HomeMy WebLinkAbout16-18021 CITY OF ZEPHYRHILLS
I 5335-8TH STREET
(si3)78o-0020 18021
` � � BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit r'3umber: 18021 Address: 5916 5918 9TH ST
Perrriit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Propos�ed Use: NOT APPLICABLE Lot(s): Block: Section:
Squa�re Feet: Subdivision: CITY OF ZEPHYRHILLS
Es�. Value: Parcel Number: 11-26-21-0010-01500-0170
Impro�. Cost: 2,125.00 OWNER INFORMATION
Date Issued: 12/22/2016 Name: 5912 9TH ST ZEPHYRHILLS TRUST
Total Fees: 50.00 Address: 2202 DURANT CT
Amo�nt Paid: 50.00 VALRICO FL 33596-5301
Date Paid: 12/22/2016 Phone: 813-205-4362
WoPk Desc: RERROF SHINGLE
- I CONTRACTOR S APPLICATION FEES
KINGDOM CONSTRUCTION & DESIGNS, REROOF RESIDENTIAL 50.00
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I Ins ections Re uired
DRY IN R�OF WSP
TAPE JOINTS ROOF INSP
FINAL II
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REINS�ECTION 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
II 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 property that
may b�e 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.
"Wa ining 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
�I City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
� NO OCCUPANCY BEFORE C.O.
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ICONTRACTOR 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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e���aaoo2o City of Zephyrhills Permit Application Fax-813aeaooz�
Bullding Department
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� D�te Reeeived ' � , �
ii r , �.Phone�Contact:for:Permlttin -' , _
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Owner's Nam� l� �[ � � Zp �P C ` Owner Phone Number �� �.��- � (�
owner•s�dd��a 22 02 �� ��T� ��v� �� � - Ow�er Phone:Number�
Fee Simple T tlefiolder.Name � � - � ' Owner Phone Nufnber � � '
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Fee Simple T tleholder Addreaa _ �
JOBADDItE S � G(� ��& � S( � /� � �� �� 3JS�2 � LOT# �
SUBDIVISIO � PARCEL-.ID# /l.� 2• �D: �BI=�� �f
, , (OBTAINEDF.ROM..PROPERTY.TAX'NOTICE)
WORK PROP SED +tNEW CONSTR' ADD/ALT [�� SIGN' 'Q � ' Q �DEMOLISH
�,,. B INSTALL � ..:..REPAIR -
PROPOSEDa�$E - :Q � SFR. �] •COMM . Q OTHER'
TYPE OF CO I STRUCTION'-� Q�'- r��BLOCK "" Q FRA�AE Q STEEL 'Q �
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DESCRIP710 OF WORK I' - K�-Q.CL�O $ ��./�. � •� � t Q.4lJ�A-�"G��..p�'r v� v✓e�ty r-�2, ,S� � �
�UILDING�SIZE`` � � � ' � '�Q'�FO'OTAGE;�. , ,.HEIGHT�
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QBUILDING $ yALUATION'OF'TOTAL COPJS7RUCTION � ' � "'
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QEL CTRICAL $ " AMP SERVICE. = �Q � '"PROGRESS EfVERGY- Q W:R.E.C.
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OPL MBING � :$ ,,. .. � � _. �/��
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OME HANICAL' . $ '` � 'VACOi4T`ION OF;MECHANICAL INSTALLA710N: � �
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[�GA „ � ROOF,ING , . � SPECIAL,l'�Y�.Q;f,.;,OTHER; , _ -
FINISHED FL OR ELEVATIOfVS FLOOD ZONE AREA „QY�S. ,NO
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BUILDER COINPANY'` �t � .`', ` •� , "
SIGNATURE REGISTERED Y/ N . ��`'-�'%'F.EE CURRE��-` °°Y�/`N` " � `
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ELECTRIC��� - ,�_ . , , r�COMPANY`'; _ ix;-,��„�,,:;�.:, :�K " : � � , '
SIGNATURE ' � �REGISTERED y } Y/ N F.EE;CURFtE�f`< "'�`:'P Y/•:N.. �: .
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Addre$s ' . .. ; .... . , . . � . , , . � , -,u.,l.igense{#��. ,`
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PLUMBER3� � ..C.OMPANY ...r,:>._.:_ ,'r � s�:..,. -. ,.� r,. .
