HomeMy WebLinkAbout106 Mayfair Ct 05-269 Roof1
CIIYOT SAND.ORD PE'I:h4rI,AITIAUAIIU1N':• • : +
Pcy,init-ll
Job Address:
Description of Work: e—t'i IL. vu r —
Zoning: Work: SValueofHistoricDistrict: ,
Permit Type: Building rlcclrical Mechanical Plumbing Fire Sprinkler/Alarm
f
1'ogl•^—_
Electrical: New Service— It of ANIPS Addition/Altcration Change of Service Temporary Pole
Mechanical: Resi(lential Non-'Rcsidential Replacement New (Doti i_.ryout erg C'si, Required)
Plumbing/ New Conuncrcial: ll of Fixhtres II of Water Fc Sc% Lines it of Gas Lines
Plumbinr/New Residential: it oMatcr Closcts I'lunibing 1'.cpair—Rcsidential or Conuncrcial '_ ..••____ Occupancy
Type: Rcsidential Commercial _ industrial Total Square f ootare: Construction
Type: fl of st.orics: Il of Dwelling Units: Flood Zone: (Crete\ form required for outer that X) 2YIL'
1.:'.'rl•!:.:':='YL!M'i`::'7Y•1"!/.S Parcel
ll: Attach
Proof of Ownership & Legal Description) Owners
Name & Address: t L ^ `<'` I
i7 Co ""A-""A-a`-1 d7 Ap
i
i /t
Contractor
Name &'Address: C D 0 1 C% _..._.__..._.._....._ U
p2_ 1j l S D % _ C I J2_% L S:atc Liccnsc \umltrr: G 1'
llone 'Fax: Contact 1'crson: linndin;;
C Address:
Nlor(":
Address:
Architeco
Address
Application
is hereby made to obtain a permit to do the work and installations as indicated. 1 ccrify that no wort: or installation has colttn'+enced prior l(I the issuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsrcgulatingconstrictioninthisjurisdiction. I understand that a separate permitmustbesecuredforELECTRICALWORE, PLUM111NG, SIGNS, WELLS, POOIS, FUkNACES, BOILERS, I-IEA1'ER.S,1'ANK.S, and AIR
CONDITIONERS, etc. OWNER'
S AFPIDAVI'I': I certify that all of the foregoing information is accurate and that all wor.: willbe done in Compliance with all applicable. laws rrt idaaing construction andzoning. WARNING 1'0 OWNER: YOUR FAILURE'f0 RECORD A NOTICE OF COMMENCE-ME-NT I.4AY RL•SUI:L 1:1 ! 1.( 1.I'/,YTNG TWICE FOR
IMPROVEMENTS '170 YOUR PROPER1Y. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER 01" AN ATTORNEY BEFOIT?
RECORDING YOURNOTICEOFCOW%`I NCEMEN'r. In addition
to the requirements of this permil, thcic may be :10dition:+l ic:;trictiUus :+plilic:+blc to thi:; property that ru:q• be liwnd in the public rccordi of this county,
and there shay be additional permits required from other j-.0vernntctil;ri entities such ;e, wafer nuna cnhcnt di strrcts, slate a;;cnr,.u::, or federal ag rtctcs. Acceptance of
Permit is verification that I till nt of c o+vr.cr of tc ;y of the rcquiremct+ f Mori cn (aw, FS 7 Signature ol'Ouaher/
Agent D: 0 I` Si n' u c of :onlcu for/Accnt :uc L UXE ,u/_j /
ZYA-V j ; Print O\ Name Print
Ct tractor : ^ent's Nam D t Si" a
of -Slate
