HomeMy WebLinkAbout915 W 1 StCIIYOFS,iNFURl) 1'IiltNll'1',1l'1I,lCA lvwc. . . ,; .:•.::r, r ••t , ,r +,: ;,;r,r; fs„ :;;
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1 C! (fit li-T ist>r N Fc 2- ( 3•z-71 '., . <.:; . •.
Job Address:
00 F L 47F M o F1 C7 1 ' ` 00 yr'T rl
Description of Work:
a 7 0 ' DO 't
hIistoric District: 'toning: Value of Work: S _------•
Permit Type: Building Electrical Mcchanical Plumbing Fire Sprinkler/Alnrm - Pogl• . _
Tcmpor:iry Polc
Electrical: New Service -11 of AMPS Addition/Altcration ChnnCe of Scrvicc
Mechanical: Residential Non -Residential Rcpincement New (Duct Layout .0 rncrry C iG. Requirctl)
Plumbing/ New Connnel•cinl: it of Fixtures ll bf Waier F< Sewer Lincs t/ of Gas Lines
1'luntbing Repair - l:csiacnlinl or Cotrnncrcial___•___ Plunlbing/Ncw Residential:ll of V;'nlcr Closets
Occupancy Type: Residential I Commercinl _ industrial 'Total Square footape:
Construction Tyne: 0 of St.orics: 1l of Divclling Units: 1, Ioo(1 Zone: (FENIA form required for other thin X)
rzzvm•res
Parcel 0-:
Attach Proof of Ownership & Leal Description)
3Z?% I1Oe . 4(A-N F-0 mo - n •
Owners Narnc Sc Address: .1-(K42Q11
Contractor Nnntc &-`Address: A Do 1J C%—....._..._._...._
DO A- ED I 2KII State Liecnse Number:
1'1 anc.0 Fax: -5D-5- Contact Person: _ q-IvpeoC+` I'honc:
tlondin; Company:
Address:
Mart;;at,,c Leader:
Address:
Architect/Cnoinccr:
Address:
Application is hereby made to obtain n permit to do the work and installations as indicated. I certify that no work or installation has corlmencui prior to theissuanceofapermitandIhalallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. i understand that a separatepermitmustbesecuredforELL•C1TUCAL WORI', PLUMBING, SIGNS, WELLS, POUTS, FURNACES, BOILERS. HEATERS, TANKS, and
AIR CONDITIONINUS, c(c.
OWNER'S AFFiI)AVITI. i certify that all of the forgoing information is accurnic and that all wort: will be done in compliance with all applicable lava m..1,itb Lingconstructionandzoning. WARNING TO OWNER: YOUR FAILURETO RECORD A NOTICE OF COMMENCE1viL•NT MAY RESULT IN YOU11 PAY(NG TWiCEFORIMPROVEMENTSTOYOURPROPE10Y. iF YOU INTEND TO OL''TAiN FINANCING, CONSULT WITH YOUR LizNDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NfZ1'
I(,ai: In addition It) the requirenr:rat:: of This pCnnit, thcrc may be ad+lili++nal 'n^aiclious applic:+blc «t This properly That ncty be found in the public rcconli or this
county, and there may be additional permit:: required lrom uthcr govcrnntcntal entities such a:: water nunagrmcnt districts, stair al;cnt ics, or fctlrral agrncles. Acceptance
or pc lit is Verification that I tvi 1 notify the o"vier of tine pntpc,;y of the rcquircme of Flo ' .Lien 1
l2 Cri i;
na«ncol'Utvt,er/At;enl Uate Jirm«,rt ofConlnctor/Atcnt Ua i-
r 4, e (Z E- I_Ll Print
Ot cr/Ag u I's N me Print Contraclor•A-,Cnt's Name 7-
c5 tit;,
tilt re of t` tary-Stale of Flo t a I) c S;_:,:,fill a ,ovary-. tots o n .a Dare DEBBIE
BLANTON MY
C0161,1k;SION 8 DO 188491 EXPIRES:
February 25, 2007 Utvilcr/
At cnt is 1. -tzno++n ,n Ndc or (fk6RytJtl r(kEi^-: i'+rwa y'di'iir'.'o I'
ruduced IU _._-- ---- -- - -- '" .-------- -- - — APPLICATION
APPItOVIsU llY: Illdg: rinitia!
