HomeMy WebLinkAbout2536 S Palmetto Drper _. 'SPcrinitIt
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Job Address:
Description of Nord(:
Historic District: _
00
7.onind: Value of NVorl(: S 0 0
i`'I JVt,AT
Pcrinit Type: Building f:IccIric:II Mechanical Plumbing Fire Sprinkler/Alarm
r
I'oal• _
Electrical: New Service-0 of AMPS Addition/Alteration ChanP,c of Service 1'cmpor iry Polc__
New fncrgy C iIC Required)
I WI-tilical: Residential Non -Residential RcplaccmcnNt w (Duct Layout . - Plu,»
binr/ hlcty Connncrcial: !1 of hixRlres Il or Water & Sewer Lincs 11 of Gas Lines PluntbinpjNcw
Residential: if of 'alcr Closcls III umbin- Repair- i:csidential or Commercial Occnpancy'
I'ypc: Rcsidcntial Conu,lcrcial _ industrial 'I'ol:ll Squarc Footage: Construction
Type: f! of S(.or ics: I! of I)tt cllinr Units; Flood Zone. (fr`IA form required ror other chxn X) ram`-,
rcwx+,7-r,•.•'se Parcel
1!: Contractor
Name C'Address: i'
banc fi fax: qD7 ?'/?7lI 33 Gnitact 1'crson: llrrndin,^,
Company: /_---— Attach
ProororOwncrship & I.cCal Description) Phone:
qv-7 C.=.aI 55g Address' - ---
Mort,;
a;;
c Lender: - _ — -- _ -- Address Architect/
rnl.
inccr: 1 \ Address'
Application
is
hereby made to obtain n permit to do the stork and installations as indicated. 1 ccriry that no wort: or installation has conrs -I <i prior
In rile issuance or.,
permit and thaCall work will be perfotYi,cd to nice standards of all laws rcrubtinC con;truction in this jurisdiction. I undcis1. nd Ili. a separate permit mustbesecuredforIiLL•CTRICAL WOM, PLUMI)ING, SIGNS, WELLS, POOLS. FURNACES. DOILERS: HEAT _M, TAN1GS; and , AIR CONDITiONL•
RS, ctc. ,•, , ;,,, ,.. „ , . I'..':.1.!?:
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F•' ii:nuc'• •ri ,)!. O VNfiR'
S Affll)AVI'1': 1 certify that all of the foregoing; infomialion is''aceuratc and that aD work: will be done in'coinpliancc with•all applicablts 1. ves rcl;uhling construction andzoning. WARNING TO OWNEI:: YOUR FAILURE'CO RECORD A NOTICE Of C0 1MGi:CCTvtrNl';.1A1' RrSUi,T IN l'QUI.I'A.YfyG TWiCC FOWIMPROVL•MENTS TO YOUR-PP.01'CItiY.-if YOU INTEND TO 01)'1•Aii i;INANCiNG, CONSULT WITH YOUR LENDEROR AN ATrORNr:Y •ucr:
Or.r,RrcOiZDING•YgVR No;riCr_ or•,CO-%1tirr.cru1:N'r. In addition it)
the requircmcnls or thi• ptn»it, tiler, stay he atlrlitirmal 7,sclion; applicahle it) Ihi:: property 111a1 inay be found in 111C public records of this county, and
lhcre may be additional permits required from other r; lt'crmrn:n1:11 entities such a:: Water nl.•maLemcnt dis1rici%,;talc al;entacs, or fcdeml agoieies. r .n 1
i Aecepwnce of perinil
is verificqzz7i_ oi'hott'ec
of rite propel;v of the rcquiren,cl f i l tla Lien i a U. Mo¢ CAS o Go
N Sign:Uurc
ol'O%mer/Al;ent - Uat, it;rr u Contricror/A!;,. _ Ual, r C4& Print Owner/
Agent'
s Nan„onlncror•:\gent'; Name / vs U_ H to
S ena ,
rc orNotary ul' 1•lurida 1 ue , i_a:: . to DEBBIE BLANTON 7 tJ ,.
MY
COM'7tSSICN #
DD 11i8491 . g. ,:..• r ' E'.r£• ('nn:.I,tul
1:: EXPIFiIi$, F MVn?A q,, I or j•.• qb'i' •'.(%t)'i1Cf/
A I;CItI'iS 'I',f:nllall \I,tl„lt.ln \it U`. V. 1 3-N0 R`%—•--
Ft r%c!M O:3coUM AWOL. Co. tli . r •I'r iduccll
lU -- .--- -_ -, _ _.— t9 ,sly, .:C'iiC: .. .:. a41
i:Y li.'!: r.: ..'' ..-ii ..:t': ! )'1:: 1' r'' .. .. ' /:.I! •!' i': .. : a.:. .a :...' , , irli`' Y .Jli7.( i C•.