o Florida Dalci S:_cnatun: of \.:ary.St:ue of Florida Da 4 Y eyk,, RODGER
C. TAYLOR MY COMMISSION # DD 268095
EXPIRES: Dece4e[:14 2007/
n : Known to i\•1t or Owner/Agent c; I
i.r.:onall\ Kno ht In: r t oFFy,a BondedThruNotaryPublicUnd --- 4'Wti rc cr vduecxl IU _ /ilc h
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ICATIONAPPROVE.I.) BY: llldl;: r!_—_--•—•— Iln+ti:rl & Datc; (
Initial ,': U:utl Initial k Dahl (Ithitial L D ' 1
M tYA1Vl A'I ERK QF CIRCUIT CWT
SEMINOLE l`CIi IY
BK 05501 PG 0372
CLERK'S # 2004168828
h• Fc,2--C)( i 107 ZC ; Ok 1 1 C N RbED 11/t1 /POp4 09t00eS1 AN
Imp 1.0.00
erlllit I`!o. :` D BY LKinley
Sfi.:ltc of Floricki
Coullty Of sci1111101cid l
etch ivc:: notice -that 1LllprovCillCnt will be 111:1(lc to ccrt:lill lcal prop c L
1' tlcc of CollCi1GCl11C11tGOrda11CC with
z'
11c uJldsrslgncl h y L cl;
l St:ltulcs, illc o110wingr in ol•111:1tioa provided ill Ulis No Cllal
tcr'/]3, Flocd tic )
lolor, Ill(, trc ty: (
lc al cic.,;Cptoll o 1. cscriptioLlo plo)crc l(
ll'c.3J 1-7--) 1()
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2. General
dcscril)tion of." HITI-ovcIncllt: A, OWl1cr1111'
Or111:1tioll A a,{
alne
and adClress f f i L b. Tntcrest
ill propcl•ty 0 2-!L2-EL-- — c. i
anlc a116 -lc1c1lcss of Icc Sll1]plc tlticlloldcr (if otllcr L11an O rncr) 4. Contractor
1, TIa111C
alld b, h11011C
numbC1' 5. Surety
1. Manic;
111d adcll•(;SS b. )'11onc
n11111bcr c. Amount
of bond G. Lcndcr `
I`lalllc
and address nuinbcr b. '
1'
laollc 11un1bcr 1. Persons
vitllintllc St-1tc of lorlcla cicsigllatcd by Ov,111cl' UpoJ1 ,rllolll notices or otJacr doeunlcnt l])ay proviciccl by
Scctioll7l?.13(1)(a)'/., Florida Statutes: — a, ..rlanlc
and address — l'<Ix
1111111bCr b..)hollc
nunlbcr ---- g. Xl1
addition to hil"Scif or 11"cl', 0 llcl cicsiLnalcs of to
receive
a copy of lc .iCllOr'S J oticc as p) ovidcd i11 Scction lrlorida Sta.
tutcs. Pa): nurl]bcr a. Phonc
1111111bCL' 9. Expil-
ation ClatC 0 110t1CC O1'COL]1111CnGC(11Cnt (ti1C C plratloll datC 1:; l year 1'U111't 1C datC OfL'CCOrCli11L,T 11111CSS a cilt'CrCnt date is
spccil~icd) _ SIt UatllCl
1 V` ilcr 61 1
by X51+,
Orl1
t0 (O1' a lrll,ccl) a11C1 s lbscribcd bcCorc nlc Uli s • ROQGER
C. TAYLOR CCS011ally Ilo\"!
L1 OlthCpollGCCI1dC11tl IC t'toll_— _*; «, MY COMMISSION#DD268095 EXPIRES: December
14, 2007 r .. •. - .. » .• "' "I • • ^ l .'sF of
4 Bonded Thru Notary Public Underwriters
POWER OF ATTORNEY
Date: / 1— / o z-
I, Andrew J (Andy) Adcock do hereby authorize Ruben Birch /
To pull the R e r o o f _permit for ID x
type of permit) (addres) 3?,7- /
SiQn4fture
Linda A Keeling
vMy Commission D0359999ZnExpiresDecember09. 2008 a
Stamp e:
rsonallyo me or driver license # , of State of Florida, County of day
of dr E'er,— d , 2004.