HomeMy WebLinkAbout17-18826 CITY OF ZEPHYRHILLS r,/
f '� 5335-8TH STREET
(ssa)�so-oo20 18826
FENCE PERMIT �
� � PERMIT INFORMATION - - LOCATION INFORMATION
Permit Number: 18826 Address: 39014 MANOR DR LOT 14
Permit Type: FENCE ZEPHYRHILLS, FL.
Class of Work: FENCE REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 12-26-21-0050-00000-0140
Improv. Cost: 5,050.00 OWNER INFORMATION
Date issued: 8/31/2017 Name: FRAME, DEBBIE
Total Fees: 50.00 Address: 39014 MANOR DR
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 8/31/2017 Phone: (813)782-9377
Work Desc: INSTALL ATION 246 X 6 PVC FENCE
CONTRACTOR S APPLICATION FEES
POST R US INC (813)779-7795 FENCE 50.00
� .� , � Ins ections Re uired �
F AL
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 property. 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.
All work shall be erformed in accordance with City Codes and Ordinances
ONT R PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO ,
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
�
� w
C'7���� 1' ��Cl�+ ACME FENCE
���g 5150 Halstead Ln.
FEI�CE Zephyrhills, Florida 33541
"Your PYC Specialisls" 813-779-7795 �13-973-0826 888-779-8553 fax
acmefence@yahoo.com
LICENSE # 11795
PROPOSAL/CONTRACT oi�a9igoi� ,
Customer Information: Job Information:
DEBBIE FRAME JOB LOCATED OFF 23RD ST
39014 MANOR DR 904-629-5882
Zephyrhills, Florida 33540 DFRANE@FZORIDAMEDICALCLINIC.COM
Notes: I
- REMOVE WOOD FENCE & HAUL AWAY -
246' 6 FOOT PVC TONGUE & GROOVE PRIVACY 79�
ALL POST SET IN CONCRETE
2 5' WALK GATEs �
s�� �GATE POST W/ ALLUMINUM I BEAMS 74.
FULLY INSURED COMP & LIABLILTY 6' House
6'
LIFETIME TRANSFERRABLE WARRANTY (PRODUCT) 13�
LIFETIME ZABOR WARRANTY AS LONG AS OUR 13�
FENCE SIGN REMAINS ON THE FENCE.
ACME FENCE agrses to gusrantee above fence to be job and adjuatments for labor will be charged or
free from defecte in materiale and workmanahip for credited at the current�y eatabliahed ratee.
one yesr. Additional chargea for any extra work not covered
ACME FENCE ahall adviee the customer as to loesl in this contract that wae requ�sted by the cuatomar
aoning regulationa but reaponea.bility for complying �eill also be added. The full amount of thie
with eaid regulatione and obtaining any required contract along with any additional chazges �vill
permits ehall rest with th� cuetomer. ACME FENCE become payable upon completion of all work orhether
mill aesiat the cuetomer, upon request, in or not it hae been invoiced.
determining vahere the fence is to be erected, but A finance charge of 1 1/2� per month (or a
under no circumstance does ACME FENCE asaume any minimum of $1,00), which ie an annual percentage
reapoaeibility concesning property linee or in any rate of 18�, ahall be applied to aacotwts that ase
way guarantee their acauracy. If property pins not paid aithin 10 daye after completion of sny
cannot be located it is recommended that th� work invoiced. All msteriale aill remain the
cuetomer have the property eurv�yed. property of ACt� FENCE until all invoicea
ACME FENCE will asaume the re�poneibility for pertaining to this job are paid in Pull. The
having underground public utilitiea locat�d and customer agrees to pay sll intereat snd any co�ts
marked. However, ACME FENCE seaumes no incurred in the collection of thie debt.
responsibility for �+n+�++rked sprinkler linea, or mny
other unmarked buried linee or objecte. Tha
cuetomer aill seaums all liability for any damage
caueed by directing ACb� FENCE to dig in the
immediate vicinity of known utilities.
