HomeMy WebLinkAbout1401 Mara Ctfj 1
1 )
t4e s- 11crmit # :
5 — Job
Address: CITY
OF SA14FORD PERMIT APPLICATION Date:
Description
of Work: (N2 /i to p-r 5-7a7 R—M r 17 AM A 6912 <::? '-- I. Acy to (Q--V Historic District:
Zoning: Value of Work: $ 4 -36 b 14 Permit Type:
Building
Electrical Mechanical Plumbing Firs Sprinkler/Alarm Pool Electrical: New Service — #
of AMPS Additiori/Alteration Change of Service Temporary Pole Mechanical: Residential Non -
Residential Replacement New (Duct Layout & Energy Calc. Required) Plumbing/ New Commercial: #
of Fixt ut # of Water & Sewer Lines # of Gas Lines Plumbing/New Residential: #
of Water Closets Plumbing Repair — Residential or Commercial Occupancy Type: Residential
Commercial Industrial Total Square Footage: C-:O Construction Type: # of
stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: _- Owners Name &
Attach
Proof of
Ownership & Legal Description) JL ILA ^ /-A
I - 1 ! 0' / / Phone: Contractor Name & Address:
uNku 1 WA, q Q A ;u If 17, Sate License Number:
GGCi m \ $613 Phone & Far: Contact
Person: Phone: Bonding Company: Address'
Mortgage Leader:
Address:
Arcbitect/Eagineer:
Phone-
Address: Fax: Application
is hereby
made to obtain a permit to do the work and installations as indicated. 1 certify that oo work or installation has commenced prior to the issuance of a
permit and that all work will be perforated to meet standards ofall laws regulating construction in this jurisdiction. l understand data separate Permit must be secured
for ELECTRICAL WORK. PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR CONDITIONERS, etc. OWNER'
S AFFIDAVIT. I
certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable htwc regulating concoction and zoning. WARNING
TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR. PAYING TWICE FOR IMPROVEMENTS TO
YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT. NOTICE: In aildition to
the requirements of this permit, there stay be additional restrictions applicable to this property that may be found in the public records of this county, an am
may be add itio is required from other governmental entities such as water management districts, state agencies, or federal agencies. Acceptance of permit is
Produced ID Coe that
1401 ockify
the owner of the property of the requirements of Florida Lien FS 713. 1 7-as5 A6
t Date Signature
of Coatract@7190EEt Date ry 1 4 rt
s Print Contractor/Agent'
s Name ar 4 5 Date
Signature off Notary -
State of Florida Date swY COMMISSION N DD230431EXPIRES: August 3. 2D07
l Bor ed Thru Notary
Public Undenrritpm APPLICATION APPROVED BY: Bldg:
initial & Date) Spccial Conditions: "
Contractor/A
Seat is -
4 Personally Known to Me or Produced ID Zoning: Unliries:
initial & Date) (
Initial & Date)
I'-A FD: Initial &
Date).
O Locally Owned
Licensed & Ilisured
T ' & Operated Serving Central Florida
P ,s Z C Since 1974
1 7
S / ' ROOFING
State 13 /y8s
V
CCC 03699
Insurance Claims Specialists" 72O S. Orange Avenue
Orlando, FL 32809
407) 251-5112 9 (407) 322-1895
CONTRACT Salesman CLA RCKGE CH f 4 7""
o .7 9y7 (0ds6
CLA%IToo IvRNEit q-017 3z3 ON, U'L30
PROPOSAL SUBMITTED TO PHONE DATE
IYol Ma -RA cT
STREET INSURANCE CO.
