HomeMy WebLinkAbout15-16173 :
CITY OF ZEPHYRHILLS
' S335-8TH STREET
'� (sis)�so-oozo 16173
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16173 Address: 37530 NEUKOM AVE LOT 26
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: GRAND HORIZONS
Est.Value: Parcel Number: 34-25-21-0090-00000-0260
Improv. Cost: 5,400.00 OWNER INFORMATION
Date Issued: 4/14/2015 Name: THALER LEO J JR & KAREN J
Total Fees: 97.50 Address: 37530 NEUKOM AVE
Amount Paid: 97.50 ZEPHYRHILLS FL 33541-7697
Date Paid: 4/14/2015 Phone: 813-782-8804
Work Desc: REPLACE 9 WINDOWS SIZE/SIZE I
CONTRACTOR S APPLICATION FEES
R N CONSTRUCTI N L RIDA I BUILDING FEE 97.50
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Ins ections Re uired
FOOTER 2N R U H PL MB I C INSULATION CEILING
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d)work not ready for
inspection when called e) permit not posted on job site� plans not at job site g)work not accessible.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans,Specifications Must Accompany Application.All work shall be performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
TRA TOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-f8U-UUGU l.ill�/ UI LG�.Illylllnw � �..���n�i•rr�,•••,••.,•••
` � Building Department
Date Received Phoae Gantact far Perm�tfsng �!3 �$Z - 6�q`� ,
�:
Owner's Name ��v ��`"'I� Owner Phane Number �s''� ..J`���`0��� ,�
Owner'sAddress 3�"r�" � ����k'�� �� ' Owner Phone Numher� �',
Fee Simple Titleholder Name Owner Phane Number�� �;E
Fee 5imple Titlehalder Address
JOBAp�RH^^uS � is�3b �{(,te�}m �� � � {"1 r�1i��c5j � � 35�#� �.ar# L�
susu�v�sio� �+'r,�� �+i ri 2r.�s ��''1�� � :PARCEl::ID# 3`�-�2 5-2t-�'��- Qt�c�—c72r� .
� �(OBTAINEU FRdM PROPERTY TAX NOTIGE)
WOFi1C FROt'{JSED e P3EW CtIt�3STR e ADD/A�`f Q SIGN � MOVE � DENiOLISH
� � � INSTALL REPAIR
PROPOSED USE Q SFF2 C,.,� COMM Q �OTHER �� � '
TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL Q QTHER .
DESCRIP7'IQN OF�.WORFC; ��1�1�\lE,'- G�t� r I ttL'�..'� W�tv.�.tx,uS �J�C`� �K �U t �S if't`�'G�'1 ��-��.�3_.t .
BUILDING SIZE � � SQ FOOTAGE C-_� HEI�FI`F �� ,
BUILDtNG � � VAC.t1ATIOPi OF'FOTAL Ct�NS3FtUG'FIOfd � � , � �
��� '
Q EI.ECTi31CAL �$'� � AMP SERViCE 0 PF20GRESS ENERGY Q W.R.E.G.
� �
� Pl.UMBING $ ��,I�
Q MECHANlCAL $ VAWAT(ON OF MECHANlCAL INSTALl.ATION ,�` �
� '
� GAS Q RQOFING Q SPEGIALTY Q OTHER
FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA QYES QIVO .
BUILDER_ �__. - -• - - ...__._.._._.__�' .� � CClMPAG1Y-- ��L�'°"1 ��'��`"t �`'c .
SIGNATURE REGiSTERED Y IV . FEE CURRENT 1' !V "
Address 'J��t 3 S�- 5�1� �h r�t l�s�' �- 335�t ' L�cense# � C.�G�t�1.�'Y�`7(�
ELECTt21CtAN COMPANY � �
SIGNATURE REGISTERED Y f N �FEE CURRENT Y I N
Adtiress License#` � �
PLI.IMBER GOMPANY
SIGNATURE REGISTERED Y I N FEE CURRENi' Y!N
Address License# ��-- �
MECHAN[CA� COMPAt+lY � '
SIGNATURE REGISTERHD Y J N FEE CURRENT Y J�I
Address ' - License# � �
OTFIER CC71MPANY ` � ' . ,
StGNATURE 4 REGISTERE,p Y/ �f FEE CURRENT Y I EI
Address '`liceose# � �
�, _
RE9[DENTIAL Attach{2}P(at Pians;(2}sets of Buitding P1ans;{1)set of Energy�orms;R-O-W Permit ftar new construction.
