HomeMy WebLinkAbout100 E Jenkins Cir 05-1678 (roof)Job Adtlresr. '• I I-t fo
Description of Work, R6 200
51storic District: VAl ing:
Permit Type: Building Electrical Mccltanical Plumbing Fire Sprinklcr/Allirm POQI-. -
Rlectr inl: New Service -11 of AMPS Addilior/Allaatioi: C1ianru Or Service Tcnrpor"S-Y Pola —w—
rAtcbaaicat Residmitial Non -, c=Wenlml itcpl,ecmcnt New — (Dutt layout tC Energy (;jk-Required)
Pl>it blorot / New Commercial: 11 of >:ixturc: 11 of Walcr fi Scwcr Lincs 11 of Gas Lines
Plumbingiftor Residential: 9 of )kater Closets 1'Iunlbiu� Repair Itesicicatia) or Colnmcrt:ial
Occupancy'rypc: ft.csidcntial Coairnrreial industrial 'Total Square Pilotage:
Constri action Type; I't orSrnr1a: r of 1)ircllia(; Units. Flood Zone: (rkl;MA form required for gftrftt% )
e
Pared p:
& Address: m
(Altacli Pr-otu-f of Ownership & Legal Desa•iplion
loo �. V �Iv1ttN elt 1A-N�aiT.j >
Phone: 4*'1 - r7o1-- zo
` tAr�CDoOFt t�C�
Contractor dame S['A<ldrels: .---...
200 aL NC- A -I L af-r-5 F'O 4-0 ZZ
Phoned Fax: �Di+ ai�iD �%�J�✓' 3 Caniact rcrsom osj5�a`1 AoEoC�e "bona:-3ZZ�5Sq
llondlilw Company: _
Arldress•
Mert.age Lender: --
Address:
.Yrchittret/F.n�lnocw.
Address:
Applieslion is hereby erode to obtain a perniii to do the ivorP. and installations as itxticatcd. I certify that no work or installation boas eorircancal iW c,r In lhr
issturice era permit and that all work will bG porforficd to Meet standard:Of all laws rrip blie6 comumcdon in this jurisdiction. I ondcistand Plato separate
permit nwst bewcured for L•Ll7I A(.yORK. I'LU.MBING, SIGNS, WELLS. POOLS, f•URNAcs. DoiLERS, iirrATmis, TANKS, and
AIR CONDITIONERS. etc. -
Q W,,,{�L-&:s A r-pIDAyIT: I eciti ry thai all of dtc roregoin;, inromialion is aceumia mid that all work trill be done i:) cod» pliance wilh oil applieablo lay - r%twint
W.%4tsc3on acid itpninli NYARNINO W OWNER: YOUR FAiLURE TO RECORD A NOTiCG OF COMM ENC&ENT :dAY RL•SUI;r iN YOUR PAYIWC
TWiCIb FOR IMPROVEMENTS 'ro YOUR 1'ROPL•ILiY. If YOU IM111-41) TO FWANCNG, COI.'SULT W IT1i YOUR 1.1- lDER Olt AN
ATTORNEY BEFORE RrCORDiNG YOURNOTiCE OF LOM:+tENCr-31IENT.
lei Tlr.,I�a III adlliliun to lite retpdreniant: of diix pci:11h,111cre : roy he addilinnal ensirklioax applivaille is Ilk, prope"y Ihal nray lot; rvunil in the putllk rceonk of
this ceunly. and there ntiy be additional perrni:x ayuired Cron, other I;Overnntental talalies arch a,: iP.:ier rn,Iiagcnxiq clisl:iels, si.•tk arencirx, oar faleral al_xeeies.
the owner of dta propmy of the morpirermn Florid. I data, F5 7
Uric :i or nlracl I'= u,la
S 0�1
Prim :Iln AR-31 s Na :Ile
4,14 41/0-5- RRLL
Sir, lr Ot Nolaly-Stara o, rl :u a )ale ,l'i^,raidii tlt'iit :y�i'pe RAste
M# MY COMMISSION # DO 164280
AEXPIRES: November 12, 2006
a Bonded Thou Budget No" Services
tii�7lef/A(;Cnl iS I' •YStNt411' SUr ('ta,:.^.tC ltfrlA?:::.: i;: —.— 1'l'r;IbLait' 1�t1Ut+n Itl i•4< Vr
hii:ial ,t:: Il:a.; (blitl:d :� I)Alti .•(Ini;i;.l �• Dale', Dsi:
Accepnnce orpegnit ispyinca%ii that 1 fttiU
)'Na
It Name
Tel WH8£:80 S00Z TZ 'qad 22260F£L01s : 'ON 3NOHd !food )I000pWaou2ansuI-6ut Tel : WOad
POWER OF ATTORNEY
Date:
I, An r w T (Andy) Adcock do hereby authorize Ruben Birch
To pull the Re oof permit for /00 E, �I��„t S C12 _ t q4.
