HomeMy WebLinkAbout907 Laurel AveaPc0.
1 rittit !/ :
Job
Aa(It ess: t-3 0-7 Description
of Wor1c: Ic—Li 2ao F Histor-
ic District: Zoning: C1,
YOFSAN1 01,u) l-A1 I'l,Al')'! I(.;,\ilul'i': Date:
y
Value
of Work: S 1 7 3 110 ep U _._...._._._. Permi(
Type: Duildinz, Electrical Mechanical Plumbing fire Sprinkler/Alarm Ponl•^—_• ElectricaLNew
Service —11ofAlvlPS Addition/Alteration Chan(;eofScrvicc Tcmpot:iryPolc—,--__• Mccha:t!
ca!: Residential _Non=?csid(ntial lteplaccmcnt Ncw (Duct Layout & f ncrgy Ci1,IG; Rcquimd) Plumbing/ New
Commercial: 1/ of fixturcS 11 or Vhtcr & Sewer LincS it or Gas Lines Plumbing/Nciv
Residential: ll OrVA'atcr Clorcls Plumbing 1\'pair— Residential or Commercial ,-,- Occupancy Type:
Residential Commercial _ In(lustriil',— "Total square Footage. Construction Type: —
11 of St:ot•ics: 11 of Dwellinr Units: 1.loo(I Zone: (rrNfA fora, required ror other(hsn X) Parcel 1/:
Owncrs Name
S Address:J zi1Z0 7/
l,"6,-- Attach Proof
of Ownership & Lcyal Descrip(ian) Ar 60
Cam__ —tea o ' S'-- _.... _._..._ Contractor Name
C' Ad(Iress: ,3z_ale
iccnc^hSoo C-2 l 7i o zz,1. Phone .0
fax:71 77-76-'333 Conl3c( Person: —_Phone: -3zZg
r—J Bondin,^ Company: ---
1(1
rCSi: lnrl a
C Le der: i\(ldress:
Architect/rnl.
inccr: A(ldress:
v Fax: ----- -- ._....._._.__.......... ........ .
Application is
hereby made to obtain a permit to do the work anti installations :15 indicalcd. I ccr,iry that no vrorl: or installation has comn-lenced prior to the issuance ofapermitandthatallworkwillbeperfonnedtomeetstandardsofalllawsregulatingconsinictioninthisjurisdiction: I understand that a separate pcnnit must
be secured for GLL•CTIi1CAL \VOP\}:, PLUMBING, SIGNS, \VGLLS, POOLS, FURNACES. BOILI.F'S, HEATERS, TANKS, and AIR CONDITIONL-•
RS, cic.. . OWNER'S
AfF(()AVI"I : 1 certify that all oCthc Cer'}joinl; inCornulion is accurate and that all work \rill be don( in compliai,cc \viol :ill applicable, lava rc;;nLaing constnution and
coning. \YARNING 10 01'11SLR:;YOU1t FAILUi'IN10'jCO,RO,I/l' 10T(CL Of CONa1 ICNCL•T`4GN1' MAl ,ESULL 11 ! 1'OUl' t'/,.Y(UG TWICC FOR
i1vf1'ROVG1virN'1'S f0 Y0' U1t Pf\01'[il\1Y: IF YOU \ FINANCING, CONSULT W11'1I POUR: LI:NDL"•ROIL AN. _ A170RNEY BEFOI'\
I RECORDING YOUR. NOTICE OFC0VI1.4C-.NCG.4iiN"I'. NO Il('
li: In addititni.to lh'-cduircolcnts of this permit• ilicrc n1:ry be a(I lilinnal icstrictions ap;,lical,lc to thi:: prtq,crly that rn:ry be found in ill(: publi'rcconli of this county,
and there may be ad(liti<inal j,cnnio: reyun'c(I from other 1; n crnn,cnud cnlauc:: such a:: water n::utaPcnlcnt di:ands, star. aj;ciir,tc::, ur ((:(legal aginctcs. Acceptant' of )
crmit is verification a(I tail notify tc ov-'r.cr 7f rite prq%;,et;yCof the requircmc s Rorida t I-aw, FS 71 uu'e
of 0, 'r/i\j;cn ,/1 - 'a ):uc tii[
rnurc of nartctor/A1, lit. - A k •(
SS6 rinl 0%
WAg tI's Nan r7 I(
j ID 7 Sit;na -
c ofNI, tary-Stale I' FI ac :a J D u
I'
rit' •onlractor:\
t;cnt':: Nan,' Sita:aturc of
i..:ar}'•St:u of:Florida Date C'n:t;::
ic og ii t iil aii ITQ1(7 \•1< 01 Uwn'r/A•
rcnt i:: _ I'crsonal_I> i' L ur, I'r ula
TJIYOtvt Rl S10N #,
DD,;1S8491 47'41-800
3-NOTARY FL Notary Discount Assoc. Co. DAFNEY,FAYEADCOCK NOTARYPUBLICST (, %
L c+: ii qT FFLORIDAnnan1P — In,
tial l D t: In, 1 al1,a DD37 Npecu!Con.