Minimum fen(10}warking days affer submittal date. Requtred onstte,Construction Plans,Sformwafer Plans w!Sitt Fence insfalEed;
Sanitary Facilities&1 dumpster;Site Work Permit for'subdlvisions/large projects __ . _. _
GONItVtERCiAL Attach(3}se#s of8uliding Pians;{3)set of Energy Porms.R-fl-W..Permik far new construcfion. .
Minirnum ten(10j working clays after submit#at dafe. Required onsite,Canstrucfion Ptans,Stormwater Plans.w!Silt Fence 9nsfalled,
Sanitary Facilities&1 dumpsker.Site Work Permit for all�ew projects.All commercial requiremen#s must meet compliance' �
SIGN PERMIT Attach{2}sets of Eng3neered Pians.
**'*PROPER'i'Y SURVEY required for att NEW ccanstructian. •
Direations: , ,
Fiil out appiication compietety.
Owner&Contractor sign back of application,notarized
If aver$2500,a NaE�ae of Commencement is required. {AtC upgrades over$5040j
`• Agent(for the contraatar)or Pawer of Attomey(for the owner)would be someone with notarized letter from owner autharizing same
�OVEE2 THE COUNTER PEE2MtTTING (Frant of AppGcation OnfYj
Reroofs Sewers Service Upgtades A/C Fences(PiotlSurvey/Footage}
Driveways-Not over Counter If an pubtic roadways..needs FLOW
, , ' � , � . .
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NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed" restrictions"
which may be more restrictive than County.regulations. The undersigned assumes responsibility for compliance�with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or�contractors, he is advised to have the contractor(s) sign
� � portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County. �
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that T.ransportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as-amended. The undersigned also understands, that such fees, as may be due, will be identified_at the time of
permitting. It is fu�ther understood tFiat�Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certi�cate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, .the fees must be paid prior to permit issuance. Furthermore, if Pasco County WateNSewer Impact
�fees'are due,they must be paid prior to permit.issuance in accordance with applicable Pasco County orciinances.
CONSTRUCTION;LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Flomeowner's
Protection Guide" prepared by the Florida Departmer�t of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner"prior to commencement.
CONTRACTOR'S10WNER'S AFFIDAVIT: I certify that all the information in this applicafioq is accurate and that all work
will be done�in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be pertormed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, �nd land development regulations in the jurisdiction. I also
. certify that I understand that the•regulations of otfier government agencies may apply to the intended work, and that it is
my responsibility to identify wliat actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, V1later/Wastewater Treatment.
- Southwest Florida Wate� Management District=Wells, Cypress Bayheads; Wetland Areas, Altering
Watercourses: �
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health .� Rehabilit�tive Services/Environmental Health Unit-Wells, W�,stewater Treatment,
. Septic Tanks. '
- US Enyironmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Ru�iways. -
I undersfand that the following restrictions apply to the use of fill:�
- �Use of.fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fill rnaterial is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
li.censed by the State of Florida. �
- If�the fill material is. ta be used in Flood Zone "A° in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect. adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the.conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform;the owner of the permitting conditions set forth in
this affidavit prior to commencing const�uction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in�the application. r4
permit issued shall be construed to be a license to proceed with the work and not as authority to.violate; cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become.invalid
unless the work authorized by such permit is commenced.withirr six months of permit issuance, or if work authorized by
the permit is suspended or abandaned for a period of six(6) months after the time the work is commenced. An extension
may be �equested,.in writing, from the Building Official for a period not to exceed ninety (9p) days and will demonstrate
justifiable cause f.or.the extension. If work ceases for ninety(90)consecutive days,the`job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING.TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER-OR-AN:ATTORNEV BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. •
FLORIDA JURAT(F:S.11� ) - - _- �.,a _ _ ----— --- -- - - _ ---- -� _- - --- �-- - — -- -
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OVIINER% R�AGENT��.— . ° . . ,' ,. ; .�. �CONTRi4CTOR'T.':�'::`� '- .. '
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S saritieil-and sw r�ffi )betore ine this Subscribed and swom r me�ef re e�
���-(S by � .c..r•la�-wit> �l'c-l5 by (J�w+�`1
' , Who.is/are personally known to me or haslhave produced Who is/are personally known t e ar has/have praduced
, "' as identification. as identification.
