HomeMy WebLinkAbout15-16228 C1TY C!F ZEPHYRHILLS �
5335-8TH STREEi'
_ ;.
�si3)�so-oo20 16228
` ' ' BUILDING PERMIT
�PERMIT INFORMATlON LOCATtON WFORMATION
P�ermit Number: 16228 Address: 6948 GALL BLVD
Permit Type: Ct3MMERCiAL ZEPHYRHILLS, FL.
Class of Work: ADD/ALT COMMERCIAL Township: Range: Baok:
Proposed Use: NOT APPLlGABLE Lot(s): Biock: Section: �
Square Fee#: Subdivision: CITY QF ZEPHYRHlLLS
Est.Value: Parcel Number: 02-26-21-0010-00800-0134
Improv. Cost: 55,000.04 OWNER INFORMATION
Date Issued: 5J14/2015 Wame: PMPM INC
Total F�es: 637.50 Address: 7561 49TH ST N
Amount Paid: 637.50 PiNELLAS PARK, FL 33781
Date Paid: 5/14/2015 Phone: 817-538-4945
Wark Desc: REMUDEL 3,000 SQ FT
GQNTRACTQR S APPLiCAT10N FEES
T R R BUIL IN GON C O L C U L ING FEE 457.50 ELE T I AL FE 60Ad
RQGERS E�ECTRIC PLUMBING FEE 60.00 MECHANICAL FEE sa.ao
RED GAP PLUMBING
MERCURY HEATING AND A{R INC
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- ins ections Re uired
O R 2ND Rt�t1GH i�L B M S N�-ULA°fl C ILING
FOOTER BOND DUCTB INSULATED SEWER MISC.
ROUGH ELECTRIC LWTE� M1SC MISC.
1ST ROUGH PLUMB PRE-METER 1NSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING M1SC. MiSC.
CONSTRUCT{ON POLE FFtAME MISC. MISC.
itEINSPECTION FEES: Reinspection fees wiii camp{y with Ftorida Statute 553.8Q(2)(c) when e�ctra inspection
trips are necessary due to any one of the fotlawing reasans: a)wrong address b) condemned wark resuiting
from fauity constructian c) repairs or correctians not made when inspecti�ns called d)work not ready for
inspectian when callad e) �ermit not posted an job�ite Y� ptans not at job site g}work not accessible.
NOTICE: In addition ta the requirements of this permit,there may be additional restrictions appli�able to this property that
may be found in the public records of this county, and there may be additional permits required from other governmenta!
entities such as water management, state agencies or federal agencies.
"Warning ta awner: Yaur failure ta�record a notice of commencement may resulfi in yaur paying tumice for
improvemants ta your praperty. If yau intend ta obtain financing,consult with your lender or an attorney
before recording yaur notice of cammencement."
Comptete Plae�s,Specifications Must Accompany Application.AII work shall be performed in accordance r�rith
City Codes and Ordinances. NQ�CCUPANCY BEFO C.4.
r
�CO CTOR SIGNATURE PERMIT OFFI R
PEitMIT EXP'IRES IN 6 MC►NTHS WiTHOUT APPROVED INSPECTI(?N
CALL FOR INSPECTION - 8 HOUR NOT�CE REQUIRED
PROTECT CARD FRt3M WEATHER
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City of Zephyrhills
BUILDING PLAN REVIEW COMN�NTS
Contractor/Homeovmer: �(,l,(�d'�Q� �G�i(d I
Date Received: �- !� �—I�
Site: �� �7" � �j�,� � � I/�U
Perrnit Type: �����;� L �� � �� �
Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑
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a�D i t � /�� � �2°�6?�
a��,� �� ������� �C� � � ���6/-�
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This comment sheet shall be kept with the permit and/or plans.
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Ka S —Plans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
.r I IIIIII IIII�III�E III�I�Illl lll�f 11111 IIIII IIIII lil�f lilf f�ll
, 2015059745
'~i�cpt:1675539 Rec: 10.00 �
DS. 0.0@ IT; 0.0@
@4116J2015 T. S. , Dpty Clerk
N?�DTIGZt'OI+'{:O�t�IM�N{.'EM�ENT r�RULA S 0'NE I�,Ph D ARSCO Ci�ERK & CO---- (�pj�p��Ek
04/16/2015 11:5$am 1 of 1�y
Permit No. OR 8K ���� FG ��r��
Praperty Identificadon No.��L-Z�'Z i^f7D�lJ-(�V�jG��0��
THE LINDERSIGNED hereby give uzforms you that the improvement will be made to certain real pruperty,and in accordance with
Secrion 713,13 of the Florida Statutes,the following informatlon is provided in this NOTICE OF COMMEIVCEMENT.
