HomeMy WebLinkAbout407 Summerlin Avet CTFY OF SANFORD PERMIT APPIJCATION
Permit # : . Q 1 Date: d2 I D
Job Address: - 0 7 e := rZ L i >n % ORS / 3
Description of Work _ z
Historic District: tl Zoniag: -SIVA Value of Work: S 12n
Permit Type: Building—Z Electrical Mechanical Plumbing Fim Sp inkicdAlann Pool
Electrical: New Service - # of AMPS Addition/AltcMdOn Cbange of Service Temporary Pole
Mechanical: Residential Non -Residential Replacem ttt New (Duct layout & Ener'gy Cale. Required)
Plumbing/ New Commercial: # of Fxtturs # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Phunbing Repair - Residential or Commercial
Occupancy Type: Residential _V Commercial 'Industrial Total Square Footage: 66
Construction Type: Lip 7Fok t# of Stories: _ # of Dwelling Units: Flood Zone. (FEh1A form required for other than X)
Parcel ii: - S2 S - 0000 " 07570 (Attaeb Proof of Ownership & Legal Description)
Owners Name & Address: -' 01 rt
407 SuwtrvteRL r. 1/F, i4 roR17 t'
L 3.Z771 Pboae: 4D7 3.2 ' OSSO
Contractor Name & Address: Q A 0-7 • I O 2
State License Number:
Phone & I
Bonding
Address:
Mortgage Lender:
Address: — -rrD
Architect/Engineer; el JA
Address:
Application is hereby made to obtain a permit to do the w- At and fy that go wont or installation has cannlenced prior to dtc
issuance of a permit and that all work will be performed t3;ineet 1 onstruction in this jurisdiction. I understand that a separate
permit must be secured for ELECTRICAL WORK PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVITA certify that all of the foregoing information is a0mrate and that all wont will be done in compliance with allapplicable laws regulating constructionandzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICEFORIMPROVEMENTSTOYOURPROPERTY. IF,YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. of
NOTICE:
In addition to the requirements of this permit, there may be additional restrictions appticabk w this property that tray be found in the public records ie
thiscounty, and there maybe additionalppmits required from other governmental entities sucb as water management districts, state agencies or federal agencies. I
will notify the owner of the property of the requirements of Florida Lien Law, FS 7)3. Acceptanceof y atior t 2
vs Date
2-
z3 0,- Date
fcoc
Rca oAES: Match 23 Owner/
Agent is Persona ll'9Q91tleyyj 0r Produced
10 APPLICATION
APPROVED BY: Bldg: O 7 Zoning: ni[
iat & Date) Signature
of Contractor/Agent Date Print
ContractodAgent's Name Signature
of Notary -State of Florida Date Contractor/
Agent is _ Personally Known to Me or Produced
ID Initial
A Date) Utilities:
FD: Initial &
Date) (Initial & Date) Special
Conditiom:
THIS INSTRUMENT PREPARED BY AND RETURN TO:
Harry G. Reid, III
Law Office of Hang G. Reid, III
1120 W. First Street, Suite B
Sanford, Florida 32771
Property Appraisers Parcel Identification (Folio) Numbers: 30-19-31-525-0000-0790
Grantees SS its:
Space Above This line For Recording Data
THIS WARRANTY DEED, made the 9th day of August, 2004 by JERRY A. STEWART and
ASHLEY S. STEWART, husband and wife, herein called the grantors, to James A. Nettles and
Joanne Nettles, husband and wife, whose post office address is 407 Summerlin Ave, Sanford, FL
32771, hereinafter called the Grantees:
Wherever used herein the terms "grantor" and "grantee" include all the parties to this instrument and the
heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations)
W 1 T N E S S E T H: That the grantors, for and in consideration of the sum of TEN AND 00/100'S
10.00) Dollars and other valuable considerations, receipt whereof is hereby acknowledged, hereby
grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the grantee all that certain
land situate in SEMINOLE County, State of Florida, viz.:
Lots 79 and 80, of Fort Mellon, according to the Plat thereof, as recorded in Plat Book 3, at Page 69, of
the Public Records of Seminole County, Florida
Subject to easements and restrictions of record.
