HomeMy WebLinkAbout16-16878 CITY OF ZEPHYRHILLS
. �,�� : 5335-8TH STREET
(813)780-0020 16878 ',
FENCE PERMIT I
P.ERMIT INFORMATION. -� � � - - � . � � LOCATION INFORMATION
Permit Number: 16878 Address: 7313 APPLEGATE DR �
Permit Type: FENCE ZEPHYRHILLS, FL.
Class of Work: FENCE/NEW Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: ALPHA VILLAGE
Est. Value: Parcel Number: 35-25-21-005A-00000-1000
Improv. Cost: 4,400.00 � - OWNER INFORMATION �
Date Issued: 1/06/2016 Name: WHITE DANIEL
Total Fees: 80.00 Address: 7313 APPLEGATE DR
Amount Paid: 80.00 ZEPHYRHILLS FL 33540-1033
Date Paid: 1/06/2016 Phone: 813-782-3521
Work Desc: INSTALL 232 X 6 WOOD FENCE
" - CONTRACTOR S � ' _ APPLICATION FEES °
POST R US INC (813)779-7795 BUILDING FEE 50.00
CONTRACTOR CERTIFICATE 30.00
� -�'1/ .
� . � ,
I � �
— "� � - � Ins ections Re uired = _ -
FINAL '
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 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.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your properly. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans, Specifications and Fee Must Accompany Application.
ork shall be performed in accordance with City Codes and Ordinances
CONTRACTOR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
m.
A{� k'ENCE
���� � � � ��r�� si�o x�ate�a r�..
����,� Zeghyrhills, Flarida 33541
"Your PY�Specitzlists" 813-7T9-??95 813-9?3-0$26 888-7?9-8553 fa�:
acme�'ence@yahoo.com
� LICENSE # 11795
�R����7��C��T��� Q 9111�l�415
. i
Customer4Iraformation: Job Infoz�mation:
DA23IEI, WHITE JOB LdCATED I�T ALPHA VILLAGE
7313 APPLEGATE DR 782-3521. ,
Zephyrhills, Florida 33540 PAINTBW@VERIZON.I3ET
Notes: '
- 232' 6 FOOT PVC TONGUE & G1200VE PRIVACY - ,
i ,� ea' z_......._�......
2 5 FOQT WALK GATES � �
�
� GATE POST 63{ ALLUMINtTN! I BEAMS �
AI�L POST SET IN CONCRETE 61� �
_ so•
POCKET RAILS � �
(
LTFETIME TFANSFEI�ABLE WARRANTY B�
s�
HOUSE
y y� $.
6'
, j
�
e
ACME S�NCE agreea to guaraate� above fenc� to be job �r►d adju�tmertta for labor pill be charged or
fs� from defeat� in mat�rf�ls and workm�n�hip for esedit�d at the csurr�ntly eetabliehed rsYsa.
ons� yesr. Additianal aharges far any e�ctsa aaork nat cavered
ACl+� k"ENCE shall �dviae the customer as ta loc�], ia thia contract that Nae reque�ted by the customer
aor►ing regulation� but re�ponsib311ty #`or camplyiaq will alao kre added. The full amount of Chia
vrith said regulatioae and obtaining ar►y required contsact aloag xith any additional, ch�rgeffi wi21
permits shall re�t x3.tis the cuatomer. �Cb� FENCE beaome pay�ble upon aamplgtion of all work �hether
will ussiat the cu�tamer, upon requeat, in or not it has been invaic�d.