SIGNATURE:� �'. _ ., _ .�. � �:� • �, � _ - - .,. .
, - `REGIS.T.ERED :r. _Y/.N:.� ��FEE:CU,�3�n�� �x:.`Y/.N,:..� _,
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Addre�s ,. , , , ,k.._. -�,License,# ' -_ ` _ � - �
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•MECH�NIIC . , . . _ .., ". . �.., . COMPANY �='� _� _ >. t ;�•:;,�.._„ •�� ' , , �.,. _� -
SIGNA7UFtE; �r: Rr.r, �,,. , .. , , . ,r, ,_ .z�;.... . . ._ ,. , ,
�' REGISTERED _ Y/,N :t,FEE�CURRE�.. Y./�:N.��
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Addr� '-- v. , , ,: � � �License#� ' .
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OTHER , � '"�' L"� ;�. . ��.U'o�� �+ ,,., � ..� , �., G `
'''' .CO,IlNPI4PIYq� � ��- ;/1� 778�1 � _ ,T�y('' ,
51GNATURE _. ,�+ _ _, ., , � „ _ .:�, , ,9..: , ,
REGISTERED`' Y/"N..,. ;FEE CURRE�'�� Y`/N
' ::Y:vY(/:.:�� ��...., h.. . . _ ..� .'+�:..' _ . ` . '_. 'i f ' _,�'S '; :>... .�i.- > �
�►ddre� , -�'`i3�°� .:1� �.�--���t.33.6';a - .'- ' �Liceii`se#�� ���`�!" (3 �j D �j'` � ° .,
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"RESIDENTIAL,$%.:��AttaoFi'(2')„P1Qt�Plans;i-(2)sets_of'Bu�IdfnglPlan"s;(1)sett`of?Energy°Fortns;�R=0=1N�Peririlt#or=newcon§tructton,; � - '
„ Minimum � Q rt - a.��,x.y.-�, ..� ,g.�_ . �..�.�,_, ,..�, .. _ . -
�r�_.�;���,.,�a,f,a,�ten:;(10)aviro,r141ng�tl�ys�aiter'submiltal:date:,�R;equired onsite;'Con'stiucdon.Plans;.Storniwater-Plans w%S`tk Fence installed,� �
"�' Sanita FadUdes,�&�1 dum ster zSite WorkmPertnl,t for sutidivisions/la,��e,': �ro ects;�,s-�,-,::��; `;'--��'�"�_.,,'.", �_ 'A , `��:`r ° , - �-_
ry` ,� , >. s E ,.�b. �s.f.:,�_�u:,.,:,;� . .. ,L�.�:�9 �p µ��,:.;__rk,.�:.
COiNt�ERCi ° Attech(3)�eort►plete'sets'of'Buildfng'Plans plus a Life Safety"Page;(1j set�of Energy Forms.R O-W Parmit for neW construotlon.•'t •
Mlnimum ten(10)working days after submittal date. Required onsite,ConstrucNon Plans,Stortnwater Plans w/Silt Fence Installed,
Sanitary Fadlitles 81 dumpste�.Site Work Permit for all new�projiscts::All commercialSeS�ulr�aments must meet.campllance`'` �� ' -
.�SIGN PERMIT AttacFi"(2)`sefs of`Eng,i'neeredsPlens:t��:s��� :�'s �-.�:s:�<a-:.�._ , _ . ° - - ,
- ••••PROPERTY SURVEY required fpr all_NEW cons#(ucUon._.:., . - -
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DlrAotlon�s .._�,,s�,,,;;,.,�.>,._, .. .,.,, :
FIII out ap�licadon completely.