TOGETHER, with all the tenements, hereditaments and appurtenances thereto belonging or in anywise
appertaining.
TO HAVE AND TO HOLD, the same in fee simple forever.
AND, the grantors hereby covenant with said grantees that the grantors are lawfully seized of said land in
fee simple; that the grantors have good right and lawful authority to sell and convey said land, and hereby
warrant the title to said land and will defend the same against the lawful claims of all persons
whomsoever; and that said land is free of all encumbrances, except taxes accruing subsequent to
December 31, 2003.
IN WITNESS WHEREOF, the said grantors have signed and sealed these presents the day and year first
above written.
Signed, sealed and deliv ed in the presence of:
4e-;
5
Wit / ' ' atur / Y A. S T
v fA I ` e f Vim-- 51 Highbanks Rd., Dcbsry, FL 32713
Witn*amo
Witn #2 Signat1 e HLEY WART
OTJ aU/c it 151 Highbwks Rd., Dcbary. FL 32713
Witness #2 Printed Name
STATE OF FLORIDA
COUNTY OF SEMINOLE
The foregoing instrument was acknowledged before me this 9th day of August, 2004 by JERRY A.
STEWART and ASHLEY S. STEW A 7' ho are personally known to me or h ve produced
IC LD/t r0,* pRr 01f. l is identification.
SEAL
N
Y MYtoa, pl:tt5_AIMI -4).'
1?orw°
g _..
ems*=.'
Notary Name
nmission Expires: /11 y0/"04
Fil• Nn• W.1K.
1 -- —ram:.:_.
CA
PLAT OF BOUNDARY SURVEY
for
JAMES & JOANNE NETTLES
Legal Description
LOTS 79 and 80, FORT MELLON, according to the Plat thereof as recorded in Plat Book 3, Page 69, of the
Public Records of Seminole County, Florida.
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1 SCALE:
1 "=30' SURVEY
NOTES: r 1)
The street address of the above -described property is 407 SUMMERLIN AVENUE. 2)
The above -described property lies in a Flood Zone X. SURVEYOR'
S CERTIFICATE This
is to certify that I have made a Survey of the above described property and that the plat hereon delineated is
an accurate representation of the same. I further certify that this Survey meets the Minimum Technical Standards
set forth by the- Florida Board of Land Surveyors pursuant to Section 427.027 of the Florida Statutes. REVISIONS:
CERTIFIED CORRECT TO: KITNER
SURVEYING, INC. JAMES & JOANNE NETTLES R .
BL A I R K I TNER - P.L.S. NO. 3382 COUNTRYWIDE HOME LOANS, INC., ISAOAIATIMA FIDELITY
NATIONAL TITLE INSURANCE COMPANY PostOfficeP.ox 823, Sanford, Fl . 32772-0823 HARRY 0. REID, III, ATTORNEY -AT -LAW 407)
322-2000 PROJECT
NO: Q, 6'( SURVEY DATE: AU&UST Z004
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FE8-22-2W le,37 MILESTONE WIMRPAIb Our ad.) 177l46 F. ru
e—
NATIONAL CERTIFIED TESTING LABORATORIES
ssao PARKLM BLVD t ffE 32D v- ORLANDO, FLORIDA SM • TELUPMCME (4M 240-108
FAX (an wow
wW...110d0640m
SMUCTEMU PERFORK4NCE rMT RF""
ftort No: NCTTi-210-5089.9
not DOW USIS4/98
Report 1 09/24/98
1Revision Dkft* 10/S6102
Client;. Florida Extrwder8 International Inc.