Ptt P P rtY� g �G � �.e.t���O Z.. �CS?��C�_'`-�l`�'a���,Z ���Gq
I.Descri on of ro e le al d�Jp4n:) FS�L� �n , r 2(v Z{ ����
a)S�eet Address:__ y' � a4-1 l V'.L�
2.C3enaral acscriptian ofimpravements: (}�,��t.p ,�- �,,e,t.� -t c,rY�5� �_
3.OWner Information
��rr���,a�aa��s: R�P���'�•t.� 75��.�11-15� r� P��.r�-����" �tas� ��- L ��`���
b)Name and addrese of fee simple titlehoider(if other than owner)
c)Tnterest in property
4.Contractor Informatiou l i �
a)Natne and address:Ga r� T�''j`^'�' ��f2.�j�0 A"�QYjdY� S'`�. �'.,.�'i�i+�,t� �r ����
b}Telephone No.:"').��-�f,'8 . /� �'� Fax No.(Opt.) �a 7^��=�±',Z. �Z
S.Surety Information
a)Name and address:
b).Amount of Bond;
c)Telephone Na: Fax No.(Qgz.}
6.Lcnder �
a)Name and address:
Phone No.
7..Tdentiry of persan witfiin the State o£Flarida designated by owner upon whom natices ar oiher doeuments may be served:
.. a)Name�and 8ddress: . ` ` . , �
` b)Telephone No.: Fax I�To.{Op�.}
8.In addiriou to himsel�owner designaYes the folIowiag person ta receiva a copy of the Lienor's Notice as provided in Section
713.13(1)(b),Florida Statutes: ..
a)Name and address: �
b}Telephane No.: �= F�No.(4pt.}
9.E�cpiration date ofNotice of Commencement(the expiration date is one y�aar from the date of recording unless a diffeient date is
speci5ed):
WA�2NING TO OVVN�ER: ANY PAXMENTS MADE BY TI3E OWNETi AFTEIt THE�XPIRATION QF THE NOTICE OF
COMNIENCEME1+tT ARE COPiSIDERED�PROT'ER PAYMENTS TJi�IDER.CHAPTER 713,3?ART T,SECTIOIY 713.13,
FL;dRTDA STATOTES;AND CAN RESUI.,`I'TN YOUR PAYING TWICE FOR IMF'ROVEMENTS TO YOUR PROPEI2TY.
A NOTICE OF C4MMENC'EMENT MUST BE RECORDED AND PQSTEb ON THE JOB SITE BEFURE THE FIRST
INSPEC"1'ZOIY. IF YOU INTEIYD TO OBTAIN FIlYAIYCING,CdNS`[7LT YOi7R LElYDER OI2 A'�TORZ�TEX BEF'{}RE
COMMENCING WORK Olt RECO�tDING YOUR 1V'OfiICE OR CO NCEMENT.
�
STATE OF R[,OR1DA
C4t1i+iTY OB PASCd
I 5 re of Owner or Qwner' Au oriad O�_ lDirackor/Partna/Ivfineger
�. C� C.�ExJ D•��''
rcinc Nau,e
The foregoing insuument was aclmowledged bafare me this�(p�day of�i�l „ ,20�by��arl ►J`` �
as {type of authority,e.g.offscer,hvstee,aitarney
in fact}for (name of party oa behal£ om insirumant was e� ute�.
PersonaIIy Known_OR Produced Identlficatian Natazy 3ignature � 'tx'Xd�- � .�_
�
Type of Fdenti8catioxi Praduced G-` �J�-�V�✓sl���e(P�x) �-�- �+-'��- �
Ver'efication pursuant tQ SecYian 92.525,Florida Statutes.Under penalties aPgerjury,I declaze thaY I hava read tha foregoing and thai
the facts stated in it are trae to tfie 2�est of my knowledge and beIief.
Signanue af Nsa��at Puson Sign3ng Above i
FORMSRiOC.rvndIIDW ��W'�
�Fxu, � t •;•,M1�+•r-r
Y Pr�1 UEL�NF� ..-�.
,����„ ..�..�.�...,... ��,,....t;�;;: JA LI
*+,�s�.r�%��. JACQt1ELINE BO�ES -�:.�� :�= C " is'.�a �i��ion i?t=F t°'4_2
su ?