; Notary Public Notary Public
� Commisston No. Commission No.
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� Notary Pu�lic-State ol Florida
�: '_•� » •= My Comm.Expires Apr 4,2016 =•: : •= My Comm. Expires Apr 4,2016
�' �;9, P�� Commission #EE 166865 ':` `'��
��''%�1��1i�`���` '�i�FOFF��P`` Commission#EE 166865
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�;;f==-f~ 36413 SR 54•Zephyrhills,FL 33541
Office: 813-782-0825 •Faa�: 813-788-6773 o Q �,� Proposal#
`�� iNC. License#CGC 1517771
SUBMITTED TO PHONE DATE i
L�e :S `�,Gl�� �;3 - �7�2- zs8�y Z—Z� -�S �
�E� JOB NAME
3 ��U �/IJ C r� e ��'
CITY,STATE and ZIP CODE ��----,, JOB L�O/C]ATION
� /� .i�� v � � � [ , f C%L���
SALES AN DATE OF PLANS JOB PHONE
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We hereby submit speciiications and estimates for: ,
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�P �CQ}tIISP hereby to furnish material and labor—complete in accordance with above specifications, for the sum of:
g' /� ] n �
J /U �wv� ''y ' r` ci e✓c Cc� /r' ,c vr dollars($ Z�z�- ).
Payment to be made as foilows:
All unpaid balances subject to 1.5%monthly interest fee. ,
All material is guaranteed to be as spec�ed.All work to be compieted in a wotkmanlike � —
mannet according to stendard practices.My atteration or deviaQon trom above specificatfons AUtho�zed /'
involving extra costs witl be executed only upon written orders,and wiil become an extra Signatu�e
charge over and above the estimate. All agreemenis contingent upon sUikes, accidents
or delays beyond our control.Owner to carty fire,tomado and other necessary insurance. Note:This proposal may be 7/�
Our workers are fuity covered by Workman's Compensation Insurance. withdrawn by us if not accepted within �t�' days.
�CC��JI�IYCE Of �rO�7�A1—The above prices,specifications RCI
and conditions are satisfactory and are hereby accepted. You are authorized Signature •"'� Date
to do the work as specified. Payment will be made as outlined above. � -
Date of Acceptance: S gnature `�� I `'� Date o�f�`� N
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USER:Puhlic User
Regulafiion
Product Aooroval Menu>Product or Aoolication Search>Aonlication List>Application Detail
t�9�e^ui�'�r K�i
����'���-����"'^ FL# FL9333-R4 '
s, � - r•
Application Type Revision
Code Version 2010
Application Status Approved
*Approved by DBPR.Approvals by DBPR shall be reviewed and ratified
by the POC and/or the Commission if necessary.
Comments
Archived ��•
Product Manufacturer Vi Win Tech�
Address/Phone/Email 2400 Irvin Cobb Drive
Paducah, KY 42003
(270) 538-4431
swheeler@viwintech.com � �I,I.H
N � i
���IxY��
�iJI�U1:t�IG S�i136,�- `-- ��G,
Authorized Signature Steven Wheeler , ��?LjCP�����'
swheeler@viwintech.com �L�,r,a�C�� pT,jJi+lB�G �'�
����Y h���b�C.G��
Technical Representative Steve Wheeler
Address/Phone/Email 2400 Irvin Cobb Dr
Paducah, KY 42003
(270) 538-4431
swheeler@viwintech.com ��
+�.�ci�!C'�tV i.,�TE — J�
Quality Assurance Representative Ronnie WIliiams
Address/Phone/Email 2400Irvin Cobb Dr �STY OF {.___'r`FjHYRNILLS 'fr ('
Paducah,KY 42003 PLANS EXA�/�IhlER ����
(270) 538-4437
rwilliams@viwintech,com
Category Windows
Subcategory Double Hung
Compliance Method Certification Mark or Listing
Certification Agency National Accreditation&Management Institute
Validated By National Accreditation&Management Institute,
Referenced Standard and Year(of Standard) Sta�dard Year
AAMA/WDMA/CSA/101.1/I.S.S/A440 2005
ASTM E1886 2005
ASTM E1996 2002
TAS 201, 202, 203 1994
Equivalence of Product Standards
Certified By
�
� ' .
