1805 W 13 St - BR08-000720 - REROOFCITY OF SANFORD PERMIT APPLICATION
Permit # : b q ' ' 1 ;-y` " ' Date:
Job Address: ksDS a,7 o 3 Z
Description of Work:
Historic District: Zoning: Value of Work: $ '-e—oo O
Permit Type: Building Electrical
Electrical: New Service - # of AMPS
Mechanical: Residential Non -Residential
Mechanical Plumbing Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Wa r Closets Plumbing Repair - Residential or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 1 (Attach Proof ofqwyership & LegalDescription) Owners
Name & Address: L-- \Ptrn S \ ' 0. %'Z li r V71 6", 0\4' K 3 2 b 3 Phone:
Contractor
Name & Address: State
License Number: Phone &
Fax: 40' g Jd(67_ c7,6. ( Contact Person: (` ` "~` h ` Phone: Bonding
Company: Address:
Mortgage
Lender: Address:
Architect/
Engineer: Address:
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 alllaws 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 this
co n e -inay be additional permits Acceptance
OfpnffR is r,
there
may be additional restrictions applicable to this property that may be found in the public records of I
from other governmental entities such as water management districts, state agencies, or federal agencies. Signa
wner/Agent }} ( Date 0/'
v) y 1?G+ Al d Print
Ow er/ gent's N e lzvl
8 Signature
of otary-State of Florida Date Ow
r/Agent is _ Per ly Known to Me or Produced
ID iF ! V e &-J''.. APPLICATION
APPROVED BY: Bldg: Initial &
Date) Special
Conditions: o.
rr °c^ Notary Public State of Florida Wayne
D Stone My
Commission DD453366 OF
I/ Expires 08/17/2009 Zoning:
requirements
of Florid Lie L w, F 71. Signature
o ntractor/A%t \ _ Date Pri
t Con ra)O&Agencs Name Signature
of otary-State of Florida Date Contractor/
Agent is _ Personally Known to Me or Produced
ID Initial &
Date) Utilities:
FD: Initial &
Date) (Initial & Date) vRY °
N, Notary Public State of Florida Wayne
D Stone My
Commission DD453366 r`
Expires 00/17/2009
Permit Number
Parcel Identification Number 2L _
Prepared by:
Return to:
NOTICE OF COMMENCEMENT
State of Florida
County of Orange
The undersigned hereby gives notice that improvement(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.
ARYANNE MONSF, t,LERK OF CIRCUIT CUURT
IEMINOI_E. COUNTY
K 06915 Rq 11741 (1pg)
LERK' S # 2008009307
DiECORMD 01/25/2008 Oia21:42 PM
ECMDING ("F_'ES 10.00
ttltRM0 BY L McKinley
CERTIFIED COPI
MARYANNE MORM
CLERK ,OF CIRCUIT FAURT
SEIAINO U ; Y. FtARIDS
BY c-Q
JQN 2 5 00
1. Description of, roperty (legal descyiption of the property, and street address if available)
2. Generar descrionof 3
AL._ >z improvement(
s)" 3.
Owner information Name &
Address L.'e, ly" '^ N `2 2 V, t-c r 5 Z `0 Telephone &
Fax Number Interest
in Property: 4.
Fee Simple Title Holder (if other than owner shown above) Name &
Address Telephone &
Fax Number 5.
Contractor Name &
Address lJ
Telephone & Fax Number 6.
Surety (if any) Name &
Address Telephone&
Fax Number Amount
of bond $ 7.
Lender (if any) Name &
Address Telephone &
Fax Number 8.
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided,
by 713.13(1)(a)7, Florida Statutes. Name &
Address Telephone &
Fax Number 9.
In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in 713.
13(1)(b), Florida Statutes. Name &
Address Telephone &
Fax Number 10.
Expiration date of notice of commencement (the expiration date is one year from the 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
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 OBTAIN, FINANNCING,
CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR? RECORDING
YOU N TIC ., F COMMENCEMENT. Siqddture
of Own or Wxwr s-Aathoni-e-d-Cff—icer/Director/Partner/Manager Print Name Sworn
to (or affirmed) and subscribed before me this day of _ z•` , 20 0 by
KTYVA y - as (type of authority, e.g. officer, trustee, attorney
in fa t) for (name of party on behalf of whom instrument was executed.
personally known to me OR produced t ., L etiy - `--4 tf - q O- 3 %? )- Oas identification. upr
n Notary Public State of Florida Signature
of Notary SEAL 20i Wayne D Stone t/\%
tf'`'— Q My commission DD453366 A c Name (
pri t) y'tof 5f Expires 08117/2009 Verification
pursuant to Section 92.525, Florida Statutes Under penalties of p rjury, I cl to tha fnave read the foregoing and
that the facts stated in it are true to the best of my knowledge and belie Signat6fe
o atur I Person Signing (in line # 11) Above