L:. 4 —.,. .;i • ;f..:.•:!.Y ..`•:. ;•r ' ,.: `-r L:1 p: wl•: t 71 .^' .. `, fl:. ••''• _ 1'.U• .. AI'I'LIC'ATION APPROVED
IIY: 111411;: _ %talus;;: __,_ la:'::: ; :: --.•, ' - Initial 0310 (Inl:ial . U110 (
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fir, .;•. _ i X' '•'
POWER OF ATTORNEY
Date: bCj
1, Andrew T. (Andy) Adcock do hereby authorize RubenBirch To
pull the Reroof permit for type
of permit) Si4j:ps) Signature
N
Stamp DAFNEY
FAYE ADCOCK NOTARY
PUBUC, STATE OF FLORIDA MY
Comm). Spires DEC. 2, 2= COMM,
A DD376609 Perso
o me or driver lice e # , of State of Florida, County of I
day of
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
AFFIDAVIT
COMPANY: D l C CCo zzs oDo N LICENSE NO:
T
PROJECT INFORMATION
SUBDIVISION:
PERMIT NO:
I,Ln 4L 0 affiant, hereby
permit, that all of tA foregoing information is true an
beentinstalled in accordance with all applicable codes
STATE OF FLORIDA
ADDRESS: a` 3 Q S. R `K'e_t-o
z=77
LOT:
d
affirm that I am the duly licensed contractor of record for the above reference
accurate, and that the dry -in, flashings at the above referenced address/lot has
and standards.
CONTRACTOR: & b Aoo<
Printed
nIr ) a" , '/ -
Signature)
COUNTY OFjS C,"A-L K-D ESL
This instrument was acknowledged before me this day of IreLx—riw ZOO c5 , by the above referenced
individual, AW CD 644, , who acknowledged th e? e is a dul# licensed contractor with
and who acknowledged t fi e73 a was authorized to execute this documenhe is
ei ona y own to me or produced as valid identification.
WITNESS my hand and official seal this
y.+^"" DAFNEY FAYE ADCOCK
NOTARY PUSUC. STATE OF FLORIDA
MY Comm. Expires DEC. p, 2M
im
COMM. 0 D0376809
Printed Name:
My Corn issi on Expires: lZ Z Z ••
NOTICE OF COMMENCEMENT
A, State of Florida County of Seminole
Permit No. Tax Folio No. (PID)
AtN V 2 / 71ie 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 PR RTY (Legal description ofj hlte property and street address)
25(0 •Lr1'T 0 SAt,3EDMI-->
GENERAL DESCRIPTION OF IMPROVEMENT E k- DD r
e
OWNER INFORMATTON
Name and address
ZS3Ca r4L1"(FTfb S,4r.9F"D1i1( Z-7(
Interest in property (Fee Simple, Partnership, etc.)
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER (IF OTHER THAN OWNER)
CONTRACTOR
Name and address
3z-7'7
SURETY (Bonding Company)
Name and address ti
Amount of Bond CDQYCERTIFIED
LENDER ' M ARY ANNE MOBNameandaddressOFCIRCUITC,
lE OUNTY.
Persons within the State of Florida designated by Owner upon whom notice or other documents may be served as p"'j pUTY CLE
by Section 713.13(Ixa)7., Florida Statutes:
Name and address
1
ss+•sss s•s s s sssss s sss s s as•s ss wss•s s ss•s+++•s+
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.
m n pd m 3sss++•s ss ssss ass•s ss s ss*sss+st s s sssss r+ss+ss•s++sss•+•++++•++ n n n r x z
Expiration Date of Notice of Commencement M 10 (
gybW41x. pThe expirationdateisIYearfromdateofreoordittQtutleceadifferentdatetisnr+ ifirrl 1 rn i rQ N tr Fn
m t!) r
3 SIT ru
CI c Signatureof
Owner A ' -Z-I miz • N,
N Sworn
to
and subscribed before me this Day of —t¢ pS " "'' O r-
r}F
Y JoQnit Kigci r c°n+ xMy Commission
Expires; 2.p c: Co7tnliSSion # DDF 0 Ntfog bloc -,
a
i,IDondaOT
Fain. 8L!'118i/
MY Inaurrnc•,
Inc. p 7078 Thnstrumentwas acknowledged
before rite this day of 19 by M M name of person
acknowledged), who is personally known to -+ me or who
has produced (type of identification) as identification c and who did /
did not take an oath> e