8540 Jewett Lane
Sanford, FL n7714600
Tent Specimens Florida Eutruders International Ins.'s Soria 'Xitatone 8000' Single HungAluminumprimeWindow (H•C45X56ac90Xlntcrior and Exterior Design Pre88ure 45 pefl
Teat Specoeation: AN91/AAMA/NWWDA 101 /I.&8.97, "Voiwatary SpecUka:iona for
Aluminum, Vinyl (PVC). and Wood Windows and Olms Door'."ASTME8a91, peat Method for
Ddertko the Rote of Air LsakW ?hrough Exterior Windows, Curtain Walls and Doors Und mierSpecified
PFeaaure Differences Acroas the Specimen. ASM &930-90, Tat Mahod for Structural Plsrformancs
of Exterior Wtndowe, Curtain Walla and doors by Uniform Static Air Pressure Difference.
AST M K831-93, not Method for Water Penetration of &wrior Windows, Curtain Walls and
Doors by Un4arm Stone Air Pressure Difference. ASTM S547.98, Test Method for Water PenetrationofExteriorWindows, Curtain Walle and Doors by Cyclic Stacie Air Pressure DWferenfiak AS71Vl
FSM-85 (94). "Standard Teat M68h0d for Measuring the Forced Entry Resistma of Window Assembiiss,
Excluding 0kningImpact TEST SPEC1MXNDE8Cx
1M0N General: The
test specimen was a one -over -one tilt tingle hung aluminum prime window measuring 474/8"
wide by 7161 /8" high overall. The fx*d lite was glaaed to the frame members providivw a viewing area
of 50-1 /4" wide by 43.1 /8"high. The bottom active sash n aw&&rtd 4'4-11IC wide by X6.7/
8" high. Remand =4 members were not thermal& brnfxn. The aetiue saah was removabie via a
single block and tackle bakuto systenn with locking tilt shoe kwxAod in each interior jamb track - One metal
Qum-typs sump lock was located at 6" frame each end o/ the interior meeting rail. The hWor was
extruded onto the exterior nesting rail as the lock positions. One nylon tilt latch with thumb actuator
was located at each end of the top rail. One netpl pivot bar was fastemw with two screws at
each end of the bottom rail. The frame and wish wen of double screw Paged corner co ratruction.
The f od meeting rail wag fatkmO to the jambs at 44" from the sill with two (8) screws. InetallatL%.
L
T?he specimen was fastened to the wood test buck u6no ten (10) flat head screws, tua(8) 8 xl')
were used at the )lead and four (4) (08 x X-) of the faxed lite jambs; two per x Y")
were used at the active sash Iambs. two per jamb- 09" /astaner diagram) PROPUMNALa tN
rff SOME Of rMTMNI PL44S CITY
M.
REVIEWED
FEB-22-2M 18- 37 MILESTONE WINDOWS 416( J" M (Q r. w
ors Euruders International lam. -. tvcr sraso-s
Gilaaing: Both she hand lite and active sash were interior slated using 8/ 16" anmsaled clear glass
With a 8iiicor+e back -bedding and a snap•iot rigid glazing bead-
M660d-
HU
HUMA double strip of polypik weatherstrip (0.1 W MOh) was located at the acdm sash stale. A sir+
gk strip of polypi,# weatherstrip (0.150" high) was hooted at the active sash meeting mil. A single strip
of Rap vi"l aWaawTatri ping tvas,coated at the active MMh bottom lift rail. Inwior &
Exterior Surface Finish.- White painted aluminum. Sealank
A small joint sealant was applied to the jamb/eltl Corners. Screen:
An insect screen measuring 43-1 /8" wide by 51-1 /Z" high toss of butt." corner oonetruction
with nylon corner keys. The screen employed o ftberpbse mesh cloth with a hollow vinyl spline,
two jamb retainer sprims. TT69T
RESULTS Par.
NcL t T"t & Methud Mid Blle 8.
11.6.1 Operating Force 22 lb/ft WWI 8.
1.2 Air Infiltration LV
pef (gS mph) 0.02 cf n/ft 040 cfin/ft 1.
8 Wafer Resistancc s
0gph/ft WxP=
s. 00 psf No Leakage No Leakage 8.