Ouuner 8 � ntr�ctor slgn back.of appltcaUon,notarized
If over 5�'�0,a Notice;of.:Commencement Is r�quired. (AIC upgr�des over ST500) , .._
�m::,°:�.�'�:s:�;�H.',>._
" Agent(fo i the oontractor)o�Podirer of'Attomey{for the=otiiner)`�nrould be someone virith notarized leiter from owner authorizing same r
OVER.THE.CqUNTERiPERMITTING��•-�;�-(Front-of-Application-0nly) ---- ' "'- "
Reroofs If shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage) - ` j
..t�:iie9'..,�. •_ ;r`�9�'ii�3'�`'
Dr1V�Wa I -Not over Counter If on public roadways:.need`s ROW
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NO'flCI�.t3F DLED R�3TRiC11QI�S:_ Ttie.under�fgt�ed,under�tar�tds:;th�ttif�s�p�cm��rr�ay;ber,: b�, ..�,. tr#r �'.;:��..���'.v}��`�
l+� , su �c,#�to."d,�e,e,d"res �tiatis"
.;;s,. ' ,i!. _ r:��- _ »:r�Cri r�.nf;-. :f+...,,. S�i��J�ti-.'.s', ^t:a �:yk a,rv'�'Y'w'�-�'«''.y,., -cw» ts,t,..w..tk,a�✓'�
which may;tie'�mioiire:�res'trtctfv�..t#ia��C�unly�:re'��ilet�ons:•`�TtieSunde'.slgned��assumes,:re�p�'ns�tilltty:fiir:,cofnp�llan�e:viilth�any
applica6le'd�ed;re�tcicttons. �' :�:;> ,�.'°tiR-;�µ?:,��r� ` _ • __ . .._ -.�} � .�;��'M`"�,="��';
UNI.iCENS�D�=CGN�TRAC�:ORS:�AND .CCIN�RJ�►GTOR-RE�PQN�I�tCiY1�S:���tf=tiieYowner``lia.r�`�tiired��:�.co�tir�ctar vr
contractors to undectake work'�the�/.i�i;a�/:�6sirte'/�`utretl.sto:;�bealtcenseii;=lit;accor.dance:tiwtth;state.:•and;local,re ul #lans��:if��ther4:<:`a=����'
,cy�, 1. .7_. .7 . ....,`a� k r^x�r;-F...- ...r .+..�.��.. .. . ,. . _ - •�;._:� � .
co�t�actor�=ls�-not�ltc�nse��as=>reqult�+�"by law;•.tiothtttie'owner arfnf=�c+a��a�itc`ramay��e��ctted'for�a"r�ilsdei�rie�ndr v[alatton
under state law. If the owner.ar Intendetl��contra�tor,ar,"e;xuncertaln as to what Itcenain r uiremenfs;(me, �e� t"`r��for�tl�ie',}�4.W�-�A--.'�
to t� ���eq..._..�. Y'�� �P_Y
F µ.r<.i. 3-�vs":.v f#�e+aw't»�
lnte�ded'�ni6rk�ttiey afei"advisei!`:toAc�iiitact`lhe��Pasco;C+�unty;8ulldliig�l�is�ectltin�,Qivl�li�n-l�tce.nsing Sectlon at.T27-847
... rv+.;..�.v...5.3.i=,c-.v.•:'.
8009. Furttiermore;`it+ttye aviiner=�'iias"fiired-a.coiiUacfo��or�co�itracfo's� he Is advi�ed b have��the contraator{s):sign,
ortlons•of.th.e.;.-contractor Black'.of:xt�is.,a Ilcatlanrfor�which�.,the will,;be�r,es onslble.:.•:,ff.:. ou� as��.'the�oviine���sl``n�"�a�s�t�ie`�`y`�'�`�"���''
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P . .. .. .pp ..: ,... _ .._ . :: e�.y' �...p f�- y � � l�
eontrac#or,ttiat�naiy'��e an indica#1on�tQ�`af'fie�=fi`s��toE�rop�iEy"li�ensed"an��''1s not'en���i!'-to�piarmit#ii�g�p�llege:s in Pasco.