(type of permit) (address) ; !�Z 7 - /
Signature
N
W.IT'
DAFNEY FAYE ADCOCK
NOTARY PUSUC. STATE OF FLOFUDA
MY Comm. Expires DEC. 2,2008
COMM. N DD370600
Stamp
ersonally kno to me or driver license # , of State of Florida, County of
day of .
Z ovS
REGARDING ROOF DRY -IN AND FI ASHINGS
INSPECTIONS
I
COMPANY: 1) 0 go o r, N
SUBDIVISION:
PERMIT NO:
AFFIDAVIT q
LICENSE NO: C C Ca Z Z Sa I
PROJECT INFORMATION
ADDRESS: /0 D
LOT:
1
I, 0 0 affiant, hereby affirm that I am the duly licensed contractor of record for the above reference
permit, that all of the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address/lot has
beenrinstalled in accordance with all applicable codes and standards.
CONTRACTOR: b117
rinted n )
ignature)
STATE OF FLORIDA
COUNTY OF Sely-ot,�.. e—J—
V-
This ins rument was acknowledged before me this Zr6 day of C -. Zoa S , by the above referenced
individual, N 2,,, , who acknowledged that he/she is a duly licensed contractor with
A---, y o F C-, ,z Z�,4 . and who acknowledged that he/she was authorized to execute this document. He/she is
either rson known to me ✓ or produced as valid identification.
WITNESS my hand and official seal thi day of e4;&,,'--e Zoa S .
DAFNEY FAYE ADCOCK Notary ublic
NOTARY PUBLIC 8TA
TE OF FLORIDA
MY Comm. Expires DEC. 2, 2008 NCO
COMM. N DD376609 Printed Name: l IJ E
My Commission Expires: i Z Z
Age
eState of I%rida
Permit No.
NOTICE Or COhWENCEMENT
Courtly ofSeminofe
14w Folio No. (Pro)
7bi underriped hcrcby gives notice War impmv=wnt will be ma& to attain tend propaty, and in accu dwee with Chapter
713. Fronds Stawtrs, the following intimrptatien is provided in this Notice of Gommencemenc
DPSMIP?ION OF IFROMRTY PAO desciWm of the property and meet address)
gyp• E. 7�114h1S CtiZ� ,SA.r.aCo>z.�, al, ,a��-1i
GENERAL DFSCRWnON OF MUROVIEMI?N'P :9, E • • i'
OWNER INFORMA770N
Name and address
Inletem iu property (Fee Simple, Patrmetsltip. etc.) W rJ
NAME AND ADDRESS OF uz Smnx TMJ& SOLDZR V OR IM nW OWNER)
Nam CONTRACTOR htoe
Name end eon'
0 '&>= e
r r• CERTIFIED COPY
SURD ) MARYANNE MORSE
VLERR Name and address '
OF CIRCUIT COURT
AmoatttofBond SEMINOLE COUNTY. FLORIDA
L$ND> DEPUTY CLERK
Neste xnd address --
MAR 0 2 2005
rTsrsiisslslsirsrriitpsis*sstiiisrsrrr++*�iwwr�s*ssrssssssssss#sr•rsrrsssrirsr:tartsssssts•
Per50tls rrithla the State oFF10Qida desipa0od by OMmd' upon whom aotia ae outer do�b mry 6e Qrved as paovidtd
.