de+t�rmi.n3ag wh�re the fena� is to be erected, but A £inance charg� of 1 1/2�tr per month (cr a
und�r no circum&tanae doe� � &�1+iGE asaume aay mini.mum of $1.OU), xhich is an aruival g�rcentage
r�epons3.bility conc�rning property lines or in any rate of 18�, ehali be �pplied to aacounice that are
aay guarantee thair sccurscy. ZE prop�rty pins aot paid aithin 10 dmy�s after completion oP any
c�nnot be loc�ted it is reao�aaaded that the s�ork invoicQd, Al1 materiale xi11 remaia the
cttstoat�r havs th� progerty suiveyod. property o� IsCME F£HCE ssntil all invoice�
� ACt+� SENCE ai.il a�euma tt►e reapoasibility !'or pert�ining to th3.s job ase paid in gull. The
having und�rground pubiic utiiities located and cuntomer agreea to p�y ail interee�t snd any caet�
masksd. However, ACME BENCE as8umea no incnrred in th� oallection of t3sis debt. ,
reeponsibility for ssnmarked apr3nkler lines, or any
otlser unmarked buried lin�s or obj�eta. The
customer �rill aasume all ].iability for any damage
c�naed k+y direating ACt� FENCB to dig in th�
immediate vicitaity aP known utilitiea.
The £inal billing will be basad on the actual
faot�ge og fencing built and the �ark perfarmad..
Partisl billing far materi�ls deliv�r�ci to the jab
eite and work compl�ted may bm eer►t at weekly
int�rval�. Adjust�nts Eor materisl ueed on thi�
App ved & ��`epn"��/�or Customer:
I � �
i CQI1tT�Gt AnlQilrit: y4' a���.QO stomer Date
; Down Paymerst; $ 1400.40 Ae pted f r ' �./
� 1 '�l�y �J
sa��C� nu$: s �aoo.00 �
alespersan Date
813-780.0020 City af Zephyrhills Permit Application Fax-813asaoaz�
Bu[iding�epartmant _
Dats Recelved � - . Phar�e=CaM�o#for°Permttt[a '�
�
Qwner's Nart►e W�� . , .' Owner Phane Number �� `� �— �Z 1
Owner's Address ��� C Owner Phon�Numlaer -� .w� ��
Fee Simple Tltleholdar Name Owner Phone Number �� ` �
t , . . �
Fee Simple Titleholde�r Address • �
_ �� �i
JOB ApDRE$S �I� I '� � LOT# ,
sueorvis�oH _ ��1i�� "� .� P�ce�io� ��S� ��—�C� `t,�(�l�d— ���� ��
, . (OBTAINED FROM.PROPERTY,.TAX NOTICE)
WORK RROPOSED, �.NEW CONST�t ADD/A�.T �� S1Git1' Q Q DEMOI:ISH
� •:e,� INSTALL 8' REPAIR � ' -
PROPOSEQ�tlSE Q SFR- [� COMM C] t}TFEER
TYPE OF CONSTRUCTION � Q� �' BLOCK `" `Q FRAME [� STEEL 'Q �
- .
DESCRIPTiQN OF WORK' �j. C� j {� �/� c�' 0� ��I�'� i
SUILDING�SlZE' �' '�"��fOLiTAGE `r�-c7Z� HEtGHT � � !
„ - ;., _
,-, ,_.,_.. ..�_ ..._..-. .-
BUI�RiNG $ L ,L�I�Q�QQ�. VAIUAi'iON�:t�°F"i'OTAL CO(�STRUGTTON
QE�ECTRICAi, r$ � , ' �j AMP SERVICE Q �PROGRESS ENERGY Q W.R.E.C.
�.� .�
QPLUMBtNfa ' � � '
Q MECHANtCAL $ Vi4�l1AT10N OF'MEGHANtCAL IPIS7ALCATIUN � J �� ��
- �_-_ , � � -
�c,�s Q RC}QF1NG Q SPECIAI.TY [[� OTHER °
FINISHED FLOOR ELEVATIQNS r�� FLOOD 24NE AREA QYES. NO
L
BUI�DER COMPEWY' �' � ��' G.`�
SIGNATURE � ' REGISTERED Y/ N �EE CUR�n Y/N" .
