HomeMy WebLinkAbout531 N Palmetto DrPcrinit ll :_ 5
Job Address: _4
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1 Date: ( 'O r j _
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Description of Worh: re IL DO
t
ALMA_ Noy<'Fr fr I t • honing:
Valuc of Worlt: S tT -- -•-'-' Historic
District: , Permit
Typc: Building Electrical Mechanical Plumbing Fire Sprinkler/Alnnn Poctl•-,_- Electrical:
New Service -0of AMPS Addition/Altcrntion change oCService Tcmpoe:iry Pole -,;_- Mechanical:
Rcsirkntial Non=Rcsidcntial Replacement New (Duct L:ryout af' Energy CiIG.Rcquirctl) Plumbing/
New Commercial: 11 of Fixtures ll of \rater & Sewer Lincs II of Gas Lines Pluntbing/
NIc\\' Residential: ll of Vl'atcr Closets Plumbing Rep lit- Rcsidcntial or Commercial Occupancy
Type: Rcside5tial Commercial _ Industrial 'Total Square Footage: Construction
Type: , - 11 of stories: ll of Duelling Units: Flood '/.one: (FrNIA form required for other thin X) Parcel
It: Owners
Name Sc Address: Contractor
Namc C'Adth•css. ^ ' Roo
ty 'LF- G S L State License Number: GCisi o ZZ Phalle .
te fax: qQ-7-;Hb-C2333 Contact 'crso: _ AC>e0e_ _P1,onc:40132Z955 Ilondin,
Company: Address: - -
1nr(;
n:^,e Lender: - — -- Address• -
Archited/
t;n.incer: r: __—----_........ .._.....
Address:
Application
is hereby made to obtain a permit to Jo the work and installations as indicated. 1 cerify that no work or installation has counmcnc ll prior to rat issuanceofnpermitandIhatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that . separate permitmustbesecuredforELECTRICALWORK, PLUMBING, SIGNS, WELLS, POOI.S. FURNACES, 001LrMS, I lf.:l"EILS, TANKS, and AIR
CONDITIONERS, ctc. Attach
Prooror Ownership & Legal Descrip(ion) 7
2 VkA-.) V 0 L. L-LPhone:
OWNER'
S AFFIDAV 1: 1 certify that all of the feregoinr infomettion is accurate and that all work will be done in compliance with all applieahlrs lava rr.I;nhrting constructionandzoning. WARNING TO OWNL'R: YOU It FAILURE TO RECORD A NOTICC Ol. COMME•NCCMENT' IMAY f.L•SUI.T IN YOUR PAYING TWICE FORIMPROVEMENTSTOYOURPROI'ERIY. 1F YOU INTEND TO OBTAIN FINANCING, CONSULT W ITI•l YOUR 1.11NDER OR AN ATI'ORNEY
BEFORE RECORDING YOUR NOTICE OF COMI•iL•NCEMENT. NMICai: In
addition lu the rcquirenvtnls of This permit, there may be aJllitit,nal nsurictiuns a, plicablc to ibis properly 111a1 nc,y he found in Ihr. public rcconk of ibis wanly,
and there may be additional permit:: rcquircd I'rum otltcr f; n crnnn:ntal entities such as :voter nunagcn,cnl districts, stale alencic::, ur fialcral al;rncics. Acceptance o
verificatio hawill notify the owrcr of ti,c prapc,;y of the rcquirem '• ,f i'I 'Ja I. la:v, 713. 1 3-
cz- Signature o :
bier/A;;cnl — Date tiir;nat I' omne r/A;;cnG D
c
Jo Print
U
vn r/Age I'x Nam I' ' : Conlnctpr :\gent':: Nano tii_:nalurc
of Lo:ar •Stale of Florida Dalt Sirn 'o
ar Stall: of Flori a I) to ) Y ° DAFNEY
FAYE ADCOCK DEBBIE BLANTON f :. NOTARY
FUWC,
IITATB OF FLOAIDA s. ' MY
C7 OuIr IRI,r,°try i 'i itDiT6 Coll:-1o My_g&M.itliS7CINIYI1MIN41 } D 3%60p
I' Litt—.).[lEti$ FeltrLagt2S.200Z 1-800•3•
NOTARY FL Notary Discount Ann. Co. AI'I'1_
IC'ATION AI'1'ItOVI-I) BY: lnilial Dahl (Initial &
D21' t-lu ... w
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
AFFIDAVIT
COMPANY: Q 6d LICENSE NO: (1.V 7i7i C7 1
SUBDIVISION:
PERMIT NO:
PROJECT INFORMATION
ADDRESS:
LOT:
I, 0 ant, hereby affirm that I am the duly licensed contractor of record for the above reference
permit, that all of the foregoing information is true and accurate, and that the dry -in, fleshings at the above referenced address/lot has
beenhnstalled in accordance with all applicable codes and standar
CONTRACTOR: COC-
Printed
n7z'.4c*
Sign)ifuFe)-
STATE OF FLORID
COUNTY OF
4!
