HomeMy WebLinkAbout107 Long Leaf Pine Cirr.
Pcrinit f{ s
Job Address: 0-7
Description of Work: IL t:., IC. vv r
Historic District: Zoning:
Permit Type: Building Lilcelrical Mechanical Plumbing Fire Sprinkler/Alarm
Electrical: New Service —11 of AMPS Add ition/Alterntion Change of Scrvice Tcmpor:l'ry Pole
Mechanical: ResidentialNon=Resictcntial I.cplacement New yout & (Duct LaT,ncrry 04... Rcgttirc:d) Plumbing/
New Commercial: ll of Fixtures 11 of Watcr &. Sewer Lines a of Gas Lines Pluntbinp/
Nc\v Residential: 9of Walcr Closcls 1'luntbin- Rcpair— Residential or Commercial Occupancy
Type: Residential Commercial _ Industrial 'I'otal Square T'oolarc' Construction
Tyne: _ v of Slorics: i1 of Divcllinp Units: Flood Zolle: (F>;yrA form required for other than X) Purccl
ll: AltachlProoror
Ownership .^Legal De wiplion) Owncrs
Name & Address: =6_— n S E"A'E I —I k
Phone' 14a%— 4 z- Contractor
Namc &''Address: `Aer7 Lt O C2 ........ 7l
D
0 0 r'z_ N ` "& J L (- Sf-{-3 Q ?=12 1 3Z%i L S;aLi tc cense, m-11 er: D i;,
44—i j?j Contact Pcrson T ADe6C _Phny. o 1 %_3ZZ
r7r
JS hone& Fax,
1lnndin; Company:-
Atldi•css:
N•lort^
a;;c Lender: cldress: Architect/
rngince":
Address: Phone:
Application
is
hereby made to obtain a permit to do the work and installations as indicated. I cenify that no work or installation has commencr i prior u, the issuance ofnpermitandthatallworkwillbeperformedtoniectstandardsofalllaw, regulating construction in this jurisdiction. I understand that a sepanic permit must
be secured for IiLL•CTRICAL \'%ORK. PLUMBING, SIGNS, WELLS, FOULS. FUI.IhACFS, BOILERS, TANKS, and AIR CONDITIONERS,
cic. OWNER'S
AFFIDAVIT: 1 ccutify that all of the rorcgoing infomsttion is accurate and that all wort.- will be done in compliance with all applicable rrl nl:aing construction and
zoning. WARNING TO OWNER: YOUR FA1LU1,,R'r0 RECORD A NOTia OF COMMMNCETvIL-NT MAY RGSUI.T IN YOUR PAVNG TWICE FORIMPROVEMENTSTOYOURPr'.OI'la.'IY. IF YOU INTEND TO OL''1'ATN FINANCING, CONSULT W ITI•t YOUR LENDL•R OR AN A'i'
I'ORNEY BEFORE PJCORDING YOUR NOTICE OFCOMMENCEMGN•r. h 'IUIr;
I:: In addition to the rcquircnv:nts or rhi;: pcnnil, Ihere may 1m additional n;::rrictinns applicable to Ilrir properly that ma)' be futmtl in the publie recordsor this county, and
there ma be addition permit:: required from other goe crnnn:nt:rl entities such :ts v:atcr nunagcntent districts, stale al enci :, orrrdcrol actencies.11 Sign; Print
ivcal
th13.
da •
7 aeytt1yr`r1
7 l,Zdi ,// rtr: t
C_'k ol• Novivy-Jlale
of
Hixida DAFNEY FAYE
ADCOCK NOTARY PUBLIC. dTATE OF
FIO R.I
p; tt1 I rHr:l3ityll if' :91.1
to tllU il —Z) AI'1'LI('A*I'
ION APPROVED
BY: 111(I1;: pccia! conditions: zoning: m ractor Agent's
Name 3.