fitiun:;:---------------_ ----
a
POWER OF ATTORNEY
Date:
I, Andrew J. (Andy) Adcock do hereby authorize Ruben. Birch
y
To pull the R e r o o f permit forO Q t.t,
type of permit) (ad ress)
C4
J
Signa
W
DAFNEY FAYE ADCOCK
NOTARY PUBLIC, STATE OF FLORIDA
MY Comm. Expires DEC. 2, 2008
comm. # D0376609
Stamp
Personally knn to me or driver license # , of State of Florida, County of
day of 1 ram (—
Zo s
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
AFFIDAVIT
COMPANY: AfW064_1 o N LICENSE NO.
PROJECT INFORMATION
SUBDIVISION: ADDRESS: d 7 L a (. , ck 4-ve-
e c:z-7
PERMIT NO: LOT:
I 1ti+ r- 6C-" affiant herebyaffirm that I am the duly licensed contractor of record for the above referencey
permit, that all of the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address/lot has
been,installed in accordance with all applicable codes and standards.
CONTRACTOR: 6,_ P> Ca(
Print nam )
Signature)
STATE OF FLORIDA
COUNTY OF-eyKL &V
This instlt ment was ac owledged before me this day of /- Z °O S , by the above referenced
individual, -1 " 1 r2t o d-t--*'_ who acknowledged that he/she is a duly licensed contractor with
1 A;4 - C v F r7t_. n e, c>A , and who acknowledged that he/she was authorized to execute this document. He/she is
e, person to me or produced as valid identification.
Ck.r
WITNESS my hand and official seal
DAFNEY FAYE ADCOCK
NOTARY PUBLIC, STATE OF FLORIDA
MY Comm. Expires DEC. 2, 2008
a a; cow # DD376609
day of w 7Z .
Notary Pub is
Printed Name: ( A'
My Commission Expires: Z z Ze°
a p NOTICE OF COMMENCEMENT
g o /J ` 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 rop perty, and in accordance wit(iiElWWO COPY
713, Florida Statutes, the following information is -provided in this Notice of Commencement. MARYANNE MORSE
DESCRIPTION OF PROPERTY (Legal description of the property and street address) CLERK OF C RCUIT COURT
SEMf %b LsLtti EC, r; li v rsCtaj ( 2`t`i 1 NTY, FLORIDA
D CLERK
GENERAL DESCRIPTION OF IMPROVEMENT i2r
1
OWNER INFORMATION PW-y—b
Nam-- and address tI-,,o g E iZ t - . 2 1 i S D tJ 7 l Z o (7t1 + 4vAlp— t—' Pa.
Interest in property (Fee Simple, Partnership, etc.) oi-+ r-JEZ
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER•(IF OTHER THAN OWNER)
SURETY (Bonding Company)
Name and address
MARYANNF NOW.. C1.10 GE CIRCUIT CMJRT
Amount of Bond SEMINOLE COLWY
BK 05662 r #G 0351
LENDER CL_ E RK % S # 200504 25
Name and address l;!f<MDED 93tP i eu L-34 AN
T1IN -FEES 10
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(l)(b), Florida Statutes.
Expiration Date of Notice of Commencement
The expiration date is 1 vear from, date of recording unless a differ°rt :iat is cro-r•i Pei Z
V `
Signature of Owner j
ADCOCKDAFNEYFAYE
SW b cribed be re me this I 1 Da of N^' ZOD G . M' y oorARY PUBLIC, icesSTAEC FLORIDA
2008
I
Y /
MY Comm. Expires OEC. 2, 2008 a.. al
yi COMM, # DD376609 My
Commission Expires: )Z _ oS' 14—
Theffjegoingrostrumwasacknowledgedbeforemethisday of `- , - 9 by K (
name of person acknowledg o is rsotin
ykno 0 me -
or who has produced (type of i tcahon i rcauon and
who did / did not take an oath>