1100 W 25 St - BR08-001014 (REROOF) DOCUMENTS (2)E ^ CITY OF SANFORD PERMIT APPLICATION
Application # : ) +' - Submittal Date:
Job Address: % ° iJ e . J—tC Value of Work: $ - G G r 3
Parcel ID:Zoning: Historic District:
Description of Work: Square Footage:
Permit Type:. Building Electrical , • • • Mechanical • • • • • •Plumbing 0 Sprinkler/Alarm 0...... Pool •.. Sign •
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 Commercial
Occupancy Type: Residential Commercial Industrial Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
Property Owner: : Qm- Zli Contractor:.
A dress: U W Address: to aWJ!:-
92L-9 7 1
Phone: E-mail: Phone ;'fig S"74 State License Number: Ccr _0 `
Bonding Company: Mortgage Lender:
Address: Address:
Architect/Engipeer: Phone:
Address: Fax:
Plan Review Contact Person: Phone: Fax: E-mail:
Application is hereby made to obtain permit to do the work and installations as indicated. 1 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. 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.
NOTICE: In addition to the requirements of this permit, there may be additionar 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.
A eptance of permit is verifi 'on that I will notify the owner of the o , rty of the uirements lorida Lien Law, FS 713.
gnature f0wne /Agent Date Signatu of Contractor/Agent Date
r
AintOwner/
a 's ame Print Contractor/Agent's Name
ature o otary-State of F ida ate ,Nau Na -M5. Date
s. IRENIE CI A11AtpQT1
a gIft• Sf6 of Fkft
SMy C=WftlWEW=Fft22. Will
CannnisslOn if 60 043272
8
Agent is _ Personally Known to Me or0Known to Me or
Preroduced ID1'LpL W\ (P D03 5a l Produced lD
APPROVALS: ZONING: UTIL: FD: ENG: BLDG:
Special Conditions:
Rev 07.07
X
THIS I "'TRtrMENT PREPARED BY:
Name: -fAdres,.
State of Florida
MARYANNE MORRE-1 CLERK OF CIRCUIT, Ctj H
SEM>INOLE CUUN'I`Y
HK 06931 PQ 1348; (1 pi
SEMINOLE COUNTY CLERK! S .# 2008022689
FLORIDA'S NATURAL CHOICE RECORDED 0212712008 0914964 EMI
RECORDING FEES 10.00
REWRI)ED BY J Eckenroth
NOTICE OF COMMENCEMENT
Permit Number Parcel ID Number (PID) ,3 9 --
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.
GENERAL DESCRIPTION OF IMPROVEMENT
OWNER INFORMA
Name and address:
CONTRACTOR
Name and address:
9-4 L
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 and'address:
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.
of
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 IMPROVMENTS 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.
STATE OF LORIDA f'' COUNTY OF SEMINOLE
WN RS SIGNAT E NERS PRINTED NAME
NOTE: Per Florida Statute 713.13(1) (g), owner must sign...... and no one else may be permitted to sign in his or her stead."'
The foregoing instrument was acknowledged before me this day of V 0 - : , 20
by - 1;'G:{ IA,''1an\lam Who is personally knoa to me
Name of person making statement -f-
OR who has {produced identification -t'(l' inlpb U type of identification produced
VERIFICATION PURSUANT TO SECTION 92.525, FLORIDA STATUTES.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING AND THAT THE FACTS STATED IN IT
ARETRU0 THE BEST OF MY KNOWL 9GE AND BELIEF. SIGNATURE OF
NATURAL PERSON SIGNING ABOVE IRENE CLATWORTHY
J Notary
of Florida My Cann=
DF0 22, 2011 / Commissions DD
643272 ' Notary Signatu
e o , •• BondedTft* National Notary Assn.
City of Sanford
BUILDING DIVISION
RE: Permit #
Inspection Affidavit
ICJ licensed as a(n) Contractor* /Engineer/Architect,
please print name and circle Lic. Type) FS 468 Building Inspector*
License
On or about , I did personally inspect the roo
Date & time)
deck nailing and/or secondary water barrier work at / Y%
circle one) (Job Site Address)
Based u on that examination I have determined the installation was done according to the
Hurric e Mitigat' n Retr ual (Based on 553.844 F.S.)
C
Signature
STATE OF FLORIDA
COUNTY OF (
Sworn to and subscribed before me this day of ,t ..4 .200Y
By tA-a! 'ALE-<, 4 d
Notary Public, State of Florida
type 616starr)rlame)
Commission No.: 20 39 /add
Personally known or
Produced Identification
Type of identification produced.
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o09N : 's
o #DD 391202
i 9 ' Sa Bogded ihN ; • p.••
General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.S. to make such an
inspection. Include photographs of each plane of the roof with the permit # or address # clearlyshown marked on the
deck for each inspection.