HomeMy WebLinkAbout116 Kaywood DrPcrinit tf
Job Address: ( K+M WG D I Z
Description of Work. fLti L nvv t-
flistoric District: Zoning:
clll'OF rI\Ir.UI:1)1'I;l'ulll'1'AI'1',II;A itVrv •, ::,: .;::•rt:4i;r,• ;,2,ytib7:,:+::,•
N.
Date: •• ...t.Y;:;.';-:•.,.
S „tSl e S
Permit'I'ypc: 11uik1inS r..Icclrical Mechanical I'lumbinl; Fire Sprinkler/Alarm
r
P0Q1- _
Electrical: New Service — it of AMPS Addilion/Altcrntion Change of Scrvicc Tcntpot.iry Pole —;--•
y c l;ncrgy C iIG Required)
Mechanical: Rcsicicntial Non=Rcsidcnlial Replacement New Duct La out .
Plumbing/ New Conultercink ii of Fixturc, it of Water Fc Sewer Lincs It of Gas Lines
Plumbiug/New Residential: it of',Pater Closcts Plumbing Repair— Rcsidcnlial or Commercial
Occupancy Typc: Residential Commercial _ Industrial 'Total Square Foolagc:
Construction Typc: — 1/ of Storics: ii of Dtt•clling Units: Flood zone: (Fri'vrA.form rcquircd ror other than X)
Parccl it:
Attach rrooror Ownership & Leal Descrip
Owners Name & Atldress: -
f'Z_'_t'_•"1, ^
nn -
1'honc• L-fQ%— 3Z0= QS .
Contractor Name &•'Address: 4r2 tip C L O ) ——•••_•—•_•••_•••_
Of7 QZ i-O-•cI 3Z%%Lf Stt alcI.icensc-Nitn1)cr: 27--_—....._.
t-ro" 1, zj?j _ G?j?j Contact I'crson: _ x'rni T T`C C rltonc: 3ZZ 5r—J
Phooc .c r_x• — _ ----
Itnndin
Address: - ---
tort,
Address:
Architect/En'.inccrt
Address:
Application is hereby made to obtain a permit to do the work and installations as inclicalctl. I ccrify that no vrork or installation has col:rctcncrri Prior u, theissuanceor., Permit and that all work will be performed to meet standards of all laws regubting conslnlction in this jurisdiction. I understand that a separate
permit most be sccurccl for IiLLCTRICAL WOR}:, PLUMBING, SIGNS, WELLS, FOULS, FUI:NACP_S. 001LI-M. HEATERS, TANKS, and
AIR CONDITIONERS, ctc.
OWNER'S AFFIDAVIT. I ccrlify that all of the forgoing infomiation is accurate and that all wort: will be done in compliance with all apPlicablo laws rtq obaingconstructionandzoning. WARNING TO OWNER: YOUR FAILUI:E TO RECORD A NOTICE 01, COMMENCEMENT MAY RM- UI:P IN YOUR PAYINGTWICE- FOR IMPROVEMENTS TO YOUR PROI'Elt'IY. IF YOU INTEND TO OL''1',11N FINANCI 1G, CONSULT WITH YOUR LENDER01: AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMI.QENCf:MEIJ'r.
NMICI: In addition to the requircnv:nl:: of This pt:nnil, Ihcre may Ire atMilional re:arctiuns applicable to thin properly that may be found in Ihr, public rceomk of thiscounty, and Iherc may be additional permit:: rcquirctl from other I; vernmcntal entities such a:: waacr nunagctnent districts, state alit nt ic::, or redcrol aprocies. cricati0
I, 1vi1 ' pet;y of the rcquAcceptanr erxSignature
orOttiter/
Agenl )ate t O•
ncr/
A1;cn1 is __ I' :r.:a thttl.' nnt n In •lt ,r AI'I'
I_IC'ATION A141ROVED tly: Illclg: I Initial ::
1)::tc) anin:;: b116:
11 &
D.110 L):,It) ((—vial ,t D_u
Iz
POWER OF ATTORNEY
Date: . D
I, Andrpw T (Andy) Adcock do hereby authorize Ruben Birch
To pull the Re oof permit for i ( o i
typc of permit) (ad ess
ODDAFNEY
FAYE ADCOCK
NOTARY PUBLIC, STATE OF FLORIDA
MY Comm. Expires DEC. 2, 2M
COMM, A DD370609
Stamp
Personally k n to me or driver license # , of State of Florida, County of
day of — -266+.