t • Product Approval Method htethod 1 Option A
Date Submitted 04/04/2014
Date Validated 04/15/2014
Date Pending FBC Approval
Date Approved 04/20/2014
Summa of Products
FL# Model,Number or Name Description
9333.1 � 5100 DH Non-Impact HVHZ 5100 DH Non-Impact HVHZ 52 x 75
Limits of Use Certification Agency Certificate
Approved for use in HVHZ:Yes FL9333 R4 C CAC NI010803-Rl.qdf I
Approved for use outside HVHZ:Yes QualityAssurence Contract Expiration Date
Impact Resistant: No 08/31/2016
Design Pressure: +60/-60 Installation Instructions
Other:GIASS COMPLIES WITN ASTM E1300-04. FRAME FL9333 R4 II 08-01317.pdf
MATERIALTO BE RIGID PVC FROM ROYAL WINDOW AND Verified By: Luis Roberto Lomas 62514
DOOR PROFILES PLANT#7 AAMA CERTIFIED (TPL-1) Created by Independent Third Party: Yes
Evaluation Reports
FL9333 R4 AE 12062009.pdf
FL9333 R4 AE EER 5100 DH 511926 A.�df
Created by Independent Third Party: Yes
9333.2 SL 5100 i DH 5275 ShoreLine 5100 Double Hung Window, Impact Rated, 52 x 75.
H-R70.]amb install method.
Limits of Use Certification Agency Certificate ,
Approved for use in HVHZ:Yes FL9333 R4 C CAC NI008081-RS-signed.pdf
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant:Yes 04/30/2016 '
Design Pressure: +70/-70 Installation Instructions '
Other:N/hen used in HVHZ color of fremes to be WHITE FL9333 R4 II 08-00206B.odf
only rigid PVC. GLASS COMPLIES WITH ASTM E1300-04. Verified By: Luis R. Lomas, P.E. 62514
FRAME MATERIAL TO BE RIGID PVC FROM ROYAL WINDOW Created by Independent Third Party: Yes
AND DOOR PROFILES PLANT#7 AAMA CERTIFIED (TPL-1) Evaluation Reports
R9333 R4 AE 11062401.odf
FL9333 R4 AE 12062009.Odf
R9333 R4 AE 5100 SL DH IMPACT EER.Ddf
Created by Independent Third Party: Yes
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Contact Us::1940 North Monroe S[reet.Tallahassee FL 32399 Phone�850-487-1624
The State of Florida is an AA/EEO employer.Coovriaht 2007-2013 State of Florida. ::Privacv S[atement::Accessibilitv Statement::Refund Statement
Under Florida law,email addresses are public records.If you da not want your e-mail address released in response to a public-records request,do not send electronic
mail to this entity.Instead,contact the office by phone or by tradftlonal mail.If you have any questions,please contad 850.487.1395.'Pursuant to Section
455.275(1),Florida Statutes,effective October 1,2012,Ifcensees I(censed under Chapter 455,F.S.must provide the Department with an email address if they have
one.The emails provided may be used for official communication with the licensee.However email addresses are publfc record.If you do not wish to supply a
personal address,please provide the Departrnent with an email address which can be made available to the publfc.To de[ertnine if you are a licensee under Chapter
455,F.S.,please dfck here.
Product ApprovalAccepts:
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: �� I� �� �o NS t R u C,°r l d�
Date Received: y — 9 — `
site: 3'1 S 3 o N�u�:�M AV�
PermitType: I��P�AC.� q ���yp0�,` SIZE/S�Z�
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Approved w/no comments'..C� Approved w/the below comments: ❑ Denied w/the below comments: ❑
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9
This comment sheet shall be kept with the pernut and/or plans.
