HomeMy WebLinkAbout15-16525 i �
i �y CITY OF ZEPHYRHILLS �
� 5335-8TH STREET
(sis)�so;0020 165
,� BUILDING;PERMIT
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� "PERMIT•INFORMATION � � LOCATION INFORMATION
Permit Number: 16525 Address: 39201 PARK DR
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s):5 Block: Section:
Square Feet: Subdivision: ZEPHYR HEIGHTS
Est. Value: � ; Parcel Number: 12-26-21-0030-00600-0050
Improv. Cost: 5,800.00 ; OWNER INFORMATION
Date Issued: 9/01/2015 Name: THORNTON, JOHN M & ELLEN
Total Fees: 97.50 Address: 39201 PARK DR
Amount Paid: 97.50 ZEPHYRHILLS, FL. 33542
Date Paid: 9/01/2015 Phone: (812)569-7094
Work Desc: REROOF RUBBER �
CONTRACTOR S ; APPLICATION FEES �
A.BARTLETT RO FING F NTRA F REROOF RES DENTIAL 97.50
- � � 2P � �
� �,� �
- Ins ections!Re uired � •
� DRY IN ROO I SP �
TAPE JOINTS ROOF INSP
FINAL � -2 -( 'S°
REINSPECTION FEES: (c)With respect to Reinspection;fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the�amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater;for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this properly 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 pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
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CONTRA OR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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City of Zephqrhills
BUILDING PLAN REVIEW COMMENTS
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Contractor/Homeowner: ���� � t
Date Received: (� -- �(�—'/si
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Site: � ��(7 I ��i � ��...
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Permit Type: ���� � �''�
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Approved w/no comments: Approved w/the below c;omrnents: ❑ Denied wlthe beiow comrnents: ❑
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I �This comment sheet s e kept with the permit andlar plans. ,
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Kal n `t r—P s Examiner Date Contractor andlor Homeowner
(Required when camments are present)
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a�s-�so-oo2o City af Zephyrhills Permit Application Fax-813-780-0021
. Buiiding department
Data ttecefved.. I .. . �......>�.. _ ...<_�.,... .ri.. .� �,
_ h e.Cantact k►r Perrtiiftlri" �,. —�r i
Owner'sNaine - '� -�"�' :I�. . �' '.': ,_.,,,", . .`,:;•� ,,��,� - � I'
:t'- =.Owiie�Phone Nembe�'=�
.; ;.•�:; . '(' , „�:�' "'�'r; `.=. z�-_.:� ��;., _ ... ',
Owner's Addresl � � ' ��Owner Phone Nomber� ,� �
, � , : � s ,I� ��'.,. _ . . �
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Fee Simple"Titleholde'r Name ,' ,, � Owner Phone Number
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Fee Simple Titleholder Address I "
JOB ADQRESS � � � �'�'� - LOT# ��
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SUBDIVISION � � " � ��;, PARCEL ID# � �� '��.- �'� ' o b 3 0 — D C 6 0 Q � 0 O�Ca
'� � (OBTAINEQ FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR . ADDlAtT �` S1GN Q Q DEMOk.ISH
, � �e INSTALL 8 REPAIR I
PROPOSED USE Q SFR Q COMM �,� OTHEF2
TYPE QF CONSTRUCTION � BLOCK Q FRAME I STEEL Q
DESCRIPTION OF WORK � �
BUtLDtNG SiZE SQ FOOTAGE�_'�� HEIGHT �______�
�$�t����� ���.�.�lBLUATION QF T i TAL CONSTRUCTION
QE�ECTRICAl. ri� AMP S�RVICE Q PRQGRESS Et�2ERGY � W.R.E.C.
