506 Plumosa Dr 05-494 RoofCITY Or SANh01.2D .. -
Pcrittit lF :_L N (
rob Address: oeo PLV M o S
Datc:
Description of Work: IL UO it
Historic District: Zoning: Value of Worh: S l40 D. T 1Tvrat
I'errnit Type: I3uitding Elcctriatl Mccitanical I'lunibing Fire SprinkicrU'.arm
Electrical: New Service — it of AMPS Atiditiort/Altcration Cilan c of Service l:cmpot iry Pole—,__
Mccitanical: Residential_ Non=Rcsidentisl Ile0iccmcnt New (Duct L:ryout . I;ncrgy Ci Ir, Required)
Plumbing/ New Conuncrcinl: 11 of Fixtures Il or Water &cc Sewer Lines 11 of Gas Lines
PlumbingP.epair— ]csidcntial or Commercial
Plumbing/Ncw Rcsicicntial: 1l of Water Closets
Occupancy Type: Residential Commercial _ industrial Total Square rootarc:
Construction Tyne: 11 of stories: 11 of Dwelling Units: Mood Tolle: (Fl ivfA form required for outer than X)
Attach Proof of Ownership do Legal Description)
Parcel 11:
VAr-j t'T /4' kAt,.tuT r7 o(o PL"M0-5A 7 e 3Z"77
OwncrSNaoie Address:
1' Ito rz c: ........ ..
ppC a I --
Adtlress: `H Contractor Name
Soo C-2 Ne J L S ri D I 3Z?_1 L State License umbcr: _Ci
hone &gas: Contact Person:
Bonding Company: -- ---
Atldicss: - -- —
lort;'a^e LcItdcr: _ —• ------ ----'
Address: —
Architect/rtlginccr:
Va`: - --
Address:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has comnIC11MI print' It) III(: issuance of a permit and that all work will be performed to meet standards of all laws regul3ting consintcuon in this jurisdiction. I undcrstantl that a sePanrcpermitmustbesccuredforFLECTRICALWORIC, PLUMBING, SIGNS, WELLS, E1001-S, FURNACES, DOiLI:RS, HEATERS, TANKS, and
AIR CONDITIONERS. etc.
OWNER'S AFF DAV iT: I certify that all of the foregoing information is accurate and that all word: will be done in cornplinnce with all applieahle. la\vs rrgnl*cling
constntction and zoning. WARNING TO OWNER: YOUR rA1LURES
E,TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT I.1 11'OUI:.PAY (NG TWICE•
FOR IMPROVEMENTS TO YOUR PROI ln'y. IF YOU INTE•ND'1.O OBTAiN FINANCING, CONSULT WITH YOUR LENDER OR A.N ATTORNEY
DEFORIi PJ CORDING YOUR NOTICE: OF COWMENCEMI?NT. Ill
addl11011 Ih 111C I'e(iU11'ellll:Ill,'; Of rill!: 1>!Illlll, llll'f Imly he additional ic;irictions applicable to ihi:: properly that nta), be linnul in tile public records of this
county, and there miry be additional permits rcyltircd front other got'crnntcnCtl Cntitic:c such :1:; w;I nt:ntagcntcnl disc: ictssl:lto altenc a:::, or (iaicr Igeflcier. AccCptanec Of
P 1-11t k vcri(icalio hat 1 wi11 n tify the otv r of rite property of the requiremcllx )f Fl icn fart, FS''11 . tgn:Ittn'
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Agent's Name Sit;naunc
of Notary-St:uc of Florida 1.h(c Owner/Arent
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LICATION APPROVI D BY: 111d1': — _. Lollill: _ rinitial2. at).
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November 12, 2006 rFOF FtOQ-\
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date0MEGANB.
VANDEN BRINK r, date
kNotaryPublic - State of Florida M My
CommissionE)q*m Aj4 5,2006 S Ul rc 0. f D
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POWER OF ATTORNEY
Date: //' — D 4
I, Andrew J. (Andy) Adcock do hereby authorize Ruben Birch
To pull the Reroof permit for 56& PI- Gar? o4A -De--
type of permit) address) !
C( —3Z-7-7 SAN'Oz o, 6%
j Linda
A Keeling My
Commission DD359999 oExpires
December 09, 2008 Stamp CPersonallyo
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tom e or driver license t# , of State of Florida, County of day of
A/ ' V& ILI 13 E 14 , 2004.