2102 Amelia Ave -BR08-001043 (REROOF SHED ONLY) DOCUMENTSApplication # : (2 k In
CITY OF SANFORD PERMIT APPLICATION
Submittal Date:
Job Address: 2102 AMELIA AVE. SANFORD, FL 32771 Value of Work: $ 1,100.00
Parcel ID' 36-19-30-534-0300-0030 Zoning: Historic District: NO
Description of Work: RE —ROOF SHED ROOF ONLY MODIFIED BITUMEN Square Footage: i
Permit Type: Building if Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Sign
Electrical: New Service — # of AMPS :Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cale. 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 Pr Commercial Industrial Occupancy Use Group(s):
Construction Type: # of Stories: _1_ # of Dwelling Units: __ Flood Zone: (FEMA form required
Property Owner•Donald W. & Hazel R. DYESS Contractor: A & B ROOFING COMPANY, INC.
Address:2102 AMELIA AVE. Address:3905 MOORES' STATION ROAD
SANFORD, FL 32771 S8I,TFORD, FL 32773
Phone407-322-5108 E-mail:
Bonding Company: N/A
Address:
Architect/Engineer
Address:
Plan Review Contact Person:
N/A
322=9 i
Phone: 4 3— 22—A41SIate License Number: ccci ust;
Mortgage Lender: N/A
Address:
Phone: Fax:
Phone:
Fax:
E-mail:
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. 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 additional restrictions applicable to this property that may be found in the I
this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or
Acceptance of permit is verification that 1 will notify the owner of the
Q/a61v v=
Signaiure of.Ow /Agent Date Print
Contractor/Agent's Name Signawre
of No State Flnda D Owner/
Agent's Name o]
fK_ -
11
tatclAfOtWiL[
NE M WILLIAMS 166
MY COMMISSION # DD704783 EXPIRES
August 13, 2011 Owner/
Agent is Personally Known to Me or Produced
ID7FL 6 L "tip' LiVtO 3 32 WO 0 APPROVALS: ZONING:
UTIL: FD: of the
requirements of Florida Lien Law, FS 713. iign7ture of
Contractor/Agent G F.
BOHANNON Contractor/Agent
is X Personally Known to Me or Produced ID
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Conditions:
Rev 07.
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LIMITED POWER OIL ATTORNEY
Altamonte Springs, Casselbert-y, Lake Mary, 1-ongwood, Sanford;
Seminole Count), Winter Springs
Dater
I hereby name and appoint: JAMES ANDIIZSON ---- -- -
A & B ROOFING COMPANY,INC.
to be my lawful attorney - in - fact to act for nle to apply for, receipt for, sign for and do all things
necessary -to tills appoillLil1C11t for (check oil[), one option):
All permits and applications submitted by this conu-actor.
The specific. permit and application for work located at:
162 ------- .-An 8=--
i lt t nJclrc.>;
Expiration Date for This L.inlited Power of
1-1cense holder Name:
G.F. BOHANNON----------_—__--
State License Number:
CCC 1326255
Signature of License Hol
STATE OF FLORMA
COUNTY OF SEMINOLE
The foregoing instrument was acknowledged before me this a\dsy o) a {.
n, n
7000 by G.F. BOHANNON--------- [XI -
is
to me or who has produced ----------
identification and who did (did not) take an Oath.
TERE6AJOHNSON
MY COMMISSION k DO 343250
EXPIRES: August 12, 2008
d' r,,&-d?tvu Notary Public undatwrHers
Signature
TERESA JOHNSON
Print or type naille
Notary Public - State of FLORIDA —
Commission No.DD 343250 —_
My Comilllsslotl Expires: AUGUST__ 12, 2008
Rey. 3 27/07)
L.