Counky. . . . ��P�r;., �,;.,
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TRANSPORTATION:IMRACT/UTIL6'�IE��1�'lRAC�l�N�?kE��l�l�tCE ItECQVEEtY-fEES;`Tl�e�under�t�t�e�urtderstands
that Transportation imp�ct Feias:and.�ecourse:Rec�very.�e��rrQti�y;apply:�#c�ti�e;�conatructlon:of nsw.b_uiidings,:schange�af�>'�:4u.'�:
use in.ezisting buildln8s, o�-expar�siGi��of�e�ite�i�i��taulldings� as spec�fied.tn Pascq County Or�dinance number 89-07 �nd.e
90-07, as amended;,,,:�,Th� under�lgned�a1so:�nderstands, th�ifi�su�fees;ba��m�t�;b��due;,��+u�kctie�+�er�if�ed at t�te�tim��of;��`.-u���
s: , � t �.�--�r- � k
permitting. It Is fiirthe�+understood that Tra�g�oFtatfon Impac�'�Fees and�ftesour.ae�Reco�ery�Fees�,mt�st be pald priar to
reaeEving;a"cerf�tcate�-of�ocxupa�cy"�or`#1n�t�power�,�elease:'.:If`th�.prc����:does�not t�avo�rek�a�.certiftc�te af occuparicy�atr��-"-t���z�
final povuer.�retease;;tFie�fees��inusi.t�'be�`paid��pcl+�r to;permft iss�ia�ice. f..,�tthermore���lf:�Pasco;�CouMj�"1NatedSewer.;�:tmpacts ..��
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fees ace due,,_they.must:be;:palii,_p�.ior_�o;pecnnithlssuance��n�acciardanaa..wlt�:apPllcatile�Pasco'yCountjiyari!lnanc:es. • .
COIYSTRUCTIAN�CIlEN"I.AY�{Ch�pter 715,FIoM'da�t��u#����m�ad�d): {f vsiva�on of wark is;�2,500.OQ;or.,more;;ji���.;. :�ro�z
certify that �I, the.- appllcant;:have;:be.en_ proVldeil�wlth���a-copy-;of-�thei�"Florida���onsiTucttan� Lieri=.:Lauv Homeqwner's
Protectbn Guide"pr�pared by�tl�e'F'to�ida D�p��r�fine�t;of Agrtculture and C�nsc�m�r,;�alrs. if the�pplEt�nt Is,someo�e:�.,..;-;...�,
other than#he`rnnmer"� I aert �:th�t l�liave:;o ineid"a�c'u .of..f e��ab v.e:�de� c"r '`'fgk ; `' , _
KY bta. PY:., h Q... s,.,,Itied�:�loau�ent'sand;P�nii�:e;iri;goad�:faith•to . ,i s
d�liver it to:.the�'ovimer"pi�o��trigccrt�tm'eni�men�;��. . . . , ... -. . ._.. : '_ . . . --
�ONTitACTOR'S70WNER'��IF�iDAViT: 1.cei��ty2#ti�t;.a)I:�th+��inf.oram�tlor��,l��thi�appltcatton is accurat�.�nd that aii work
r.��.
will'be done in compitance wfth all.appitcable laws.reguleting cons#naction, zontng and��land�tlevelo�m�nt. Appqcatlan Is
hereby made.�to ob#atn'�a.pecm.i#<<�tot;wdo�.vw��k;:�and:sl�isfell�tlon �s Ind#�a#�id�>=-.1� certify that no worlc�or Ins�altatlon lias=
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coenmenced p�lor to IssWance of�a permit��ind that'.all work will be pertormed�ta meet;st�ndards-of„all laws regula�ing• ,
canstructEan, County and City codes, zonMgFregulatians� and tand devebpmer�t re�ttiia�ons�ln't1ie:Ji�rlsdtctiori:�°2`�l:�ai'so.=
aertify that 1 undersfand that th�regulaflons of�ather gavernment agencl�s may��apply�,#o:.the�.lntended.work, and that it ls
my responslblllty to Iden#tfy•wha�t.actlans I;must�teke:to be�in,co�lplianca_h�,3,u�,h agencles�lnclttde�bu#�aie,not Ilmlted:to:.� �.=
St�:, ..,.. z
- Department of Env6ronmental��Pro'tectlon=Cypress:'Bayhead�, V�letl"and Areas and Environmentally Sensitide
Lands�IAlaterNVastewater Treatmenk. , . - " "' " � �
- Sout#rwest Florlda W�#er Management��:0�strlct-lNelts,r'=Cyptes�.`�Bey�earl�� �,{t4►efland Areas� AtEertng
WBte�r'�V�sQ$. ,. ..,,j ,..:;.,''"S�.,iMu,:. ,��'.r_£� . .. , . , �
- Army Corps nf Engtne�rs�Seawalls;'�ocks,Navigatile Watermraiys. . .
