HomeMy WebLinkAbout1607 W 17 StCIti Or D 1 L ill Al 11.,It.,A11vr. ,SrlNl Uli 1'l INr.
Pcrri}it.:
Job Address: J IDO S d,4/ 4 4(.3—t11
Description of Work:(2 DO t ) Sh oZS {" `o s ti. taS
m adt-t r.Q
historic District: Zoning: Value of Work: S
i'crmit Typc: Building I.Icctrical Mechanical PlumbinL—_ _ Fire Sprinkler/Alarm Pogi•_,___
Electrical: New Service — It of AMPS Acid it: onh%ltcratioa Cltartze of Service __ Tcrrtpot.Itry Pole—;.•
lk
MccHallical: Residential Non -Residential Replacenlent New (Duct Layout S: irneMY Cali, Rcquired)
Plutnbinr/ New Commercial: 11 of hixturs 11 of Water c< Sewer Lines it of Gas Lines
Plumbing/Nciv Residential: it of ` .Itcr Closcts Plumbing Repair— Rcsidcntial or Commercial ___•_—_
Occupancy Typc: P.csidential Commercial — Industrial — 'I`otal Squarc Foolarc:
Construction Tyoc: — 11 of Stories: _ 11 of Dwelling Units: Flood Lonc: (Frhtn form required for other tttzn X)
n.res..0 - wr.--^••^"Ell::!\.^. :i1lc-rr:.':?l P!r.E
Pnred Ih (
Attach I'r 000rof Ownership «Legal Descripllon) --_
Owners Nnnic & Address: lervCi.( LA•' ' E I & o—1
Contractor Nantc &.'•Add'.O.N: 46\117:' 60
Do D. SA—
l"f—^L
o t 1 327_i L o
1'irone & Fix: `'id1' 7 d 33 Contact Person:
Bonding Company: I--—• --- — —._._......—
Address:
Mort,•ape Lender:
Address:
Address.
Fax: _........
Application is hereby made to obtain a permit to do Ate «•orb: and installations :is indicated. I certify that no wort: or installation has cortrrtcncui prior u, theissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllaw; regulating constnuction in this jurisdiction. C understand That a separatepermitmustbesecuredforELECTRICALWORE, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, 3011-EI'S, HEATEI,'S, TANKS, and
AIR CONDITIONERS, ctc.
OWNER'S AMDAV I'I': I certify that :III of the foregoing InfornL•ttion is occur Ite and that all work will be done in compliance with :ill applicable law:: rnl Ilbaingconstructionand'zoning. WARNING TO OWNER: YOUR FAILURE'r0 RECORD A NOTICE OF COMMENCEMENT IMAY RL•SUL`I' I.1 ! l'OUI; l'R.1'[NGnVICEFORIMI'ROVEMEN'I•S TO YOUR lip 01'[:I IY. 1F YOU INTEND TO 01'TAIN FINANCING, CONSULT WITH YOUR LENDISIZ, OR AN
A170RNEY BEFORE. REC01'.DiNG YOURNOTICE OF COMMENCEMENT.
In addition to the rcquircm!:nls of Atis perntil, there Wray In: aeldilinn;tl icstricliuu:; applicabtle to this: properly that nlay be found in lhr. public recordi orandthereBraybeadditionalpertnic; required front other l; wernntcntal entitle:; ::uch a:; water nunaLctncnt di ll S, stale: al;cncic::, ur fcdr.ral agcrtctes. this cotluly,
Acceptance of pc"I'lit is verification that 1 will notify the ot."ncr of tthe property of the rcquirentc o Florida icn [ant, FS 71
u _
Sic; tune ul' ontnciclaxcttl Date
Signature Of Uttvtcr/Agent
0-gN L Nu D LEY -
S' na y tw rotary-SRilt/ID tiIZN INt ivtypYPUr
20'* C, s Notary Public - State of Floridp
My Commission Expires Jan 4, 2007'
o Commhsicn # DO156630
O ncr/t lit _ e¢ed:>S.N9zti`Ztl`4ArX/ sst4?
AI'1'I.IC'ATION APPROVi I) BY: 111c11;:
Ilttiti:tl D%te)
3-// d6-
D;lie
nnin':
I'ri ' Contracror Allent':; Name
S;I_a:atnr
DEBBIE BLANTON
MY COMR1 1' 1'ION # DID 188491
EXPIf{,7ti
nn::ac or!n a ct tln r' hr'1fYii aOWlt o
I Be'tl-2, 0TART t-_ t y Di t .wnt Assoc, Co._
Initial rl: D:ttc1
1-11,
I11;6:11 ,l Dar.
