HomeMy WebLinkAbout1811 W 12 Stn r.L r. ';5t; t!.1.'\:{yt •' :iXt?;•':..'. :it!'° .
crinitl
Job A-dr`css:
Description of Work:'
Historic District: toning:
CITY OF SANFORT) I'Ii1:Tif1' AITI,tt. XI LVIN
Date: I
Value of NVorl(:.S
Permit Typc: I31,iltting Mccirical Mcchanical Plumbing Fire Sprinkler/Alarm 1'onl•,—___
Electrical: New Service —11 of AMPS Addition/Alterntion _ Change orService Tcmporiiry Pole Mccbanlcal:
Rcsidcntinl Non-Rcsiticntial Rcpinccmcnt New (Duct L ryout S rncrgy CaIG. Rcquirrtl) Plumbing/
Ncw Contmcrcinl: 11 of Fixtures 0 of Watcr &- Scwcr Lines 1/ of Gas Lines Pluntbing/
iNew Residential: 11 of R'atcr Cioscts Plumbing Repair— Rcsidcntiai or Commcrciai______ Occupancy
Type: Residential I Commercial inclusirial Total Square Foot -are: Construction
Type: 11 of Storics: 11 of Dwcllinr Units: Flood 'Lone: (FI:MA form required ("brother thttn X) x
s nv.:•trr+.ee Parcel
A: Owners
Name & Address: I <
I 1 0. IZc., Altach
Proof of Ownership & Legal Description) c"
Address: A COr 200 r'I tJ C2 __._..._ ContractorName. •—••-•— 172Iiy\&
it L— St-tQry i—o Cl 3Z7'l L state i.iccnsc umbcr: Si 0 ZZ i— -..--- 1'henc C : _
r1 O 33 3 Contact Verson _ .r — I'lio:ic:
0') 3ZZ alSss Ilondin,^,Company:—'-- Address:
Mortgagc Lender;
ddress:
Architect/i;
ngincer:
Address: Application is
hereby
made to obtain a permit to do the workand installations as indicated, 1 cerify that no work, or installation has commencai prior to the issuance of a permitandthatallwort: will be performed to meet standards of all laws regulating constniction in this jurisdiction. I understand that a separate permit must be securedforELECTi:ICAL WORI', PLUMBING. SIGNS, WELLS, POOLS, FURNACES, BOiLERS, I•IEATEWS, TANKS, and AIR CONDITIONERS, c1c. OWNf:
R'S AFFIDAVIT:
i certify that all of the foregoing information is accurate and that all wort: will be done in compliance with all applicable laws rot elating construction and zoning. WARNINGTOO\r/NER: YOUR FAILURE; TO RECORD A NOTICE Or COMMENCEMENT 14AY RESULT D-4 YOUI: l'A.YiNG TWICE FOR IMPROVEMENTSTO YOUR
PROi'E110Y. IF YOU INTEND TO OL'TAiN FINANCING, CONSULT WITH YOUR LENDER Olt AN ATTORNEY BEFORE RT:COI'%.DiNG
YOUR NOTICE OF COMMENCEMENT- Nn'1;1(,1 : In
addition to rite rcgnireirvait:: of Ihi:: peririil• Ihcrc may bE additional r,::arictiuns :grplicablE lu Fitts pruperry that may be found in Ihr• public reeonls of this county, and there may
be additional permit:: required from other I-pvcrnnicntal Entities such a:: waternuinagenictit districis, slate sl encic::, or kah:ral agtricil , Acceptant( o' mtit is verificatiol
Ilia 1 I notify the o: rcr of lit ropci;y of the rcquiremcl Mori cn ia, FS uSign:itu al'Owiicr'/Agcn1
a, ignatum of 'onttaclo rcnl Uate 1'rinl Ut cr/Agl:
nZNN' // I'rin: C'\!)eel's Name Si ;nature ofilglitary-Sl:uc
ul' Owner/At em is ler::
ana(h Kilom Produced APPLICATION APl'ItOVI:I)
tlY:
I Initial ;, D%16 S,)
C6:jl ("llulilions: re
of N.1:arySlale
of Florida pate commwon N OW 17M EVIrn
5114112MI DEBBIE BIANTON r-
IIt ISSION DD 18849
BW4*d h('nn'.^,I
urr/A.:: i, r: t n. ii •"t;ntiwr t \• 2007 Fbrida No Nttl , YIC.—j(
pIRES: Febi75 w•wow••i PWI allucE.: :
i) -- . ynl A9309.
c• Initial : l)•rltl — Ini:i
it U:ne) (h54tial t D_Y,
State of Florida
Permit No.