1.4.2 Uniform Load Structural 30.
0 psf Exterior 0.004" 0.208: So.
0 psf Inkrior 0.016" 0,208 DeAwing
Active
Sash MeetiniRail (
7010) 4,2% (0.0167) 100% Bottom
Rail (70 lbf) 1.8% (0.0810) IWO Left
Mand Stitt (SO ibfl 9.4% (0.019") 100% Right
Hand Stile (50 ibJ) J.6% (0. 0860) 100% 1.
8 lorded Entry Resistance Grade
10 (See Appendix A for test resuits) Mess As Stated PUX.
So REVIEWEV b
OF SA:17011ftf-D
FW?2-2M 18: 38 M 11.t5 I uNt w t NUJ4)
Florida Mdruders InumWiomal Inc- -3
OPTIONAL PERWRIMNCE
par, No. mle 91 t MOU
9 + Water ResietaPnce
6.05ph/ft'
NoW2?- 6 75 pof
4.4 2 Uniform Load Structural
0.0$1 it67.6 psf Exterior
67.5 pef Interior 0.0I6"
Tgsted with and without screen
TEST COMPLMD 0*124198
0 f Jr-,) W ('9 r . w
NCTL-210-30mz
No Leakage
0.2080
0.2or
This teat specimen maeta (or ax+veeeds) the performance leusb speclfted i>.. Table 2.1 of AAVSII AMAINWWDAIo1 /l.S. Z-91 liar air inftltratiom The listed results were secured by fk4 the des'gruoted
test methods qnd indicate oo nplimm with the performance "Quiremeate of the referenosd
speeiication paragraphs for the H•C45 5&90Aroduet designation.
Detailed drawings were auaiiable for laboroto y records and compared to the test specimen at the
time of this report. A copy of this report will be retained by NCTL. ne results obtained apply only totheepeeimentested. No conclusions of any kind regarding the adegtocy or inadequacy of the glad• itsthetestepeenseemaybedrownfromthisteat. Thte report does not constitatQ eerttftaation of the
product which may only be granted by a certijicatlon pmrvm uolidator.
NATIONAL CERTMED TES77NO LABORATORIES
tu u&, --- -
MICHAEL E. LANE
Division Manager
ONE BY WOOD CONCRETE OR CAULK BETWEEN
WOOD BUCK 6 B'W' 1-1/4' MIN. BUCK BY OTHERS MASONRY OPENING MAS'Y. OPENING BUCK WIDTH) EMBEDMENTBYOTHERSBYOTHERSINSTALLATIONANCHOR
CAULK BETWEEN ONE BY WOOD 3/16' DIA. TAPCON p
WINDOW FLANGE BUCK BY OTHERS
r!. WOOD BUCK
p 1-1/4' MIN. STu
BY ETHERS
D
o EMBEDMENT SHIM AS RED-D.
RIGID VINYL 1/4' MAX.
GLAZING BEAD (SEE NOTES) 0
INSTALLATION ANCHOR TYP.)
3/t6' DIA. TAPCON
STUCCO —/
BY OTHERS
PERIMETER
CAULK
BY OTHERS.
RIGID VINYL
GLAZING BEAD
W H. (TYP.)
WIDOW HEIGHT)
CAULK
BETWEEN WINDOW FLANGE
S PRECAST SILL W/
VULKEM 116 ADHESIVE CAULK.
OR APRV'D. EOL. PERIMETER
CAULK
BY
OTHERS 0
SHIM
AS REG-D. 1/
4' MAX. SEE
NOTES) FLANGE
TYPE WINDOW
FRAME HEADER
GLASS
TYP.) (
SEE NOTES) B.
H. BUCK
HEIGHT)
FLANGE
TYPE WINDOW
FRAME SILL
PRECAST
SILL V I BYOTHERSNOTES . ..