1
POWER OF ATTORNEY
Date:
I, Andrew J „(Andy) Adcock do hereby authorize Ruben Birch
r
To pull the Roo ermit for Iloo j IJ, j " LrT. r-v—tc ` .
type of permit) (addres )
DAFNEY FAYE ADCOCK
NOTARY PUBLIC, tl'PA7E t3F FLORIDA
MV Comm; Expfrse DEC. 4, M
COMM, 0 DD378900
Stamp
Personall n to me or driver license # , of State of Florida, County of
day of - (%
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
AFFIDAVIT
COMPANY: 4r2evc,11, N 6" LICENSE NO: C D ZSD I .
SUBDIVISION:
PERMIT NO:
PROJECT INFORMATION
ADDRESS:
LOT:
4I, affiant, hereby affirm that I am the duly licensed contractor of record for the above reference permit,
that all of the foregoing information is true and accurate, and. that the dry -in, flashings at the above referenced address/lot has beenrinstalled
in accordance with all applicable codes and standards. CONTRACTOR:
STATE
OF FLORIDA COUNTY
OF —/Pi ' 04
This
in trument was ack nnowledged before me this (—aay of Z'S , by the above referenced individual,
who acknowledged that he/she is a duly licensed contractor with 5P-
rA--T 4C:7 and who acknowledged that he/she was authorized to execute this document. He/she is eithe
ersona own tome or produced 00
as
valid identification. WITNESS
my hand and official seal this day of v C/— Z e o S DAFNEY
FAYE ADCOCK Notary ubli NOTARY
Comm.
Ex iresSTAOFF , RIDA 2008 V1.'
4 e ^ MY m. Expires DEC. 2, 2009 Printed Name: G COMM. 0
DD376809 My Commission Expires: IZ -Z:.o
AND . 6`c6-'
V p, r7'tu)'A - A. State of Florida
Permit No.
NOTICE OF COMMEN EMENT
Tax Folio No. (P1D)
County of Seminole
The undersigned hereby gives notice that improvement will be made to certain real property and in accordance with Cha ter
713, Florida Statutes, the following information is provided in this Notice of Commencement
p
37-`77 I DESCRIPTION OF PROPERTY (Legal description
te D 7 W. I?4"- 4-7-- 4,- ate,.
GENERAL DESCRIPTION OF IMPROVEMENT 0V oc—
T,; tF D - GUM,
rMIV,F. MORSE
UF-C;,',CUIT COURT
AUNTY. FLORIDA
R 1 5 2005
OWNER INFORMATION
Nate and adss 0 Interest
in property (Fee Simple, Partnership, etc.) D (a tn.?— NAME
AND ADDRESS OF FEE SIMPLE TITLE SOLDER jIF OTHER THAN OWNER) CONTRACTOR
Name
and address CD o l'n SURETY (
Bonding Company) Name
and address Amount
of Bond I
IN A AINNWNINN IA N NA I LENDER
Name
and address MMMM MOM CLERK OF CIRCUIT COURT N•••
ts•»r•»•r»»ir**»*»r*••s»ss*»*rs*»»r*srtrs*»rs»»»ir*r•»ssyµy y s» •sy p,yr I..
CR' J C'WP+7 Y``F Persons
within the State of Florida designated by Owner upon whom notice or other UMMra111 ¢ by
Section 713.13(lXa)7., Florida Statutes: - WXMIMB FEES• ICN Nameandaddressfh..
is ssssss»
ssssss»ssss»s»rss*»ss»s*rsrss»ssrrssrs»s*ss»sr»ss*»»rsr»»sssrsss:sssssssssssssssssss 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. sssssss*
ss»»»»»s»ssss*ss*»sssrs»s»sssss»s»sssss»ss*s»sssrss»s»*ss*ss»ssssarss»rs•ss*ssss»+• Expiration
Date of Notice of Commencement CMt
expiration date is 1 Year from date of recording unlem a different rlate is mwrtifird i ignature
of Owner Swo
p a subscribeed/bbefore me bis _ Day of ,// el , :¢e$ r'
My Commission Expires: Notary
Public . The
regoing instrument acknowledged before me this day of %74I_;-iS r' by 41.L-6<-f (name of person aclatowledeecil. who -as nersorrakvIo-- n me
or who has produced /A•+^ of t and
who did /did not take oath ; r ";,k,; o
tra Notary
Public - State of Floridp v
My Commission Expires Jon 4, 2007 Commission #
DD156630 Bonded
By Notional Notary Assn.