91to RiDR 32-7-71 CITY,
STATE AN ZIP CODE ADJUSTER CLAIM We
hereby su it specifications and estimates for: Lay
over existing Tear
off layers of shingles Each
additional layer at $ Q_/square t/ !
s lb. felt as needed lVew
ZS year fiberglass shingles Style
and Color 0Es r SWC e kind) Flat
Roofing System / Modified / Roll Roofing t
New
Closed Valley Nails
Only - No Staples Replace
Vent Flashings as needed F_
72•3 3' 4" 1 Install
wind turbins Install
air vents Install
feet ,offrridge-vent t/
Install /A N*Vp' e3ge / Color WAM, Clean
up and haul off all roofing debris 6'
fjtoll magnet roller over yard t/
Protect landscaping L'
00e' Wood damage (if •needed) at extra cost per foot Plywood
S L_ per sheet I
x 8 or I x 10 - S per foot Homeowner
authorizes job sign placement in yard Special
Instructions: 1,
r &#*4;xAoE 7a .4.tcylrEGr c , y bo o.F, of yoo Speigle
Roofing Co. is not responsible for any cracked or broken driveways. Verbal understanding and
agreements with representative shall not be binding. All understanding and agreements mutt he set
forth in writing on this contract. Purchaser agrees to remove breakables from outside walls of home
during installation of all work. I.
All contracts subject to approval of management. 2.
Speigle Rooting Co. reserves the right to file for supplemental insurance claims
if insurance adjuster measurements are used and prove to be incorrect.
At no additional cost to the customer. Speigle Roofing Co. reserves
the right to file supplemental insurance claims due to material and
labor price increases due to storm environment.. 3.
If applicable. 20% overhead & profit will be billed separately. 4.
Homeowner authorizes Speigle Roofing Co. to make adjustments and settle their
insurance claims. PAYMENT
TO BE MADE UPON COMPLETION: tom -
A small fee We
also accept: i ;v will be applied D
THIS
CONTRACT IS CONTINGENT UPON IN- SURANCE
APPROVING THE WORK STATED ABOVE. *
Should there be a difference in price or scope
of work contractor will negotiate the same. Do not
start work until approved by insurance com- pany.
Homeowner responsible for deductible. Total
Is 9,3 0 Deposit
S Date
Balance $
BUYER'
S RIGHT TO CANCEL BUYER
MAY CANCEL THIS CONTRACT BY DELIVERING WRITTEN NOTICE TO THE SELLER AT ANY TIME Signaturdt PRIOR
TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. BUYER MAY
USE THIS CONTRACT AS THAT NOTICE BY WRITING "I HEREBY CANCEL" AT THE BOTTOM AND ADDING
BUYER'S NAME AND ADDRESS. THE NOTICE MUST BE DELIVERED TO THE SELLER AT THE Signature ADDRESSSHOWNABOVE. AFTER 3RD DAY, THERE WILL BE A 15% CANCELLATION FEE. 9 Upon
completion of its work. Speigle Roofing Co. guarantees work performed in this contract for a period of two years against defects in material and workmanship. This
guarantee does not extend to damage from any other cause including, but not limited to damage from other trades, extreme wind or ice, lightning, hailstorm or otherunusualoccurrences. This guarantee does not extend to the repair of any interior feature of a structure. THERE ARE NO OTHER WARRANTIES, EITHER EXPRESSED
OR IMPLIED BYSPEIGLE ROOFING CO. PAYMENT
TERMS: Upon presentation of invoice, the job payment in full is immcJiately due. Interest re
a
rate it
hall per month shall accrue beginning ten days thercafter.
Should Speigle Rooring Co. utilize the services of an attorney to collect amounts due under this agreement, it shall also recover all costs of filing and releasing liens, corm
costs. and its reasonable attorneys fees incurred in collection efforts. If payment is not made warranty is void.
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NMWM MORSE,.. •CLM GF ..CItB1lIL6M
Permit Number .
Parcel Identification Number .3 1- I q - 3 ! -'.SOS- -:UC/GG —
Prepared by. 157
a
Return to: t;t`l lam °S'nel- Le:=. • _off
7o v'':S: p ef u
NOTICE OF COMMENCEMENT
Slate of" :., 4?JQ.lQ. .,.•
County of
BK 05580 PS 1895
CLERK'S 41 290591674fi2
REORDER 811141M OB&ASill 4"
WMIMINS FEES 10. 1,
FEMUM BY D Thoulf?; o g
The undersigned hereby gives notice that Improvement(s) will be made to certain real property, and in accordancewithChapter713, Florida Statutes, the following information is provided in this Notice of Commencement.