- Depar#ment,;of;He,aitha:;�:;,Ret�abilitaHwe�>Se.ri►,ic�s/Enx�ronme�al;..Meaftt� -Unit:VVetts;:V�astewater�Tre�tm�nt, � '
Septic Tanks:.;.:, ; ,.. . , ...._ _ . , _. .,, , -. . � ,
- US Envlconmen�l�Pro#�ctlon Agency Asbestos�bateme.nt�:. �
- FederaFAviat�vn>Autho,�ity;�wRunways3'_� `.`� -� .
t undetst�nd.that.the:follrii�ting:�i�stcict�ans apply to�the use of fltl:�
- Use of fltl is not altowed in�Ftooc�'Zone"V"unless expressiy pemnitted. .
- If the:�flll"m�ite�lal'is��to'b.e used:In ,Flood�Zone: "A", Ik. is unde�etoad thaf-a drainage plan addre�s(ng a _
pcompe�sating vafiume"will be submltted a##ime af�permli#Ing wlilch ts prepared by a professlanal engineet: � -
� Ilcen�ed by�the��tate�of floi�ida: .� �;-, �:- - .
- If th��flH:materiail�:ts to:be..u�ed in Ftood �one 'A" 1n.�connec�inr��with:a���ermitted bulShcng usln� stem wa11., ..
aonstruction,,l;ce.rtify,�that fill:vuall:b:e�us�d only.to flll#he are�within�the�s#em�wall: -
- It fll! mate�af'1s�to be used 1�i�.any .area; I �ce�tity,th�t .uae. of:su�h fllf wNl no! adversely affect adJacent _
� praper.tles.F.iF..use;of fi11,,1s.�fot�ncF:to.,advets�Fy;.�ffectMa�lJacerit���prctperties�.the owner may be cited for viatattng.
the condi#lons�of.the bi�lli�ing�:perniit=�issyed��u�der tfie:;'�tt�icfied,_�ecmlt_�pplicatlon� for:lats�:less�tFian`one (1�_
�cre w1ili:ti�re e[evated`�by flll,a�t.engtneered dra6nag�plan is�requir�ed. .
if i�m the.A13ENT�OR:Tki�;,O..VYNER;;.IK.prom�se:ln,good,.f.alth#o informftP�a�awner of�the permitting condRlans set forth In
thts affidavit`p�tor fa commeracln�g constn�ctlon. ! uriderstani!thet azaeparatei pet�tnit may bs requlred for electrlca4'work. , ..
plumbing,,signs� welts.,,poats;.atr..canditioning,s:ga�s,,-.ac:ott�et Insfatt��i#�ions na���pec.�fiaatty included-in.the�apptication. .A
permit issuetl�hall be coFistiued to:`b'e_�a�licensei;ko�proce�ed wikh�tFi'e.k+uvork.and!nat-as:�authority;;to:violate;�car�cel��alter, ar
set aside any�provtslon�01`tFie:tecl��lcal�cod�;�nor sh�111ssa�nce�of a.petmlt.prever�t the Bulldirig CNt1da1 fram thecea#ter
requirtn.g a cor�ectlon:,af,eRors,in-,pians;:con�ifnictlan.or_ylalat(ons of-any codes: ��ery�p'ermtt��l.s'suetl'stiall�becom�r°invalid
unless the w�rk authorizecl.by suah p�rrr9lt:�{s�-connm�n�dvulChln st�c,,mon#hs �f�permlt Issuan�e, or It wrork�uthortzed by
fhe permif is suspended•ar,:abat�doned�for:a,perlod;of;�ix�:�)�montiis:`.after,the-tlnae the�work>is commenced.. M�utension -
may be requested,�ln.writing;vimm;tFie;Bullding,�fficlai�for a peirlod��not.to exceed'fiinet�r=(90)wiiays�a�id�wi�l~demongtrate
, jus#tflable�cause for.�#he extenslon: �f work ceas.es.for nlne#y.{90}cons.�cutive:dsy.�,..th��ab;ts.considered,ab�ador�ecl. �
WARNlNG Tt? QYMN�R: YOUR;�A!l.1JRE:.:TC�,.RE�O�ttQ.Ax1�Q�;IGE=QF.�CQMMEi�CGME�:MAY{RESUi�T`.iN�YOUR �
PAYING'iWICE;;FC1R�°iIWPRO�EMEN�`i��Tfl:Y�3U�t�:P�tOREiiTY:���1��Y0U;i�F'�E�i1U��T���B�A1N�FINAfi�E1N�;:CON9Ul.T
WIT AN� O FO' •R� t,. �, .} - __ .... -- -
- F10R10R J!!RA'i'{FsS::1.1 _ .._,. .- �, ; . , � �. - �..,, ._-_ - _
OWNER OR A0�1�1T •-, QqNTRAGTO - -�Yo '
Subscxibed and s�wm� m� �a 8tib�ibad�nd, ,#ii�
by .:by...:
Who Is/are pensanalty kna�wn b.me.or:has/have,prcducesi -Who.ls/sre;p.ersolnetly.�nrnlm•to;,me�or F1ae�lhav.e�p i�ced, •
� as td`eri�ftcat�in. . as[dent�ic�tion.