_�. �.= Commission#FF 150422 '�:;t,%�:��,; �' b -��4��`r��Emb�r 1 Z.1013
�•.,r� anded Tfyu froy Pein In::urancu B�(�:i.q5.'019
�y; �4;: Expires December 12,2018 ;r;t�'� ����r�� �:�•�• �
�g����{��� 9anded 7hru Tray Fnin iRSUrenca 80a389d019 -`' .,. . �
���-�W�N GIryoTZephyrhllls PermltApplicatlon FeX-s�a-�eo.00z�
, � . Bullding Dapertment -
')ataRecetved �(��r� . ,•�n ��
Phone Contact for Parmlttln �Jl.i
Jwnofs Nam9 � fvt • G. Owner Phone Numher 38,•� 9 �
�
:wnor's Addreas 7 �� � � ('%� F' Ownar Phona Mumber
�ea Slmple Tltlaho(der Nama Ownei phono Number
��ee Slmplo T�tleholder Address C�'�j �pr�� �,[
IOBADDRESS LOTit �
IUBDlVISION PAEtCEL IDH
(08TAtNED a PROPERTYT�TICE)pEMOLISH
NORIC PRDPOSEO NEW CpNSiR ADDlALT Q SION
e INSTALI '� REPAIR ,
�ROP08ED USE [� SFR � COMM � OTHER
1YPEOFCpNSTRUC'f10N Q BLOCK FRAME Q STEEL Q '
SHSCRIPTIpN OF WORK ,1• l a f
1UILDING SIZE 8q FOOTAGE HEIGHT �
' QBUILDING S �� VALUATION OF TOTAI CON9TRUGTIDN
QELECTRICAL § AMP SERVICE L] PROORE38 ENERGY Q W.R,E.C. ,/•` �Z�
[�PLUMBING , $ � ���ii riP
MECHAN1CAl � ��� �J
� � VA�UATtoN OF MECHANICAL INSTALLATION 7. �'r�,�j$/�Q't'�"�
[�GAS Q ROOFING [] SPECIALTY Q 07FiER �y�
NvW
�INISHED FLOOR EL�VATIONS � FLOOb ZONE AREA QYE3 NO a l;t�'f�M.J p��'C��
Q1J►1Prsh�t
iui�oeR ' ��� �coMP�wY 'y"v r n e►^ I�v,`�r'� �vt'lv�cc�S
IIGNATURE � �cis� Y!N F�cuHF�n` Y 1 N ,
Addreas ��¢� ' /y.�i i �ti 1� 1-l� ayb/a
� Uoense# ��G O�j ��a�
ZECTRIEIAN � TyT^-- � � COMPANY G G��' �GE'C���C�L
lGNATURE REGISTEAEO Y/N FEHCURREA J
Atidrees
,LUM9ER COMPANY
IGNATURE rcEC�sr�rseo Y/N FEE CURREA Y I N
Addresa ��
se# /�
(_ � � K-�/�'n
COMPANY /�Iz
`GNA7URE� `L REGISTERED Y/N V FEE CUqq6p Y/N • �
Addr9as -- ���
�.��, --^�_ , /
(d �°
7HER COMPANY pr++u•�
IGNATURE RECISrEqEp Y/N FEE CuRREA y�N ��
Addroos
Llnenae#
ESIDENTIAL ptlach(2)p�ol Pians;(2)sets af Bullding plene;(1)cet oF Energy Fortns;Fi-O.W permH for new conatructton,
Minlmum tan(19)Wprlcing days eRer auhmlNfll dale, Requtred onslte,Con�truciion Plane,S�ortnwater Plans w/SIIL Fenoe Installed,
dMMERCIAI. Attaoh 3)complste els o}B tlding Plan p ue a�NerSakH Page;(1j etof Eergy Fortns,R-0-W Permit for new conslniction.
Minimum len(10)warking daya'okor au6mlltal data. Requfred onslte,Cons W dlon Plans,Slormwater Plans w/Sllt Fence installad,
SeNtary FaaHllles 81 dumpster.511e Work Pertnit for eQ new proJeclg,M commerclal requlrements must meel compifence
GN PERMIT Attaoh(p)sete oI Englneered Plans,
""PROPERTY SURVEY teqvired(or gll NEW constructlon.
�
wctlona
FIII out eppliratbn campletely.
O�+mer 8 Contrector sign badc af appl(ratlon,notetized
If ovor a2900,a Notloe of Commancomant Is requl�ed. (16/C upprades ovor 57500}
Agent((or Ihe contrectar)or Power of Attorney(for Iha ovmer)wou(d be somaone w1►hnptarized.ielter(mm owner authonzing eame
rER 7HE CDUNTER PERM�TT�Np (Front of Appllcatlon Only) . � '�+-` • �
uoofs If ahinples Sewers Servioo Upgradea'A/C Fences(p�ot/SUrveyjFodtaga).. ••
Drlveweys.Notover Counter If on pu6iic roedways..needs ROW�.;,, ''
„��r.
���-►aU-�,��v Gity of Zephyrhills Permit Applicatian Fax-813-780-0021
Buitding Department
Date Received y'f'--��j�'i�j phone Cantact for Permittin �V �
Dwnar's Nam� Q � ' �- Clwner Phone Number " _ J�t �,,,
7�'{rt y�'`i► sr � �
Ownec's Address �'!G �� � Qwner Phone Number
Fae Stmple Titlehoider Name �`� � Owner Phane Number �� �
Fee Simpie Titleholder Address ��� Ca tkl l ��, !r
J08 ADDRESS LOT# ��
5U8DtViSiON � � PARCE!Id#
(QBTAlNED FROM PROFERTY TAX NOTiCE}
WORK PROPOSED • � New coNSTR� ADDlALT [� S1GN Q Q DEM0�18H
IPISTALL REPAIR
PROPOSED USE ' Q SFR COMM [� OTHER
TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL Q
DESCRlPTiON OF WORK ✓t��r' �d�S �"'�
BUILDlN�SIZE �� i� SQ FOOTAGE HEIGHT ���
QBUILDING $ �� � VA[.UATION OF T,OTAI CONSTF2UCTION
QELECTRICAL �� AMP SERVlCE Q PROGRESS ENERGY Q W.R.E.� /'! ��,,�
� IlQ
QPLUMBING $ ` ������„�,,
i L ��JMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION '�i �,,�5 /lQ� '
OGAS Q ROOFIMG Q SPECIAI.TY 0 OTHER ����
°INISHED FLOOR ELEVATIQNS FLOQD ZONE AREA QYES NO � ���`�� ��� S�
fi�Jner�r�'
