HomeMy WebLinkAbout310 W 16 Str: •.:•..;.^t•:?:•. •'r•h: r,.v:i•":: life:n:
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Job Address: W I 0 ^ l 0 ( 7' z "-[ '..• .
Description of Worl(:- : ILt-' I` vv r
historic District: Zoning:
Permit T'ypc: T3uikling Electrical Mcchanical Pluunb;nl; Firc Sprinkler/Alnnn _ Po41•
L _
Electrical: New Service — # of AMPS Acidition/Altcntion Change of Scrvicc 'l cmpot:iry Pole
Mcchanical: Rcsidcntial Non=Rcsidcntial RePl."cetncnt New (Doti L:ryout & Tncrgy Cili; Required)
Plumbing/ New Conmtercial: 11 of Fixtttrc:: 11 of Water & Scwcr Lincs it of Gas Lines
Plunlbinp,/Nc1Y Rcsiticntia1:11 oCVValcr Closcls Plumbing Rep -lit•— Rcsidcntial or Commcrcinl
Occupancy'rype: Residential Commercial _ Industrial 'I'otnl Square F'oolavc:
Construction Tyne: — fl of stories: 11 of Divemur Units: Flood Zone: (FrivIA form required for outer ebzn X)
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sue-,.e.s.-•r.•rs
Parccl 0:
Owners Name & Address:
t
aclt Prooror O:wncrship F_ Legal Descrip(ion)
f
rhone• fio-I- 32Z- St3
Contractor\antc&•Address: `A C C ILOO i .—..._._. . _._
317-r Lstate 1 cclise/•umber:
NO Zj?j-L?j?j?j Contact 1'crson; ``CrOC—Phonc:-3ZZ955 a
l'honc.0 fax: -
Bondin, Company:
1 //A --- — _
Address:
Nlort; ngc Lender: — kAddress:
Architect/En inecr:
Address:
Fax:
Application is hereby made to obtain n permit to do the wort: and installations as indicated. 1 ecriry that no work or installation has commenced prior to Ilseissuanceor., permit and that all work will be performed to nlect standards of all laws rcgubting construction in this jurisdiction. I understand that a separatepermitmustbesecuredforELECTRICALWOPJC, PLUMBING, SIGNS, WELLS, POOLS, FURNACES. BOILERS. MEATEILS, TANIGS, and
AIR CONDITIONERS, ctc.
OWNER'S AFFIf?LV 11: 1 ecr•tiry that all or the forcgoinl; infomtation is accunte and that all wort:::11 be done in cornPliance with all applicable la:vs rag - ting
construction and zoning. WARNING TO OVINLR: YOU!t FAILUi:I's'rO RECORD A NOTICE OF COMMENcc-mr_NT'MAY RE-SUI r 1111 YOUR PA.YNCTWICEFORIMPROVEMENTSTOYOURPROPEsR1Y. IF YOU INTEND TO 01:'I'AIN FINANCING, CONSULT WITH YOUR 1.11NDER 01: AN
ATI'ORNEY BEFORE RECORDING YOUR NOI'ICE OF COMI.ic.. •icr:M!ad•r.
N(hI(,ai: In atlditiun to the rcquircnuau:: of this permit• there maybe mirliti-1:rl rc:aiclions applieable to this property that may be found in the public rceork orIhiscounty, and there may be additional permits mp6rcd lirom other gowennncnial entities ouch a:: water nunal;cntcnt districts, stair. at;cncre::, or federal agmcics.
Acceptance Of permit is verification that I :will notify the owner of the propery of tic requiremcnis of i lorida Lich
K S 5- SO- AD l Z.- Z. = o - G
Signature o Owrter/Agent Date Sigm or ' ntnetor/.
4 L 10
Print
S or
DAFNEY FAME AE)WOK
NOTARY U,DNC,,nATS OF FLOFtlOA
101168
Is
Comm.
o MSC 9
020 4N
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t la S 1)
atc I'::
Manic Data
DEB91E
BLANTON MY
COMMISSION # DD 1W91 nn:'
ret r/A^:...-.. EP AFi^F gNlijlX ir+ttti'RRZ or I'
ry I `p4 N0•YAI7Y FL Notary Discount Assoc. Co. ss-
bl Zo AI'll
LIC'ATION At'I'I\,UVI-'I) tlY: Illdr.:I Initial S.