SECTION A-A' 1)
SHIM AS REO'D. AT EACH INSTALLATION ANCHOR. MAX. ALLOWABLE SHIM
STACK TO BE 1/4-. D 2) WINDOW FRAME MATERIAL: ALUMINUM ALLOY 6063. 3)
INSTALLATION ANCHOR MUST BE OF SUFFICIENT LTH. TO ACHIEVE MIN.
EMBEDMENT OF 1-1/4- INTO MASONRY OR CONCRETE. 4)
USE SILICONIZED ACRYLIC CAULK BEHIND WINDOW FLANGE AT HEAD do
JAMBS. SILL MUST BE ATTACHED TO THE SUBSTRATE WITH J VULKEM116ADHESIVECAULKORAPPROVEDEQUAL. 5)
USE SILICONIZED ACRYLIC CAULK FOR PERIMETER SEAL AROUND W.H. EXTERIOROfWINDOWFLANGE.F 6) IF EXACT WINDOW SIZE IS NOT LISTED IN ANCHOR CHART, USE ANCHOR
QUANTITY LISTED WITH NExT - LARGER SIZE, FOR THE APPROPRIATE
DESIGN PRESSURE REO'D. 7)
GLASS THICKNESS MAY VARY PER THE REQUIREMENTS OF ASTM E1300GLASSCHARTS. 8)
LETTER DESIGNATIONS ON THE TAPCON LOCATION CHART INDICATE H WHERETAPCONANCHORSARETOBEINSTALLEDWHENUSINGTHEEXTERIORELEVATIONASAKEY. 9)
ALL FACTORY APPLIED HOLES NOT DESIGNATED FOR TAPCON ANCHOR
SHOULD BE FILLED WITH #8. SCREWS OF SUFFICIENT LTH. TO
PROVIDE MIN. 5/8 IN. EMBEDMENT INTO WOOD BUCK. 10)
FLORIDA EXTRUDERS 1000 SERIES SINGLE HUNG IS SHOWN. THIS PRINTALSOAPPLIESTO -HE F OR c GLASS
TYP.)(
SEE NOTES) FLANGE
TYPE WINDOW
FRAME JAMB
CAULK BETWEEN WINDOW
FLANGE 3
WOOD BUCK W.
V. WINDOW
WIDTH) SECTION
B-B i
1
PERIMETER
i CAULK
BY
OTHERS CAULK
BETWEEN WOOD
BUCK 3 MAS'
Y.. OPENING BY
OTHERS CONCRETE
OR MASONRY
OPENING BY
OTHERS E
K
B _ G
SERIES
SINGLE HUNGS. L
ILA _XtRu0ER5 1500 AND 2000 ELEVATION
11) WHERE WINDOW IS INSTALLED IN MASONRY OPENING WITH A STRUCTUAL
TWO BY WOOD BUCK, USE #10 SCREWS OF SUFFICIENT
LENGTH TO ACHIEVE 1-3/8- MIN. EMBEDMENT AT VIEWED FROM EXTERIOR ALLINSTALLATIONFASTENERLOCATIONS. o
TAPCON
LOCATION CHART CALL
BUCK LOCATIONS IN HEAD LOCATIONS IN JAMB SIZESIZE30PSFTO40PSF41PSFTO70PSF3OPSFTO40PSF41PSFTO7CPSFt2
t3
18
1/8 X 25 18
1/5 X 37 3/8 e
B
B
F,G F,G 14
to 1/9 x 49 5/8 B
B
F,
G F.G 145
18 1/8 x 55 1/4 B B F,
G F.G t5
18 1/8 X 62 B F,
G F,G 16
18 1/8 X 71 B B F,
G F,G 17
is t 8 x 83 F,G F,G,H,I IH2
25 I/2 X 25 B F•
G F•G.J,K 1H3
25 1/2 x 37 3/8 B B F,
G 1114
25 1/2 x 49 5/8 B B F,
G F,G IH45
25 1/2 x SS t/a B B F.
