HomeMy WebLinkAbout202 Laurel DrProduced II) F, ;
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Pill-WATION APPRUlrl:l) BY: 11141g:
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21
PcHnit iE
Date:
flL
Job Address: aDa La/.t
OO F 6 L 1t4T SA D (" `f O Dt ,fit >r>
Description of Work•
hIistoric District: 'toning:
to -20o LiValucoflVork• S --•-•-'-
i'ermit Type: Auildinr Mcc rical Mechanical 1'lunvbinl Fire Sprinkler/Alan»
r
Pod1•. _
Tcrnpor:iry Pole
Electrical: New Service -1/ of AiviPS Acid ition/Altcration ClranSc of Scrvicc
Mechanical: Rcsidcntial _ Non-Rcsidcntial Replacement New (Duct Layout .0 rncrry Cili<. Required)
Plumbinr/ New Commercial: 11 of Fixtures 11 of Watcr Fi Sewer Lincs 11 of Gas Lines
Plunlbinp,/Ncw Rcsidcntial: 9of Vl':dcr Closets Plumbing Repair- Rcsidcntial or Commercial___ _
Occupancy Type: Residential % Commercial _ industrial Total Square Foolare:
Construction Tyne: fl of stories: 11 of D)vcllinr Unifs: Flood Zone: (FENIA form required for other civil' X) -
rr"Imr--aEMW
Parccl 0:
Attach Proof of Ovwucrship & Legal DCscription)
Owners Name S: Address: t-t R '
o dt (,ate, )4,/. /St a_/ r (. 3?) rltone: in7- 32Z-
Contractor Name.C''Address: `AqCDJ ILD I C-% Atone2:
2 j 3_Z.—....Z...-_-
9_-. 7foo i,4G 3z1Lstalel,icenseum>cr:y/,,0%r)IQ g0zDConi,ct
o:-'honcCFax' 'v i Ilondin;
Company:---
rl <
I
d fCSS:
Lender: lldrCSS: Architect/Cn;;
inccr:
I-
I'Ironc:-•-_•--._...........---_ NJ Application is hereby
made
to obtain a permit to do the work and insL•tllations as indicated. I certify that no work or installation has corimcncoci prier Iry live issuance or., permit andthatallworkwillbeperformedtomeetstandardsofalllawsrcgubtinl; construction in this jurisdiction. I understand that a separate permit must be securedforELL•CTRiCAL WORK, PLUMBING, SIGNS, WL•LL•S, POUTS. FURNACES, BOILERS, HE-4% •EILS, TANKS, andAIR CONDiTIONL•RS, cic.
OWNER'S AFFIDAV I'
I': 1 certify that all of live forceoing infornv.'nion is accurate and that all work will be done in compliance with Al npplieablc laws rat;+thaing construction and zoninl;. WARNINGTOOWNER: YOUR FA1LUiUi •f0 RECORD A NOTICE OF C01.IMENCEMENT MAY P.I;SULT UN YOUR PA.Y(yG TWICE FOR lmPROVEMENTS 'POYOURPRoPr-.i:lY. iF YOU INTEND •1.0 OBTAIN FINANCiNG, CONSULT WITH YOUR LENDER, OR AN Al"1'ORNEY DC -
FORE RECORDING YOUR NOTICE Or7 COMI.4ENCEMI:N•f. t!gLlgli: In addition
to live rcquirenrent:: of this permit, there may be adflitinnal irs+rielirnt::gtPlic:ddc to uhi:: property That may be fuund in thr, public records of this county, and theremaybeadditionalpcnnie: required from ulhcr gowcrnnnauzl enUtics such a:: walcr immal;cnvcut districts, 5131C al;cnctc:, or federal at olcics. Acceptance of permit is
verification That i will notify the of:•rcr of the p:u;et;y of the rcqu4.a.r, to ' aLienku
l z .5lure
orUslrer/Al;
cnt Uat Conunclor/A,renl ' Ualc M Print Omer/Arcnl'
s
ante I'ri , C Far
nt's Namc dS/o s r
Not iY
vpJ4YLli 1DCOCK E)atc I _i+a:artrc of `oar) -state of Florida gare NOTARY PUBLIC, BTATE OF
FLORIDA MY Comm. Eliplrse DEC.
