HomeMy WebLinkAbout210 Maple Avet.
Pcriuitit: D.•-
Job Address:l-R-
Description of Work:- IL_ UU 1-
111storic District: Zoning:
CITY Or SANhUILD i'111'R Il'I' AI'I'WUA1t > r 4, (.
o DT
ValueofWork: S ^ -•--•--___. Pcrmit
Typc: Building Electrical Mechanical Plumbing rirc Sprinkler/Alarm r
Ponl•_
i__
Electrical:
New Scrvice-11 of AMPS Addition/Alteration Change of Service Temporary Pole —;_• Mechanical:
Residential _ Non -Residential Replacement New (Duct Layout ^G rncrgy CitIG, Required) Plurllbitlg/
Nciv Com nict-cial: Il of Fixtures 11 of Watcr ^cc Scwcr Uncs 11 of Gas Lines Pluntbinp/
Nciv Resiticntial: i/ of 'A';ttcr Closets 1'1ur11binf Repair -Residential or Commercial ___•___ Occupancy
Type: Residential Commercial _ industrial 'Total Square Foolarc: Construction
Type: — 1/ of StAI•ics: it of Dwelling 'Units: hlootl Zone: form required for outer ttlxn X) Pared
11• l , (
Attach
Proof of owncrshiil) & ICEal De cription) Oivnc -
s Name rkddress: - t.. t v .t_ lrJ 3
Phone:_—
3ZZ Contractor
Mime &''Address: `r:> Co 1'
luSonoc.oCC-j r,Z C ?Z^
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7.' I'hone: Fax: ' V
iTnndin,^^, Company: -----.......—
Adtlirss: 1ortl•
a
r Lender: Address: Architccl/
Ei
inccr: t Address:
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Application is
hereby made to obtain a permit to do the work and installations :ts indicated. 1 certify that no wort: or installation has commencer! prior to the issuance ofapermitandthatallworkwillbeperformcdtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. 1 understand that a separate permit mustbesecuredforL•LL•CTRICAL WWI', PI_U, 1.1 1G, SIGNS, \VELLS, POUTS, FURNACES. 301L1a'S, hIEA1'f_I:S, WANKS, and AIR CONDITIONERS,
cic. OWNER'S
AFFIDAVI'I-: i certify that all of the foregoing information is accurate and that all worl: %Q1 be done in compliance with :dl applicable. lm s rrl nb.;ting construction andzoning. WARNING 1'0 OWNER: YOUR FAiLUItE'f0 RECORD A NOTiCC OF COMMt NCEML-NT MAYRrSULT ilN W)UR. PAYING TWiCE FORiMPROVEMENTS •r0 YOUR PP\.OPti1:1Y. iF YOU IN1'END'1'0 0111WN FINANCING, CONSULT WITH YOUR LiiNDER OR AN Al"I'
ORNE.Y BEFOIU. R1:C0i'\.D1NG YOUR NO.1-iCEOFCOMt.4L.NCGivtlilJ'i. 1n addition
to the rcquircnu:nl;; of [Ilk pcnnil, there may b'. ael,lilimml i,::arictiun:::rpplie:cl.ric to [Ili:: property th:t may be found in Ihr• public reconli of this county, and there may be additional pcnnil:; rcquiurd from other govwnmcnutt r-nlitir; such a:; warier ntunagcrncnt district.:, slaty. al;cncrc•.::, ur rrdc.r:rl ;q;olcies. Acceptance o
crnlil is veri(iealion (lilt i m ill notify the om:rcr of rite property of the rcgtrircnlcr f i to .Lien [anm, F I3.• Signature of
Omwtel-Mgent Date Sic taairc ol'Contrmctor/Arent D:1ic Ol ry
S 1 ii Print Oi
er/A ni's Nat I'rir
ontracthr:\rcnt's Name ' Su^nali
re of t\oL'uy-Stac u' oriel: -- ):tic i r.:uu \o:ary•Stme ol• Florida Date DEBBIE BLANTON
MY COMMISSION #
DD 188491 a 4
DAFNEY'FAYE ADCOCK NOTARY PUS61C,