The final billing will be based on the actual
footage of £encing built and the work perPormed.
Partial billing for mat�risl8 delivered to the job
eite and work completed may be aent at xeekly ^Qs) �'ZS��7 nf+
intervals. Adjustmenta Por material uaed on thie �a�� �:� l\ 0� C%��
Approved � Accepted fos Customer:
�l.M�t.� ���l.�r--��
Contraet Amount: $ 5050.00 Customer Date
Dowis Paymeat: $ 1550.00 Acc e or FENCE:
Balance Due: $ 3500.00 �~�'�7
person Date
��s-�so-oo2o City of Zephyrhills Permit Appllcation Fax 813-780-OQ21
. a: Building Department
Date Recelved � Phane�Gontact for:Pernilttfn —
Owner's Name � , � I`� �'��'"� � Owner Phone Number ��"b� ""S 0��
Owner's Acidress � p� T . I�'� �fJ � {� - tswner Phone�Number -�` �
Fee Slmple TItlsHolder Name � � ` � Owner Phone Number �� �
Fee Simple Tltleholder,tiddresa
JOB ADDRESS � C�1 � ���O� � LOT# �
SUBDIViS10N ( � PARGEL ID# � �`-� � `��j"`C'�C�S� "C�C?(�G�L�^G���'f G
, , , {OBTAINED FROM PttQPERTYTAX NOTICE)
WORK PROPC}SEQ �..NEW CONSTR ADDIACT C� SIGN" �[� Q DEMOLISH
� �e. lNSTALL � ,� REPAIR
PROPOSED-USE Q SFR Q 'GOMM `� Q -QTHER �
TYPE OF CONSTRUCTION a [�� ' BLOCK ' �C] FRAME �� Sl'EEC �Q �
DESCttIPTiON OF WORK'
'{ .. �(i C.. �en c� � . . . � _
BUt�D1NG S1ZE �' ��`SQ.FqOTAGE '-2�� : .HEIGiiT�. .C�„�
QBU!!.Q!!VG , ����"O, OC VALUATiOP1�'OF�TOTAL COIVS'fFtUG'1`ION , -
QELECTRl6Al �� AMP SERVICE Q PR(?GRESS ENERGY �J W.R.E.C. �
QPLUMBING �� � l_�;.� j
�� U �
[�MECHANICAL $ ' VAI:UATION OF MECHAPIICAL lNSTALWTlON 6 �
QGAS [� ROOFING .Q SPECIALTY, � OTMER
FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA QYES NO
BUIl�DER G COMPANY• L G'�'� F" t'7C"'�
SIGNATURE RHGlSTERED Y! N . FeE GUEtREn '.Y t N
Address �f-�� � <�9 C../U License#�I � � ��� ,
ELEGTRlClAN; - � � . Gt?MPAMY - �
SIC^,NATURE �' REGIS7ERED Y/ N PEE GUR�t+'�� ' ��Y/N
Addre�s � ,. . , .. �: � . . . License# I ". '_ - �
PLUMBER ' � COMP,.AMY =
SIGNA'TURE` ` ` ' ,REGISTERED Y./.-N �eE Cukt�t� Y/N �
Addreas i.icense# ��.� .^. -� I
MECHANICAI: � y CQMPAt�IIY � ,
SiC�NA7URE ` � ' � � REGISTER�D Y/ N , r FEE CURRE� . Y./�°N -
Addres"s` . ° , � . > � ` - � ' l.icense# �. �� �
OTHER ' ,.,:, � � � .' '`;COM.PANY ,. • �
SiGNA7URE �.� '<< 'ri � �`� �� ^ ' ' ` ""REGISTER6D' ` Y/ N,.. � FEE CURRE� ' . Y/N
Actdress' • ' ,.R- <;:_ ' :t - � . . � L'tcense# (' � � �
RE:3IDENTIAL�;. Attacti�(2)�PIot�Plan`s;..(2)sets:ofsBuilBing`Fians;(1)'setiof�Energy�Faiit�s;.R=O=W'Peqnitfor new i�nstruckion, � ' ' '
.. __. _ :,. . ,.n.., ..,_ .. . _ .