NOTICE OF COMMENCEMENT
Tax Folio No. (PID)
County of Seminole
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter
713, Florida Statutes, the following information is provided in this Notice of Commencement.
DESCRIPTION OF PROPERTY (Legal description of the property and street address)
GENERAL DESCRIPTION OF IMPROVEMENT Qo fl 1
OWNER INFORMATION /I L C Name and address A
1 eI( P. o F(. 3z-
Interest in property (Fee Simple, Partnership, etc.) U
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER47 OTHER THAN
CONTRACTOR
Name and address
goo Fe
SURETY (Bonding Company)
20 V'F--'
CERTIFIED COPY .
NUIIN 10131 .-
Name and address R rria9:y L%6P'' EF CIRCUIT COURT
Amount of Bond BK 05581 FIG 0324
CLERK" S 0 e'F 05iit 1756E,
LENDER R jii U 01/14/20M 09tWt32 Ail
Name and address
1
01605
sssrssss+sss+s+sss+s+++++r•ss++++sss+++++s+ssss++++sss++++ss+s•+as++sws+s+rssrs+ssss+ss
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)74 Florida Statutes: •- •-- - • —
Name and address
s+sssssssssss+sss+s+++s++ss++s+s+sss+s+ssss+ssssss++ssssss++ss+ss+ssssssss++i*+ssss++ss++s+
In addition tohimsclf, Owner designates , of
to receive a copy of the Lienor's Notice as
provided in Section 713.13(I)(b), Florida Statutes.
sssss+s++ss+s+++saws+++++ss+s++s+ssssss++s+sss+ss++sss+rs++++ss+assssas+sssts+sr+s++sassss
1Goff 9 encement
ratloarlW —1 I lM om to of recording unle % a differrrrt date in
Esplres 5114FAM
taasd bonded tttrouph
8043z 2sa) r:-, iMa Notaryrun., AM& Si of Owner Sworn
o and subscribed befo me this O'Day of My
Commission Expires: Notary
lie The
foregoing instrument was acknowledged before me this day of L .
e QrI%1W (name of person acknowledged), who ' personally icauion:
meorwhohasproduced (type of identification , and
who did / did not take an oath>
POWER OF ATTORNEY
Date: b
I, Andrp-w T . (Andy) Adcock do hereby authorize Ruben Birch
To pull the Reroof _permit for /81/ kJ / Z Sf , a Koo i:; L2:
type of permit) (address)
a'Alzila- L z
Signature
otary
Linde A Keeling
My commission D035990
a w Expires Dumber 09, 2005
Stamp
Personally known to, me or driver license # , of State of Florida, County of
day of 12004.
y
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
COMPANY: -AgC oe g SUBDMSION:
PERMIT
NO: AFFIDAVIT
LICENSE
NO: C e- (C O Z Z sO / PROJECT
INFORMATION ADDRESS:
Fl .
3z-1-7 LOT:
1,
7't1,,j pt, ANO CK , afftant, 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, Aashings at the above referenced address/lot has been
installed in accordance with all applicable codes and standards. CONTRACTOR:
A&.),Dq A bee e Printed
nam ignaturc)
STATE
OF FLORIDA COUNTY
OF C wt e This
instrument was acknowledged before me this day of 1-- by the above referenced individual, >
4k-r--17t—n J10- fed 00- who acknowledged that he/she is a duly licensed contractor with C7-
r-Ar'Te_ D F FL. e o A , and who acknowledged that he/she was authorized to execute this document. He/she is either
person known to me or produced as valid identification. WITNESS
my hand and official seal this day of Ap tary
i lie Printed
Name: L N EEL IJ My
Commission Expires: tz -i o finds
A Keeling ` f
My Commission DD359999 a
tid8 Expires December 09, Zooa