by Section 713.13(lX■)7., Flo" Stott W
Natoe dad adti=
rtiii•r!t!!irlii•!at!lfitiiiilrriiiitrriiyii!•liiitiitiliiliiiisir#tTirrarirrisisarrsasrrsf♦
'
In tddition te• iaizkWf, Owner detigi 4a of
to ttc[+eive a dopy of the Litntor's Notice as
.provided in Section 713.13(i)(bl Fkdda Steam sMor
shm Daft of Nod= of Comme�aat
ghe eoitsaim date is 1 veer $[otn dam of tt�oot�diag ualew a ifthrms rl a :s aoeilfw i,
� m m � � m a
7;-2
S'
dz�ztz �Pam
-<'r1W �)
g
rp to and subscribed me this Day afte r , ff- 02C)O 5
My Commit+sioa Ezpis<r /� v�- �O
r $
•p rn
Q o o�� m
o
c
No blic
ro $ O ONc
w; t w4mowlodged before mo d is � day of 1A'
o M o
,
r (name ofpm= aclmowlcdged), r ly ]mown
w°
'" U1
Lne has prod (type of idetxifica on lion
� m
and who did I did nut tare an oalb>
tD c
ao
Ed Wti6£:80 SOOZ TZ 'Qad £££60££LOV 'ON BNOHd i looa )I000pt /aoueunsul-6ui iaa>i
W02Id
/F 5 It
CITY OF SANFORD PERMIT APPLICATION
Permit #: Date: al 10 ! 0
mob Address: /�d 1 n 1�/n.S ( .le i/q
ascription of Work: t /�<° tl� 1 C<1 I 1 S -1-0 .lob
Historic District: Zoning: ^Value of Work: S /660 t 00
MINEEMENEW
Permit Type: Building 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 Water 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 #:
,Owners Name &
-
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Leader:
Address:
Architect/Engineer:
Address:
(Attach Proof of Ownership & Legal Description)
--Phone:
State License Number:
Contact Person: Phone:
Phone:
Fax:
Application is hereby made to obtain a 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
pemut 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.
NOT[ : 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 permit ik verifica4o`tha wi�I notify the owner of they property of the requirements of Florida Lien Law, FS 713.
Date Signature of Contractor/Agent Date
Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
MY C0M1VJjS10N # DD 1t Mol
EXP!���: February 25, 2l>07
LjW
OTnoy � . *:�xount
Own Personall .Known .co.
Y \ /1 Contractor/Agent is _ Personally Known to Me or
Produced ID ,��- 7v !9s o _ Produced ID
el/ V
APPLICATIO PPROVED BY: Bldg: Zoning: Utilities;
(Inrtial Date) (Initial & Date)
r
Special Conditions:
IaP],
(Initial & Date) (Initial & Date)
has
l
•
CITY OF SANFORD BUILDING DIVISION
OWNER(BUILDER AFFIDAVIT
ELECTRICAL & FIRE ALARM SYSTEMS
An owner of property making application for permit, supervising, and doing the work in connection with
the construction, maintenance, repair, and alteration of and addition to a single-family or duplex residence
for his or her own use and occupancy and not intended for sale or an owner of property when acting as his
or her own electrical contractor and providing all material supervision himself or herself, when building
or improving a farm outbuilding or a single-family or duplex residence on such property for the
occupancy or use of such owner and not offered for sale or lease, or building or improving a commercial
building with aggregate construction costs of under $25,000 on such property, for the occupancy or use of
such owner and not offered for sale or lease. In an action brought under this subsection, proof of the sale
or lease, or offering for sale or lease, of more than one such structure by the owner -builder within 1 vear
after completion of same is prima facie evidence that the construction was undertaken for purposes of sale
or lease. This subsection does not exempt any person who is employed by such owner and who acts in
the capacity of a contractor. For the purpose of this subsection, the term "owner of property' includes the
owner of a mobile home situated on a leased lot. To qualify for exemption under this subsection, an
owner shall personally appear and sign the building permit application.
State law requires electrical contracting to be done by licensed electrical contractors. You have applied
for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to
act asyour own electrical contractor even though you do not have a license. You may install electrical
wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in
a commercial building the aggregate construction costs of which are under $25,000. The home or
building must be for your own use and occupancy. It may not be built for sale or lease. Ify,ou sell or
lease more than one building you have wired yourself within 1 year after the construction is complete, the
law null presume that you built it for sale or lease, which is a violation of this exemption. You may not
Dire an unlicensed person as your electrical contractor. Your construction shall be done according to
building codes and zo egulations. It is your responsibility to make sure that people employed by you
have lic nses r ed y to law and by county or municipal licensing ordinances.
1, y do hereby state that I am qualified and capable of performing the
requested construction involved with the permit application filed.
I will assume full responsibility as an Owner/Builder Contractor, and will personally supervise all work
allowed by law on the pepZi1tted structure.
Owner/Builder Signature Dale
slob I a h n's
Print O-wrier/Builder Name
Signatur Pi�MTiti�
DE�BBIE BLANTON
4
i
91
Y cotjV35foN # DDMOwner iEIMA800-3-1710TARI
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Produce
FL rtmy Discount