Address ��� �(Gr L.►`v � �� - Ltcense# � �
ELECTRICIAN: >=COMPAt+tY � � �. - ,
SIGNATURE � REGISTERED Y/ N FEE'CURRE�'' -Y/-N
` Add�eas ' - � ._ � . � Licanse#�.�~ . � - �
� .. . , , , - . : . .
li PIUMBER � � COMPANY =� � ': :r. `
SIGNA7URE` � , .. REGIS.TERED.y . Y:/,-N� , ;FEECURRE� Y;�/P�I
Address - . . . . , ` ,ltcense# �:'� , . �
! MSCFiRNICAR: . GOMP1it+tY, .. `- . ,• . .
SfGNATURE� � "' `" � REGISTERED �' Y:/ N , ? FEECURRE�. Y�/:N -
Addre��✓ -- , ' . - L � ` � License#.�. ��, �
OTHEEt` "' ` - � � . � �� � �;GOIIA.P1tNY, , � - � •
SIGNATURE- '=��` • ��` " '`' -" '"�' ' " � �' `REGISTERED ` Y/ N .� FEE CURRE� � : Y 7 N
� Addres� .r•' ,t�� _, . . . , : ' Licerise# � 1
4 ,�y " x. ��nu��.:�. -. r ,
RESIt}ENTiAt:;<.,;Attacti"{2},f�lof Platis;,(2)sefs'cf�Bitild�iigF t?laris;'(1}set of<Erierg}i>Forins;�R-O-W Perini#ior nsw construction,
-� �=Minimumvtenr(�1.0)xworktng;days;after:subiniftal'date::Required onsite,:ConstnicUori�Plans;Stormwater'plans w%Silt Fence installsd,
.,:��.,�...3,.il . . �
' Sanitary FaclllUes�.&;;1#;dumpster�Site�:WorlccPermit#orsubdivislons/Iarge:;p.roJects:�ti... ,,;� . � .- - =
COMMERCIAR. A#tach(3)�compl8te sefs"af Suitding Plaiis p�us a'Life Safeity_Page;('1}set of Energy Fornrts.R-LI-W Petmlt i+ar new construction. -- � -
'� Min(mum ten(10)working days after submittal date. Required ons(te,ConsWcdan Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilitles&1 dumpster.Site Work Pemrit for all new:proJects..All commerctal requlrements.must meet compliance �
SIGNPERMIT Attacti"{2)sets"of'Engi�ieer.eil;Plans.; -.Aa: �: .. . . � ' -
"""PROPERTY SURVEY reguired for all NEW.oanstruction.. _ _ -
13�rectlans: � . - �� _ , .
Fill out applicaUan wmpletely.
Owner&Contractor slgrt back of applicatlon,notaelzed
tt over�2500,a Notice of Commsncement is required. (A/C upgrades aver 57500} �
i:��,�;�:;��,�;�
" Agent(for the'contracto�)or'Poviie�of�Attoiney�(for tiie bwner)would tie someone with notarized letter from owner autho�izing same
� _. .. : �
4VER'THECOUNTER,RERM!'FTiNG., .,-..(Front�of-Appllca#ion°Onty)_•_ ._ -
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) �
_ _ _. _. _. .. .. -, .,�", �, . ., ...
, Drtveweys-Not aver Counter if an pubiic roadways..need"s ROVti�
� _ .
', NOTiC�QF DE�D RESTRICTION�: The undecs6gned under�tands°�th�t:tt�Gs.���rmlt may,,,be.sub�eat t�"aieed"�re�st[Ictions"._ �u..
which r�ay-be��iore.r.esthlctiv�=tt�a�C�unty r�gulatCons:�'Ttie.ur�d��igned"�s`"sumes='respori��ibiliQy-fmr4co�ipitance vvith a`riy rt �
aPplicable:deed-restricttons. .. . . ' . . - ..