G F,C,H,1 Ills
25 1/2 x 62 B B F,
G F,G,H,I 1
H6 25 1/2 X 71 B B F,
G F,G,H,I 1H7
25 1/2 X 83 B B F,
C F,C,H,I 30
1/2 x 26 B
F,
C,J,K f,C.J,K 30
1/2 x 38 3/8 2929/2/x 37 3/8 B 8 301/2 x 50 5/8 29 1/2 X 49 5/5 B B F,
G 30
1/2 x 56 1/4 29 1/2 x 55 1/4 8 B F.
G C.1 F,.H,I 30
1/2 x 63 29 1/2 x 62 B B F,
G F,G,M,1 30
1/2 x 72 29 1/2 X 71axF.G. e8F,
G,H,I 30
t 2 x 84 29 t 83 8 B mj
F,G,H,I 36
x 25 C.j,K F,.J.K F,G,J,K F,
G 23
4
Za36
x 37 3/8 B B F,G 2
36
X 49 5/8 36
x SS 1/4 B
B
B
F,G F,G,H,I 25
26
36
X._62 36
x 71 B
F,G F,G,H,I 27
36 x 833 B
g
B
F,G,H,I D.E,F,G,H,1 42
x 26 41 x 25 8
F,G,J,K F,G,H,I,J,K F,
G,H,I 42
x 38 3/8 42
x 50 5/8 41
x 37 3/8 B B F,G , G42
x 56 1/4 41
X 49 5/e 41
X 55 1/4 g
B
B
F,G,H,I 42
x 63 41 X 62 B a F.G. H,I F,G,H,I 42
x 72 41 X 71 B B F,
G,H,1 D,E,F,G,H,I 42
x 84 41 X 83 8 B F,
G,H,1 D,E,F,G,H,1 48
x 26 a7 x 25 B A,C F,
G.J.K F,G,H,t,J,K F,
G,H,I 48
x 38 3/8 48
x 50 5/3 47
x 37 3/8 47
x 49 5/8 B
B
A,
C c
F,
G 48
x 56 1/4 48
x 63 47
x 55 1/4 47
x 62 B
A.
0 A•
C F,G,H,I G. F,
C,H,I F,
C.H,1 - 48
x 72 47 X 71 B
B
a.
0 f,G,H,I D,E,F,C.H,I 48
x 84 47 x 83 A,C F,G,H,I D,E,F,C.H,I 32
33
52
I/8 x 25 B A.0 F
K F,
G D
F H I K F,
G 34
52
1/8 X 37 3/8 52
1/8 x 49 5/8 B
B
A,
C F.G F.C.H,I 3a5
52 1/5
x
55 1/a a A'
C a,
C F,
G,H,I F,
C,H,I F,
G.H.I 35
36
52
1/a x 6z 52
1/8 x 71 B
A,C F,C,H,I D,
E.F,G.H.I D,
E,F,G.H,I 37
52 1/8 X 83 B
B
A.
F,G,H.1 D,E,F,G,H,I A•
C I F.G.J,K D,E,F,G.J.K,J,K 37
SIZE NOT AVAILABLE IN 1000 OR 1500 SERIES. FTITLE:
IDA EXTRUDER INTERNATIONAL INC SANFORD,
FLORIDA TALLATION
DETAIL 7
SGL. HUNG FLANGE WINDOWS - SERIES 1000 1500 & 2000 FDRAWN
BY: B B APPROVED BY: ATF
1 (./Ii9/f11 Icr rr. h1TC`
CITY OF SANFORD BUILDING DIVISION
OWNERIBUILDER AFFIDAVIT
CONSTRUCTION CONTRACTING
Owners of property when acting as their own contractor and providing direct, onsite supervision
themselves of all work not performed by licensed contractors, when building or improving farm
outbuildings or one -family or two-family residences on such property for the occupancy or use of such
owners and not offered for sale or lease, or building or improving commercial buildings, at a cost not to
exceed $25,000, on such property for the occupancy or use of such owners and not offered for sale or
lease. In an action brought under this part, proof of sale or lease, or offering for sale or lease, of any such
structure by the owner -builder within 1 year after completion of same creates a presumption that the
construction was undertaken for purposes of sale or lease. This subsection does not exempt any person
who is employed by or has a contract with such owner and who acts in the capacity of a contractor. The
owner may not delegate the owner's responsibility to directly supervise all work to any other person
unless that person is registered or certified under this part and the work being performed is within the
scope of that person's license. For the purposes of this subsection, the term "owners of property"
includes the owner of a mobile home situated on a leased lot. To qualify for exemption under this
subsection, an owner must personally appear and sign the building permit application.