2, 2008 IOMM. % OD379809 16 Nr:
on iv
Known
it) \•Ic ur 7. 0-SS3-3l -
llorl-
D Fluidal Dmcl (Initial;. Uattl
Ini:ial :: Uatt1 (Inaial fi U_t:
POWER OF ATTORNEY
Date: a a D
I, Andrew J. (Andy) Adcock do hereby authorize Ruben Birch
i f ao Lxk-ea 4ve. To pull the R -roof permrto
type of permit) (address)
itgnature
Stamp
DAFNEY FAYE ADCOCK
NOTARY PUSUC. STATE OF FLORIDA
MY Comm. Explra DEC. 2, 2008
COMM. # DD376609
nally k n to me or driver license # , of State of Florida, County of
Z day of A-'y- , e664.
Z ao S
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: Aw'Deet-
1, '1 °D N License #: C C C 0 Z7_1;6 l
0D Pam_A,,i
Project Information
Owner: C'teL —6 & S t L 4,_ name
phone
Permit #: _
Subdivision:
Lot #:
I,
ADCZ), 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:
Zzg& If signature
a
4-o eo p •
nted name STATE
OF FLORIDA COUNTY
OF 41—
This
instrument was acknowledged before me this day of b. , 20 by the above
referenced individual, Z'w h.._, - AC.o C_V_ , who acknowledged that he/she is a duly
licensed contractor with Gi-rn,- E o F C4 0 e, m>4' , and who acknowledged that he/
she was authorized to execute this document. He/she is eithe ersonally known me or produced
as valid iden ' WITNESS
my hand and seal this Z day of 20 n DAFNEY
FAYE ADCOCK Notary ublic NOTARY
PUBUC, STATE OF FLORIDA MY
Comm. Expires DEC. 2, 2= COMM.
0 DD376WO
ANb Atwto .t NOTICE OF COMMENCEMENT
QQ n ' A State of Florida County of Seminole966411&4-fermif No. Tax Folio No. (PID)
ilre undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with ChapterS.4"V-j 713, Florida Statutes, the following information is provided in this Notice of Commencement. i
7 `7 ( DESCRIPTION OF PROPERTY gal description of the prop and, strpet address)
o a /-4 k v. —21111M
GENERAL DESCRIPTION OF IMPROVEMENT -k E -42c o k=
irit;Z ',-' ED COPY',
70MORSE rl
4FRKRCUIT
COURTOWNER INFORMATIONUN ,Name
and address M / K% --L. '
7 '7C ER Interest
in property (Fee Simple, Partnership, etc.) r> Lr --5 oo- I
NAME
AND ADDRESS OF FEE SIMPLE TITLE HOLDER41F OTHER THAN OWNER) E- 2 J 2 00CONTRACTOR
t„
Name and ev D D 7 v`
vD0 SURETY (
Bonding Company) I IM 111110 I M III I N N 611ai I al I a IM 1 M Name
and address RCUIT
WAT Amount
of Bond SEMINOLE BK
05627 PS 1186 LENDER
CLERK' S R 200-541132724 Name
and address RIWIDED 8R/WeM Q19te035 AN RcRGryt
labNeINN8FEFSy,10.00 Iii t##
Milt•««....«ti#it«i«i tiiit«tiii«.#..#tiitt«RE 01
BY +inley ...t 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 tstsi«stssssitsstsiississiisstt«
sssssssss is•ti sittstii st#sisstisitistisis«sitis«tisit 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. listsits#tii
ii«t«iti«ttitt««toll•titill•tiittislit«ti#itt#iitii«ti ii«#iitt ti«t###tint Expiration Date
of Notice of Commencement ne euG
I - .n unlecc
a diff6im-tdate is m-w mfirrt 1 NOTARY PUSUC.
STATE OF FboR10A MY Comm.
Expires DEC. 2, 2Z COMM, a
Oo37 ignahmof 53-3/—/67-0 Sw o
a sub bed befo me this Day of 49. Zoo S
ublic My
Commission
Expires; Z /zm Ir No ryP,
The fore
goin rostrum t was acknowledged before me this oC7 day of V1' by tea f
l 1 f _- (name of Person acknowledged), who is personally known to me or
who h4radu . -POT.;. (type of identification) as identification and who
did /UNmorgke an oat}t> -5Z A - 553- 3