HomeMy WebLinkAbout16-17813 /
CITY OF ZEPHYRHILLS
. 5335-8TH STREET
� 4_
�ai3��8o-oozo 17813j' �
PLUMBING PERMIT �
PERMIT INFORMATION LOCATION INFORMATION
Permit�:17813 Issued: 10/11/2016 Address: 5850 13TH ST
Permit Type: PLUMBING ZEPHYRHILLS, FL.
Class o1�Work: PLUMBING RENOVATIONS Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Fee �: Est. Value: Book: Page:
Cost: 5,747.00 Total Fees: 65.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 65.00 Date Paid: 10/11/2016 Parcel Number: 11-26-21-0010-03900-0110
CONTRACTOR INFORMATION OWNER INFORMATION
Name: BENJAMIN FRANKLIN Name: EVANS, KELLY ANNE
Addr: 5808 56TH ST STE A Address: 5850 13TH ST �
� AMPA FL 33610 ZEPHYRHILLS FL 33542-3757
Phone: i813)664-8973 Lic: Phone:
Wor Desc: REPIPE BATH WATER LINE & SUPPLE LINE FOR WATER HEATER
APPLICATION FEES
PLUMBING FEE 65.00
INSPECTIONS R Q� IRED
1ST ROUGH PLUMB
2ND ROUGI PLUMB
SEWER
WATER �J
FINAL I
1� �
l
REINSP�ECTION FEES:(c)With respect to Reinspection fees will comp y with Florida Statute 553.80 (2)(c)the
local g vernment 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 ound 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
"Warn�ng to owner: Your failure to record a notice of commencement may result in your paying twice for
impro ements to your property. If you intend to obtain financing,consult with your lender or an attorney
� before recording your notice of commencement."
Comple�e Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
Comple e Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
����
CONTRACTOR PER OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
. 813- 80-0020 City of Zephyrhills Permit Application Fax-813-780-0021
- � Building Department
Date Receive , Phone Contact for Permitting " — •
Owner's Nam �i l l ��1 Owner Phone Number . �3— I��—J O �7 7
Owner's.Addr ss � � E��` J� . ���r` r����� Owner Phone Number �
Fee Slmple Tidleholder Mame . Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRES�S �8 s� r3�- s� � h' Y` "l��-r �L LOT# �
SUBDINISIO PARCEL ID# �
- (OBTAINED FROM PROPERTY TAX P10TICE)
WORK PROPOSED �IEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
B � y INSl'ALI. e REPAIR
PROP.OSED SE:_ Q SFR Q COMM � OTHER
� TYPE OF CO STRUCTION Q BLOCK - Q FRAME 0 STEEL Q
DESCRIPTIO OF WORK ~ � L �i � "u��r � �n�
�UIL`DING'SI E SQ FOOTAGE�' HEIGHT ,
QBU LDING $ VALUATION�OF'TOTAC CONSTRUCTION �
QELECTRICAL , $ AMP SERVICE �Q PROGRESS ENERGY Q W.R.E.C.
�L'MBING $ -
� 5 7 � 7 � ���8�3
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLi4TION �
QGf�S Q ROOFING Q SPECIALTY Q OTHER �p� Z Z
FINISHED.F IOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COfVIPAIVY
SIGNATURE REGISTERED Y/`N FEE CURRE� Y/N
Addres License# �
ELECTRICI, COMPANY
SIGNATURE ' REGISTERED Y/ N FEE CURRE� Y/N
Addres � Cicense.# �
_ PLUMBER:: � COMPANY ����'�n ��n�11V► �'L v mb�n
SIGN/�TURE •REGISTERED- �Y•/ N �FEE CURRE� Y/N
Addres License#-� -
,_MECHANIC COMPANY
.',SIGNATURE - REGISTERED -, Y/,N FEE CURRE� Y/N
' Addres �' � • � � ' � License,# �
..!;'st:: ..
-OTHER=� ��{- � COMPANY
:xSIGNATURE�; � ' REGISTERED ' Y/ N FEE CURRE� Y/N
r.rr'. - , . . - . .
Addres � - - � _ . - " License#
,:�::.,, .