� UN�.I�E�1��D°�t�NTl�GTOF�S�l��m CClNTR,�+�TOR R��iPf:3NS1�ICITBESa =-tf the c�wr�er-ha�L'hlred a coc�tracto���or
contr�ctors to undert�ke work, they may:b�..r�qu.ired<.to�be•:Ilcen�ed In accardance.wlth:stat��.and�local.regulatlans:�'If�the� �' '
contract�r #s e�vt�l�cens�d as�re�q�tlred�6y la�r, �a�th the n�vv�er,a�nd-co�tca�tor����iy b��cited for a�m€sdem��nor vlol�tl�n
under state law. If the awner ar Intended::contra�tor�are.;unc���in as to wrha� flc�en�ing,,,requ0remenfs;snay-apply--ior:the- � -
�
�i Intended woNt�they are advisetl to contact th�a Pasco C¢�unty 8uildi�g'Insp�ctlon Division--L(ce�sing�S�ctlan at 727-047-
80U9. Fu�thermoc�e, �f the ovtmer tias tii�d a con�c#o� flr'coritractor�. he�is advised to �►av� the �an#ractor(s),.5sign
portierns of the �contr�ctar Block" of this.�pplicatiar� for which they will be.,r�sponsibie. If you, �s.the ovimer;'_sign'as'4h� '
. ,_
contta�tor,th�t�ay be an indic�tion'4h�f`fie fs"e�ot'.properly 1lc:�ensed ar�d`�is`���t`entd##eii Qa permitting p�lvileges in Pas� :
Counky. � , :��.,� .
TitIANSP�RTATIAN�IMPACT1UTll���'IES`IMPAC`C AN�I�ESCbURCE REG��ERY FEE�: The under�lgn�d understat�ds
that Transpartation Impac#Fees ar�d.Reca.urse Rec�ve�gryFees rr�ay`:appty:#o:the`con�tructia�ro_of new.buildiags,,�ch��ge.mf`� �: .:
use In existing bulldings, or;�xp�nsi�r���of�°existin�'�buildings, �s �pecifl�d.Ir� Pasco County O�"dinance number 89-07 and �
90-07, as �t�ended.,.;�"he undeusig��d �I�o;��nders#a�ds, #haE�stach fe�s,���smay�b�:dtte::;w111:6e �dent�ied at the�ti�vie°of-�� -
permitting. Ik is furtlier understood the�t Trat�spork�tion Impacf Fees and�F�esouec+a.Recovery�Fees.onust be pald prior to
� r�ce4ving-a "�erf1#icate.�f accupancy"��tr flnal•�power-release; :���the pro��ct�.d�es t�ot fnvolve;a�-.certi�c�t� of occapa�cy�o'r'.:` �,, ,.;;
final podver retease,.#he.fees mq�t be paid pclor#o permit issu�nce. �ti�t�termore,-if:Pasco,County�WaQer/Sewet:lcnpac� -
fees are due,.th�y:�nust be�,pald..pNor ta�,permit�-Issa�ance�in acc�rd�nce w(kH�pplicabl�_P'asco'.Coun��a�dina�nces. �•
CON3TR��T10N'1:lER!'I.A�t11{Ch�pt�i�713w �I�rl¢ia St�tcate���ds atn�nd��): If valua�c�€�o€vvork Is$�,500.p0;or rnore, 1� .,
certify that I, the. applic�nt, have�been provlded �with,�a copy- of the "Florida� Cons#rucNo�n Lien Larnh—Homeowner's
Pratectton Gulde" prepared by,tti� FI�i�1da Qep�rtment of A�ricut�ur� and Gan�amer-A#fiairs. If#he �pp8tcar�t Is sar�eone .
