HomeMy WebLinkAbout1116 Cypress Avet.,.• ':• " 1.
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Per hit 11
Job Address:
CI`('1'OrSrli\I UL D1'151\lCl'nl'1'LIC:r\11v1tc r t + !t r
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ZDescriptionofWork: ' ((Z
Toni Value of 1Vorl(:.S CJ C) D -- -- -
Historic District: C
r,..rrre,
Permit Type: Building Electrical Mechanical I'lumbing Fire Sprinkler/Alarm,
Electrical: New Service- it of AMPS Addition/Alteration Change of Scuvicc 1'crnpot:iry Polc
Mcchanical: Residential _ Non -'Residential Replacement New (Duct Layout & rncrgy Citli , Required)
Plumbing/ Ncw Commercial: // of Fixtures It of V,'atcr & Scwcr Lincs it of Gas Lines
Plumbinr/New Residential: it of Water Closets 1'lunubin ; P.epail. Residential or Commercial
Occupancy Type: Residential Commercial _industrial (btal Square FOoLlre:
Construction Type: — it of Stories: If of Dwelling Units: blood `Lone: (rrhfA form required for other tllzn X)
Parcel il:
O%v"rs Name & Address:
mlach Proof of ownership
t'-D I_tI Lo
i'bone:
Legal Dcscrip(ian)
Contractor Name &''Adti1_...._
S2far{ } D 2•C I 3Z7-7 LStatc Liccmc' //Number:7_._ ___.....__
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Zj j-'j?JJ Contact Ilemll:_K t ZZ t 7 J iS
1'ilone & Fax: —r`
sort^a, c Lender: -
Address:
Archited/tin ilice":
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t,
V:Ix: -------- -._..__.__.......... ..........
Address: - -
Application is hereby made to obtain a permil to do the work and insulllations as indicated. I cerify that no work or installation has commenced prior to theissuanceofapcmlitandthatallworkwillbeperformedtonicctstandardsofalllawsrcgulalingconstructioninthisjurisdiction. I undcrstand that a separatepermitmustbesecuredforELECTIMCALWOP.K, PLUMBING, SIGNS, \VELLS, POOLS. FURNACES, BOiLIM, II LATf_(LS, TANKS, and
AIR CONDITIONERS, etc.
OWNEWS`AFFIDAV I-T: I certify that :111 of the foregoing information is accuraic and tilat all wor,: will be done in compliance with :111 aplilic:lbie• Iaws rr.);,d<etingconstructionandzoning. WARNING TO OWNER: YOUR FAiLURG'r0 RECORD A NOTICE 01r COA9MENCL•1vtENT MAY R1iSU(:L I.h! YOUlt.l'AY(NGT\ViCE FOR 1MPROVEMEN'1'S 'T'O YOUit PR01'GfaY. IF YOU IN1'END'1'0 OL''I'ATN f:Ivr\NCING, CONSULT WITH YOUR 1.ENDER Olt AN
ATI'ORNEY BEFOI`E RT--CORDiNG YOUR NOTICE OF COMJ.QGNcr-.w N•r.
In addition to the requirerlv.nL: of this permil, lhcrc 111:1y be :lddition:ll i,:::Il;clion:::gtplic:thic to [Ili:: property plat m:ty be found in the public recordi ofthiscounty, and there Amy be additionni permil:: raluircd front olhcr l;over11111colal entitle:: such a:: w:11er nunagcnu-nl di::tr 1cts, st:uo a);cncu::, or federal ng.mcies.
Acceptance Of permil is verification that I will notify the owr.cr of tilc propcl,y of the requircnun', f no6(ia Lien I
i nauncol'Ou ler/Agent I :1t + Sir tauiie 4r z
ontmctor/%gent D:t C
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lPrint0Aner/lAenl's Na I'f ' Contracux :\gent'': Naar_ 1J.
