERMSAND CONDITIONS ON THE REVERSE SIDE OF THIS PROPOSAL WILL BE BINDING ON THE PARTIES.
S.' This proposal may be withdrawn by Roto-Rooter if not accepted within days. This proposal constitutes the entire
agreement between the parties, and no modifications will be valid unless in writing and signed by both parties.
Res ectfull submitted:
ti OVI V
Tec is n Signature Print d Nam i7echniclan Number Dat
ACCEPTANCE OF PROPOSAL
I authorize the services indicated and agree to pay the amounts specified. I have read and agree to the terms, including the limits of
Roto-Rooter's responsibility specified in those tents. I acknowledge that under paragraph 2(b) of those terms, if Roto-Rooter equipment gets stuck
in a pipe, I may be responsible for the cost of removing that equipment, including any required excavation.
Dol7a LQ4 ? Customer
Signature Printed Name Date PF.
EXCA BFi OFFICE
COPY 3ry I
L-
Scanned
by CamScanner
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: `1 12—r k V
I hereby name and appoint: f!{!W
an agent of:
Name of
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 (check only one option):
The specific permit artd ap lication for work located at:
Address)
Expiration Date for This Limited Power of Attorney: VX
License Holder Name:_ 2p 53 `A c4 i J( 7
State License Number: q2 S 4 1 I
Signature of License Holder: &X-4
STATE OF FLORIDA
COUNTY OF
The foregoing iq4kument w knowledged before me this 2 F' day of ,
20V E, by j zV <dd VIA who is personally known
to me or o who has produced
identification and who did (did not) take an oath.
Signaturea>
9s,sooI rY `` C —'t 4 ySP
f'1
Print or type name
FF M740 '
4'
Notary Public -State of L
PC Commission No.
My Commission Expires: 4N zo
Rev. 08.12)
as