L ,
QPLUMB��lfi,� $ , � t�'�L� �
1 � �������'��
MECHANICAL �~��/�'' -
C] $ VAI.UATION C}F M i CHANICAI.INSi'ALLAi'fON �_� f��� �/
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' QGAS Q ROQFING Q SPECiAl.TY ; OTHEE2
FINISHED FLOOR ELEVATIONS ��� FI.00D ZONE�AREA QYES NO
BUI�DER COMP�
, 51GNA7URE REGISTERED Y/ N FEE CURRE� Y/N
' Address License# �
, E�ECTRiC1AH COMP�
SIGNATURE REGI3TERED Y/ N FEE CURRE� Y/N
Address License# �� ��
PCUMBER CONIRANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
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Address '� License# �i � I
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MECHANICAI. COMPANY '
SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N II
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Address - I icense#
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OTHER GOMPANY
SIGNATURE REGISTE � Y/ N FEE CURRE� Y/N.
Addre�s � License# �_ �
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FtES1DENTIAL Aftach{2)Ptaf Plans;(2)sets o#�BuIlding"Plarts;{1}set af Ene�gy�Forms;R Q-W Pecmlt for new coostrttction,
Minimum,ten_(10).working days after.submlttal date. Required onsite,,Construcdon P1ans;Stortnwater Plans w/Silt Fence installed,
Sanitary Faollides&1_dumpster,Sita Worlc;Rermit for subdivisionsAarge projects
COMMERGIAL Attach{3}complete set�of Bu3ldtrig P1ans ptus a�ife Safe#y Page;(i)set of Energy Forms.R-4 W Pecmtt for new canstrucHan.
Minimum ten(10)wo�lcing days after submittal date. Required onsite,Canstructian Plans,Stormwater Plans w/Silt Fence installed,
Sanitary FaoiliUes&1 dumpster.$ite Work Pertnit for all new proJects.All commercial requlrements must meet campliance
SIGN PERMIT Attach{2)sets o#Engineered Plans. � i
'•*"pROPERTY SURVEY required for ail NEW construcUon. 'f
Dlrectlans: i"
FUI out application completely. i
Owner&Contractor slgn back of appllcarion,notarfzed i
tf over 52500,a Notice of Cammenaement is required. {A/C upgrades dver 57500)
'" Agent(for the contractor)or Power of Atkamey(for the owner)wauld be sameone with nota�zed letter fram owner autho�izing same
DVER THE COUNTER PERMITt1NG (Front af Applicatton Onlyj
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Foatage)
Driveways-Not over Counker if on public roadways..needs ROW �
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NOTICE OF DEED RESTRICTIONS: The undersi ned under.�tands that thls. �tmlt.ma .be,sub ect to"deed"restrictlons"
9 . � Y 1
which may be:more r.estcictive than County regulatlons. �The undersigned assumes responsibility for compliance with any
appl(cable 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.11censed in.accordance.with state.and�local regulations. If the
cont�actor is not Itcensed as requlred by law, both the owner and contractor-may be ctted for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what Iicensing.requirements may apply ior the
intended work, they are advised to contact the Pasco County Building Inspection Divislon—L(censing Section at 727-847-
8009. Funhermore, 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 responslble. If you, as.the owner sign as the
contractor, that may be an indication that he is not.p�operly flcensed and is not entitled to permitting privileges in Pasco
County. '
TRANSPORTATION IMPACTIUTILITIES IMPAC7 APID RESOURCE RECOVERYfEES: The undersigned understands
that Transportation Impact Fees:and.Recourse Recove.ry.Fees may�apply to the construction of new buildings,.change of
use in existing buildings, or.expansion.of��existiri,g��6uildings, as speclfled.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 further understood that Transportation Irr�pact Fees and Resource Recovery�Fees must be paid prior to
receFVing a °certificate of ocbupancy" or final.power release. .If th� project does not involve a certificate of occupancy o�
_ final power release,=the fees_�must_tie-paid_prio�to=pe�rrelt-Issua�ce.—�u�h�rmoc�;-if Fasco=County�lNat�r/Sewer-impact— -- -
fees are due,th�y�must be-pald p�lor to permit-Issuance�fn accordance with�applicable Pasco'County ordinances. '
CONSTRUCTION LIEN LAW'(Chepter 713� Florlda Statutes�as amended): r`If yaluation of work.is$2,500.00 or more;�I,
certify that I, �he•applicant, have,-been provided with a copy of��tFie� "Florida Construction Lien Lav�—Homeowner's
Protection Guide" prepared by the Florida Department of Agric.ulture and ConsumerAffairs. If the applicant Is someone
other than the"owne�", I certiry that I have.obtained a copy.of.the abQVe..described�document°and.promise in,good faith to
deliver It to the�owne�'prior�to-commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify ttiat all the Inf.ormation im this appl(catlon 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 indlCafed: 'I certffjr that no work or Installatton 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, and larod development cegulations�in the jurisdictfon. i also
certify that I understand that the regulations of other government agencies may�apply�to the intended work, and that it is
my responsibilily to identify�what.actions I must take to be�in_.compliance: $uch agencles include but are.not Iimited to:
- Department of Ehvironmental Protection-Cypress.Bayheads; Wetland Areas and Environmentally Sensitive
Lands,WatedWastewater Treatment.
