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HomeMy WebLinkAbout1612 W 8 StJ Permit if : N-il—I gab tUdlcss: 1(0 / Z•- n Description of Work: Historic District: Zolling: CITY OrSA1FURD1'1;IL\ll'f'rll'1'Llt.:r\11Vt c :.4; ';r{•t};s:. :t.:;;,,.;:.?:;:r, ::r 4 Date: 47Z. s-07 Valuc of Work: S' O D Permit Typc: Building 1 lcctrical Mechanical Plumbing Fire Sprinkler/Alarm Pogi•^ ___ Electrical: New Service - it of AMP> Addition/Alteration C111 of Sccvicc Tcenpoc;iry Pole _,;.--• Mechanical: Residential _ Non -Residential Rcplaccmcctl - Ncw (Duct Layout & i;nergy Cali , Required) Plumbing/ New Connucrcial: if of Fixture 11 of Walcr &cc >cwci Lillis I/ of Gas Lines Pluntbing/Ncw Residential: it of Water Closcls Pltnjib ill „ rzcpair- I1csidcnlial or Commercial Ocenpancy Typc: Residential Commercial - IndusCri:ll Total Square Footage: Construction Type: — 11 of Sf.orics: 11 of Divclling Units: Flood Zone: (FI MA form required for other t4711 X) vCV/ YI`!'!\•'.:`-14I711r'l'i,:'7A"1^!I.'E YY Parcel ll: II % ( A( tach Proof of Ownership &. Lecil Description) OwncrsNantc& Address: v' ^ — I ( 9 I Z W `di SlA ny1O l. 3 rhonc: ` Contractor N: une &'`Address: r! 0 rZ0^-......_...._.._....._ 00 2 >< S& J G CAA-t-3 p {Z-C I 3Z-7rl L Statc Liccnsc .\ttmhr.r. V il1 D 2,Z/a onacC(t 11crson: rhlte,e fax: Address: - - --- c Lender: Address: — Architect/ Gnginccr: Address: Application is hereby made to obtain a permit to do the work and installations :Is indicated. I certify that no wort: or install:uion hats comrrlenctri prior la the issuance of a perntitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconsinictioninthisjurisdiction. I understand that a separilc permit mustbe secured for I:LL•C1'RICALWOR}:, PLUM11{1gG, SIGNS, WELLS, FOULS, FURNACES, I301L1a'.S, HEATERS, TANKS, and AIR CONDITIONERS, c(c. OWNFR'S AFFIDAV I' f: I certify that all of tlrc foregoing infomt.•ttion is accurate and that all work will be done in compliance with all applicahlo tarty. rr.};nls:ting constncction and zoning. WARNINGTOOV/NLl': YOUR FAILURE'f0 RECORD A NOTICE OF C01`1P4ENCEMEN-I- IMAY RI:SUI T I.N 1'OU):. PAYING TWICE FOR IMPROVEMENTS'f0YOUIt11R01'ER1Y. IF YOU INTEND'i'0 Olyl'AIN FINANCING. CONSUUr WITH YOUR I.I:NDER OR AN A170RNEY BE WLE RECORDING YOUR NOTICE OFCOMt.4L":1ICG:vfI:N'f. In addition to the requirements of dtis permil• lucre miry be :4t141ililtn;41 i :;tr.eliuus :Ipplic:4bic (o Illi:: property that stay be found in Ihr, public reconli of this county, and thereImybeatddition:11 permit:; rcgoired I'min other govcrmncnt:41 rntitie:; such a:: water imutagcincilt dkll-ict::, stale.. ngcncic::, or fcdcaal agrrtcics. rmit is v riGcation tat I will notify Acceptance ol'pct : ot:'rcr of rile property of the rcquirel ol'Contncior/Arent Date Signatt oI*O\vllcr/AJ CII( U:uc Sic t:nurc 44 , 20 Z-ILo -E) Print t ter A cnl' s to Pr' t: Conlratctor Argent':: Name 1 •Dal .Si!a:anl ... ce Si ; aanc tl• notary -Eta c of F ncla DEBBIE BLANTON DAFNEY FAYE ADCOCK MY COMMISSION # DD 188491 r R NOTARY PUPI.Idi STATE OF FLORIDA ? EX ,IR F br ar 25 ?0 Otvl MYI 4rri I Rta418 C'tut::ae or/n...... li PI I:.it:.; il nitwn2fo0 1c of I-QOr3djOTAh Y FL Notrvy Discount Assoc. Co. AITLICATION AITR,0VI:D BY: Illdg: / l y 1'1 1 I r7 ylsnin Initi:11 L. 1111i1 Initial . 