.,�`'RESIDENTIAL ;, AttacFir(2j;Plof Plans$,(2):sets-of Building Plans;(1')set of�Energy;For'ms;R-O-W Permit foi new.construction,
,:• :.a.5.:.,::�•�.-�Minimum'ten�(.10)working�.daysafte�;"su6inittal cl'ate. Requireii'onsite;'Construction Plans,Stormwater Plans w/Sfit Fence_installed,
..: �",_._.... ,
� � ��" ��� Sanita.ry.;Facilities.&?1t,;dwmpster•,;Sife;Woek Permit for:subdivisions/large projects • � " � -
COMAlIERCI Attach'�(2)�complete"'set§`of'Builcling�Plans plus a�Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constniction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,.
=. Sanitary FaciliUes&1 dumpster.Site Work Permit fdP,all new projects.Ali commercial requirements must meet compliance
___...._. ... .
v�SIGN°PERMI Attach(2)�sets _o.f;EngineerGd P,lans� •-
""*PROPERTY SURVEY required for_all.NEW.construction. .
'-Dire'c,tions: I ;�r�:.,sr`°: ��_. , _ _
Fill�out application completely.
qwner�j ConUactor sign back of.application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
" Agent(f'r the�cont�actor)or Power�of Attomey(for tfie owner)would be someone with notarized letter from owner authorizing same
�..'_OVER:7'HE OUNTER_PERMI]'TING__ _(copy_of contract-required)
'Reroofs ff shi�gles Sewers�✓'..�•".Servic"e Upgrades�Yk/C��',; �Fen�es(Plot/Survey/Footage)
,__.,_. :._�.... ' . � � ,,� s
Drivew ys-Not over Counter if on public�roadways.:needs.'ROW ;
• .. - .., =r .. .,., �, �
x .,. .x� ,�,..._...�.�.,.�...,.. ,,.M.,.��.. .,..,..e
.�__.
-- - . 4-��-�..-:�,.�-..���.�-�-.._.�=z�h r,�,
� f
.__ _. .. .... —<�"ra��t..;".+. _'�^
NOTICE OF DEEG.RE�TRICTIONS: The undersigned understands,that.this;permit.may be subject.to."deed" resfrictions°:"�:
urhich�rr�ay:be�mare:restr9ctive#Ftan�County r,eguia#icins: ,TEie.u%idecs�gned=assuiries=�esponsitiilityfor�compftarice wifii�any"'K`'
applicable deed restrictians. ` ,., __, .. .,. �
UNUCENSED=CONTRAGTORS AND CONTRACTOR RESPONSIBILITIES:- If #1ie awcier�tliss�:tiired�a�cont�actor�or
contractors�to undertake work;;they.may be required to be�licensed in accardance writh.state and�local_regulations:-zlfi;tlie� �`
contractor is�not licensed as•required by'law, both"the av►mer�and contraetor-may��6e cited�for��a�mi'sdemeanar vrolation =
under state lavir. !f the owner or intended.,contractor are uncer#ain as to what tiaensing requireinents:;mayt,appiy�for::#he:;��%' ,
intended�wock, they are advised to cantact'tlie Pasco,Caunty Building'In"speotiori"Divisio'n`,=L`icerising Section at?2Z=847=
8fl09. Furthermore, ifi the awner has hired'a corttractor ar contractars, he is advised to��}have the contractor(s),.sign.,.y,, "
portions of#he "contractor Block° of this application,_for wrhich they.will.be responsible. If�you,,as°�tfie'owiner sign as�:#he`- �
contractor, that may be an indicatian that he is not properly licensed anii'�s no#entitlet!�fo�permitting p'rivfleges In Pasca;_,� ,
County. . ._ .. . - .� ,__.. :_ .. .,
TRANSPORTATION IMPACT/UTILI7"IE� IMPACT AND-RESOURCE RECPJVERY�FEES: The'und"ersigned understands
that Transpartation Impact Fees and Recaurse Recovery Fees t�nay�apply;to the,construction of.new,..buildings, change�'of�'��` ''
use in existing buildings, ar expansion�of:existing �uildings, as specified in Pasca County Ordlnance nurnber 89-07 and
90-07, as amended. The undersigned also undetstands,-that such,fees, as�rnay:,be•due, will 6e>identi€�ed�at':tF�e�#irne:of?=� �"�
permitting. It is'further understaod that Transportation Impact Fees��and Resource�Recovery...Fees must be paid prior.ta
receiving a "certificate of occupancy"--ar fi�al:power release. If the project does not involve a ceitificate of occupancy�-or_��-�- '
final pawer- release, the fees.must be paid prior to permi#,issuance. Furthermore, if,-Pasco County Watecl�Sewer.�;tmpact� -��
fees are due, they must be paid prior ta permif issuance in accordance with�applicable P'asco County or.dinances.
