326 Live Oak Bvld 05-457 FenceCITY OF SANFORD PERMIT APPLICATION /
erm Date: to II c'/ 0V
r
Jol) Adilr i • t_ G f 73
Description of Work: RL
Historic District: Zoning: Value of -Work:_$
Pefftiit Type: Buildingka'15-1,
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 I Commercial Industrial Total Square Footage:
Construction Type: #//of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
r -
Parcel #: 1l— a CD - 30 _. J 06 _ U 0d2 - "3 C% (Attach Proof of Ownership & Legal Description)
OPl -
a OeL k b v S . d q.- -3. -Y Owners
Name & Address: ;Pffc1 (''W,'s% p.
3
y 3c;
El O 3S s -7-1 b t-c JQ 0A1C 9 U Q_ D .30A LL of-Cl Pt- AX7i3 , Phone: Y0 Contractor
Name & Address: - State
License Number: Phone &
Fax: Bonding
Company: Address:
AMortgage
Lender: _ Address:
C' Architect/
Engineer: Address:
V
Contact
Person: 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: 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 y be ound in the public records of this
county, and there may be additional permits required from other governmental entities such as water nagerr di cts, s e agencies, or federal agencies. Acceptance
of n t is verification that I vill notify the owner of the property of the requirements; 'da Lien w, FS irJ Signature
of Owner/Agent Date , ure of Contractor/Agent Date Prink%'
Rer/AQent's Name. i1 I Print Contractor/ gent's Name Si
ature of Notary -State of Florida Date r otary-State of Florida Date G';
y TI•ilSF A M I-S MY
COMM'SSl^"! it OD 163833 a
FXPh`=S: "„-.,:c:n r, 2007 tf•,.
pQ;• Bonded rhro rdoxry Pub'.,-, Underwriters Owner/
Agent is ent is Personally Known to Me or sonallyno to Produced
ID Produced ID APPLICATION
APPROVED BY: Bldg: Initial &
Date) Special
Conditions: Zoning:
Utilities: Initial &
Date) FD:
Initial &
Date) (Initial & Date)
r
I FROM':PEDERSON CONSTRUCTION FAX NO. : Oct. 05 2004 Oi:11PM P3
S41a of Florida NOTICE 01' CoMMENCEMENT
County of SeminolePermitNo.
Tsx Folio No. (PM) _ ` `, ti' - Ci --J ""() QThetlnderaignedherebygivesnoticethatha - Y 0
713, FJoti4a Statute wtt will be tnadt to certain real PAY, and in recordmce with Chapters, the following informst{an is provided in this Notim of Commencem"t. 1 `
VZ5GIiMON OF PROPERTY GENERAI,
DESCIMWN O1t:17 OWNER
MFORMATTON Name
and address doscrittti000ftheTrty
et 7m) _! CERTIFIED COPY F?
ORSE:- CIRCUIT
COURT- TY,
FLORIDA Interest
in Plwc* (Fa Simple, Parmm*ip, etc) e— '
a ,u ( NAME
AND ADD tSS OF FEE SMLFTM R HOLD$R.(,F O'nft n AN O'W)) C0NTItef"
1•nV Nam
sodaddr ZKONY) Amount
of Bond x
LEER l3arne
atxf address 66
JDA,<—L p4 v Ln
4 r+
ass;ss ss*ss*r*
asawwsssssrrrwwwiwas*sss rws ss*ssssr*ws**ssssss r ssssrrr+wttssrarWssrs L3 +ir Parsons within the Stec of Florida dAsi U r., " greed ty Uv w ups whom notice or otlrar daeum y'Cu
5y. Section 7J3.13(i)(47 , Pimida ssrb tas: 3' savad as pruridcd Name and
address s w,! Cxs p4,./ t y
Fire
r re s sassy,y;•ss itw rsfsrwiwbl lr srrri*i wit*iw kifOi r itttsasi itis rsmrrktaxa s O Law
W1, % IT)
addition whiznsclii OWM ties' X L) -+
tfJ rrtk 4 w W " t7
z a= t0 tt',GIVt 8 RI if- "J"
w
provided in 5action 713.13(lXb), Florida Stggitea. Copy ofthe Lienor's Notim as W rxs••rrrr+M Mik M4rrlwr+tt'IirY*4sffsMy4 y as t#rrrrrrssstsir rrry t s wWrsisssta+sass y. r•. W
ix 2C 3C .
S P F.xpitrrtfon Date ofNotiee of commencement W ri Liasrx(Tbe Mha! M Batt is I year from dax of WMrdina M&Iml a di r dnte is rifirrt ) ith f O
ipv+"
Sheryl L.
Smwner Corn " o tfaaionf4/Q8firLiS Sworn to't3
W6Wfike this _ Day of Ci Notary PubfM° MY
Commission Expires: L7 LY The fo Ring
iasw= W4S scknowlodged before rite this r. day of
JUj, the or who
has produced A, (nee of person acknpwledg personally kno to and who did /
did not take an oath> ( of itkntc`ation psi nu Cation CLERK-,1 24'.
U a
If
Lb
e.