- Southwest Florida Water Management ..District-Wells, Cypress. Bayheads; Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health� 8 ReY�abilitative Services/Environmen�ai Health Unit Weil.s� Wastewater Treatment,
Septic Tanks. � _
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviatton.Authortty-Runways.
I understand that the following.restrictions�apply to the use of flll:•
- - Use of fill is not allowed in Flood Zone"V"unless expressly permittgd.
- If the fill material is to be used in Flood Zone. "A", it. (s understood that a drainage plan addressing a
°compensating volume" will be submitted at time of permitt(ng which is prepared by a professfonal engineer
Iicensed by the State of Florida.
- If the fill material is to be used in Flood Zone 'A" in�connection�wlth.a �ermitted building using stem wall
- construction, I certify that fill,:will�be used only.to.flli the area within the stem�wall.
- If flll materlal is to be used in any a�ea, I certify that .use. of such flll will not adversely affect adjacent
properties. If use of flil is found to adversely:affect adJacent propertie�,.the owner may be cited for violating
the conditions of the building.permit issued�under the_atEached permlt�application, for• lots less than one (1)
acre which are elevated�by flll, an engtneered drainage plan is required. .
If I am the AGENT FOR THE OWNER, I,�promise In good f.aith to Inform the owner of�the permitting�conditfons set forth (n
this a�davit�prior to commencing construction. I understand that a:separate permit may be required for elecMcal work,
plumbing, signs, wells� pools; air conditioning, .gas, or other install�tions not spec►f(cally included-in.the application. .A
permit lssued shall�be constcued to be a Iicense to proceed with ttie�work and not as.authority to.vlolate, cancel, alter, or
set aside any provisions of�the technical.codes; nor shall issuance�of a permlt.prevent the Bulldirig Officlal from thereafter
requlring a cocrection af errors In-plans, construction or violaUons of any codes. Every pennit issued shall become invalid
unless the work authorized by such perm(t.•is-commenced•wtthln six months of permit issuance, or if work authorized by
the permif is suspended or.abando�ed for.a:period of�six(8)montfis.after the time the�work ls commen�ed. An extension
may be requested, in writing, from the Building.Official for a perlod.;not to.exceed�ninety�(90) days and will demonstrate
justi�able cause for.�the extensior�. If work ceases:for ninety(90)cons.ecutive:day.s�..the job�is.considered aba�doned.
WARNING TO'OWNER: OUit.FAILURE.TO.,REC:ORD A:.NOTIGE OF•COM CEMEMT.MAY�RESULT IN YOUR
PAYING TWICE;FOR 1 ,OV ENITS TO YO.UR:PROPERTY.=IF�.YO.tJ 1N�' O�O �AIN��FINtANCtNG,'CONSULT
WITH UR DE AN� ORN $ FOR��� CO � G% �U '.O . C N ;, ?�,.f. �-.
FLORIDA JURA�'(F.S..1. ° � � • _ � ` . ° . . ,
OWPIER OR AO CONTRACTO "
Subscribed and swom afli efore me fhis Subscribed and'swo ( aflirmed) efore me ttii�. '
by �by •.
