HomeMy WebLinkAbout919 Laurel AveC17VOrSA\101U)1'ERMt'1*A1'1'I,luA1lu1Nr ti+ U
CA d3
Pcl•ittit //
Job Address:
Description of Worlc: ' i2j 2
rustoric District: Zoning: Valuc of Work: S_ ` ' `-•-.--. •___.
Permit Type: Building I Icclrical Mechanical Plumbing; rire Sprinkler/Alain
r
Ponl•
Electrical: New Service - If of AMPS Acid i(ionlAlterntion Change of Scrvice Tcmpot`&y Pole _; —•
Mechanical: Iicsidcntini Non=Residential Rcpinccmcnt New —_— ;nOct %_;lyout .0 f>ncr y C tIG, Required)
Plumbing/ New Commercial: // of 1'iXtLlrC:: fl of %),fater ace Sewer I-incs iI of Gas Lir,c.,
Plunibinr/Ncty )<csidcntial: l/ of !alcr Clost s Pluntbili; Run!?- I:csidcnti, I or Commercial
Occupancy Type: Residential Commercial --_ industrial "Total Square rootage:
Construction Type: _ // of sforier: 11 of DivellinC Units: hlood %one: (GIsNtA form requh i for otter tt)zu X)
y...
m tzartr_•.l•:'.:.+[c+z•,-7r,^!tt
Parcel Ih (
mtadl Proof of O-nership I-egal Description)
Ownevs Name tUddress:
tZ o 7t—r 6,—, , Ql., A—,6V ( 9AA9 rl:on: ]Z1—? 8 (—
Contractor \ante S.'Atleh•css: ^ n
i oo 1 2 - N(1 J C Sfl{. {-D _•[ I 3Z`i L S:atc License \unlltr.r: V i! Z?
D _
Zi d—333 /e'oC rh ne: 32Z9554
1'Iwnc.0 Fix: Contact Person`.\ — — "—
Bonding
V
Address: - - ---- —
Architect/17ll,.incer; ` -
Address•. -- ---
Application is licreby.made to obtain a perntitto do the work and installations as indicalccl. ! ct r,ify that no lvorT or install:uion ha ; commencui prior to the
issuance of a pcmtit and that all work wilibe perfonncd to meet standards of all lass, rcgul3ling conslnlcuon,in lhl jurisdiction. i undcrslnnd that a scpantc
permit must be secured for ELECTi.ICAL %VOP\ ',, PLUMBING, SIGNS, WELLS, POUIS, hUI:NACF-S, BOIL1.I'.S, HZAI f-_ILS, TANKS, and
AIR CONDITIONERS. cIc. -
OWNER'S Art IDAV l'I': I certify that all of the forcroing; inromlatlon is accurntc and that ill work will be done, in- compll Ince with 111'ajijtlletlilii i)s )r fhaing
constniction,and zoning., WARNING 1-,0, OWN. L('YOUi FAILURE "f0 RECORD A 1\0 LICE 01r CO3IMCNcr-MENl I.I Y 7\I SUf,L LN 1'UUl' t P,YTNG
TWICE FOR TMPROVT vifN"1'S"TO YOUIt PRUP[iRTY. it YOU iN•1 LNU "t'0 OL'`I'A1N FI1'rUNCiNG, CUNSUC"T V']TI 11'OUIt T•i:NDLI,DR AN
A•I-i'ORNGY BErOIWI- PTCORDiNG'YOUI'\ NOTICE OF CU 41.41".NCG:vigiN'f.
addl.lion Iv.tllc rcquircnlr nt of thl. pcnuli• Ihcrc m:ry be :1eLlitinn;lf i,: a clioni: I,)phe Il.11a 0.7 this-pruperl.y.lh II ntty;l)c, lound ut Ihr put>II recoils of
ibis county, and tierenl:ry`be adehllon,ll pernlltr; requiied I'rbal other t; )wcrnntenl;ll cnulic:; sue h .1., .:':I! r nun;itranenl di t 1u sl Ile II e ncu or fc:d<lal :igcr)cics.