State law requires construction to be done by licensed contractors. You have applied for a permit under
an exemption to that law. The exemption allows you, as the owner of your property, to act as your own
contractor with certain restrictions even though you do not have a license. You must provide direct,
onsite supervision of the construction yourself. You may build or improve a one -family or two-family
residence or a farm outbuilding. You may also build or improve a commercial building, provided your
costs do not exceed $25,000. The building or residence must be for your own use or occupancy. It may
not be built or substantially improved for sale or lease. If you sell or lease a building you have built or
substantially improved yourself within 1 year after the construction is complete, the law will presume that
you built or substantially improved it for sale or lease, which is a violation of this exemption. You may
not hire an unlicensed person to act as your contractor or to supervise people working on your building. It
is your responsibility to make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You may not delegate the responsibility for supervising
work to a licensed contractor who is not licensed to perform the work being done. Any person working
on your building who is not licensed must work under your direct supervision and must be employed by
you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation
for that employee, all as prescribed by law. Your construction must comply with all applicable laws,
ordinances, building codr,s, and zoning regulations.
I, J P-t Zr do hereby state that I am qualified and capable of performing the
requested construction involved with the permit application filed.
I will assume full responsibility as an Owner/Builder Contractor, and will personally supervise all work
allowed by law the pfl<ffitted structure.
09y OS
O ei wilder Signature Date
Print Owner/Builder Name
2.23.0S- nature
of Notary—S orid,-A
n
to Y ,
MY COMMI SpN pp 2W2 EXPIRES:
March 23, 2008 OwnerisPersonail} 'I nowVtolvft,,om ,rvicga Produced
ID
NGLEt
Ctl Jlt OF CIRCUIT C1dURT
THIS INS ' MOENCEMENPK 85655 F G 3782
CLEWS 0 58465t2
Permit No. ( ' 7 7 NAME J' ES
T 03/2112N5 W-'33150 PIA
State of Florida Wee
y(a dr•t r K • `
8Y D ThomCountyofSeminoleJUR. ---- >z7i 'oe
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.
1. Description of property: (legal description of the property and street address if available)
075 7 1 ' ' v ., oiz Mr- / L O 41) SZ-2 2.
General description of improvement: 3.
Owner information _ a.
Name and address J l LCn Interest
in Property D.,. z s c.
Name and address of fee simple titleholde 4.
Contractor a.
Name and address 5.
b.
Phone number < Surety
a.
Name and address than
Owner) 1
b.
Phone number Fax number c.
Amount of bond 6.
Lender a.
Name and address JA b.
Phone number Fax number 7.
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes: a.
Name and address 4{ A 8.
b.
Phone number Fax number In
addition to himself or herself, Owner designates 11 1,4 of to
receive a copy of the Lienor's Notice as p5,y)ded *Section 713.
13(1)(b), Florida Statutes. a.
Phone number Fax number _ 9.
Expiration date of notice of commencement (the expiration date is I year from the date
is specified) Sworn
to (or affirmed) and subscribed before me this ct I day of NQme_
C c1c -4-de C Personally
Known OR Produced Identification eb L Type
of Identification Produced Ft L— N 3 4 d — `I y I • SS"'' 1lk);
CRCXSignature
of Notary Public, State of Florida Commission
Expires: DEBBIE BLANTON P.
1Y COMMI::SION # DD 188491 EXF!
R2S: February 25, 20 77 1-
80 -3-NOWY FL Notary Discount Assoc. Co. a
different Signature
of Owner 20
O S' , by