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HomeMy WebLinkAbout1102 Santa Barbara Dr 05-507 RoofPermit # Job Address: h Description of Work: CIITY OF SSAANFO.RD PERMIT APPLICATION j Date: 1 C` n Historic District: Zoning: Value of Work: Permit Type: Building 1/ Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool — 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 Watey , losets Plumbing Repair - Residential or Commercial Occupancy Type: Residentiali/ Commercial Industrial Total Square Footage:IZICC© Construction Type - #Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) 511IParcel #: n ./V p XIQ ayo (Attach Proof of Ownership & Legal Description) Owners Name & Address: 0 /6. S Phone' 0-7 ame & Address: Phone & Fax: Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer: Address: CJ State License Number: C (AL Contact Person: MM eay,t! Phone: 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 p nor 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 s 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 lawn regulating construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN T`KPEi1€. 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 permit, there may 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 is verifi on that I will the owner of roperty of a require nts f orida Lie 713, l 3164inaeoOer/ gent Date ( Si azure of Coax ctor/Age ate P ' w dA ent's Na t g Print Contgact (Agent's Name gna re of Notary-S to of Florida Date Sign"af6re of Notary -State of Florida Date fir ,p,, vr Chry W WNW a4 C pry p p gg • my Commission DD358594 Owner/Agen errson;a mown oT-Ff"eo' i S to k r 20.2008 Produced w Expires Contractor/Agent is + ersogn lai l rto[ n {ai 1e orSeptember20, 2008 _ Produced ID APPLICATION APPROVED BY: Bldg: Zoning: Utilities: nit al ate) (Initial & Date) Special Conditions: FD: Initial & Date) (Initial & Date) PERMIT AUTHORIZATION PLEASE PRINT ALL INFORMATION LEGIBLY) C40NAMEOFFIRM: r l2 D2C' QUALIFIER / LICENSE HOLDER:6L1 i ( LICENSE NO.: do hereby authorizeon to obtain a permit on my behalf under my license for the job at the following address: li G of C 3ntya Apf 1 I[ Lt , the 6b i-ctw/ zl- Signature of License Holder I / iA 1n4 Date , This foregoing instrument was acknowledged before me this v day of XaeN--ale, 20, by who is personally knowp to me or who has produ d (type of identification) as identification. STAMP) No ary Public, State of Florida ChrY" VOW 0 My Commission DD356594 or n Expires September 20.2008 S:±ate of Florida Permit No. 1N v 111,It' Vr t-VIVI1VIEIN UtME , r CountV of Sem/in/ole / I Tax Folio No. ID K / '7" -l! 60 6/ C 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. DESCRIPTION OF OF IMPROVEMENT OWNER INFORMATION ;n rNameandaddress,'': Interest in property (Fee Simple, Partnership, etc.) CERTIFIED COPY T4nnynt-,iNF MORSE r.I.FRK OF CIRCUIT COURT SEMINOLE CIAWY NAME AND ADDRESS OF FEE SIMPLE TIT OLDER-GF OTHERVfI'MIOYWME1 1 k' CO TRACTOR NMe and address S>TY (Bonding Company) N e and address of Bond NAME ADDR. ame and address RECiIRDE'D BY L McKinley L rC sons within the State of Florida designated by Owner upon whom notice or other documents may be served as provided Section 7I3.13(1)(a)7., Florida Statutes: and address k******************************************* designates of to receive a copy of the Lienor's Notice as provided in Section_713.15(1r),(5lorida Statutes. Expiration Date of Notice of Commencement The expiration date is 1 year from date of recording unless a different date is specified.) JENNIFER A CAVERLY MY COMMISSION # DO 067915 EXPIRES: July 26, 2005 Bonded Thru Notary Public Underwriters Sworn to and subscribed before me this V`Day of N oy , My Commission Expires: `1 lzu IDS N to Pu is The foregoing instrument was acknowledged before me this Z day of N C IF by rY1Q V(` j Q,('G ct7i L1, (name of person acknowledged), who is personall known to me or who has PAduced (type of identification) as identification and who did / did not take an oath>