HomeMy WebLinkAbout103 Centennial DrPcrinit 11, iti 'yn
Job Address: 10 3 N
C11Y OF SANFURD 1'I:ithirl' AtTIAL;A71vn t ::r: •r ;.;}:i+= ; r ':w>:;_ i y^'ti:^. S
Description of woric, ! ILri IC- t/y t'
rIlstoric District: olling: Value of Work: S 5`3r7.
rnic.•: r:5 aaa r
Permit Typc: Building; riicclrical Mechanical Plumbing; Fire Sprinkler/Alnnn
r
Pogl•ii_
Electrical: New Service - it of AMPS Addition/Altcrntion Change of Service Tcmpor iry Pole
y Energy C:ili: Required) Mechanical: Residential Non-Rcsidcnti:tl RepinccmenD tNewuct L:t out Plumbing/
Neiv Commercinl: 11 of Fixtures 11 of W-ltcr sec Sewer Lincs 11 of Gas Lines Plumbing/
New Residential: I/ of W.atcr Closets Plumbing, Repair- Rcs:dcntial or Commercial ____^_ Occupancy
Type: Residential I Commercial industrial 'Total Square Footage: Construction
Type: i1 of Storics: it of Divellillp Units: Flood Zone: (FENIA form required for other thin X) Parcel
It: Owners
Namc & Address: Attach
Prooror Ownership .C• Leal Description) isitTE[,-
Pu&-(- 'DR.- 44foFDZ4 Phone:
40%- 37-1- 7n23._..._..- 37--
7 -7 i ContractorNantc &'
Address: Ar>Co00 1 C-% _....._..__._....._ 5;0
o lZ 'C t- A J SlkN3F'o I=-O L l 3Z'1'11 State Liecnse N*umbrr: cCG 0 Zz Sew----- -• t p"1 _ 7?
p_ 333 Cnnlacl Person:_ S.t _Phone: 32z55g Phone.& Fax: -- Iloodin;; Address:
Nlortgigc Lctrder:
Address:
Architect/
Cn.;iitccr:
Address:
Fax: Application is
hereby
made
to obtain a permit to do the work and installations as indicated. 1 ccrify that no work or installation has commenced prior to the issuance of a permitandthatallworkwillbeperformedtomeetstandardsofalllawsregulating; construction in this jurisdiction. I understand that a separate permit must be securedforELECTRICALWORE:, PLUMBING. SIGNS, WELLS, POOLS. FURNACES. BOILERS, i-IrDIJE LS, TANKS, and AIR CONDITiONL•R.S,
ctc. OWNriR'S AFFIDAV I.
1•: i certify that all of the fercroing; inrom-ation is accurate and that all work will be done in compliance with 311 apg>licalrle la:vs regul16119 construction and zoning. WARNINGTOOWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY R13SUi.T 1N YOUR PAY(NG TWICE FOR IMPROVEMENTSTO YOURPROPERTY. IF YOU INTEND TO OL'TAN FNANCiNG, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECOi.DiNG YOUR
NOTICE OF COMI.4ENCEMCNT. NZI'I(; li: In addition
to the rcquircolcov, of thi . permit, there may be adrlitirmnal n::arietions :grplic:rblc to iris properly that may be found in Ihr, public records of this county. and there may
be additional permits rctiuircd from other g raernnrcnial enlitier such an water ouna;;enncnl districts, slale. al enciv% Or fedcnal ay.rncics. A cc la t D
at i will notify the ot:ncr. f tinyov xOpery of tic A gnature
of rarer/Al;
en;
I :ric H I inl U r
lAganl`• Nar naun o Notary laic of
Florida Datc r t rcr/Atpll is
I' :onally "nnttn r Ny nr 3 _ Produced ID /18-
APPROVED BY: 1110V: unin:
I
Initial Dmc) o S,
si_rr:ature
Or 'o
r ••State of Florida Dale DEBBIE CANTON MY C0M1,:: 1S}«
Sr R
i8Ri61 Cron:r rclur/ February25.2007I'rUth •. t-
001).,lypS4W__rttNoT....._..__ cry Discount Assoc. Co.
