410 Orange Ave 05-428 Roofy
CITY OF SANFORD PERMIT APPLICATION
Permit # : O } o Date:
Job Address: U ) o GR.A M GE ANC S.
Description of Work: IS& R00f •DO'E io UAMAGE FROM AJIM1CANE O)ARUEY 5]A)qf_ 4 i A
Historic District: Zoning: Value of Work: $ 4Y 7d • 00
Permit Type: Building 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 V' Commercial Industrial Total Square Footage: 5S
Construction Type:
pQ 2 #
of Stories:
h #
of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 30 + -1 - 71 - 1 /// on G 13 D - ` (Attach Proof of Ownership & Legal Description)
Owners Name &^Address: - 5, 5E-LA A N"DE R, 5o A 910 01' ,606E A V C SAAJ EVRp
T (
Phone: _
Contractor Name & Address: 1 1? J-0Q ROF-i N 6 GO. ,.yiv i - ?• O.',3pX q4 ) 9 159 M0A 1LANb,
F'La7 q State License Number: GGG D 3;L4 -1 0
Phone & Fax: 0 ' 6 0' 0%-"0'G I;O9Contact Person: W l LLi AM M ELSON Phone: 407 _66Q= a;kQ Bonding
Company: Address:
Mortgage
Lender: Address:
Architect/
Engineer: Phone: Address:
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 WORT{, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR
CONDITIONERS, etc. OWNER'
S DAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructio
and z g. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
FO IMPR VEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNE
EFO RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE:
In ad 'on t the requirements of this permit, there may, e " dditional restrictions applicable to this property that may be found in the public records of this
county, and the ay be additional permits required from o1her governmental entities such as water management districts, state agencies, or federal agencies. Acceptance
of pe i erificatio that I wi n e own o property f the resof Flo 'ien FS ignature of
Owner/Agent Date Signature of Contractor Date Owner/Agent
s ame Punt ontractor/A et' I g Signature of
Notary- to
of Florida Date Signature of Notary- tate of orida l5ate Owner/Agent is -ally
Known to Me or Produced ID Contractor/Agent
is _' Personally
Known to Me or Produced ID APPLICATION APPROVED
BY: Bldg /
1 onmL Initial & Date) (Initial & Date)
Special Conditions: Utilities: FD:
Initial & Date) (
Initial & Date)
LIMITED POWER OF ATTORNEY
November 12, 2004
1, William H. Nelson, authorize Thomas McCaulley to sign my
name or whatever is necessary under my State License
CCC032490 in order to obtain a permit for a re -roof for:
410 Orange Ave. S. Sanford, FL 32771 from the City of Sanford
Building Department
William H. Nelson V.P.
STATE OF FLORIDA
COUNTY OF ORANGE
Subscribed and Sworn Before Me This
11/12/2004 By William H Nelson who
is Personally Known to Me and did not
take an Oath.
DEBRA A. BANNICK
Notary Public, State of FloridaMyComm. exp. May 5, 2006Comm. No. DD 114748
Permit #
Parcel I.D. # 30-19-31-517-0A00-0130
Prepared by: Bill Nelson
P.O. Box 941959
Maitland, F132794
NOTICE OF CO
State of Florida
County of Seminole
MARYANNE MORSE, CLERK OF CIRCUIT COURT
SEMINOLE COUNTY
BK 05516 PG 1473
CLERK'S # 2004175531
RECORDED 11/16/2004 09:38:17 AM .
RECORDING FEES 10.00
RECORDED BY t holden
CERTIFIED COPY'
MARYANNE MORSE,
CLERK OF CIRCUIT COURT
S N E C UN Y, FLORIDA
BY
EPUTY CLERK
NOV 1.6 20N,
CEMENT
The undersigned hereby gives notice that improvements(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. I
1. Description of property:
410 Orange Ave. S. LEG LOT 13 BLK A
Sanford, FL 32771
2. General description of improvement(s):
Re -roof
3. Owner information: Isabella Anderson
410 Orange Ave.
Sanford, FL 32771
4. Interest in property: 100%
5. Fee Simple Title Holder (if other than above):
6. Contractor:
Tip Top Roofing Co., Inc.
P.O. Box 941959
Maitland, F132794
7. Surety (if any):
S. Lender (if any):
9. Persons within the State of Florida designated by Own
be served as provided by SS713.13(1)(a)7., Florida St,
Owner
10. In addition to himself, Owner designates the following tore(
SS 713.13(1)(b), Florida Statutes.
Owner
11. Expiration date of Notice of Commencement (the expiration
A different date is specified)
Date Signed Si;
Sworn to and subscribed before me this 12th day of November,
to me,---_ n n
N
IP ADD PB 8 PG 3
Phone: (407) 660-2212
upon whom notices or other documents may
to a copy of the lienor's notice as provided in
is one year from the date of recording unless
c
are of Owner
by Thomas McCaulley who is persona y known
DEBRA A. BANNICK
Notary Public, %tog of Florida
exp. May 5, 2006
Comm. No. DD 114748