Sicmalt le ol'llqotary-Stag ofl lorida
OT
ADCOCK3.+y.;.....,.,..b
3 NyARY PU STAZE OF FLORIDA
e '
rMll 1..d 'itiJkktt.tfijlD+tdG:14; E00g, : ; ur
Iuc Si!:t:aturc of i:o:ary-State of Florida Date
AI'I'l_IC ATION AITROVED BY: tlidl;:t `!- 31 I0ilI
Mrr
u 1 n+:: -D - B_BIE IEttI:,A{nijlb nn,vn w dt ur
i(M1 C WyMI_SSION:II 18ggg}.. ----
ws`a`` EXPIRES February 25, 2007
1-800-3-NOTARY FL Notary Discount Assoc. Co.
lblitia{ .'i Batt] (Initial .; Date) (Initial .l D2t:
POWER OF ATTORNEY
Date: ?7 ZZ D S
I, Andrew J . (Andy) Adcock do hereby authorize Ruben Birch
To pull the R e r o o f permit for 0 e- A
type of permit) (addTrs,
6—,,.D ,q, C_ 4l . --3 ?-77
Signa
Stamp
DAFNEY FAYE ADCOCK
NOTARY PUBLIC, STATE OF FLORIDA
MY Comm. Expires DEC. 2, 2008
COMM. # 0037HOO
I
Personall wn to me or driver license # , of State of Florida, County of
Z day of w ,
zoos
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: 4QeQe.4=-"a6oroz License #: CCL D S D
goo
S 4 [ . 3Z%`7
Project Information
Owner: M (L(-)zc7o "" Permit #:
name
I I t Lo & Pre_4-7e7_ LC , Subdivision:
ad ss`
r 32! ,
o ` — 651- ®O "?-!5 Lot #:
phone
I, 0 "60 , affiant, hereby affirm that I am the duly licensed
contractor of record for the above referenced permit, that all the foregoing information is true
and accurate, and that the dry -in, flashings at the above referenced address or lot has been
installed in accordance with the applicable codes and standards.
Contractor: all/
signature
0 a&")
printed name
STATE OF FLORIDA
COUNTY OF P,r v o
This instrument was acknowledged before me this Z44day of , 20 a5 by the
above referenced individual, n t"1 410dO C t.--' , who acknowledged that he/she is a
duly licensed contractor with 4i`r-IL-t 1',-- D P A--, and who acknowledged that
he/she was authorized to execute this document. He/she is eit rsonally kno to me or
produced as valid ion.
WITNESS my hand and seal this
DAFNEY FAYE ADCOCK
NOTARY PU9LIC, STATE OF FLORIDAMYComm, Expires DEC. 2, 2008COMM: # 0D376609
z day of
Notary P lic
I
p
e of Florida
NOTICE OF COMMENCEMENT
Tax Folio No. (PID)
County of Seminole
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with "A (_ l 713, Florida Statutes, the following information is provided in this Noticc of Commencement. t'Ir 1 CflNr
r MARYANNE MOOSEDESCRIPTIONOFPROPERTY (Legal description of the property and street address) CLERK OF CIRCUIT COURTMINOLECpqV'FLORIDA
GENERAL DESCRIPTION OF IMPROVEMENT K 0
OWNER INFORMATION p ,
Name and addre s t ` I ( (- LD 0-
I i l T--- , -
Interest in property (Fee Simple, Partnership, etc.) n'--D K3
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER -OF OTHER THAN OWNER)
CONTRACTOR 1/1
Name and
Odv ad DL D L
SURETY (Bonding Company) 11000101101111111110111111111011111011 IN IN
Name and address
Amount of Bond
MAR FMNE MRCP PI FRK X 11RCUIT CEIIiRT.
SEMINDL.E MMTY
LENDER
BK 056&2 PS 0349
CLERK' S 0 2005049523
Name and address 83.1284 at 88,472 AN
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
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.
Expiration Date of Notice of Commencement
e 4? of_tecording unlecc a different date. is mPrifeYi 1
t""'y ., DAFNEY FAYE ADCOCK
1 NOTARY PUBLIC, STATE OF FLORIOA3 / MY Comm, Expires DEC. 21 2008
coMM. # DD37 09 ignature of Owner
Leh z oocj
Swor to a sub ibed be a me t Day of /VJ P-14A- , t9
My Commission Expires: Z- 7- ZCO'F<
Nota Pu Iic
Q Z" c,
The foregoing instrument was cknowledged before me this day of 1-9 by
h'1 t L. t'7fz + Tp 4P4c a (name of person acknowledge: s
pMidentiy kno
me or who has produced (type o t deal fcationtcation and
who did / did not take an oath>