CONSTRUCTION �tEN t:A1N(Chapter 7'!3; Fior�da Statutes,as amended): If valuation af work is$2,50Q.00:.or�more,el,;;_,:�
certify that I, the applicant,.have been: provided -with a copy. of the "Florida Construction,:.Lien. l.aw=:Homeowner's
Proteckian Guide" prepared by#he"Floritla Department of AgricuEture and Consumer Affairs. ff the applicant�is someone_
o#her than the"fl�une�', I.certify that I have obtained a copy of the above describetl''document and promise=in good:#aith.#o`,
delivec it.to_the"owner"prior.to commencement. - ' " � ,
Ct3NTRACTOR'SIOWNER'S AFFIDAVIT:;I.certif,y.#hat alt-the infocmation in this application is accurate and tha#alt work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to abtain a .permit.to da �nrork and installatian as indica#ed. 1 ce�tify that no�=vuork or.�nstalla#ion�-has
commenced prior to issuance af a permit �nd that all work will be performed ta meet standacds af all laws regulating
const�uction, County and Gity codes, zoning regulations, and land development regufatiaris iri`the jurisdictRon: F also
certffji that ( understand that the regulations of ofher government agencies may app(y ta the intended work, and that it is
my responsibility to identify wha#actions I must take to be in compliance. Such agencies include�but are not.limited�.to:
- Department af Enviraninenfal Protection=Cyp�ess Bayheads, Wetland Areas and Environmentally $ensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Sayheads, Wetland Areas, Altering
Watercaurses. �
- Army Carps of Engineers-Seawalls, Docks, Navigable Waterways.
- Departmen# afi Heaith 8� ReFta6ilitative Services/Environmental .Hea(th Unit:Wells, W.astewa#er Treatment;
Septic:fianks. �
- US Environmen#at Protection Agency-Asbestos abatemen#.
- Federal.Aviation Authority-Runways.
I understand that�th'e:fo!lowing restri�tions apply to the use af fiU:
- Use af fiit is nat aliowred in Flood Zone"V"un(ess expressly permitted.
- If the fill ,material is to be used in. Flood Zane "A°, it is understood that a drainage plan addressing a
i "compensating volume" vui11 be submifted at time o# permifting which is prepared by a professiona! engineer -
licensed by the State of Flarida.
- lf the fill material �is to be used in Flood Zane "A" in connectian with a pet�mitted building using stem uvall
canstruction, I certify that.fill will be used only ta fill the area within the stem wall. ,
- If fill material is to be used in any area, ! certify that use of such fill will not adversely affect adjacent
properEies. if use of fiil is found to adversely affect adjacent properties, the awner may be cited for viotating �
the conditions of the building permi4�issued under the attached permit application, for lats less than one (1)
acce which�are elevated by fill,an eng�neered drainage plan is required.
If I am the AG�NT FOR TH� OWNER;�I°�promise in good faith ta inform the owner of the permitting conditians set forth in �
� this a�davit prior fo commencing construction. I understand that a separa#e permit may be required for efec#rical..wark,
�I plumbing, signs, wells, poots, air canditioning, gas,.or other�insfallatian§ nat specifically included in the apptication. A �
permit issued shall be construed to'be a license to proceed'inrith the wark and not as authoriry to�violate,.cancel, alter, or
set as9de any provisions of ttie technical codes, nor shatt issuance of a permit prevent the Building Officiat from tttereafter ;
, 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 pertnit is comrt�tenced within six months of petmit issuance, or if work actthorized by '
, the permit is suspended.or abandoned for a period..af siz(6).months after the time the wark is�commenced. An exkension '
may be requested, in writing,,from the Building Official far a:period not to exceed•ninety{90) tlays and wi!! demanstrate �
justifable cause for the extension. If vrrork ceases for ninety{90)consecutive days,the jab is considered abandoned. .
WARNING Tt1 OWNER: YOUR FAILURE�TQ_RECQRD;A.Nt?TlCE OF COMMENCEMENT MAY RESULT IN YDUR '
PAYING TWICE FOR.tMPROVEMENT�.TO,,YO.UR:PROPERT�If.�.IF YOU.�INTEND�TO.OBTAIN�FINANCING;�CONSULT
WITH Yt�UR CENDER OR AN A7"TORNEY BEFORE:RECQRDING YUUR N TICE OF COMMENCEMENT: _ _
—FLQRI�A JtlRAT`{F:S:'C"C?:D8) —- - — _ �� —_
OWNER OR AGENT CONTRACTOR
Subscribed and swom fo{or affismed}before me thls Subscribed and sw o or affirm be{or r�e this
by �0'/-/._�v by �.►1 ���l�l� Y.