Acceptance of t•rn't is verilicali t hat i will tltl ify the o`'rycr of to l Y of l!I rcquircmc :>f Mori icn Law, fS 7
3!°s
Si naulrc of Uwrlu/ cC (
Sil;laulr o ontraetol Ar nl
1 rint Ot er/Ag In IS'' Na --- -
I'ri t Contractor :UL;cnt':: Name -
v
Data
tit{;ns urc of foully -St: Ic of ond:i U:uc S•,i.aturc of ,\..ary-Suite of hloric,a
DEBBIE BLANTON
Y 00MM ISSIONa# DD 18 8491 Odylnla
1 to IMC or r^"'+l , _ ,aa 1 io ai•' ,: t•uary t2 ncr6V _ DQ3b hn E Eab a
CP1
L'
NbTivy"UfSconnfAssoa.GoTATE OFFLQA_ 1-8_03-tJOTARY oExpires
DEC 2 2008 ^ ^ a, CQMM'#'
DD376608 n r
r
t j•'l lnl I II S I) a r. lIn1U al
U lh l it Itli 1tl ` U (It17G.11 l U
POWER OF ATTORNEY
Date -
Andrew J. (Andy) Adcock do hereby authorize Ruben Birch
To pull the Reroof permit for
type of permit) (address)
1
Signature
DAFNEY FAYE ADCOCK
NOTARY PUBLIC, STATE Of FLORIDA
1 J MY Comm. Expires DEC, 2, 2008
COMM, 0 D0376009
Ngtary Stamp
ers K-y kno;;( me or driver license # , of State of Florida, County of
day of Kn ,-ifi6-
so
r__aa
REGARDING ROOF DRY -IN AND FLASHINGS
INSPECTIONS.
a
AFFIDAVIT
COMPANY: LICENSE NO: (BCD ZZSU
y
B
PROJECT INFORMATION
SUBDIVISION: ADDRESS: 11 A.C
PERMIT NO: LOT:
ry 0 DCD i 1 li ncontractor f r rd f r the above referenceI, affiant, hereby affirm that I un the duly ce sei • record •
permit, that all of the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced addresd1olt has
beenrinstalled in accordance with all applicable codes and standards.
3
CONTRACTOR:
Printed n )
ignature)
STATE OF FLORIDA
COUNTY OF c4tk vl a Le
This instrument was acknowledged before me this day of 0-- ODCi , by the above referenced
individual, who acknowledged .that e/she is a duly licensed contractor with
GTi D P' f tnc , and who acknowledged that he/she was authorized to execute this document. He/she is
ei! town to me / or produced as valid identification.
t I
t WITNESS my hand and official seal thisday of a•- 0/t- Zoo cj , M^ •
y
DAFNEY FAYE ADCOCK NOTARY
PUBLIC, STATE OF FLORIDA Notary ublic MYCommEIIXIDIesDEC. 2, 2008 COMM; #
99376609 Printed Name: I SWI, & 4L40 e—Ae— My
Commission Expires: 1 am
NOTICE OF COMMENCEMENT
80 0 *
tate of Florida County of Seminole '
n 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. I
DESCRIPTION OF PROPER (Le al descri tion the pro
G l L.. Iti
p ( and stet address)
RMED COPY
MARYANNE MORSE
CLERK OF CIRCUIT COURT
GENERAL DESCRIPTION OF IMPROVEMENT IMP FKoo (/
OWNER INFORMATION
Name and address
N
Interest in property (Fee Simple, Partnership, etc.)
FLORIDA
NAME AND ADDRESS OF FEE SIMPLE TTTLE HOLDER•(IF OTHER THAN OWNER)
CONTRACTOR
Name and ad ess - --tom (J D K oo ti9 c D qya_,
Z`7Z
SURETY (Bonding Company)
Name and address WRMI CLM OF CIRCUIT CWRT
Amount of Bond
CLERK' S # 2005049521
LENDER REMRDRD 03/f8/P.M 68147134 AN
Name and address RECORDIN6 RREl3 10.14
n ey
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.
E'7rQir'.rtionrbate of Naliee of t t
fit `t iratPAFEeY Iai f+f16i06i%- f recordin¢ t:::lecs a ditYe »rr :e :c ,if.2.) NOTARY
PUBLIC, STATE OF FLORIDA MY
Comm. Expires DEC. 2. 2DO8 ( l!.!
COMM. # DD376609 J f Signature
of Owner / Sw
to nd sub ribed befo me this _ Day of -!/` f-T j
L _
My Commission Expires: Z Z No
ary Public 4'`'
Zoe 7 The
foregcKrtg instrument was knowledged before me this day of plIn by 3 E
M: ( P t 44, ate-- (name of person acknowled= o is personally known me or
who has produced (type of i en t tca to identification and who
did / did not take an oath>