; ather than the"owner", i certffj+that I ha�re,o�ta)netl°a°copy.of.#h��abQye.de�crltied tlocuii�ent.and.praa�ils�:ln;good::fait6�to .�
��deliver!t to.the."owrrer"�.pi�or.�t�rcomm�nceme�4:" ' . ,
C�PITI3�GTAR'S/K��VNER'��,FfIDJ�VIT: I.ce.rt��,that•atl�_tfi��;inf�rma#1dn}On thd�appticatlon is accurat�.�nd ti�a��11 work
will'be done in corciplfance wfth all appllcable laws regulating constructlon, xontn� and land development. Applic�tion is
hereby made to �btatn .� permbt.:�o.;�o wor`k,.,a�nd�tiis#a11a#lor� as Indt�a#ed:,-,�:# cer�lfjt Qh�t oto work`ar tnstell�tion has
commenced prior ta issa�ance of a pe��(t and that:all work wlll be pertormed #o meet standards af �II I�ws regulating�
construatlon, Cau�tty �nd City codes, zoning r�gulatlQns, and land d�ve9op�ea�t regula#lons�#n the jurisd6ct{or�. I� at'so
cer�ify that t understand that the r�gulation�of oth�r gov�r�m�nt agenci�s m�y�appiy�to the intended work� and that i#Is
my re�ponsibllity tc�idenkiiy�what.�ctions I must take.to b��in�c:c�mpliance, S.u�h,agencles include but�are not Ilmit�d to:
- Dep�rtme�t ot Etl�riron�enta6rPro#gcti�r�=Cjrp�ess.�ayhead�, Vtiefland A�eas and Envicor�ment-a#ly SensiQive
Land�,WaterlWastewa�ter Treatment. �,r ,
- SovtP�ws�t F1or3de Wat+�r IUfan�geme�tt .C7isUict-Wells, CYPress. �ay�eads; VVetia�d Areas, Attec�ng
Watercaurse�.
- Army Corps of Engineees-aeawalls} Dooks� Navigatile Waten�a��.
- Departe�ne�t of.,Flealth �► R�F�abilitat3ve S�rvices/E�vitonmenf�l Nea�lth U'rtit V91e11.�, Wastev�fer�Treatment;
Septic Tanks. � � .
- US Environmenta#F'rotectio�A►gency o4sb�stos�ba#emen#.
F'ederal�vl�t(on AwlhoMty-f3unways.°� �
1�unders4and that the.follovv�ng.��estrlctlons apply to tf�e use o#fl10:•
- Use m#filP�s not s{low+eti ir�;Ftood Zone°'!i"unleas expressty p�rmltt�d. `
. - Of the �II m�t�rlal- Is to�6.� used��ln•,Flood Zone. "AW, It. is urrod�rstood that a drainage pEan addressing a
"�ompe�sating vol�me*w311 be subm�tted a�ti�e of�p�rmifttng wli�ch Is prepared by a prof�sston$1 enginee€
Iicensed by th�St�ti�of�Fd�rida:� "' � - �
- !f the fill materiai-!� 4o be•used.In Ftood �one °A" in4 conn�c�i+�n�wlEh�a perm6t#�d building a�sing stem wail
� construct6on, 1 certi�y th�t f�il;vulll:b.e-used�nly:to fill the ar���nrithin�the�ste�vvatt.
- If fill m�terlal is tm be u�ed in ariy area; ( cet#Ify that use caf such flA wIU r�ot adversely affect adJacent
pr�perties. If use s�f flll l�found.to adversely,�ffect ad�a�ent�pr¢�perfies�.#he avun�r may be �i#ed f�r v#a�ating
the conditlons of.the build9ng:permlt issued under 4fie.attached.permik appllca4lon, for:lots.less than.one (1)
acrs whieh aa�e eievated��iy`fI!!,a�r en�lneersd dr�lnag�plan is rec�ulred.