CZ
Or J tJ
W :O W
a
m
1. Description of property (legal description of the property nd street address if available)
r_•^— i r 3r7712. G
New,
on of Improvement(s) /
rd 7a?}
w Ma rj ti. iy xw .ice
e`
i+ V.GiI/1 •` •. "'
Y S` K' it - r : r
i Uy t .• .)r •!? `'
3. Owner Injormatiori /
Name Wi V Telephone Number 8.L3" j3 4&
Address et ll/Q PyJ /J Fax Number
Interest in Property:;:- 4. Fee Slmple TIUe Holder (f other n owner Shown above) }'
Name •: , -3 a '' Telephone Number +
Address '
a _,. Fax Number i
Contractor }
Name e" /'y( 'r f(Li .. OT Telephone Number U Cf SAddress ` f - Fax Number7d-
n,o.(tS .' 0 . Q
6. Surety (if anyp''I-YR h' n O :. a p l7
Name Telephone Number
Address' Fax Number
t'°;:• Amount of bond S
7. Lender (if any)
Name ?., tr = r:._.:, - Telephone NumberAddressFaxNumber
8. Persons within the State of Florida designated by Owner upon whom notices or other documents maybe
served as provided by §713.13(1)(a)7., Florida Statutes.
Name ';,.y ;* r - = '':.-ri Telephone Number -
Address Fax Numbert
9. In addition to himself or hersetl, bW4e desi'gnafes Tthe following to receive a copy of the Lienors Notice asprovidedin9713.13(1)(b), Florida Statutes.
Name s. :.; • '' S; Telephone Number '
Address_r. Fax Number
10. Expiration date of notice of Commencement (the elcplration date is one year from the date of recordingunlessadifferentdateIsspecified). --
Date Signed ;; 5i re of Own re,.per §7 .13 'own
mustgn ...and nma a permitted to sign in N.
or her stead " this
who
Is as
idenUficafion. by
seal
to appear below) DAWN
STALLWORTH arm
RevtsM 39e ; W.h MY COMMISSION 11 DD 23D431 WE
EXPIRES: August 3, 2DU7 Babed7lwu'
IQ" P tos Unon I"
POWER OF ATTORNEY
Date:
I hereby name and appoint Q;/ L C.'
p
of Q "c• ,v to be my lawful attorney
in fact to act for me and apply to the
a
Building Department for a /Coo permit
for work to be performed at a location described as:
Section Township Range Lot Block
Subdivision 2_,c> - ,g C
Address of Job)
Owner of Property end Address)
and to sign my name and do all things necessary to this appointment.
I lct zo0'g eci( C' o t 3 G 9
Type or Print Name of Cert ied Contractor d Contractor's License Number
Signature o rtified Contractor
SA
The foregoing instrument was acknowledged before me this 3 day of 20 —
by ^j i (-- 4- 4 .S Pet--) cc-L
who is personally known to me/who produced DX ( L)(?k.0 k-(Ce-,U r
as identification and who did not take oath.
State of Florida
County of
P+
Cynthia M Erard
My Commission DD123828
p ti Expires June 09, 2008
Seal
Noiary Public, Orange County, Florida
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: ilo'tj ,
i
17.2 a• f
2
Owner: C2W_41__)
name
address
phone
License #: C" CC O/ 36 F F
Project Information
Permit #: Jr' - X0
Subdivision:
Lot #:
I, (y) 1' l. , affiant, hereby affirm that I am the duly licensed
contractor of record for a 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:
s' atu
00,
pri narnif
STATE OF FLO
COUNTY O
This instrument was acknowledged b ore me this day of , 200 by the
above referenced individual, CY1 , who acknowledged that he/she is a
duly licensed contractor with
t ,
and -who -acknowledged that
he/she was authorized to execute this document. He/she is
stPid==7tL!ifi
rsonally known to me or
produced as valication.
l i
WITNESS my hand and seal this day of Lq. %\ , 2CO'.
TON
D 1SM91
5, 2OD7
1 0p3-NOTAQD,= t Assoc. Co.