P4 '
Sirr:
attrre of N,,.vy-
State of
VioridaVY I)atc r::on .!:' Known to &
Ic
or Initial;
I)•rhl Ihti;ial:: Uatt:) (In+
UaI,F U_i: 1
POWER OF ATTORNEY
Date:
I, Andrew 7 . (Andy) Adcock do hereby authorize Ruben Birch
To pull the R -roof _permit for /oi Lrn&, L ,PNe Ct
type of permit) ' (address)
Signature
Stamp
0a DAFNEY FAYE ADCOCK
NOTARY PUBLIC, STATE OF FLORIDAiMYComm. Expires DEC. 2, 2M
COMM. # DD376609
Personally kno
l
o me or driver license # , of State of Florida, County of
day ofof
a o 45
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
AFFIDAVIT
COMPANY: I> 8 keo ri I J LICENSE NO:
PROJECT INFORMATION
SUBDMSION:
PERMTT NO:
ADDRESS: ID-1 Lv-y.C, LC -AP- P1JE C lP-- .
F-I . 37-7-7 1
LOT:
I, '-1 ( affiant, herebyaffirm that I am the duly licensed contractor of record for the above referenceY
permit, that all of the foregoing information is true and accurate, and that the dry -in, fleshings at the above referenced addresstlot has
beeninstalled in accordance with all applicable codes and standards.
CONTRACTOR:
STATE OF FLORIDA
COUNTY OF. 0 LQ
This instryment was acip pledged before me this —9 day of e --' 'Zoo 5 , by the above referenced
individual, k iv v, f-1 C 0 Ct ,who acknow;=
W23hapUthorized
is a dulylicensed contractor wi
e. p and who acknowledged to execute this do e .He is
eit ersonall to me or produced as valid identification.
WITNESS my hand and official seal this day of Z.o
I-S
No Publi ,
DAFNEY FAYE ADCOCK
tart
NOTARY PUSUC, STATE OF FLORIDA Printed Name:
i MY Comm. Expires DEC. 2, 200a My Commission Expires: Z Z Z+o
COMM. # DD376M '
do L
State of Florida
Permit No.
is, c—j
3z
NOTICE OF COMMENCEMENT
County of Seminole
Tax Folio No. (PID)
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 PROPERTY (Legal description of the property and street address)
10 -i Pt "e dt e ` ,n "atGc 3z 7 r
ey GENERAL
DESCRIPTION OF IMPROVEMENT , IsN r\\\'\ ZIA-
OWNER
INFORMATION Name
and address Y t t CA sip L i>n - C
120 Interest
in property (Fee Simple, Partnership, etc.) NAME
AND ADDRESS OF FEE SIMPLE TITLE HOLDER.(IF OTHER THAN OWNER) CONTRACTOR
e Naaandaddressb / ahr 5
00 P7I2t SURETY(
Bonding Company) Name
and address Amount
of Bond profflMM11FAWPOWE.
IT CART SEMIMLE
CtilNW LENDER
BK
05612 PC' 0952 Name
and address CLERK'
S SiI 20654824446 R@9
Persons
within the State of Florida designated by Owner upon whom notice or other.documents may be served as provided by
Section 713.13(lxa)7., Florida Statutes: Name
and address ssssssRRrstsss*
ss#s##**s#s#*s*#*#*ss#tss#sss*ssts#sssss;sss**t**sssstssrtss#sssss*rRtrts##rr In
addition to himself, Owner designates of to
receive a copy of the Lienor's Notice as provided
in Section 713.13(l)(b), Florida Statutes. iitti;#
rt##i#r#t##**#*its###;;*i#iti#####**#i;t#t*ii#i;;##;##*;;#t#i#t#ii#ti#;###R##rr##RR Expiration
Date of Notice of Commencement The
expiration date is l Year from date of recording ens a di t d . ie enerifirri ) DAFNIsY
FAYE ADCOCK NOTARY
PUBLIC. STATI OFfLOIt1DA Signature O •Owner MY
Oorlltn. l tnl r+s tlae s R.A.sS
o 6 s# ft *e t6' Day of , 19_ p #-
V V My
Commission Expires: Not
P blic j
I zmo s The
foregoin was acknowledged before me this G day of , 39r by name
of on acknowledged), who is personally.known.to me
or who h uced k---P . c.1C - (type of identification) as identification and
who did id no a an oa 67-p 0 -1 2-3 7l 00 ( o