If i am the AC�E(VT FOR TM�A�ItNEEt, i;.pror�tse In good faith#�infarm the owrner of-the permltttng aonditlans set forth in
this affidavlt'p�lor to coi�menoing constructia�n. 1 understand that�-s�paraQe permlt may be requtred for elect�ical'work,
ptur�btng, slgns� well�� poats;.air c�r��itlonit�g..ga�s,�;or:otii�r'. Ins#al��#ioh� rt�a�.spea�tcally in�#uded-In.th� �ppl3catian. .A �
permit Is�ued shall be cartstrued to'b��'a�Hcense ta`p�oceed with the wrork and not as:authoriky to.vialate;`cancel, alter, or ,
set asld�any provisions o#the#ech�[ca1 cod�s;�nor shall lssa�ance�of a�.perrnit.pr�ue�t the�uitdirig Ctf�t�3�E from#herea€ter
requiring a conectton Qf errors Im.pians, constivctlaco or vio�iatlons of,�r�y cod�s. �very perrnR l.ssued�s�iall become inv�lid
unless th�work authorized.by seach permit:�s.corrnmsnced�wtthlr� sfx month� af permJt Issuance, mr !f wark authorized by
#he p�rmt�is suspended�or.sbandonad�for a:peri�d af���C(�}�masntdts.afte�th�tire�e ttte�wa�tl��is aa�rromec�c�d, An e�ctension
may be requested, In wri#In�g,from tH� Building,Of�l�lal far a p�r(od-.not to �xceed raine�,r(90) days ��d will demonstr�te
�us##frabl�c��ase for�he extensto�: If w�rk c�ases:for nl�e#y�9Q}coa�s.+�cutiv�day.sr..#h��ob�is cansEdered�ba�doned:
1l�ARNIt�G TC? A1AtNElt; YOUl�..FAMl.WRE•TO.R��GL)�Q/si,:i��TIG�.AF•��MlI�I�NCEME�"� lVt�►Y RESt;lLT iN Y�Ul2
P'aYiWG'�WtC�.�OR:a�l�'RAVEMEN7'�T�I�oUI��.P�tt�PEt3TY:��iF�Yo.U,i =.� �IN�flt�cP��rtNt�;�CC�NSUL�
4iPIT ll Ci O AN,A'PTOitBVEY F�R�=, E��lZ�1 G�� � ' -
FL.QRtD�4 Jl1RA�':{F.S.1.17.�3) - " _ _;_. , —-- -�-- ' �.:_ __- __ . _
_ __ _ - . _ ,
PJWNER AIt ACi�NT - �ONTRIA�TO
Subscrib�d and svorom M{or a�ltmed)befare t��fhts Subsa�ib�cf and' {at�#�rmed}•befor�e me t#i1�
by �by � -
Who Is/are personally kna�wro to.me or has/have produced Who.ls/�re p.erson�lryknoum te�me or has/have produced
' as Id"en�RwBon. as Iden�flc�tlon.
Notery Public _ Ndtary Public
Cammtsslan�lo:- Comrt�l�ston_No.
tdame of Notary typed,Printed or stamped Name ot R4ot�ry typed,prin4a�or stamped ,
�I . .
I
�
I
� y • IIIIIIIII�IIIIIII�I/IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII •
� � � 6 20160018/0
Pe�mlt No.
Per�i ID No � ZS�"+~ O`^��-u-�w�/�I DO�
/ NOTICE OF COMMENCEMEN
Slete of `� '!��1(aGl CouMy of �S�O m O�
r+Nf n
THE UNDERSIGNED nereby glvea notice thal Improvement will Da mad t certain al property,and in,exordar�r�witl�Cliapter 713,Flaide Stetutes, � �� r�..
the follwNng infamation la provi0ed In this NoUce of CanmencemenL• ��j� �$�,� �/00 or C�Zt�r� �( 3.3(O °�'�;.:.
1. �escrlptlon of PropeAy: Peicel Idenlifi on No. N B�I
� ���
sv�+naa�e9s: 3f ...