Who is/are personally nown to.me.or has/Fiaye Produced Who ts/are p.erson known to�me.or has/have produced.
as Identlflcatlon, as idendflcaflon. �
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Notery Public Notary Public '
Commissi �,,,,., � ,,,�.,.,,, I
�o Commisslo �P •
��._ Commission#FF 137073 • -- • � � , :►: ':= Commission#FF 137073 ' �,
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�!�;���!�I�P� Product Aooroval Menu>Product orAoolicatlon Search>Aooliration List>Appliration DeWil �
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FL12772-R3 �
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Application Type Revision
Code Version 2014 SHALL COMPL D�CI �
Application Status � Approved ALLW��G CODES FL��DAB EAN� I
pgEVAILIN ELE�TRIC COD
Comments CODES�ATI�NAL ILLS���p,NCES
Archived o OF ZEFI�
i CITY �,
Product Manufacturer Mule-Hide Products Co.,Inc.
Address/Phone/Email 1�195 Prince Hall Dr
Beloit,WI 53511-5481 /
(608)365-3111 Ext809 � ✓ �
lindareith@trinityerd.com ���� � �.J
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Authorized Signature Timothy McFarland "'" ����`�8��'�
li�nda reith @trinityerd.com
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PL��i�� ����1�1{��'�._______-- - �----
Technical Representative Tim McFarland
Address/Phone/Email 1�195 Prince Hall Dr
Suite A
Beloit,WI 535115481 �
(608)365-3111 �
tim.mcfarland@mulehide.com �
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Quality Assurance Representative
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Address/Phone/Email �
Category Rloofing
Subcategory Si ngle Ply Roof Systems
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer
iEvaluation Report-Hardcopy Received
Florida Engineer or Architect Name who developed Robert Nieminen
the Evaluation Report �
Florida License PE-59166
Quaiity Assurence Entity UL LLC
Quality Assurance Contrad Expiration Date 06/05/2016
Validated By ]�hn W. Knezevich,PE
� Validation Checkiist-Hardcopy Received
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Certificate of Independence FLi2772 R3 COI 2015 01 COI Nleminen odf
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Referenced Standard and Year(of Standard) �tandard Year
ASTM D6878 2008
FM 4470 1992
FM 4474 2004
TAS 114 2011
Equivalence of Product Standards I
Certified By I ; j
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- Sections from the Code
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• �.Florida Building Code Online i Page 2 of 2
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Product Approvai Methad Method 1 Option D �
Date Submitted 03J24/2015
Date Validated 03/27/2015
Date Pending FBC Approvel 03J31J24i5
Date Approved O6/22/2015
Summary of Products �
FL# Model,Number or Name � pescription
12772.2 Mu(e-liide TPO-c Single Piy i oof Thermopiastic polyolefin single ply roof systems
Syskerns
Limits oE Use � Tnste!lation Instructia»s
Approved for use in HVH2:No FL12772 R3 II 2015 03 FINAL AS ER MULE-
Approved for use outside HVHZ:Yes �IDE TPO-c FL12772-R3,odf
Impact Resistant:N/A Verified By.Robert Niem3nen PE-59ibb
Design Pressure:+N/Aj-495 � Created by Independent Third Party:Yes
Other: 1.)The DP noted in this application pertains tp one Evaluatian Reports
particular assembly.Refer to the ER appendix for a!1 � FL12772 R3 AE 2015 03 FINAL ER MUL -NIDE-
assemblies and DP's.2.)Refer to Eft sec[ion 5 for�imits of TPO-c F�12772-F23.odf
Use. j Created by Independent Third Party: Yes
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IBaGt Next
Contact Us::1940 North Monroe Street.Tallahas=_ee R a�ggg phone:850.487-1824
The State of flodda Ls an AA/EES?emptoyer Goovrioht 2Q07-2013 State of Plarida.:;A�,ri+,� S,�tateme�t:;�ssibflitv Statement::Refund Statement
Under florida law,email addresses are public records.If you do n t want your e-mail address reteased in response W a publiarecords request,do not send
electronit mail ln khis entiry.Instead,contact the office by phone orjby traditional mall.If you have any questlons,please contact 850.487.i395.*pursuant to
Sec[ion A55.275(1),Florida Statutes,efPet[ive October 1,2012,Itcensees Itcensed under Chapter 455,P.S.must provtde the Department wSM an emaft address if
they have one.The emafis pmvided may be use6 for afficiai cninmuriltation wtth the Iiceasee,However email addresses are pobtic tewrd.If you do not wlsh to ��
supp(y a persona!addras,please provlde the Department with an emait address wh{ch can be made avaifabie to the pubiia To determine If you are a Ifcensee under
CNapte'r 455,F.S.,please click here. •
Prolduct ApFrovat Accepts:
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� C/O Richard Bartlett �
� 38408 3rd Ave.