I)att; (Initial .1: Dale) Spcci +::
t ns:DAFNEY FA.YF NOTARY
PUBLIC, STATE OF FLORIDA MY
Comm. Expires DKC, 2, 2008 COMM. #
DD37f>,60g----------------- Initial::
Uatc)
POWER OF ATTORNEY
Date: Z
1, Andrew T . (An y) Adcock do hereby authorize Ruben Birch
To pull the Reroof permit for W • 14-f -!: - —
I,
type of permit) (address)
Signatur
i
N
ova` Linde A Keeling
My Commission DD359M
OP n Expires December 09. 2008
Stamp
tn!7 ndayof
driver license # , of State of Florida, County of
29@4.
20O'S
fl N X)LI 'kid t O w—• NOTICE OF COMMENCEMENT
OO f (Z rK 'A- 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 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 pror and street address)
illci ItJ 14-( 4-F.i k 02 , l Sz'7-71 GENERAL
DESCRIPTION OF IMPROVEMENT U
RT OWNER
INFORMATION ', EPi1TY. CLCRK Name
and address 1
0 L N l_-o r_ t Interest
in property (Fee Simple, Partnership, etc.) d u— N EiZwr-IFT 2005 NAME
AND ADDRESS OF FEE SIMPLE TITLE HOLDER{IF OTHER THAN OWNER) t
CONTRACTOR
eD e f1C o ,c r N Name
and address T l ZOO
t= C- ECG 44 g , SURETY (
Bonding Company) I
uua aulu iuuur atunl uaiaauul+ Name
and address Kamm
Plila611 wE-W W CIRWIT CW1lT Amount
of Bond MINULE CUl11M BK
05581 PG 0320 LENDER
CLERK' S 0 200500756;2 Name
and address RWIKit.1l M /14/P-KG 09103:32 PX RFCUNDU
H FHiS MIS EE-}
y BBY t holden tti
hilt itiltt#ttt,tttittit!#ttiiliitlsitu!!!#•iitilii!#ii•tt•i•ii#itt#iiitt#Ifni##••• Persons
within the State of Florida designated by Owner upon whom notice or other documents may be served as provided by
Section 713.13(lxa)7., Florida Statutes: Name
and address ss#•
stissstt#stsiiis#•sst#stst•ttrstaitisiirs•iti#rsis#issssrrt•isstisr•it••#issisrirrtirr In
addition to himself, Owner designates of to
receive a copy of the Lienor's Notice as provided
in Section 713.13(lxb), Florida Statutes. t•
ittttt###tt##ti#tiMNiti#ttiitiit#•t###tiiitiiii##!!ii#itiii!#iit#INN#i#tNi!•ti#titiir Expiration
Date of Notice of Commencement The
expiration date is 1 vear from date of recording c diffemmt date. is xrecifird.) DAFNEY
FAYE ADCOCK NOTARY
PUBLIC. STATE OF FLORIDA Signature of Owner MY
Comm. Expires DEC.2, Za.C> Swo
t subs Day ofJA^& ,) tti
L My Commission Expires: oZ vz oZ D o Notal
Pulblic The
foregoing instrument was acknowledged before me this / G day of S,,, 07-5 by
t-
f,A G eQ E L—L t (name of person acknowledged), w is nail own to me
or who has produced (type of identification) as identification and
who did / did not take an oath>
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
COMPANY. Aroeo&l' 00riA36, AFFIDAVIT
LICENSE
NO: C CD Z Z So PROJECT
INFORMATION SUBDIVISION:
ADDRESS: PERMIT
NO: LOT: I,
A_NJ0L_j AW4<: affiant, 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, Aashings at the above referenced address/lot has been
installed in accordance with all applicable codes and standards. CONTRACTOR:
Printed
n ignaturc)
STATE
OF FLORIDA COUNTY
OF This
instrument was acknoww- lodged beforemethisdayofM a- Zoo S , by the above referenced individual, A
W I> L., 1> e 000' Z -,who acknowledged that he/she is a duly licensed contractor with 4-r
o p r off. r A. , and who acknowledged that he/she was authorized to execute this document. He/she is either personally
known to me or produced as valid identification. WITNESS my
hand and official seal this /2 day of go;uiblic
Printed Name:
MIA `A • k- . l My Commission
Expires: Z oo Linda A
Keeling My Commission
DMOM w V Expires
December 09, 2005