HomeMy WebLinkAbout157 May Fair CtCI'1'YOFSA\1{URI)1'1•:Iv\Il'l'AI'1'Llla\11VI t ..... ..r...;.;...•:.r.••::.;_r•^ti:r>^•r.,.:1;,.,....r;,.:a,..:.•.,..
I vane:
Job Address:
Description of Wort(
Historic District: _ Zoning: Value of Work: io 3( 3 i.c(o S •rr••IG S
Permit Type: Builtting r:Icctrical Mechanical Plumbing Fire Sprinkler/Alarm
r
POQI•—_-
Electrical: New Scrvicc- It of AMPS Addition/Alteration Chnnr,c of Scrvicc Tcmporfiry Pole
Nev.,(Duct Layout . y C f;_ncr y C;ili:.Rcquimd)
Mechanical: Rcsidcntial Non=Rcsidcntial Replacement
Plumbing/ Nciv Conrtnercial: Hof Fixtures ll of Water & Scwcr Lincs it of Gas Lincs
Plunlbing/Ncw Residentinl:11 of Walcr Closcls Plumbing Repair- Rcsidcntial or Commcrcial
Occupancy Type: Residential Commercial _ Industrial Total Square Footage:
Construction Tync: _ y of stnrics: it of Mvcllinr Uui(s: Flood Zone: (Gl:,rf,l form rcquircci for otltcr thzn X)
Parcel q•
Owncrs Name & Address: S
A(taclt Prooror owncrsi l F Lc:. IPcscrrp loll)
Phone:
Co n7tractorNNaamc &''
Address: `Ar C C 2O t _....._..__._ ._
Do o F- 2 tVl tt-t G S> IZ C I 3z%% L S:alc License Numl,cr: 3/ 0 2Z
yo—t— 7/-4d—e333 cnntael rerson: Q i v:f CoC _Phone:-3zz955g
Phalle .0 Fax: -
llondin, Company:
n /-
Address:
Mortgage Lcnder:
lddress
Architect/ro-.inccr:
Address:
L NJ l
Application is hereby made to obtain a permit to do the work and insL•rllations as indicated. I cerify that no wort: or installation has commenced prior to 1htissuanceofapermitandthatallworkwillbeperfomudtomeetstandardsoral) laws rcl;ubtinr construction in this jurisdiction. I understand that: separatepermitmustbesecuredforIiLECTRICALWOIU', PLUMI)ING, SIGNS, WELLS, POOIS. FURNACr:S, BOILERS, HEATERS, TANIGS, and
AIR CONDITIONERS. ctc.
OWNER'S AFFIDAV I'f: I cerliry that all of the rercl;oinj; inromution is accurate and that all wort: will be done in compliance with all applicable laym rrj nlalingconstructionandzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR 1'A.1'1NGTWICEFORIMPROVEMENTS 'rO YOUR 1'P.OI'ra:IY. IF YOU INTEND'1*0 OBTAIN' FINANCING, CONSULT WITH YOUR 1.1's14DER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE Ot: COMMGNCr:MIiN'r.
N(ZPI(,ai: h addilinn lu the rcquircmcnL: of Ibis permil, thcrc may be thlitional I-w0 ictionr. ap plit'ablc lu 1hir properly 111a1 nla)• be found in the public rcconli ofthiscounty. and there may be additional permits required from other j;()vcrnnrcn1A rntitier such as walcr nunaj;cment districts, stair. al;cncim, or rcderal numcies.
Acceptance of Iminil is verification That I will 110 'ry d1C o..-ner of tiro p:o;)CrIV or the rm,
lI ln5
Signajurc orOwncr/Agent Ua:e
Joni Sao- 03-43 -s`tQ
iALcnl's N le
notary -State of orida
DAFNEY•FAYE ADCOCK
NOTARY PUBbc, BTATE OF FLONDA
MY'OANHRir4plmoitQ fYt
AI'1'1.1('A'I'ION AI'I'[%OVI:1) IlY: Illdg:
Special t ooklitiml9:
of i to Licn Lz% 13.