This instrument was acknowledged before me
individual, ,tYt—p6,, tyel -4e . c
c t.-o and who ac either
personally known to me or produced 1
this
day of .Zoo.Zoo< by the above referenced who
ac owledged that he/she is a dul licensed contractor with knowledged
that flshewas authorized to execute this document. He/she is as
valid identification. WITNESS
my hand and official seal this DAFNEY
FAYE ADCOCK NOTARY
PUBUC, STATE OF FLORIDA 2MYComm. Expina DEC. 2, 2006 COMM.
M DDa7M Printed Name: e My
Commission Expires: iz z •
aN NOTICE OF COMMENCEMENT
D tate.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
I sz-n / 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1 I
DESCRIPTION OF PROPERTY (Legal description of the property and street address) '
020 ?sz p COPY
MARTA
31 I •E MpRSEI
GENERAL DESCRIPTION OF IMPROVEMENT IZ. F- ` CLERK OF CIRCU TI COURTTvlrt'nR11
OWNER INFORMATION
Name and address n., 2 b 030 e_ t to
Interest iA property (Fee Simple, Partnership, etc.) 06.a V-5 irjZ
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER41F OTHER THAN OWNER)
I
A
CONTRACTOR
Name and address
SURETY (Bonding Company)
Name and address
Amount of Bond
LENDER
Name and address
31
I
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I
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
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In addition to himselt Owner designates I ti of
to'receive a copy of the Lienor's Notice as
provided in Section 713.13(I)(b), Florida Statutes.
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isr#+/
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Expiration Date of Notice of Commencement
The expiration date is 1 vear of recording ecc iffererit date ;¢ xnpmfi
i
DAFNEY FAYE ADCOCK
NOTARY PUBLIC, STATE OF FLORIDA
o OWne< MY coOMM
xll raD376609 ooe
V
Zoo S is
Day o 19- i
My
Commission Expires• le;; --2 1---Z 0 O o
Pu lic I The
foregoing instrument was acknowledgef before me this I day of 49 by 7jf-'
M% VN r ESL. V OLIL (name of person acknowledged), who is personally known to me
or who has produced 41.1>¢t. i LtC.. V42 o - b0. 13S U I (type of identification) as identification and
who did I did not -ce an oath> o ;
r 09
lap ro
N
cn
WEI
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NN
117
4
POWER OF ATTORNEY
Date:
I, Andrew jT (Andy) Adcock do hereby authorize Ruben Birch
S31
To pull the Reroof permit for . 4 Na
type of permit) (address)
Signature
Stamp
DAFNEY FAYE ADCOCK
NOTARY PUBLIC. STATE OF FIORIDAziMYComm. Expire DEC. 2, 20M
COMM. N DD376609
Per wn to me or driver license # , of State of Florida, County of
Zj I4-t
day of R094
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