Wha Is/are personally known to me or has/have produced � Whq1s( re rso a y known to me or haslhave produced
as iden�ftcation. �_,� t' �,����cb„L_ as IdenBfica�on.
tVotary Public Notary Pubflc
Commisslon No. Commi s3 No
rauunru u.r�Avi+WlPeP1108 ,.�q���'�•.
Name of Natary fYP�,P�n#ed ar stamped Name of Natary egl�,p�tgl��td�t� X3 =�' �
� ZZd05l��#uoiss�wwo� ,;.. '"�
•;�e�A�`a?,,:
' S3JOS 3NIl3f1D��1f '�,�i�,,,.
:�-
(
-----
----— —,
— �
_-------� - �
Pce ared by and return to:
�r�sti L.Sereno Haven Title,LLC '
907 N Florida Ave Suite 3Q0
', '�'ampa,FL 335Q3
�13-699-3054
�i1e Number: 39Q
P�rcel Identificatian No.2I-26-I 1-001.0-434.4Q-Q1].Q
[Space Above This Litte Far Recording Data]
Warranty Deed
(STATUTORY FQRM-SECTIOAI6$9.02,F.S.)
'�' is I�dCntut'� made this 2$th day af Septernber, 2016 between Strafegic Property Investment Speciaiisfs, LLC a
Flarida Limit�d Lia6ility Compapy- whqse.past._o�ce address is 1Q046 Cross;Cr.e.ek Btvd;_Tampa., FL 33647,af the ,
Caiunty of Hillsborough,S#ate of Ftorida,.grantor*,and Kelly Anne:Evans,�a marrieil wom"a'n w6ose:post office adcTress is �
1a�07 Byan Road,Tampa,FL 33610 oftfie County of Hillsborough, State of Florida,grantee*,
Witnesseth that said grantor, for and in consideration of the sum af TEN AND NO/100 D4LLARS ($10.00} and other
go d and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowtedged,
has granted, bargained, and sald to the said grantee, and grantee's heirs and assigns forever, the following described Iand,
situ #e,tying and being in Pasco Connty,Fiorida,to-wit:
Lots 11, 12, 13, and the Sauth 112 of Lot 14, Block 39, CITY C3F ZEPHYRHILLS (FORMERLY A
MAP OF THE TOWN OF ZEPHYRHTLLS), according to the Piat thereof, recorded in Flat Book l,
Page 54, of the Pulalic Records of Pasco County, Ftorida.Lots I l, t2, 13, and the South 1!2 af Lot 14,
81ock 39, CITY OF ZEPHYRHILLS (FORMERLY A MAP OF THE TOWN OF 2EPHYRHTLLS),
according to the Plat thereof, recorded in Alat Booic 1, Page 54, of the Public Records of Pasco County,
Fiarida.
� Physical Address: 5850 13th Street.;ZephyrhilIs,FL 33542
TOGETHER with all the tenements, hereditaments, and appurtenances thereta belonging or in anywise
appertaining.
�
TO HAVE AND T4 HOLD the same in fee simple farever. �
. AND grantor covenants with.grantee that grantor is lawfuiiy seized of the land in fee simple; that grantor
has goad rigtit and lawful authority ta seil and'convey the tand,that grantor will`full��warcant the fitle�.ta:".the � .
� land and will defend the same against the lawful ciaims of ait persons whozi�soever; and ihat the tand is free
af all encambrances except taxes aceruing subsequent to December 31,2015.
This is nat the Grantor's Fiorida ConstitutionaI Hamestead property.
'`"Grantor"and"Grantee"are used for singutar ar piurai,as context requires.
� In Witness Whereof,grantor has hereunto set grantar's hand and seal ths day and year first above wr4tten.
i
DoubieTime� ;�
\ , - ---
>�
,:,
, , ��:
'�;:
�3;
cl
Signed,sealed and delivered in our presence:
Strategic Properry Investment Specialisu,LLC,a Fl Limited
Liabilty .
By:
Wime e: Y Shehzad Ali,Manager/Authorized Signor
'mess a
(Corporate Seal)
State of Florida
County of Hilisborough
The foregoing instrument was acknowledged before me this 28th day of September, 2016 by Shehzad Ali of Strategic
Property Investment Specialists, LLC, on behalf of the corporation. He/she [,]is personally known to me or [X]has
produced a driver's license as identification.