. . .. _. .:.. :, ,
:• �s;:.� Minimum;ten(•1,0)„working;days:,aftersubrrttttal date:::.Requlrerl onslte,;Constructlon:F1ans;Stormwateh Plans�w/SIIt Fence 9nstalied,
' ; SanttaryFaclittles�&;1�dumpster-.8lte=Work,�Permit,forsubitivisionsRarge:propects: ;_:;;.,: . „ �-�``` '
COMMERCIAL Attach(S)�cnmplste sats''of�Bulliiing'Plans`plus a Ufe S�af�ty Page;{1)set of Energy Forms.R-O-W Permit for new constn�"ction. -
Minimum ten(10)working days'after submittal date. Requtred onsite,Constructlon Plans,Stormwater Plans w/Silt Fence instalted,
8anitary Facitities&'t dumpster.Site Work Permi#for all new;projects:All cammerciai requlrements_must meet compllance + �
SlGN PERMlT Attact►"(2)sets�of�Eiiginiaer.e'.drPlasis�,,�."�-,- .. �-. -, �
"'•PROPERTY SURVEY raquired„for all_NEW constructlon..
alrectlons: �. , , . � . "
Fill out applicatlon completely.
Owner 8 Contractor stgn back of applicadon,notarized
if over$2500,,a Hotice of Commencement[s requFrad. {A/C apgrades over�T500) ,
'* Agant(for the`contractor}or Power 8f Attomey(fo�ttie owRser)wouid be somaone with notarized letter from awner authorizing same •
OVER THE COUNTER.PERMI'fTING-- {FronEaf AppifcatEon Oniy} �
Reraofs If shingles Sewers Service Upgrades A(C Fences(PlotlSurveylFootagej
drivewaya-Nat over Counter#on pubtic roadways..needs ROW
�
��/�
�
. , � .
NOTICE OF DEED RE�TRICTIONS: The under.stgned�under�tands=�tt��t:thi�,;p�rmit:may be.subJe.ct,to_"aaea"res�tctton's",�_,.`_�;;.,,:.�.
,,: . - . :, _ ,� ;,u .. ., ,� , . , �_. ,. . :� r �
which may�6e:marerrest�ictNe-�tha��County+�r+�guiattons:��TF�e undecsl�ned"'assumes�re"spisnstbillly-:for compllance°witFi`any",_. .,�._.,...
appftcabte deed�res#rictions. ..7.,;.:,,: - . . _ ,_ ; � : -:`=%
, ,
. .,. > :..�.. .
_.
, �-
UNl.ICENSED�-CONTRACTCIRS:AND=CQWTRAGTt�R RESPQNSlBtLITlES: =�{f-fhe�aiivner°has�'hired�a�`�contrac#ar or
coMractors to undectake work, they maybe.r+�qulred�.to�b�,llcer�sed�ln accordance.with:state.and��focal.regulatlon.s,:��lf�the���� ����'�-�
contractor ts=not Ilcensed�as�requlred.�tiy law,:�tioth�the owner and�cont�acta��-rriay be��clted�fiir�a�re�lsdemeanor violation
under state law. if the owner or iMeride.d:contractor,are.„uncertaln as to wha# Ifcensing;requlrements.�may�apply�s�fcir,=ttie�- � �� ���'�
. ,,.,.r.,..:�.,�k..f, . . . .. .. .- ..., .. .