, Zephyrhiils, FL 33542
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One of the Largest, Oldest, Most Dependable OFFICE
Roofing Companies;m Central Florida PHONE
Specializing in Mobile Home White Commercial Rubber& Color Meta!Roofing �g 13) 782-5585
RESPDENTIAL • COMMERCIAL • MOB9LE HOME (813) 973-7737
LICEtdSED - IIVSIlRED - BONDED (352) 523-1944
• MEMBER OF THE CI�AMBER OF COMMERCE
& BETTER BUSINESS BUREAU• Lic. #CCC 1325499
Ser�ing Zephyrhiils, Dade City, Quaii Hollow, Wesiey Chapel, Land O' Lakes and Surrounding Areas
We have re-roofed or repaired more roofs(18,000)in the past 39 years, than the fourlocal leading roofing companies combined.
We do not charge extra fees tor credit card p'urchase.Most companies charge 3 to 5%. ,
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i Datengi� , i, �
Name John Thorn�on �
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Addt'eSS 39201 �ark Drive ,
,
Phone i-312-Sb9-7C94 Qx �l'��� (� �' 3�0�
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President&Owne� artlett f' � �FL, Inc.
Sign: '� .
ichard C. rtlett �
s
THANK YOU ' • ,
Your Business is Appreciated.
Payment upon completion unless previous arrangement made.;Warranties pertain to original owner:
All arrangements contingent upon strikes,acdderds ar delays beyond our contro�.Owner to carry fire,tomado and other necessary insurance.
Our workers are fuliy covered by Workmen's Gompensation Insurance.Customer is liable for any charges incurred in collecting this bill. . Q
Rotten wood is an exira$35.�per sheet(4ply).Rotten fascia is$2.00 per iinear foot. �� Total SO��
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Rept:2707863 Ree: 10.00
I I�'l���l�Il��t�lII�IItltii�tt��IlI��1Itl��li��I�'�����1�I�� D5: I0.00 IT: 0.00
@$l24I2@28 B, M„ DPtY CZerk ,
2015136425 ' PAULR S 4'N6IL,Ah D PpSCB Ct,EftK & COMP7ROlLEF
� 08/24/2015 02:49 m 1 of 1 �
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Permit No. Parcel ID No �l�/y��.L I �(J��Q �(�� (;��d
(
/� NOTICE OF COMMENGEMENT i
Slate of ��� �d�, �j'���
County of ����
I THE UNDERSIGNED hereby gives no0ce ihat improvemenf will be made to certain raal property,and in accordance wi[h Ghapter 713,Florida Statutes,
the!oilowing Information is provided In this Natiee ot CommencemenY i
� 1 Description of Property: P.arcelldantification Nn.�'� �� a� ���� QA/_An ���
Street Address•J�.�n � YLS�#;,,��1 U.'!�.
2. General Descriplion oi Improvement�� 1-(J(3L� �,�� � �
3. Owner lafortnalton ar Lessee intortnatipn itifie Lessee aontraded for ihe improvement:
J ah vi orrrtt�a �
3 ��t�1 �'�r��:. � r��..� .