3UILDER ,� „� �L�"`_ _...,...�-���r COMPANY V f�'1<'•tr �V�`t� �317 L,p �"'�H'c%c�.lM+�`�
M,�
>IGNATURE REGISTERED Y/ N FEE CURREt� Y/N
Address ���� f'!��t S✓� �i�t t'�• ��f Z} License# �,�� C..�c3 �L��(1� �
cLECTRI�.''IAN �" �' � GQMPANY G G l�pLS ����"CJ�`L.� t,._
➢IGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address
'LUM ER cyi� � COMPANY
iIGNATURE REGISTERED Y/ N FEE CURRE� Y/N � ((
v-�r�e
�Addeess license# �,���,�
(` v n+'Z
� C ANICAL ����,.� \(1 COMPANY �
;GNATURE `�1 REGISTERED Y/ N FEE CURRE� Y/N
��2
Address �
►THER COMPANY �/���
��`��
�lGNATURE REGISTERED Y J N FEE CURRE� Y/N � ""`�
Address i L�cense# � �
;ESIDEN'TIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of EnergyForms;R-O-W Pertnit for new construction,
Mi�imum ten(10}worictng days after submittat date. Required onsite,Canstruction Plans,Storrnwater P{ans w/Sil#Fence Instalted,
Sanitary FaciliUes&1 dumpster,Site Work Permit far subdivisfonsllarge pro�ects
OMMERCIAL Attach(3)complete sets af Butlding Plans plus a Life Safety Page;(1)set of Energy Forrns.R-O-W Permit for new construction.
_____ Minimum ten('1 d}working days�after submittal date. Required onstte,Construction Ptans,Stortnwater Plans w!Silt Fence installed,
Santtary Fac!!(ties&1 dumpster.Site Work Permlt far ail new prajeots.AI!cammerciai requfrements must meet campitance
IGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for ati NEW consttuc#ion.
Iractlons:
Fitl aut applicatian completely.
Owner 8�Contractor stgn back of appiicatlon,natarized
If over$2500,a Notice of Commencement is requ9red. (AIC upgrades over$�500j - _ ,. ;, . „
Agent(for the contractor)or Power af Attomey(for the nwner�wo.uld be someone v�it�<natarized�letter from owner autharizing same `
VER THE COUNTER PERMITTING {Front of Application,Only)._ - ' '��''"°` ` � � � .
eroofs if shingies Sewers Servlce�Upgrades'AJC ����Fences(PIotlSurvey/Fodtage);` ,`' '
>>. � , -
Driveways-Not over Counter if on public roadways..needs ROW i,,,.,.. , • ;Kt,,.;,�;,,�;
_
• .,.:r:�
� ���-,��� City ofi Zepfiyrhifls Permif Appl3ceitan F�$»-����
8ulEding Depssim�t
' �ete Recetvgd '"�'.-j�j-�f� Phona Contact(or Parmfltin �Q 3
Ownot'e kame t✓\ ' L'�. owrter Phona Numbar 3���
� ar ��
Qwneta Address � 4� � (' FL.. �wner Phoae Number
Feo 8imple'FR1s6atder Name �! � Ownsr Ahons Number � �
PeeSlmpleTTlleholderAddraas �� L�cr6l /,��
JbeADDitESS COT# �� i
BllBDiViS[dN � � PARGEL t0#
(CBTAIHEDFRUM PROPI'AtY tklC HG2ICE}
WORKPRAPOS�D Q NE1NCON5TR� ADl]/ALT [_� SIf3N Q („� 4EMOLISH �
U IMSTACC REPAIR
RROP09EI?U8E Q SFFI COMM � OTHER
TYP�Of CQNBTRUGTiON Q BLOCK � FFAM6 � STEE� Q
OpSCftlpYt�}N OE WORK = � :7�� �
8UILGlHt39lZE ��`� SQ�OOTAGE HEfiONT C_„_�
�BUItDtNG $ ��� Vkl.uq71pP1 OF TdTAL CONSTRUCFION
QELECTRICAl. �t—� AMP S�f2ViCE �] PRQ(3RFS6 ENERGY Q W.R.E.G. p���7,.P1
o������ $ j ��
z,��" �
QMECHANICAL $ VALUA770NClfMECHANICALIN37ALlATIQN �- ,�'(,(,,�JS/1���%
�OAS Q ROQPlNG [� SPEGtAS.7Y� OTHER �� �— ` ,.,�� � )
C.� �j
7N(SHEDFLOOftELEVA'f10NS � FIOQDZOtV�AREA �YES tt0�l:s.���'� ��' �Y Jitd'w i
C�Me��
iUIIDER �„ ���, +�CBMPANY ��V t'rk�5r' !��t;L��t1q t-_d Yl`�YuG�S
3IGNATURE [�c18t�aEO Y!N KE�clta��n YfN
adarese �'�O.G' = ."�,�,.�f,y�s�1,�; �'ii� �1�, �6j�' us:a,�ae#����t5,�t�'i�t7�. 1
:LfCTRiBiAH j 4,� `� , GOMPANY �V iF�.� �t'�'��'t��— �
iIGNATURB ^-"''• ttEGI:T3iEO Yf N FEECURREh Y!N
Addresss �
�l.UM�ER C4MFANY 1�1t` t-�b f �VtH� �--=�1"
IIGNATUR� RE013iEHE� Y1 N ��aUAa�t. YIN
Addreas � ��r ucsnse# i � � X�tf rl
�EC ICAL ' 1t1 COMPANY CiY W�.� I �'2 jC
A3NATURE �tiC� t�ctsr�t6o Y/N FEeCU YJN
Addrese i,icense#� � '
1THE12 COMPANY �
=tt�NA7t7R8 � � RECisT�RED Y J td F�csa�q� Y/N
Addross Lfxnsa#C�^��
;�SIpEN1TAf. Attach(�Piot Pfane;{2}seb of Bulfding Pfena:(t)setoi Ene�gy Fo�ms;R-0 W Petmft for nelv construoUon,
M}3nimutn ten(16}uvocking days aftersabmtttai dals, Required oneSie.Caostnm4on Ptens,St�tmweter pians wJ Siit Fence inateited,
Sanitary FacfitUes�&1 dumPSlar,Slte Worlc Permit for eabdlvislansAarge ProJeads
4MMERGtt4t. Atiach(8}ccmpleta sate ctBuEdeng Plans pfus e Ufa 3ataty pa�e;{t}sat c#ERergy Fa�ma.R•O W Pem�It for naw constcuWan.
