HomeMy WebLinkAbout124 Drew Ave` c 1
PccA,iit if : av
Job Address: ?
Description of Work,
Historic District:
Zoning:
GI Or SANFORD P
iso A'
APPLTCrkTION t I
Date:
go -Am
Value of Work: S a
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pogl•_-_.__
Electrical: New Service —it of AMPS Addition/Altcration Changc of Scrvicc Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & lncrgy CaIG, Required)
Plumbing/ New Commercial: 1,1 of Fixtures it of Water & Sewer Lincs it of Gas Lincs
Plumbing/New Residential: it of Water Closets I'lurnbing, Repair— Residential or Commercial ......
Occupancy Type: Residential Commercial Industrial 'Tota( Square rootage:
Construction Tyne: it of Stories: 11 of Dwelling Units: Flood Zone: (myfA form required for o(Iter titan X)
Pnreel ik (AttachProof of Ownership & Legal D
escription)
OwncrsName&Address: -i-DA 17d- -D2LK) `,�UL- � N(:-O,�'/,J ( J -Z -7�I
Phone:001—--
Contractor Nano C'Add�rtes�s:� �Ar�CoC� //1t _....._...._..__.-._
�0 D r-(L� N J S � �D ►�(� 1 ?lz7Z Stale Liccnsc \u!„Iter: VCili o 77-5 Q�!___...._.._
Phone ' Fax: Contact Person:- _ _Phone: �._.__....._.
flooding
Ad&ess:
xIortgnge
Address:
Architect
Address:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenc .1 prior (o tile
issuance ofa permit and that all work will be performed to meet standards of all laws regulating constntction in this jurisdiction. I understand that a separate
permit must be secured for ELECTI.ICAL WOpTC, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, DOILEM, HSATEI'.S, TANKS, and
AIR CONDITIONER• S, etc.
OWNf:R'S AFFIDAVIT: I certify that all of the Cerc9oin9information is accurate and that all work will be done in compliance with all appiicalflc:. )a� s rri;ul.zting
construction and zoning. WARNING TO OWNER: YOUR FAILURE'r0 RECORD ANO"riCE 01- COMMENCEMENT A.4AY RL—QUI—'r O'I YOIJI:. I'�/,YTNG
TWiCE FOR TMPROVEMENTS TO YOUP% PROPERTY. IF YOU INTEND 'FO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Nn"fl(1 : In addition to the rcquirc!ncnts of this permit, there Illay be additional ic!ctrictionS applicable to this: property that may be found in the public records of
this counly, and there ntay be additional permits required front other g wcrnntcotal entities Socha!; water ncut:!9cn,ent districts, slate a9cnr.lcs, or fetle.ral agc-nc,es.
Acceptance 1 perrntv lv/ ification that I t notify ti ot:ncr f rite propct;y of the require
Si9n:tture of Owner/Aber Da Slt
Print Owncr/Agent':; Name rl
il;natt uy taut o ! \NAVIN yl`! I .tic
t f`flehda
?_ ► My Cpmatissicn-r.xplres Jan 4, 2007
?' ' Cbrrirnisslon # DD 156630
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Owner I% F I'�dNd tit conal. Assn.