Initial & Dat.l VD: Initial ::
Uale) (Initial & D27:
Hal
POWER OF ATTORNEY
i
Date:
I, Andrew T . (Andy) Adcock do hereby authori ze Ruben Birch
ri
To pull the R roof _permit for d 3 (. e-n 4e t t let l --P e -
typc of permit) (ad ess)
4(" :Z -7-7
Signature
Stamp
DAFNEY FAYE ADCOCK
NOTARY PUBLIC. STATE OF FLORIDA
MY Comm. Expires DEC. 2, 2M
COMM. 0 DD376609
Personally known t e or driver license # , of State of Florida, County of
day of w,. 2004.
zoo
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
AFFIDAVTr
COMPANY: 610 601— oO C! N LICENSE NO: l C D Z S a(
PROJECT INFORMATION
SUBDIVISION: ADDRESS: % 3 C"t ex. M ( a-` —Dr'.
L_,1 e,,_(_ 3Z-7-7 (
PERMIT NO: LOT:
46 afI"iant, hereby affirm that I am the duly licensed contractor of record for the above reference
permit, that all of thi 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: yL&S,
Print e)
Signature)
STATE OF FLORIDA
COUNTY OF -7 Piwl t In o
This in tFC, rumentwasaknowledgedbeforemethis —day of Z #04 , by the above referenced individual, '
le" , who acknowledged that he is a duly licensed contractor with and
who acknowledged the was authorized to execute this document(gi he is eithFfgrsona
known to me 6—' or produced as valid identification. WITNESS
my hand and official seal this day of 4e 6w ,c—r Z oo S 4
DAFNEY FAYE ADCOCK NOTARY
PUBUC. STATE OF FLORIDA i
MY Comm. Expires DEC. 2, 2= COMM,
N DD37M Not4
PuWic Printed
Name: a_(_4 C'DC'p My
Commission Expires: / Z z
A tm A-r,>eoe-K
U 0 F-p & N CA A State of Florida
NOTICE OF COMMENCEMENT
County of Seminole
S" PE) 7'r-> Permit No. Tax Folio No. (P1D)
r
2
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter
1 713, Florida Statutes, the following information is provided in this Notice of Commencement.
VIACRSADESCRIPTIONOFPROPERTY (Legal description of the property and street address) t F\ O jg 5AKW-o r- . -F-(. F7 7 `7 1 X_ VZ Owo GENERAL
DESCRIPTION OF IMPROVEMENT O D Q
12pU7 V
OWNER
INFORMATION // Name
and adde ss 10'
zi A,.(_`.Fi2-a4 Interest
in property (Fee Simple, Partnership, etc.) e w t i NAME
AND ADDRESS OF FEE SIMPLE TITLE HOLDER-97 OTHER THAN OWNER) CONTRACTOR
Name
and address SURETY (
Bonding Company) Name
and address Amount
of Bond OI E CIRCUIT
MW BK
056 t iy P'G 0 953 LENDERCLERK*
S It 2'005024449 Nameandaddresss
s i ql sssr+
ss+sss+rrs*+sss+sr«sss sssrss+«s«s++rs ss+«s«««ssrssrs+*srKOF ssry+s««s«sr Persons
within the State of Florida designated by Owner upon whom notice or other documents may be served as provided by
Section 713.13(]xa)7., Florida Statutes: • •' Name
and address s+
ssas+«i«s«ssss«r+rssssrs«sssssss+sssassss+rsrssssssassss+ssssssrsssssrs+r«ssssrss«rsss«s+ In
addition to himself, Owner designates of to
receive a copy of the Lienor's Notice as provided
in Section 713.13(I)(b), Florida Statutes. srssrs+
rs+*s***sssr+ssrssrsss+ssssssssss+ssssssss*rassssss+sssrrssasssr+ssr+ssssrrss+++s+sr Expiration
Date of Notice of Commencement The
expiration date is 1 year from date of recording unlem. a difPe en ifirri ) Signature
of Owner e
Sw
to and subscribed before me this _ Day of _7 V
My
Commission Expires: Notary
Public The
Eqrcgoingmsturunkent was acknowledged before me this o^r-j day of Tan , * by Y
n e a- (name of person adat cu d w i e o ll t me
or w o has d Y1 ( Rf tda gtification) as katt 6on and
who did / id not an oatlr>`4•;Notary Public - State of Florida MVCom *
donB0esSep4.2007 I••••"• ?=
Commission #
DD 372117 Bonded
By National NotaryAssn.