Mlnlmum len{90)work4tq tSaysaHar mubmiRal�Fale. Requlred onslle,GdaeGucdon Plans,3tarmwater Plene w/Sill Fence Insteilad,
8anitery feciliiies&i dumyster,Slte Wark Pesmlt for sR a�w projecis.A(t camme�da!iequlrarnanta inust meat comptlance
IGN PEKMIT Aftach(2)sef�of�ngtneared Pians.
•»,PRdPERTY SURVBY requlred t�s atI N�W ecnstructton.
Icaoitona:
Fpl outeppllcatian ootnpletely.
O�mer a�Ca[[t�actor s4gn back af app8aattan.aotarrzed
IF aver 525�q a Notica oP Commoncement la raquirod (A!C upg�ados over�7500)
l�qent(tor the oot�trador)ar Power oFAtiomoy{(or the owner�wouid be someone wtik,aats�tudaericr hom owner xulhorizing same
V$RTH�COUNT642P�RMi77IH{� (ftantaEAppllo:xttaeiQc3y} . •�';:s --
tla .°
eroots If shingles 8aware Servloa Upgradea"/1!C Fences(PlotlSurvey/fo�ge).. '
OrtvaWaya-Nat over Gpuntsr ff on pubso roadWaya..naetSs IiOW�� ,,,, ., �
I
,..� �
i
CITY OF ZEPHYRHILLS, FLORIDA
5335 8TH STREET
CONTRACTORS COMPLETION
NAME: Turner Building Contractors LLC DATE: June 24, 2015
ADDRESS 6948 Gall Blvd
PARCEL I.D. 02-26-21-0010-00800-0130 SUBDIVISION : City of Zephyrhills
TYPE OF BUILDING : Remodel 3,000 sq ft
PERMIT'(s) 16184, 16228, 16302, 16325
REMARKS : FINAL DATE: June 24, 2015
/
BILL BURGESS BUILDING OFFICIAL/ JB ' .
i
HuD-1 U.S.Department o(Nousing
r^- A. SettlementStatement and Urban Development OMB No.2502•0265
- 8. Type oi toan
' (� 1.FHA Q 2.FmHA Q 3.Got�v,Uolns. 6.File Number 7.Loan Numbe� 8. Motig.Ins.Case Num.
15•01-76JL 6Q12019000
(3 R.V.A. Q 5.Corrv tns. �Q.
C. NO7E:This torm fs tumished to give you a statement of actnat setltemenS casts.Rmounts pald to and by the seittement agent are shoum.ftems
marked"(p.o.aj"were pa(d outstde 1he closfng;they are shown here for informattonal purposes and ate�ot!ncladed tn the totats.
� Q.NAME OF BORROWER: FMPM,INC.,a Florida Corporation
' Address of 8orrower: 6948 Gafi Bautevard,Zephyrhiits,Fiorida 33542
E.NAME OF SELLER: THE ICATHE 6ANE LIMITED PARTNERSHIP,ALSO KNOWN AS THE KATHE BANE LIMITED PARTNERSHIP
AGREEMBNT
IAddress ot Setier: Q/O John A.pwyer,Esq„506 N.A�exander Street,Piant City,Ftorida 33563 TiN:
F.NAME QF LENOHR: First Home Bank,a Flodda Banking Corporation li
Address of Lender: 9790 Seminole Baulevard,!P.O,Box 4900,Seminole,Florida 33772 �
G.FRpPER7Y l.QCATlON: 6948 Ga!!Boulevard,Zephyrhills,Plorlda 33542 �
H.SET7LEMENT AGENT: Meridian Titie Company,tnc. TiN:59-3597293 (
Piace oi Settlement: 3T837 Mertdian Avenue,Suite 5�0,Dade City,Ftorida 33525 Phone:352-567-0241
L SETTL�MENT DATEt R128115 DISBURSEMENT DA7E:A128/15
i� •�i
I iD1.Ca�traet sates price 335,000.00 ddS.Contract saies price , 335,000.00 i
S42.Aecsonatproperty 402.Personaipropedy '�
t03.Setttement char�es to borrawer tttne i400y 12,973.82 403.