Notery Public . � Notary Pubfic
Commis�lan Na: Cam�isslon�Mo,
Name ot Notary typed,Printed or atamped Neme of t�otary typed.PrlMed or stamped
i -- �
� 0020
i
, � -_ : � HINGDOM CONSTRUCTION & DESIGN, INC.
I`� I�� 4303 Fox Glen Lane, Tampa, FL 33624 (813) 846-4080
� 7 �T kingdomconstructiondesign@yahoo.com
� 11�! G��� State of Florida Certified Contractor
CONSTRUCTION&DESIGNS, iNc Building License: CBC125-7682 Roofing License: CCC1330-300
t
Owne md.1� �\OV S�1 Date: / 2—2 Z— (l�,
Other• Date: � 2— 2 2--�,(�
Street� ddress: �q 1�p �—S� I $' �� Sr��2.��—
City: �i�,` State: Zip: �v 3J yZ
CONTRACT
CALL CONTRACTOR TO VERIFY SCHEDULE �
Kingdom Construction and Designs, Inc. agrees to do the following work:
�temove old shingles,nails and felt paper on wood deck
il e-nail deck sheathing.Dry in with self stick membrane. �.f�� v�� ���-�
wenty-six gauge six inch metal drip edge 2-1/2" face. Color: •W �
�pply dimensional or 3 tab Class A fiber lass as halt shin les. Brand: �G'O �1� -
2� year manufacturer warranty. Color: W ` 'e- Six nails per shingle.
INew lead boots.�new roof jacks. New valley closed: fl/�O
tarter felt on top of drip edge on edges. Cement plastic on gable ends and valleys.
i nstall new aluminum roof vents and/or other: Wl2l ('L C=� 'of ridge cap.
�
All shingle mildew resistant - AR
Wood ate-Extra:
i� Rate per fascia boards to be replaced not included in this contract and plywood will be
replac Ild at a rate of$50 per sheet.
� �� v✓'AR,� [.s 5?�Ri�-�aI B� �'�rn,;2 �G�/�2� ,
Notes: C v rr�-�
,�,,�s � �y`✓��S � ���e� �n. �t�r,t� [1 T
�.ij''����T `
The filregoing constitutes the entire contract between the parties and there are no guarantees or I
agree ents except as set forth herein. Any payments not made in accordance with payment schedule
will be subject to Lien. Workmanship guaranteed 5 years, shingles guaranteed by Manufacturer.
Contra�ct Price: �j � 2� ��`�
Down Payment:
Balanci on Completion: � I
Owner�: d c �� Date: /�—�a--1(o.
Other: � Date:
Contra tor: rY+�O �.( � /NO Date: �,2— 22--�
I IIIIII IIlII Illil IIIII III11 illl111111 IIIII Illll IIIII IIII Illl � .S�-�.-�%�--�.
� , .20161987 4
i Permk No. Parcel ID No 1 � ��(/� � d� /V /� �6 D Q/7(�
NOTICE OF COMMENCEMENT
State af �-1��. .i .— CouMy of_���_f'JJ c r
THE UNOERSIGNE�hereby gives notice that Improvement witl be mede lo ce�tain real property,and In eaordance with Chapter 7�3,Flarida Sfatules,
the(ollowing Irdortnatlon Is provlded In lhis NoUce ui CammancernenL
1. Descriptton o}Property: Percel IdentfNcation No.
StreetAddress: � i � ���G_
2. General DescripUon of Improvemarrt r�d � �Q n.(?.C�
1 ri,e . i�v�.�f�� /Lh,t�cJ �c creSDYi t� 4�-��L ,V�� 3 ?3zg S`u"re,p��.