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Al'I'LIC'A"I'ION APPROVI D BY: 111(19:
special Conditions:
%onin9:
of no • Lien law, 1
o"(-Onl Clo!' 9latl'
,trnc!orAl2is/tjtame
tc
* MY COMMISSION # DD 164280
EXPIRES: November 12, 2006
N�9Tf OF F��P\o�
BondO u Budget Notary Services
Known to ,\1t or
I'nxluccf.:D
(11116:!1 fi Datil
(Initial f: D:!te) (lv+tlal L D^_t:
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S (:-D e.-(71> ; 'Z-7� i` OTICE Ol., COj�tivDztTCM0-:�N z GLE K OF CIRCAT rot
pCr111it No. '
SLiltc Of lorick,
CounLy of Soluiuolc
crcb 'ivc:: 11oLicc'Cl1 IL [[1lpr0 VCInC(1L will be 111:(Clc to ccrt;lin. real p1'opcl'ty, -ldc.I i1l'aCCOrdallcC with
�1C llilde['S1(,.'l1Cll ll y L ,
Chapter 713, ):�loricla Statutes, the followilig iliforlllatioll proviciccl ill Luis Notice o1 Co111111e11cC11n� 410,
l . pcscriptiou of propcl'ty: (lCr;al rlcscripLion of talc l)rol)crLy :111d strccL .ldclress if ;(1 �lilablc) L� 1
2. CrcnCi'al dc. cl'IpLIoil of: 1111pro,"Cillcllt:
Owner i,.tlfornl;lLioll
a. Name and adrlress
;d_
b. Xlltcrest. In pl'opertyUVV P) -
c. Nanlc alld ;iddress of fcc simple tiLlcholdcr (if oLhcr 61:.11 Owncr)
4. Contractor
a. 1`lalllc and a
5.
G.
7.
LAA// -/-1'=111—
b, phour, it unbcl' t�6� ?rZ l -/ �`��'•
Surety
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a. Name and Iddv(;ss -�� ---- --- "-" --
------ 1� a:; I1lB�Ib�1l.E
b, 1'1lalc number — HK 05469 PG 1800 ____----
c. Alllowit of bond CLERK'S # 2004152557
)`,ender RECORDED 10/0412M 09:30:28 AN ]' a:c 1111111 cr
b. 'J)llollc litimbcrn LCd by O -- —
J'crsolls `mlaillltllc sL<"ltk Of 110I'!da C1C.",If�lll';'llcr 111)0(1 `,'110111 110L'ICC5 Ol' Ot11C1' dOC11111e[1tS play bC SCrVCd as
provided by Section 713 �13(1)(a)'/., i lorida SL:[Lulc : —
a.. Nanlc and addl'ess
1';I%11111110Cr of
b. ).'Volae number --
8. xa addition to llitllsclf or Izciscll; 0 '11cl' rlcsi�natcs
to lcc o1)Y of Lllc i,iclzor's t`\oticc as provided in. Scct'
113.13(l)(b), Florida St';.LULCs.
I111111bC1'
nunlbci'
9. Exp
lratioll C1atC Of11OL1CC Of COi11l11CneC111Clit (tho (;xp1I:1L1o11 datC iS 1 yC;11' ft'U111't11C datC Ol' l'CGOi'CI111j,1
a. 1)llotic 11111Cs: a "Crcl])
J9datC 15 Sl)CG1 lCd) \
r
Src Of 0Nyllcr
r affir[llcd) and silo ribeCl before me thi ��✓d:ly of
�( S\\ orll ( a6
1'crsonally 1Cllo�.'n op,1?roduccd ldc:ltification —
or
7.0G� by
AL2ADA WASHINC�TQN
Notary Public • State of Florida
MY commisslon ExGlres Jon 4.2007
' w « y
�grnmisslon # DD 156630
"' oN e�
til
Bonded BY National Notary Assn.
State Certification
No. CCC.0225011
Since 1963
AZMVICKE��
ROOFING AND SHEET METAL
800 French Ave. - Sanford, Florida 32771
141'5Tv RED
Phone: (40) 322-9558
STATEMENT
DATE 20o4
TO:
J
ADDRESS'. Ceyol qlq-qo.
CITY, STATE: ZIP:
I MIT
ALAHINVN
A". :;K- NotaryZADAPublicW- State O
of Florida
MY Commission Expires Jan 4, 2007
Xi� Commission # DD 156630
kllwl ffl., Bonded By National Notory Assn.
A
woe f
POWER OF ATTORNEY
Date:
I, Andrew T.(Andy) Adcock do hereby authorize Ruben Birch
To pull the R e r o o f permit for yv U
(type of permit) (address)
fj-, �Z 7
Signature
a� Y nieLinda A Keeling
My Commission CC985428
NJ n..,o Expires December 09 2004
�-'� Notary Stamp
Personally know o me or driver license # , of State of Florida, County of
day of 2004.