10R. 40R. �
105. 468. '
_ I
' lO6.Cltyltown takes 406.Cityltawn taxes �
107.County taa�es 40T.CountY taxes
1 Q8.Assessments 408.Assessments
t 09. 409.
114. A10.
»�, 41i.
��Z, 4i2.
120.Grass amount due tram borrower: 347,9T3.82 420.Gross amount due to setter. 335,OOD.00
�� ��
� 201,Deposit or earnest money • 1QOOO.Q4 5�t.E�CCess deposit tsee irtsttuetions)
202.Principal amount ot new loan(s) 288,754A4 542.Setllement charges to seiler(ti�e 1400) 25,241.50
203,Extsp�g Ioan{s)taken subJect to 543.Sx(st3rsg loan{s)taken sub)ect!o
204.Principai amount of second modgage 504.Payoff of Arst modgage Joan
205. 545.Payoff of second rpoAgage toan
206.Buyer CrediC 200.OQ 5Q6.Dappsi;s hatd by seiter
' 207.Principal amt of mndgage held by seller 5Q7.PtinciFat amt af modgaqe held by selter
20&. 5Q8.
209. 509. i
.
210.Ciiy/town taxes 510.Ctty/town taxes
211.Co Taxes 53863.23 from 01/01/15 to 04l29/75 1,238.35 511.Co Taxes$3963.23 lrorn Qll01!!5 ta 4Al28115 1,238.35 r
, 212.2015 Comm SNV$62,12/yr from 07/01/14 to Q4/28l15 51.23 512.2015 Comm SM/562.12/yr from 47lQtll4 io Q4l28(15 51.23
213, 513.
214. 614.
215, 515.
, 216. 516.
217. SI7.
218. 518.
219. 513.
220.Total patd by/tar borrower: 300,239.58 520.Tota!reductions in amount dvo setter. 26,531.08
�i .��
307.Gross amouni due from 6orrower 347,973.82 6Qt Gross amoont due to setter 335,OD0.00
(Ilae 120� (Noe 424) .
� 302.Less amount paid bylfor the borrower (3�0,239.5$} 842.Less tota!reductians in amount due setter (26,531.08}
� (line 220) {line 520j
ii 3Q3.Cash( [J✓ From ❑To )eorrower. 47,734.24 603,Cash([1✓ To ❑From )$e1ler. 308,468.92
Substi W te Form 9099 Sefler Statement: The Informalion contained in blocks E,G,H,and I aad on lane 401 is impodant tax tntflrmation and Is betng
fvmished to the iRS. If you are required to fite a retum,a negilgence penally or other sanction will be tmposad on you if thls item is requited to be repoRed and
the!RS deiermines that it has not been reported.
Setier instructions: If this real estale was your principal residence,file Form 2179,Sale or Exchange oF Princlpa!Residence,tor a»y gain,with your iax
retum;ior otfier transactians,cromp�ete the app�icabte parts ot Form q797,Form 6262 and/or Schedule D(Form 10q0).
, ttUO-1 U.S.Depertment ot Hous(ng and Urban Devetopment Page 2
" '• '" Paid from Paid 6om
� � 700.Tota!SatestBrokers Com.based on price 5335,OOQAQ 6,0000%,= 20,S0o.00 f Borrawets SeGer's
� 701. 10,050.q0 3.00q0%to NYe Commerclat Advisors Funds at Funds at
Seltlement Settlement
702. 10,050.OU 3.0000%(o Charles Ruteaberg Realty '
703.Commissio� ald at setkleme�f 24,�aa.00
�oa. to
:�, - •. -.
8Q7. Loar�orig(nat�on fee °to to Ftrst tiame 8ank,a Florlda Banklog Gotporatlon 2,887.5Q
�i Sp2.Loan discount %to
803.Appraisal fee lo ValuaQon Servfces,Ina. 2000.00 I
� 844.Gredit report to Kratt Faclual Qata 8,10 �
i �
� 805. Lender's inspectian fee to
806,Tax Servfce Fee to First Home Bank,a Flarida 8anking Corporation 70.W '
847.Ftaod Certifcatlon Fee to Servicernk Nationat Ftnod Services t4.00
8a8.Wire Fee to Flrst Home Bank,a Florida Banking Corporation 22.00
849, to
810, io �
811. to
•�e .. •• -•
9Q1.tnterest from f' ' to @ /day
902.Modgage insurance premium for months to
903.Ftazard iqsatance premium fot t years ta We�cier lnsarance Agency 6,715.42
• 904.Flood tnswance premium for years to
9p5. ' years ta
�ii '- -.. -• - •• ••
1001.Hazard insurance months @ per monlh«•
1002.Modgage tnsurance months @ per month
td03.City ptoperty taxes months @ per month
10p4.County propedy taxes months @ • per month
5005.Annaaiassessmer�ts months@ permvnth
1006.Flood tnsurance months per month
1007. months @ pet month
S�pB• months @ per monlh
1009.Aggregate accounUng adJustment
�e - - �« -.