Addresa � � �} City ' State �/
Interest in Property��,�Ga�,�„(j�(/��. __�Si`f�, "
Name of Fee S(mple Titfehalder
(if diHerent from Owner listed above)
� �Aaoress Ciry —' 8laie � W Y
�, Contrector. ^ U
��iLL�_i�� ,l i L�� (. � �.} ��� � W w
Address '�7 �� Ciry Slate (,� �� � x� � U
Contractors 7elephona No..����_/(�p�,����Q J I 33 s�Z ��O� ,�� a �
� C�
5. S�retY: Name I � ��� � � �
�'� —-� cC' �
AddresS Ciry , Stale � � F � .,� a
Amowt pf Bond: $ Teiephone No,: j � � O Q� �
6. iender. _ �... �.. C�J(,L °�
� Name , � � ����
Address Ciry � State F V� �
I Lendeds Tetephone Na �
� � �' C7 CC� C3
7. Persons wifhin the State ot'Florfda d'esignated by ihe owner upon whom nodces or other documents may 6e served as provided by � U-l!!�� � �
' Seclion 713.13(1)(a)(7),Florida Stalules: i � � „��� � } W
Name � � � ��"} � d �/
- 15'" {.� Q Z.t._ �
Address " ' City i S(ate �a � � (n
Telephone Numtrer ot Designated Petsan: � �'� � � -�-� �
� ¢° � �1 �
8. In additian lo himsell,tha owner designales � p�'� $�— ��� �' d �
lo[eCelve a copy ot the L'renors NoSCe as provided in Saction 753.13(7j(6),Fiorida Statutes. � t' �"" G � Q,_ (�
Telephone Number of Person or Entify 4esignated by Owner �
i
s. ExpSratian date ot Notice ot Gommencemen!(the exp3ration date may riot be betore the compSeiian!ot constructlon and lnal payment to Ihe
contractor,bu!wiq be one year hom the dale at recording unless a difterent data Is specifled): ,
WARNING,TO OWNER: ANY PAYMENTS MAQE'BY THE OWNER AF7ER THE EXB�RATION Of THE NOTlCE OF CGSMMENCEMENT -` �
AftE CpNStDERED lMPROPER PAYMENTS.UNpER'CHAP7ER713, PART�1, SEC71.ON713!13 FLORIpA STATUTES, AND CAN 4►�� �p � �
RESULT M YOUR P;4YING TWiCE FOR 1MPFtOVEMENTS�TO Yt1UR.PftC7PEFtTY. A N4TICE� 6F COMMENCEMENT MUST 8E ,a�,,� � � ,
RECORDED AND POSTED QN TNE JOB SITE BEFORE�7HE FIRST INSPECTION. IF VOU INTENp TO OBTAIN'FINANCING,CONSU6T O�i"
WITH YdUR LENDER dR AN ATTORNEY HEFORE COMMENCiNG WOftK OR RECOR4INC�.Y4UR NOTlCE OF COMMENCEMENT. `� �' � � ° �i.a
Under penalty of Reriusy,i deGara fhzt 1 have read the tn.^,:gcirg noiice qt cam ^�cemen;an :hat(t� eas statetl Uier' are tnie to the tlest �" �� ���'� �+�!?'.• �
of my krYOwledg� ' � ' �`��',
I STATeOF FLORioA �,y�' RICFIARD C.BARTLEIT � �, , 4��,� `'. r� �� � �
� C(7UNTY OF PASCO ►�IR�/ M1fCOhA95�lONpFF12098 ' ' '�, `�, t,�.a � �-
� ��� IXYfftE4:Iuty 3t,201T Signat Rwner or Lessee,o�Ownef s Less 's�AUtharized �' �y �' �, ;� ° Q
°' Officer ectorlPa � /Mar�ger `s�� ��;���,�i '.;-�� . �d�
�; �, •`�.,���"
� Signat 's�FttefOtbce .
� ey $
The forego3ng inst�ument v"ras aaicnowtedged betore me this day of ,20 by �Q!' � �� "�
ag (lyp of thorif' e.g.,oKcer,lrustea,attomey tn fad)Cor
(name o nt was execetted).
i
Personelly Known Q Q3 Produced Id�ntlfication Notary SignaEure,_, � ., ._...—.._ �
\ �
Type of IdenGfication Froduced� �p,�G+t.l�.�.. Name'{Pri ,,,,, �`1....�
. ' ' , . � . .. ..
wpdatalbcstnoticecammencement_pc453449
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