J Cr �
� � 3. Owne��niortnatlon or Lesaee Intormetlon ifthe Lessee coritraded far the fmprovement:
a Z� �
�� 335at-j
M 2 e -'s- G�- �;�(�.:co �L.
0 Address Clty State
� � Interest in Property: OI.J�D f'
w
�~� Name of Fea Simpte Titlehdder.
o E� (If dHtefent from Owner Iisted above)
U
a�` � ContracWr.W�L/�/t-Q��I/✓t�'�-"'�-i•'Yl� C�ty(AY�S��mi'�'� ��.w.,s .� <.
�',.� P.GwL �HR r- IQ/� _
a�� � �3 D 28mGOX r �wO+t. � - '3?�.(O 2�'
Address p 1 /// Ciry State
W�� Ccntracta's Telephone No.:�O I�/ �"Y t? "� �� 8l�
?� �
5. Su
�N m Name ` _
�
¢�� Address Clty State
�N Amount of Band: S Telephone No.: �
a.�
6. Lender. r �—
Name __ �, _
Addrese Clry State
Lenders Telaphorte No.:
7. Persans wilfiln tlie State af Florida dealgnatad by the owner upon whom noUces or olher documents may be served es provided Dy
Sectlon 713.13(1)(ex7),Florlda Stalutes:
i
Y Name
L
d
"' Address City State
B V
Talaphone Number of Desigmated Person:
m8 a
��a 8. In eddttlon W hlmself,the owner dealgnates of_
V A� to iecelve a copy of the Lienors Notice es prwlded in Seetlon 7'13.13(1)@),Florida Stetutes.
�� ' Telephone Number af Person ar Enlity Deslgneted by Owner.
~m 9. Iration date of Notlee of Commencement the e iratlon date ma not be hefore the com letlan of eonstrudlon artd Mal a
E� ( xp y p p yment to the
� p contrector,but will be one year from the date of recording unless a dHfererrt date is speclfted):
� � WARNING j0 OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
� � ARE CONSIOERED IMPROPER PAYMENTS UNDER CHAP?ER 713, PART t, SECTION 713.13. FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING 11M1IICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND P0.STED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING.CONSIILT
��N WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
..BOI
ra r+ Under penalty of per�ury.I dedare that I have read the foragoing noUce of cammencement and thet the facis steted thereln are Vue to the best
Ut/1 N � of my knowledge end beliaf.
��� STATE OF FLORIDA �I\ 1\ ^
COUNTY OF�PA660 ►�tc1��1 1
Signa of L , era or lessee's Aulhor¢ed
�1�S`.7�o��� OfflceHDiredorlPartner/Maneger
Signetorys 7ltlelOtflca
The foisgofng iretnimerrt was adawwladged before me W�day of 1 O 201`�by I��O1 t.I •�o �2DJ�� .
as '�L✓ (type of autho ,e.g.,offlcer,trustee,aftomey In fact)for
� ( ame of party an behelf of whom InstrumeM was executed).
Personeliy Knrnvn❑ P IdentiticaUan� , Notary SlgnaWre
Type a(Identffication Produ�>c c�_�'r�".a-YS Neme(P' bst J �-.(
' . .'l;�s^ ' r Km+�y . .
' NOTARY PUBLIC "
STATE OF FLORIDA
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9 Expires 2/1512020
vrpdaterbcs/noticecommeneement�C053oas
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a��'' e ' ' ��� �7ATE�F FLORIDA,COUNTY OF F�A�C
v'91"' � THIS lS TC�CcRTI�T COPY OFFTOH E�OCUMENT
� � ' A TRUE AND CORR
�. o : � ON FILE OR OF PUDLICD OF�C�� SE'�OFSIC
In God"We 7rust � W�T g Y HAN 2 ��
; �`"a"''�� --��DAY OF PTROLL R
� , O . � ERK& �
PAULA S.O NEIL,
� ��8� � DEP TY CLERK
����OF FI.��@� BY
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