� /� m �
2. Generel Descrlptlon ot lmprovement i� �� nGG � C T I 11qL ^� � �
�I M
3. Ovmer formeUon or Lessee int on H the Lessea cantraded far tha trnprovemenL• � ��
�/11 t. l(,(/1\ � 3 m o
7.3(3"�"'�1-QDic a � 02 Z � ' 33.�'Yo -� o m m
Address City Stele . � �
Interest in Property: � m
Name W Fee Shnpie TfNehdder. �
(If�1►erent tran Ownar Ilsted ebove) �
7
Address Clty State �
4. Conitacta: C� '
' � N a _ O � a , z CAh r.,�/i ti�' i 33St1 I �
Cdotttradors Telephone No.: ���' / / 1" /���7 Gry State
5. Surery:
L
N�IIB �C
A�f899 C.Ih/ $18i9 ��D
AmouM W Bond: S Telephme No.: �v'
WNo
9. Lender. ' �m z
Name - �m
-�r ���
Address CIH • ��9� wr v
Lenders Tdephone No.: - I �7' '
0
7. Persons within the Slate ot Florlda dasigneted by fhe amer upan wfian notices or other dowments may be served as provided by , �pNp D
Sedfon 713.13(1)(e)(n,Flarida StehAes: 3 n
0
Name I C�1 r r�'-
m
�
Address Cihr Stete �
w0 �
Telephane Number of Deslpneted Parson: 'A
c�
8. In addtlon to himseJf,lhe ovmer designates of_ w~�
lo receive a copy of ihe Uenors Notl�e as provided In SxUon 713.�3(1)(b),Floride Stetutes. � �
0
Telephone Number ot Person or EnUry Daslgnated by Owner: �
9, F�Irallon dete of Notlee of Cammencement(the e�iration dete may not be befae the ampleUon of cansWctlon end flnat payment to the �
contraGor.but vdn be one year han the dale al recordtnp umess a diltuent date Is spedlled):
WkRNING TO ONMER: ANY PAYMENTS MADE BY THE ONRVER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPRQPER PAYMENTS UNDER CHAP?ER 713, PART 1, SECTION 773.73, FLORlDA STATUTES, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENfS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE 1HE F�RST INSPECTION. IF YOU INTEND TO OBTAIN FINANClNG,CONSULT
1MTH YOUR LENDER OR AN ATfORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMEM.
Under penaly M perJury,I dedere Ihet I Aave read the forepd�g notice o}eanmeneement and thet t feds etated thereln are We to Me beat
a(my knrnMedge and bdlet.
STATE OF FLORIDA
COUNTY OF PASCO
Sipn ure ol0timer or Lassee,or OwneYs or lessee's Authorized
_ oir�roueaaraaro,�nue�ea�
�L�i,,P-,/1
�Sipnatoys TitleJOflloa
The foregdng Insvumenl was ecknrndeEBed Defora me this o7$aay m`l�ee .zol5 by l�.,i z\ t 11���-
as QL1�hE�/ pype M euthority,e.g.�oftieer,Ws ee�erianey in facl)fa
' ��,� . (n e party on behetl t was ezewted).
PereonaQy Known❑Q6 Produced IdanUfk�atlon�'; -, , Nolary Signatu , ., �'�
Type W idenUflcellan'Produced F� JJr�� L\'C_ ,. Name(Print) � . +✓1s
: • ' f f , ,. .,,"",,,, -,.JENNIFER L GREEN I
_ _ .•�av o�e.,,,
, -, , .�-, - , - , ;a; ;�: Notary Public-State of florida
� ' � : . :�c My Comm.Expires Jun 10,2017
=;�,� �a"c� Commission M FF 025888 '
NPd��+���������� - _ '%°������, Bonded Through National Notary Assn.
�,,�����e
�c ' � ' ��4c+
� �, STATE OF FLORIDA, COUNTY OF PASCO
� ' v,► THIS IS T0�CERTIFY THAT THE FOREGOING IS A
* s TRU�AND CORRECT COPY OF THE DOCUMENT
InGncf 1ye7nut � � ON F�ILE OR OF RUBLIC RECORD IN THIS OFFICE
y� � -+��t � W�TN S MY HAND ND OFFICIAL SEAL THIS
�,,� . � oa,Y oF Yl, 2 a�la
� �887 ky PAULA S_O'NEIL,CLERK&CO PTROLLER
s�' � . � ( �
r��OF FL���A BY ���'Uf .�t/t- DEPUTY CLERK