2638 S Myrtle Ave - E19-000228 - REPLACE AMPBUILDING
FEB
Application No:
Documented Construction Value: $ L
Job Address: , fife i d :-( 142 -77T Historic District: Yes No
Parcel ID: ` Residential [3 Commercial
Type of Work: New Addition Alteration [+Repair Demo Change of Use Move
Description of Work: try?,ccC- Scxti e t fi ll GcTS^
Plan Review Contact Person:
Phone: /f ' 2 7 q' _ Fax: f - Z IcI Email: 11)"" cM`
Property Owner Information
Name art wVU_ Phone: I
Street: g j" Resident of property?: 1
City, State Zip:
Contractor Information
PERMIT APPLICATION
Name
1 !(
Phone: 6? % I il 70
LrStreet: q oc, tC °`Cr Fax:
City, State Zip: t' V& Az q j State License No.: (
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
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.
910331,
FBC 105.3 shlafl be inscribed with the date of application and the code in effect as of that date: 6`° Edition (2017) Florida Building Code
NO'1'
1('l:: In addition to the requirements of this pernit, there nay 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 o[ the executed contract is required in order to
calculate a plan review charge and will be considered the estimated construction value ofthe 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.
Y ! `
7 f.'.
l tF . Cam% . ! Cn. 7' f
Signature of Owner/Agent Date
Artdt'eui E"ry\oAcJ Vigam-
Print Owner/Agent's Name
Jf 0,910711q
Signature of Notary -State of Florida Date
I \ I , v7 f
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or Contractor/Agent is v"- Personally Known to Me or
Produced ID _Z Type of ID Produced ID Type of IL)
Am"A"UILM" Felix Brown
pAl f1, , #t10 SSIMI a BELOW IS FOR OFFICE USE ONLY pal $; tkt, Ql, 2t122
umois, x11e (4ttvu M" t obin
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps,
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
GrantWaloy, Clerk Of The Circuit Court & Comptroller Seminole County, FL
Inst #2019013731 Book:9295 Page:424; (1 PAGES) RCD: 2/7/2019 1:27:22 PM
REC FEE $10.00
N D 00 15 'V
This instrument prepared by:
Name,
Address:
NO'TTCE, OT'.C.OMMENCEMENT
STATE OF Permit #:
COUNTY OF U&M.9 PARCEL lD#: 4f I—
roperty and inUNDjRSIGNEI).herebygtves notice that tinproverneatswill be made to certain real pViiStatute*, the following information is provided In this Notice ofCommencementae;
I
edrd2mc a withChaitarli3iFlorid
I
a
LiDe'scodou 0fPIrOPertr (Lega description of the property and street address ifavailable)
5k Co (ALkO Rq (44-
2 General Desqription6flinprovements: eE
3 -Owner
Address.
Interest in property:
Name &Address of fee simple titleholder: (if other than owner)
3-1,17- *T
Phone: hone:
4 Contractor'& Name: 6Ifz Lf
Address.
Phone:
5 Surety Name: Amount of Bond: $
Address:
Phone:
6 Londer Name;
Address: who notice or other documents may be served, as Provided by Section7personswithintheStateofFloridadesignatedbyowneruponPhone:
713;13(1)(a) 7. Florida Statues: Name:
Address-
8.
erson(s) to receive a copy of the Lienor's Notice as provided in SectionInadditiontohimselforherself, owner designates the following P Phone.
70.13(1)(b), Florida Statutes: Name:
Address:
9, 9Xpiration Date of,Notice of Commencement different date is specified) the IeXDirazon date is I year from date ofrecording unless a
WARNING, TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF TBE NOTICE OF COMMENCEMENT AREPART1, SECTION ? 13,13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYINGp ,OpEp THECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, OF COMMENCEMENT MUST BE RECORDED AND POSTED ON JOB SITE
TWICE FOR IMPROVE
IMENTS TO YOUR pROPERTY. A NOTICE BEFOREBEFORETHEFIRSTINSPECTION, IF YOU INTEND To OBTAIN FINANCrNri, CONSULT wrm YOUR LENDER OR AN ATTORNEYCo&MENCING -WOk1CV0R RECORDINGYOUR NOTICE OF COMMENCEMENT.
Under penalties ofp ury, I declare that Ihave read the foregoingandthat thefacts stated in it are ave to the best ofmy knowledge and belief
A Signatory's Title/Office
Signamirme of r or Oikater a Au zed
Officer / Director Partner / Manager
The foregoing instrument was acknowledged before me this "Ith, day of 20 k6j , by
mg (
type of authority,.. -e.g. 0ffi=,2,attomeyiaa fact) for
name of person) as &1Ce 1.4 Hocfp-_c name ofparty on behalf ofwhom instrument was executed).
SEAL) Signature ofNotary Public, State * ofFlorida
Fe1iX Brown k't)C brwc'
4Print, Type or Stamp Commissioned Name of Notary, Fluttic 0/
11"
I yKnown 13 or Produced Identification
aces: ft 07, zoriCIDCOMM" 8 GOW Personally
mr"TMA"No"
September 2017
r7 o 3 3 ,
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 2,/,7 /,&)q
I hereby name and appoint:
an agent of:
Name ot'Company)
to he 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 and application for work located at:
Street Address)
Expiration Date for This Limited Power ofAttorney: —2L1q---)-6SS-- License
Holder Name: State
License Number: Signature
of License H STATE
OF FLORIDA COUNTY
OF a
The
foregoing instrument was acknowledged before me this day of 204kprsonally
known by Gtl who is to me
or o who has produced as identification and
who did (did not) take an oath. L-& Signature
Notary
Seal) -
3' Print or
type name 9 Felix
Brown Notary Public - State of MIM 0
omm Commission No.
4C. EVIRES:
Oct
07, 2022 My Commission Expires: — ------ Wed TIVU
ANN Nobry Rev. 08,
12)