Zoe S
t
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
AFFIDAVIT
COMPANY: 4Q bw DDr7-t, LICENSE NO:
PROJECT INFORMATION
SUBDIVISION: ADDRESS: j D ?
PERMIT NO: LOT:
affiant, hereby affirm that I am the duly licensed contractor of record for the above reference
permit, that all of the4bregoing information is true and accurate, and that the dry -in, flashings at the above referenced address/lot has
beenanstalled in accordance with all applicable codes and standards.
CONTRACTOR: 4 b Ln eta c.1C
STATE OF FLORIDA
COUNTY OF SP/1^- I M o C y,
This sstrument was cknowledged before me this day of Zoo 57 , by the above referenced
individual, ! o ID d44 who acknowledged t e/s a is a duly licensed contractor with
G1T94.'7 _ L22 , and who acknowledged tl t h 3he was authorized to execute this docume He/ a is
eithe sons y own to me or produced as valid identification.
WITNESS my hand and official seal this day of z a o S
DAFNEY FAYE ADCOCKNoPUBLIC,
STATEL FLORIDAMYComm. EMpine D2, MCOMM, N003ONolfryPuLqic
Printed
Name:—PAQ,',)Q1 My
Commission Expires: I Z 2 o $
goo 4(eI-i E-t A. State of Florida
NOTICE OF COMMENCEMENT
County of Seminole
4L n-7-1 (
Permit No. Tax Folio No. (PID)
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Char C,O 713, Florida Statutes, the following information is provided in this Notice of Commencement. 0\E\`t-" DESCRIPTION
OF PROPERTY (Legal description of the property and street address) 1
Fo 3z-7-7 0 0
GENERAL
DESCRIPTION OF IMPROVEMENT E tCpi'3 A . ° FEg • OWNER
INFORMATION Name
and address O134
DDOInterest
in property (Fee Simple, Partnership, etc.) 0> NAME
AND ADDRESS OF FEE SIMPLE TITLE HOLDER -OF OTHER THAN OWNER) 1.
rle CONTRACTOR
Nape
and address SURETY (
Bonding Company) Name
and address Amount
oI lfoAC CIRCUIT
COURT SEiliffu
CMX" LENDERBK05612PIG09354 NameandaddressCLERK'S ti . `1MI5624450 00
REMINO
FEES 10:80.*.... Persons
within the State of Florida deli ted Owner F mbyuponwhomnoticeorotherdocumentsmaybeservedasprovidedbySection713.13(lxa)7., Florida Statutes: Name
and address sssss•
sssssss**ssssssssss**sssssssss*ssssss*ss s•*s*•sssssss•*sss*sssssss*sssssssssssss*s** In
addition to himself, Owner designates of
provided
in Section 713.13(1)(b), Florida Statutes. to receive a copy of the Lienor's Notice as ss**
ssssss**sss*ssssssssssssssssssssssssssss*ss*sssr*ssssss*ssssrssssssssssssssssssss*ssssss Expiration
Date of Notice of Commencement The
expiration date is 1 Year fiorn date of recording unle ae a differrmt date i fi Sworn
to tb mrrris Notary
Public Day
of ' ELL, p-LZd My
Commission Expires: The
forego ' ent was acknowledged before me this day -of - - t"p—T W b name
of person acknowledged), who i is -nail kno 0 me
or who has produced (type of identification) as t en and
who id I di nqt take an Oa'th>• ': L r`:: 7
G hlar rP*?,'ic, Slate of r:1nr1dD My
com'n. xpires June 27, 2CC; No.
DD 129465