1, Dale) (Initial .l'• D:!tr J AFFIDAVIT GARDING ROOF DRY -IN AND FLASHING INSPECTIONS I Company: t> o o -ft 4e, License #: Project Information Owner: Permit #: name o V J • 1- Subdivision: Daddr ss, FEz'Z- - -{" 3 g`7 Lot #: phone I, t> Co L, 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: STATE OF FLORIDA COUNTY OF c L v,- a(__.p l I- T - This instrument was acknowledge before me this day of e vr , 20D 5 by the above referenced individual, t7 oC4 , who acknowledged hat he/she is a duly licensed contractor with D F" P-L D e'_ DA_ , and who acknowledged that he/she was authorized to execute this document. He/she is eithrsonal own to me or produced as valid identification. r "' , WITNESS my hand and seal this da yof 20 D Nota Public DAFNEY FAYE ADCOCK NOTARY PUSUC, STATE OF FLOPJDA MY Comm. Expires DEC. 2, 2008 kr c t e,,V . Jt;;., _ NOTICE OF COMMENCEMENT Ito r A/ State of Florida County of Seminole Permit No. Tax Folio No. (PID) c The undersigned hereby gives notice that improvement -will be made to certain real property, and in accordance with Chapter I713, Florida Statutes, the following information is provided in this Notice of Commencement. DESCRIPTION OF P,4OPERTY (Legal description of tlyc property and street address) GENERAL DESCRIPTION OF IMPROVEMENT OWNER INFORMA Name and address olZ 07--- COPY oof MARYANNE MORSE ULLKN Ur i;ItCUIT COURT SEMINOLE C UNTY, FMRIDA Interest in property (Fee Simple, Partnership, etc.) t> L i 11 L LF '— NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER•(IF OTHER THAN OWNER) CONTRACTOR Name and ad s-44D SURETY ( Bonding Company) Name and address 1 2005 Amount of Bond MARYWIE NNSEt IRCUIT COURT SEMINIXE Cl1LN" LENDER BK 05622 FAG 0868 Name and address CLERK'S # 2005fc 29577 iaiy ya a PM 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(1)(b), Florida Statutes. Expiration Date of Notice of Commencement The expiration date is l Year from date of recordin¢ unless different date is sm.ifM 1 aiubk DAFNEY FAYE ADCOCK ' rNOTARYPUBLIC, STATE OF FLORIDA Si gqe5&e of Owner do MYJ'2Qi9 — /XrQ MYcomm,++nnExplrea DEC. 2 2008 Sw o)and( sXQ0Al eMW i th' I6Day of r (o g ZoP S My Commission Expires: I(- Z00 S The foregoing instrume t was acknowledged before me this _) i day of _, .}9 by 44 Y- ZeAo - S (name of person acknowledg4, who is personally known to me or who has produced PL. --L> • t_1 C- . (type of identification) as identification and who did / did not take an oath> ICZo-3Za-Z- o- c7 POWER OF ATTORNEY Date'. l "D I, Andrew T - (Andy) Adcock do hereby authorize Ruben Birch c I To ull the Reroof permit for I ( I 2-UV- p ( type of permit) (address) Si uniq w DAFNEY FAYE ADCOCK r NOTARY PUBLIC, STATE OF FLORIDA l MY Comm. Expires DEC. 2, 2M COMM. # DD37%N Stamp Personally k n to me or driver license # , of State of Florida, County of day of If_ 6w z00 -r,-