STATE OF FLORIDA a EXPIRES: February 25, 2007 M(Wllr , ,
t v (O r (' :l;lRoR,t J(?TPayi> _FLNdCayc6ireiiundAe O6YQdo 1c ur AI'll
LIC'A•TION AI'I'ItOVi:D BY: Mill;: — --_— — — 1 Iniial , Dzt: I11lial D.11cl (
Initial Uatci J
POWER OF ATTORNEY
Date: C g d Ci
I, Andrew J (Andy) Adcock do hereby authorize Ruben. Birch
To pull the R e r o o f permit for IV e e •
c
c. '-+' I •Z 7 % '
type of permit) (address)
Notary Stamp
DAFNEY FAYEA CDOCK
NOTARY PUBLIC, STATE OF FLORIDA
MY Comm. Expires DEC. 2, 2008
COMM. 0 DD376609
CPerso:nal1:ykn;1 to me or driver license # , of State of Florida, County of
day of— —q V
Z coC
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: e—, N License #: C U
Project Information
Owner:: (a L,L 1--' E o ul _ Permit #: _
name
a I D y4'!,ue_ Xkre- Subdivision:
address
Lot#:
phone
I, D6004_' , affiant, hereby affirm that I am the duly licensed
contractor of record 16r 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 K C,
T>
This instrument was acknowledged before me this day ofle-L ,10 , by the
above referenced individual, r>coC.c, who acknowledged that he/she is a
duly licensed contractor with E o F F " A- , a o acknowledged that
he/she was authorized to execute this document. He/she is e r ersonally wn to me or
produced. as valid i ti ication.
WITNESS my hand and seal this day of e- , 20 0 r
Notary
DAFNEY FAYE ADCOCK
r; NOTARY PUBLIC, STATE OF FLORIDA
MY COMM, 9901(es DEC. 2, 2008
COMM, b DD3700
NOTICE OF COMMENCEMENT
Oa ''QiwG ' State of Florida County of Seminole
Permit No. Tax Folio No. (PID)
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) (' k0
pZ t 0 VIA- a q-, ,¢.- Y-We- . A-v 1 _ 3 7-'7i 1
SEWN"' GENERAL DESCRIPTION OF IMPROVEMENTS 200
t_ RK
OWNER INFORMATION
Name and address 1>4 ttilrl E 0 E—j"
owl d YvA- l.2 ate_ 3 ---1'7
Interest in property (Fee Simple, Partnership, etc.) e) I,..+ r ,iJ-t
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER -(IF OTHER THAN OWNER)
C NTRACTOR
ame and address t" b o e F-t ,,
goo - (z-7
SURETY (Bonding Company)
Name and address
Amount of Bond WRYWE RMSE, CLEM OF CIRCUIT COURT
SMINOLE COUNTY
LENDER BK 05622 TAG 0067
Name and address CLERK'S # 20050EI9576
RECORDING FEES Mal
gpp y
F/2172 _ l e PH
Persons within the State of Florida designated by Owner upon whom notice or other documents may be served as provided
by Section 713.13(IXa)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.
rati t WlS ppTW}k o recording unlece a different date is c; , .ifirri.l
NOTARY PUBUC, STATE OF FLORIDA ,
MY Comm. Expires DEC. 2, 2008
N COMM. # DD376609
Signature o Owner
Sworn an subs bed befo me this Day of a
My Commission Expires:
Nota Pu lic
z 5
The foregoing instrument was acknowledged before me this day of 2 , 10 by
fA-1..-L_t — e C--e E `ry+i (name of person acknowledged), who is personally known to
me or who has produced FL.-,->2 t " t . & 300 - 6 ? - t5, -J hype of identification) as identification
and who did / did not take an oath>