ti01,Setttement or ciosing fee io Meridtan Title Campany,i�c. 450.00 259,00
1102.Abs(ract or title search to Attomeys'Title Fund Services,LL4 25p.00
ti43.i7tte examtnatlon ta
1104.Tille insurance bfnder �a
1105.Oocumeot preparation to
7i06.Notary tees io
1107.Attarney's Fees to John A.Dwyer,Esq, 400.00
(lnctudes above ttem numbers: }
11d8.Titte tnsurance to Otd Repuhflc NallonaUMeridian TiHe 25.00 1,750.OD
(incfudes above ilem numbers: a �
9149.Cender's cavara e(Pramium): Sz$8,754.00{$25.00}
1110,Owner's coverage(Premium): 5335,000.00($1,75D.04)
1111. Endorse:6-25;8.1•25;F9-177.50 227.50
tt12.UVtre Fees ka dohnsott Auvlt Pratica&ChaRe,P.A. 25.OD
1113.CourfedHandling Fees to UP3 25.00 25.00
��
i201.Recordtng fees ' , Deed $38.00 Mortgage(s) $St.d4 Reteases 99.00
1202.City/coUnly lax/stamps Deed Mortgage(s) $577.50 577.50
1243.&tate taxlstamps �eed 52,345.00 Mortgage(s} $1.OS0.80 t,0i0.80 2,345.00
1204.Rec.Fee AtL Partnsrshlp to Cterk ot Circuit Court Pasw County 35.50
1205.Rec.Fee Aft7rust to Clark of Circuit Court Pasco C4unly 61.00
/4 ' ' .• .♦
130t.Survey (o Eddlo P.Jenkins Surveying and MaPping,Inc. 800.00
1302.2014 Real Prop Taxes POC-S to Tax Collector 3860.96
1303.Rea Fee Assn Rents&leases io Gierk ot Clrcuit Govd Pa�w Coanty 44A0
t304, �a
1308. �o I
' t34B, ta •
� t 3d7. to
1308. �p I
�
I i309. ' �
•f:
�I Enter on lines 103 Sectton J and 5D2 Secqon K 12,973.82 25,241.50
` Qatt6teTsmoQ �
� �-ICJD-� SI�'Z'TS��MENT S7'ATEM�NT�S.DDENDUM
Ftte Number: 15-Ot-T6JL
!have casetully reviewed the HUD-1 SettlemenE Statement and to the best of my knowisdge and beiief,it is a true
and accurate statement of aii�eoeipts and dtsbursements.made on my aceaunt or by me in this transactton, t
further cerf3fy ihat i bave received a copy of the HUD-9 Seitlement Statemant.
Xiorro�vex•(s)
FMPM, ZNC., a F2 ri�orporatia
� : �i�� �,`
x
uBi A. Pol
Pzesiden�. �
Settlement Agent
The HUD•1 Settlenien2 Statement which 1 have pregared ts a true and accurate accounYoi this transactEan. !have
caused or will cause tho iunds to be dtsbursed in accordance with thls staterrien2.
IMeridian itle Comp y, xnc.
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� g�r; Date: ��^' '~ �
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,S���eY'(S}
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TH�KA1'HE BANE LIMITBD PARTNBRSHiP,ALSQ 1SNQWN r�3 TH$KA7i-tG BA't�'E L1MITBD PART\'EftS1�iIP
AGREEMENT,A FLORlDA LlMI7'ED PARTNGRSI�IP
BY: ITS GENE[tAL PARTN�R
KA'1'HE BANE It�VOCABLE L[VITIG TRUST AATFD DBCEM68R 29,l999
BY: t1 '���� , �/ 1d� �
CON LAK L�N�E��F�A�""°r-/ liPd,�QLe�c�'
BY: w
GCCA A.HOSMER,iT5 �M TED PAR`['�IER
i '
i
I
WARNING:IE is a crime to knawing{y make fatse statemenfs to the United States on this or any other similar form.
F?enalties upon cocrvictton can tnctude a fine and Imprisonmenf. For detaifs see: Tikte 18 U.S.Code Section 1001
artd Section 9Q10.
i poublo7(me(9
� � -
• Hup-1 U.S.Depaitment o(Housing and Urban Development . Page.2
- '' • Paid!rom PaM irom
7Q0.To131 Sa1BS18toket3 Co[p.ba5ed oA P�ce Saa5.OQ0.Q0 6A000y,> 2Q,t00.D4 B9tFOYtLC'S SeHets
70t. "l0,050.00 3.0000%to NyeCommerclalAdvlsors, Fundsal Fundsat
Setttement SetUemeat
702, 10,05D.00 3.00Od yo io Ghatfes Rutenberg Reafly '
703.Cam�rifsslon aida2seittemen! 26.�004D
704. to
:•F •.