Dme" r` Inr:ial ;:
llata) (hrrhal , D_tt
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POWER OF ATTORNEY
Date: a b e7
I, Andrew J . (Andy) Adcock do hereby authorize Ruben Birch
To pull the Reroot _permit for 3 ? W 16 S
type of permit) (address)
5- t-- t= "o fit]
11
itgnature
N Stamp
QW
DAFNEY FAYE ADCOCK
NOTARY PUBLIC, STATE OF FLORIDA
MY Comm. Expires DEC. 2, 200S
COMM. 0 DD376609
nall :to me or driver license # , of State of Florida, County of
day off
zoom
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
AFFIDAVIT
COMPANY: . OD LICENSE NO: C
PROJECT INFORMATION
SUBDIVISION:
PERMTT NO:
ADDRESS: `
1. Ic' a WC> , Fl , 3Z-7 -7
LOT:
I,Ch.,% 4e2gaffiant, hereby affirm that I am the duly licensed contractor of iccord for the above reference
permit, that all of the f regoing information is true and accurate, and that the dry -in, flashings at the above referenced address/lot has
beentinstalled in accordance with all applicable codes and standards.
CONTRACTOR: 14 N3 DL-t 4ebete-
Printed name)
Sature STATE
OF FLORIDA COUNTY
OF ` RI,'
PiyA (
yt. D LR t ' This
inst ent was ack,n/ w ledged, ,be f/oreme thisqak-n—owledged day
of TZ Zoo by the above referenced individual,
C L.-1_ jf odAL , who t c/she is a d4 licensed contractor with S-
rA ; E o F 1=.0 /L,o. , and who acknowledged t iat-It/e was authorized to execute this docume> a is eit
nay own tome or produced as valid identification. WITNESS
my hand and official seal this day of Ff &A Z:4 2na S COMM,
ADCOCK
No Pu licTE OFFLORIDADEC.
2,2008375609 Printed Name: E y4cpl'a '( My
Commission Expires: Z Z Zoo".
A lv o. tj An coc+-,)
M Free , State of Florida
st'jo V1-j
NOTICE OF COMMENCEMENT
Permit No. 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) CERTIFIED COPY
I T ANNE MORSEa3z-7 -7 p„ .. _ _
our TY` VrTjr GENERAL
DESCRIPTION OF U"PROVEMENT E120o 4 RID,
q LERK
2005
OWNER
INFORMATION Name
and address 31
1\) -T. 1= o z-7 Interest
in property (Fee Simple, Partnership, etc.)t.. t F jZ NAME
AND ADDRESS OF FEE SIMPLE TTTLE HOLDER.(IF OTHER THAN OWNER) CONTRACTOR
Q Name
and address C'ttL ^ oa Grp ADD -
7
SURETY (
Bonding Company) i Illl N lIUi i Q Iq a (q iq [qt f ilgf li I Ifs NameandaddressAmount
of Bond MMM MRBr4 M8WWMF=1T MW LENDER
BK 056t2 PIG 0957 Name and
address CLERK' S 0 c.'2-'4453 iEC ED
02/11/ZM set lee M RECM INO
FEES 1&@0 Persons within
the State of Florida designated by Owner upon whom notice or other documents may be served as provided by Section713.13(Ixa)7., Florida Statutes: Name and
address s ss
ss ss sss»ssss»»sssssss»»s»»ss»»»»+ssss»sss sssss»»»:»::ssss s ss s s s s»sr In addition
to himself, Owner designates of provided in
Section 713.13(I)(b), Florida Statutes. to receive
a copy of the Lienor's Notice as s ss»»
ss»»sss»sssisssssssass:::ss»s s»ssss»ssss»s s»s»as»s s»+s s s»» Expiration Date
of Notice of Commencement The expiration
date is 1 Year from date of recording unlr_cc a difrorwnt dst. t, DAFNEY
FAYE ADCOCK /rs!w F, NOTARY
PUBLIC.
STATE OF FLORIDA Signature of mot Y
Comm. Expires DEC. 2008 nd air
ere t6' Day of . op; mn • PublicMy
Commission
Expires-. I Z Z Z 0t7 $ e foregoing
instrument was owled before me this day of e ij D5b ArLD L. Y t (name
of on acltnowledged), who is personally known to me orwhohoduceFL . -D2 r / LI C . (type of identification) as identification and who
did / dt not take an oath> S S 3 _ I Z _ _ S p $ _ v