Pr' : Contl!clor:\gcnt's Nana
tii_:!:aturc of K.:aryStatc of Florida Date
DEBBIE BLANTONnnCMYCOMK1*4N(!f)11• lj(>1*884yyr\•1• 1-
MES: February252NOTARF-- FLNotey0,.. A.. Co. ' Ini:
i:rl :; Uat) (Initial .l U_7: tlni;
ia) & I):at)qC
lnilial
Uae) .. onin;;:
cA
POWER OF ATTORNEY
Date: I D
I, Andrew T . (Andy) Adcock do hereby authorize Ruben Birch
To pull the Re , roof A J
type of permit) (address)
itgnature
otary
DAFNEY FAYE ADCOCK
NOTARY PUBUC. STATE OF FU)RIOA
1• MY Comm. Expires DEC. 2.2008
COMM, M DDS70009
Stamp
Personally know o me or driver license # , of State of Florida, County of
day of 6*.
zao
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
qq
AFFIDAVIT
COMPANY: C b ° LICENSE NO: l l C D Z ZSO
SUBDIVISION:
PROJECT INFORMATION
ADDRESS:
PERMIT NO: LOT:
I, 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, flashings at the above referenced address/lot has
beeninstalled in accordance with all applicable codes and standards.
CONTRACTOR:
STATE OF FLORIDA'
ZI; I ,,
COUNTY OF o .sL
This instrument was ac owledged before me this _r day of _,by the above referenced
individual, jQ v I..ti tQ .1 , who acknowledged tha e is a d ly licensed contractor with
GiY TIC o i..o and who acknowledged tWFlhe was authorized to execute this docume t H he is
eit Bona y own to me or produced as valid identification.
WITNESS my hand and official seal this day of PD
No Publ'
DAFNEY FAYE ADCOCK Printed Name:
NOTARY PUSUC, STATE OF FLORIOA My Commission Expires: 1 oZ o
i MY Comm. Expires DEC. 2, 2008
COMM. 0 DD376609
T
mil I • ` ` 1
I fi+-. State of Florida
Cja- 41ci Permit No.
NOTICE OF COMMENCEMENT
Tax Folio No. (PID)
County of Seminole
Z 7/ 711c undersigned hereby gives notice that improvement will be made to certain real property, and in accordance %with Chapter713, Florida Statutes, the following information is provided in this Notice of Commencement.
DESCRIPTION OF PROPERTY (Legal description of the property and street address)
I S -7 M PA-7 rOt• t
Interest in property (Fee Simple, Partnership, etc.)
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER.(IF OTHER THAN OWNER)
CONTRACTOR
Name and address 0 &—i OD F-1
OU Z;
OVA EMoSa
I*h-
SURETY (Bonding Company)
Name and address
Amount of Bond CIRCUIT COURT
SEillil m CMIM
LENDER BK 05612 PG 0956
Name and address CLERK' Si 1# 2eAD5024452
liECGDED W/11/' i 88159192
WXMIN6 FEES 10.08
t•s;i#l;t it#l;ii;lii#!ltriitlt itlis;lt#wi!#r;it;r!#i t/+Kbyk!!#
Persons within the State of Florida designated by Owner upon whom notice or other documents may be servved1 as provided
by Section 713.13(Ixa)7., Florida Statutes:
Name and address .
In addition to him_ self, Owner designates of
to receive a copy of the Lienor's Notice as
provided in Section 713.13(l)(b), Florida Statutes.
t#t i##!###;#iiil#!#!;#!###;;#i#;iii;it#;i#;i#;t;;#i ttt i#•tt#tiiil;#tt#i#
Expiration Date of Notice of Commencement
rdine unless a diffe ew data is w rified 1
DAFNEY FAYE ADCOCK
NOTARY PUBUC, STATE OF FLORIDA :y l/ .J S OiO I 3 ^- Ij - J Z
MY Comm. Expires DEC. 2, 2M Signature of OwnerCOMM, A DD37 ,
171TJO afl sus __ Day of49ova
v
My Commission Expires:
The foregoing instrument was acknowledged before me this _ day of Ave by
z.p {Z 4 I"(. ::Z-,o to 6<7 (name of person aclutowledged), who is personally known to
me or who h4s p uc t'7 3- t S -Sys - b (type of identification) as identification
and who di -Waontake ar t atlt> f'L tJ L-kc-