BOi.Loan odglnation fee 9'0 lo Ffrst Home Benk,a Florida 8anking CorporaUon 2,88�.50
802.Loan discount %to '
843,Appraisat tee ia Vahtaiton Services,tnc. 2000.06
604.Credit report to Krotl FacWa!Data 6.14
895,Le�ders InspBCUon fee to
846.TaX Servlce Fee to First ttome Bank,a Ftorida Banking CorporaUon 70.00
807:Ftood Certifjcaticn Fee to 5erviceCmk Naponai Ftacd ServIces 24.00
608.,Wf�e Fee to Flrst Homa Bank,a FioHda 6anWng Corporatlafl 22.00
8D9, lo
850. to
8ii. to
•,� - - •. •y
901,tn#etest trom Y to c @ tdaY
9Q2.Mortgage insurance p[emtum(or months!Q
803.HazaM insuranCe premium for 1 years to Wexler Insufanceqgency 6,715.42
8D4,F7ood insutance premium(or years to
905. yeatsta
��� - .-�� •. • �.
1001.Nazard(nsurancs months�,1 per monlb •
t002.Mortgage tnsu�anse months Q per month
1003.City p[opedy taxes months @ ger manth
1004.County properly taxes months� per mcnth
i805.Annuai assessmenfs months(a� permonth �
So06.F1oodlnsvrarice - monihs permonth
1Q07. months(r� i�er monftt
f 008, � months Qa er rnonlb
1009.Aggregate aaounqng adjustment
r� . .y
1101.Seltfement or ctosing(ee 10 Mertdtan TiGe Campany,Inc. 45p.00 254.90
1182.1lbstfact ot U1te seatch to Attomeys'T�le Fund SecvlCes,lLC 250.00
tio3.Titte examt�ratiots ta
t104.liUe lnsuranes lUnder to
1105.Oocutnent preporaUOn Co
i106.Nataryte8s ta
'l107.Attorneys Fees !o JohnA.D�vyeG�9• d00.00
(lncfudes above item numbers; )
1108.Tilte(nsunance _ to Old Reputrlic Natio4�UMerfdtan Title 25,00 9,750.00
(tncSudes above+�em numbets; } ,
1109.lende�s s�vetage Pmmium}: $288,754.04 jS2S.q0}
11i0.ptiyners coverage(Premium: S335,0�}.00{$t;750.00)
1111. Endorse:6-25:8:i•25;P8-T77.5o 227.50
tti2.Wne Fees to dahrssoa Awii PraGco 8 Charte,P.A. 25.pp
1it3.Gouderlkiand!!ng Fees •to UPS 2fr{�p �5,pp
��
1201.Recatd'mgiees • paed S3&06 Martgage(s) $6t.Od Reteeses 99.bD
1202.CYylcounty!ar/stamps peed Modgage{s) 557754 577.58
1203.Stale taxJstamps Deed 52�34b.00 Moctgage{s) $1,010.80 1,070.80 2,3d5.90
5204.Rec.FeeAfC PndnersfiTp to Clerk of CircviC Coud paseo Cotmty 35.SQ
1205.Ree.�ee Atf Tntst- to Cierk of G�rai3t Coud Pasoo County 65.00
�t - • •s
S30Z,StINBj/ . (0 EddS2 P.JBttkIRS SUNeyillg 2nd MappCftg,II10. 800.OD
1302.2Qi4 Real Pro Taxes POGS ta Tax Coltectar 3g6p,sg
1303.Ftea Fee Rssn Ftents 8 Leases �d Cleric ofCirouit CovR Pasco County A4,pp
130d. to
5995. to
73Q6. to '
t307, to
1308, to
1369. •
.��
Enter on tines 103 Seclion J and 502 Seelion K 12,973.82 25,241.50
' - HUD-1 ST�"TLEMENT STAT�IV�LNT ADDENDUM '
Fila Number: 15-01-76JL '
!have carefully revfewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a trus
and accurate statement of all receipts and.disbttrsements.made on my account or by me in this transacilon. I
fu�ther cerfffy that I have recelved a copy of the HUD•1 Settietttent Statement.
Barrower{s)
PMPM, ZNC,, a F1 rida orporatio
BY�
UeI A. Polc
IPresident �
Settlement Agent
� 7he HUD�1 Settlement Statemeni which I have prepared is a true artd accurate account of this transaction. I have
caused orwfil cause the funds to be disbursed in accordance with�thls statement.
Meridi itle Comp y, Tnc.
� �Q �
Bl'9 Date: � �,
SeIler(s)
77-IL KATHE DANE L.1M17'EA P,1lLTNERSIiIP,ALSO KNOWt�A��CHE KATFiE BAA'E LIMITED PARTT.�ERS!•1!P
AGREEMENT,A FLOFtIDA L1MlTED PARTNERSFiIP
BY: ITS GENERAL PAR1N&R
KATH6 BANE REVOCASIE L[VING TRUST DA'fED DECEMBER 29,1999
BY: ����� � /
CON LA 'I LBEN NC,7'RUSl'SE ����°"+•� �/�O�
IIY:
ECCA A..HOSMER;ITS � TED PAR'CNER
WARNING:!t ls a cririme to knowingly make false statements to the United States on thEs or any other similar form.
PenaltlQS upon codviottop can inctude a fine aod imprisonment. For detatis see: 71iJe 18 U.S.Code Section i004
and Secfion 9010.
�....��.,�__�.