% _ ���
Kalvin�wi zer— s Examiner Date Contractor and/or Homeowner
(Required when comments are present)
i i��iii li�i���i���i����i�����<«�iii�i����<«�i�<<���i��«��
,� • ' � 2�}150�23 s�
���,�L 1� �°� �90 F2e�c 1�G.06 ��
DS: �.00 IT: 0.00
- 04/�1/2�15 �. M. , Dpty Cle�k
PerrnitNo,_ �lo(��J Parcel ID No ,_��� Z5' 2��- dD`�(7-dpC�-('jZ(oO
NOTICE OF COMMENGEIV�ENT
8tate of ��t L� GounEy of i"�13Gt�
THE UNDERSIGNED hereby givea notice that impravement will be made to certain rea6 prope�iy,and in accordance with Chapter?13,Flarida 5tatutes,
the tnilowing infarmation is provided in this Notice of Gommencement:
1. Description of Properiy: Parcei Identification No. �'�'25-Zf� a�`��- cSOpbO � ��a
�treetAddress: 3��'�� NUGltocn }k�►etyu.� �k Lt,�—�-�' -((��--�r �'ll(15�'( ��`J��
2. General Description of Improvement '���CnG'�_� � W�r�'��W S
3, Owner Informafian nr lessee Rnformakion if the L.essee contracked for the improvement: _
L�a '1"�ca..k,�/
�'��3� N itG!�� �e-- �' I{� �,�itS Fz•a e35�f/
Address City
Interest in Property: a�'7�
Name af Fee Simple Titleholder:
(If different from Owner listed above)
Address �U m� �5�ec���p-� ,�� ����(u ��. City Stete
Contractor: �
3��t t 3t�arrts2 �( �'�tc.�u'j�,t t,s �- 335'�t
Address City -< State ,�n
'>..
�1�i" `'�`�2.- t��z.� • ==t? =�-;
Gontractor's Teiephone No.: ' , -_--y
5. Surety: ''�
Name
Address City Statz
Amount af eond: � Teiephane No..
6. Lender:
Name
Address City 5tate
Cender's ietephone No.:
7. Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by
y
Section 7'l3.13{1}{a}(7},Flarida SEatutes: ,� �
#:
Name �
Address Cily 5tate
Teiephane Number of Designated Person:
8. In addition to himself,the owner designates �'f--
ta receive a copy of the Lienor's Notice as providad in Section 713.13{1}{b},Flarida Statutes.
Telephone Number of Person ar Entity Designated by CJwner:
9, Expirafion date of Notioe of Cammencement(tlie expiration da#e may nof be before the compietion af construction and finai payment to the
contrector,but will be one year from khe date af recording unless a different dete is specified): '
WARNING TCl OWNER: ANY PAYMENTS MADE BY THE 4WNER AFTER TNE EXPIRATION t}F THE NC7TiCE OF GOMNIENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER_ CHAPTER 793, PART 1, SECTION 713.13, FLORIDA STATUTES; AND �CA,N
RESULT !N YOUR PAYING TWICE FOR IMPROVEMENTS TO YC�U�t PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED C3N TH�.lOB SITE BEFORE TME F1i2ST IidSPEGTtflN. 1F YOU INTEND TQ OBTAIN FiNAfi1GiNG,CONSULT
WITH VOUR LEfVDER OR AN ATTORNEY BEFORE GOMMENCING WORK CJR RECORDi{UG YOUR NOT{CE OF COMNtENCEMENT
Under penatky of perjury,t deciare that 1 hav�read the foregoing notice of commencement and that the facts stated therein are true to the best
af my knowlaiige and belief.
STATE OF FLtJRIDA �'-<� f/
cou��o��asca
Signature of Owner Lessee,ar Owner's or Lessee's Authorized
Officer/plrectoNPartnerlManager
Signatory's Titie/Office
The faregoing instrumerrt was aeknawledged 6efore me this �� day af ��� ,20��,by �� ��-�
as (type of authority,e.g.,officer,trustee,attomey in fact)for
_(name af paRy o eha F of whom instrument was executed}. ,
Personally Known OR Produced Identificatian❑ Notary Sigoiature �
(- Type af Identif�cation Produced Name{Print} �
o�°�q� Notary Pubfic State ot Fiorida
? . Tammy Verdade�o
43. � My Commission FF 184019
'�pFryo� Eupi2s 1 211 61201 8
wpdatalbcsinoticecommencement pc053048 pt�u�R s 0'PlEIL,Ph D PflsC4 CLERK & GOM°TR �L�4 R�
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