[Notary Seal] Notary Public I
Printed Name:
My Commission Expires:
�,ter s` Iff118T1 LSERENO
'b MYCOMMISSION6FF211136
t�i;�`�,�; IXPIRES:Aprfl12,2019
�.}`•'.lt r` BoridadlNuNotmyP�ScUnde�R�-
.�.�...
Warranry Deed(Statutory Form)•Page 2 DoubleTime�
��'��s�,,,�� ��-r.�
pj,Q�O �� t'scense # CFC04b00 •��
� I . •
A�'i`+LC Ctlt �
, ;:
•
� , ' j ��,...�
T�IEPUNClUAL PLUIVIB�Rm
1-866-�fi7-8309 • www.benfranl�.tintampabay.com
�, q`�`��► �, 2 �iZ.`�
, Custom�,e�r Na e ���� �� Date Work Order
°Address
Z� �c ��.s � � 35�- `�.
Gty State Zip
�j ..�- �����
Home Phone Cell Phone Email
Minimum Service Fee
`�iz"°" Emergency- $99.00
We hereby pr.opose to complete as specified the following:
c°".'°'` Reserved - $69.00
We will rovide you with multiple options c°".'"'`. ,Standby - $49.00
� ^�'`� �., � •, � ��i..,. -�-�' '�...
,
; � �3 r ,�. � . .�/"�`"1�
r
r^"""^� i.
�..- -�c���.. r �� �� �.,�.:� �, ? `� � ��� �
Z_ �� �� �, �`�--e.�- �- �.��-� .
�. ��`� `.�` ,,�.��-�1
� �
�-1� `� �Z...�15�
� ��u �
� �n ��..,� � ° �.� �l
� � , � .
� � . . • . � �
My p ofessional technician has offered me all of these other services that Benjamin Franklin provides.
Water Heater $ � Decline Protect My Plumbing System ❑Yes $27.99 ❑ Na
inrUa s
Wate Treafiment $ � Decline Protect My HVAC S.ystem OYes $26.99 D No
mUa s
DEEP P1an # � Pratect My Water Neater ❑Yes $7.99 ❑ No
Pleas check add on services if needed: O Multi Discaunt $50.38
Carp nter ❑ $400.00 ❑ $750.00 ❑ ! decline Safet Ins ection (lnitiaC)
Electr cian ❑ $5Q0.00 ❑ $95Q.00 Y A
�
AYMENT METHQDI�INANCE OPT[ONS INVESTMENT AMQUNT $
O C SN ❑ CNECK ❑ CNARGE ❑ FINANCE PROMOTION � � �- $ -
WELLS FARGfJ SYNCHRONY SNAP UTILITY REBATE $ -
PAYME T FACTOR % DEPOSIT $ -- �ti��`���i-�� �
EST. M(�7NTHI..Y PAYMENT $ TOTAL $
` �
PLAN # /AUTH # �, ' �� ��'� $ � `� �
�
�
� WATER HEA ER: MODE�"# SERIAL #
f '1 �' j . �� �� . �.
� Acceptanc : ' �1�,� .� Authorization: / Date:__��._.,.
; � CUSTOMER COMPANY
i DECLINE:
i �
' *FI.EASE SEE AGREEI3 COtV[}IT10NS QN SACK*
i
W/
�� E KELLY EVANS
585013TH ST
ZEPHYRHILLS FL 33542
D/W
REF
I BA H j
3/4 CPVC 1/2 CPVC
MAIN WATER
_ _ �«i����ii���i���«��iii�i��ir�s��»f�i�tiE�4}t�sl«<s�s��i�
T6is ace[ar u�b Qerk of the(Stnat Comt aily.' � 2016159464
„ , , �' y - .