fntended wdrk,ttiey a�e'advise�to+�ntact#iie Pasco County��Bu�lding'Inspectton;�Dtvtsion�-t.icensing Section at 727-847-
8009. Furttiemtare, (f the ov+rner'has'tiir+ec!'e +coritractair or coritractors, tie ts aiivised ta have the c�nfractor(s),sign..4 ,_,;: :
portions of the "contr.actor,.Block" of,this._app!lcatlon�for which,they,wlll�be=r.esponslble.-«(f=yc�u,.a�:the owner sEgn�-as,ttie " .f�
. . � __..._.. ..�-..�..
contracior,�that rnay�be an indication that''lie"ts`not:praperly licensed"and"is'not entiN�d"to permittl�g priulleges(n Pasco
County. , .. , . ' _ ._ . .._. ._ _�..__ � .. ��z: ,� .�
. ,. : - - _ , .
TRANSPORTAT`ION-tMPACTJU7iLITiES�rMPAG'-i=�ANb-�tE:30UitCE RECOVERY�FEES:�The understgned understands
that Transportatton Impact Fees and.Reco.uc�e.Recovery:�ees may;aRply-��to�t�e�constructlon._of.new bulidings�ichangertaf:;e'' ..�;','
use in existing balldings,�or�_exparisi�n�of�eiilsti�%g�.bull�li�gs, as speciflecl.in Pasco Gaunty t}rdfnance number 89-fl7 and
9Q-07. as amended.i:,Th�. undersigned alsa3urtderstands� ttialt:`suoh fees,�;as�may�`�e�,due,,a+ul!l::be�dent�ted at the�tlme�of�" �'� . �
permitting. It is ftir'thier understood that Transportation ImpaaC Fees and�Resou�ce.Recovery��Fe�s,.must be paid prlor to
receiving�a 'cerfificate-af occupancy° ar�flnal4power4release: :If=the.project,.does=.not irnolve�a:certiftcafe of o�cupancy-a��>='-=�� °°��
flnal power.ratease�,the�fees'mus�t`tre paid;ptior to;permi# issriance. Ftixtt�ermo�e;�if Pasco;�County�WaterJSewer.f,lmpact -������,�����
fees are due,_they.-:tnust:be�pald;prtor.#o.permit�tssyance=ln,ac.cardance.witi��applfiaa6le.Pasca��County�a`r"dinances. �
C�NSTRUCTlON'LlEN"l:A1l1t(Ctiapter 713,Eiar�da statutes,as amended); !fi valua�on of work is$2,500.00,�ar�more�.:i= ,�-., ����.,
certify tHat I� the �appllcant,��have.been provtded �with-�a.-coFY'of�the° .".Florlda�=`Gonstiuc#lon�'LRen_L;aw Homeowner's
Protectlon Guide" prepared by.'tlie'Flo�ida Depa�ment�of Agr(c.ulture and Cansum�r:Aifairs. If the appltcant!s sameone; �.., : .
� £d:r.�;
other than#he"owner", i certify.that.l�h�rre,obtained�a�copy.of..#he�above:.descrlbe�d`:�lbaui�ent�and:promis.e`In;gaod:faith..to . �
detiver it to..tii�:'owrie�:pi�of:`:to�cammencemerit:�' - , . _` , - ,.. . . .= .- v` • _ � , --
Ct?NTRACTOR'StOWNER'S AFFIDAVlT: i.ce�tify::;tt:iat.ail=�.thekinformatlon�:in�thi�appttcattan is accurafe and fhat ati work
,,,.�
wIl!'be done in compllance wlth all.�pp!lcable laws regulating construction. zoning and�.land'�develnpment. Applic$tlan is
hereby made:to obtatn..a permit::to;:do:work�,,and�-lnstaqatlan as indl�eted:=<�=:1� certifijr that no work�or Ins�llatton lias'
cammenced �prior to Issuance of a permit`aitd that�.all work wlll be pertarmed�to meet-standatds-of all laws regulating�
conshuction, County and City cades, zoning regulaftans, and land development r.egulatlons=tn�the,jurtsdiction:� I al'sa
certi�r that i u�dersfend that the regulations of other�gavemment agencies may�appiy�to the�intended,work, and that it is
my responsibll�ty to Identify.what.actEons t must t�ke.:ta be�tn:.cort;rpliance. S.uch,agenctes°inctr�de�bvt-are.not limited to:
- Depanment of Et�vlronmentaf�Pmtecttori�Cypress.`BayFiead�; V1le�and Areas and Erntranrnen#ally Sensitive
L�nds,WatedVNastewater Treatment. + �
- Southwest Florlda Water Management .I�istrlct-Welis, Cypress.��Bay.k�eads; Wetland Areas, Alkering
Watercourses. �
- Army Carps af Engtneers-Seawails,flocks,Navigatite Waterways,
- �epa�tment of,Health;,� RetaabfAfatt�e;,$entfceslEnvironmenkal;Fleaith t1c►it Welis�:til.tiastevkater�Treatment,
� Septia Tainks.. � � � � ��
- US Environmental Protection Agency-Asbestos ab�tement.