( Rcpt:1806939 Rec: 10.00
� DS: 0.00 IT: 0.00
��, 10/10/2016 L. K. ,_ Dpt,y Clerk_ .
rro�c�a�co�vnKEivcEMElvrr
j PRULfl 5 0'NEIL,Pfi D PASCO CLERK & GOMPTR4�
�'etmtt23umber ._,. � 10/10/2016 03:44 m 3 of 1 �I
T����4N�. ��i.��0-�3�CDn'���Q � OR BK ���� p� ��1�
' The wsdersl�ted heraby gives natice tiut fmigrovcmeata w�;be madeto cecddn rcai�pmperty.s�ad�ucordanee with 8ec![on Tt3.13 of fitt
. Floiida 3tatutra,ths foUmr3�+g fnforma!!onls grovided in 8ce NOTICE OF CY?14IME3+TCEMEIVT:
� 1. Legal D�tion of property(�eet address requF�ir,e�Ci): G7 2� � :lr�1 1� �U � � 5
sg�J �����1 f# �[�t����� �.' �.0
i
2. General descaptian af impmvemeats:����'� Y -�
3a OwnerName: � � `+��'� I
i
OwnerAdc�ress: � z.? � c�"'+ �
3b. Owner's interest in site:
, j
, i
3c. Fee Simple Titie holdez(of athec than awnec} � ,
Address:
4. Contxsctor23smc: BEN FRAtJKUN PZUMBiRfG
Atidness: 5808 N 56TH S�'STE A TAMPA FL.33810 Phone: 813-651-3485 i
5. Surety Name: t�ruouut of��d: i
Addre�s; Pltone:
6. Lenderllazpe: Contac� - '
Addtess: Phone:
' J
7. Person wi6�in the State of Florida designated bX owner upou wham notices ar othec documents may be served ss�vided by •
Section 713.13(1�a)7,Florida 5tatutes. , z
Name: Address:
• Fhane I3umb�;
8. In eddition to himseif,Owner des'sg�nates tha following p�raon to receive a copy of 8ie Liennr's Natice as pxovided in Seciion
713.13(1}(h),P'Iorida 8taftttes. �
Name: Address:
Phone I3umbec
4. Bxpiration date of Notice of Commencement(e�cpirarion date is one(1)year fmru dete of recarding unlea a different date is
specified)•
WARk(ING TO 044NF.t2:ANY PAYMENTS MAD&BY THE OWNII2 e�FTER'['�EXPft2ATfON flR'iHE lY0'i'tCE flF COSvII�3�fiICIIvIENT ARE
CONBIDERffiJ TME'ItdPIIt PAYMENTS UPIDER CHAPTER 713,PART 1,&ECfION 7L3.J3,BLORII}A STATUTES,AND CAN RF.3CTLT IN YdLRZ
PAYIl�iG TWICE FOR llNP'RQYEMEN'.CS TO YOUft PROPFSt'FY.A NQ'£fCE OF COMIufENCII+g;PIT MUST BE REt:ORDID APiD POSTED ON'rHE
JdB SITE BEFORE TSE FlRST ll�ISPE[.'fION. IF YOU INTEIVD T4 OBTAIId FB`IANCING,C4NS[7LT WTiH XOUR LENDIIt OR AN ATfOFYNEY
BEFORE COhIl1�iCIPiG FYORK OR RECO ING YOUR N4TlCE QF COMMENCF.MENkT: �
. �
Signature of or Lessee,or Uux►er's ar Lessee's Aufhorized 4fficerlDirectorlgartn.er/1�danaget
Si�natnry's Title/Office
STATE OF�I.ORIDA
CbUNTS'OFEI�L4B12320UGH
. y''
. "I'6e fo ' g yf� acknowledge�bezfore me this day nf � / 24�
kry � as �G'� '�� for
Pecsanuttiy Kna Praduced Ideuii5cation
Type ofIdemification Produced
, �.�`
��.��'q1V p�j��,,, ERIC JUARE2
$(l9tUI9 ' OtBt�' . 'C
o,, Notary PuGiic-State oi F{orida
Commissiaa�FF 962507
.� My Eomm.Expires Jun 5,2028
:;� •
�'E°F F`�' Bond�d throuph Naiion�i Notary Assn.
���,���,,,
l3 _— --—— —
���� ; .������
�
� • � • �
�TATE�F FLORIDA,COUNTY OF PASCO � ,'., :
THIS IS T0�CERTIFY THAT THE FOREGOING IS A ` t �
�
TRUE AND CORRECT COPY OF THE DOCUMENT � ' �ad�+e� ;'�• , �
ON FILE OR OF PUBLIC RECORD IN THIS OFFICE o �rt ` y: �
W11'NE_S�S MY HAND AND OFFICI�L SEALTHI�S �r ..1�8�� ��
d�lO�~ DAY OF �' C- G`' �GL 2 Gl G' �
PAU S.O NEIL,CLERK&COMPTROLLER � ° ��
/ � 3TA����
BY -r 2�G��� �(���EPUTY CLERK