Federal Adiattvn_AuthocRy:Rurnvays;
t understand that#he.foitowfng;.�est�i�tlons appty"ta tfie use offill:•
- Use of fit!!s no#atiawed In:Flood,.:Zone"V"untess expressly permitted. -
- If the fill materia# !s to<be used:In�-:Flood Zane. "A"� It. is understood that a drainage plan addressing a
°compeFlsating volume"wll! be submltted at#Ime of permlttlrag w6(ch Is prepared by a professfanal englneer
Iicensed by��he��tate of Florida. "' � �� _ . ---
- tf ih� flli material ls�to be�used ln Fiood �one 'A" in�connec�ion�with�a permttted buflding using stem wall
� canstruc#fqn, i ce�tify;#ha#�it:wall:b.e�used oniy.to.flli the areawithin�the�stem�ralL -
- !f filt materlal is to be used En atiy area� 1 �certify #fia# .use af'such fitl will not adverseiy af�ect ad)acent
p�aperties. !#use�of fi!! #s fount#to adversely.�fFect ad�a�en#'�pr�pe�lles�,the owner may be cited far uiofa#ing �
the cond�ions..of the buildtng-permlt is'sued�under the"at�ached..�►ermit �applfcatlon;for�lots:less than:one {1)
acre which ere elevated�tiy f111;��r en�lneered dralnage plan Is requlred.
If i am the AGENT FtiR THE�OIMNER,,i�promise l.n.good faith to infarm the�owner af the permitttng condftlons set forth In
this atf�davit�p�ior to commer�ctng cvnstructian. � ��a�r�tai,a tn�t�F separate,permlt may be repuired for elecMcai`work, ,
plumbing, signs, wells�.poals,.atr conditloning�.gats� or atk�er install�itloris not�spec�icalty inctuded-tn.the appiication. .A
permit Issued shall be cons#rued to be"a°Itcense to'proceed wikt�ttie;work and;not-as:author.ity�to v!olate;.�+cance{, after, or
set aside any provtsions of the.technical.codes,�nor shall issuance�of a.permlt.prevent the Bulidtrig O#�lolal from thereafter
requiring a conec#ion.af errors ln.pians;consftuctlan or vioiatlons of-any codes. ,�ve:ry�•p�erm(t�l.ssued sfiall become irnal(d
unless the work aufho�ized.by such permtt:�is.co�tmenced�wifhin siatt.manths of permit issuance� or tf work authorized by
t#�e permlt Is suspended�or.:abaRdoned.=f.or a;perfod..of�s�c�{�)-mont�s,:�fter;the;tlme the�work�s camm,enced. An extension
may be requested� In writing�.from.thie�'Bulliling,Officl�I for a perlod:not-fo_exceed'�nlriety�{90)days s�d�w{11 demanst�ate
justifiable cause fbr�the extension. If work ceases.for ninety.(90)cons.ecutive_day.s...th��ob�is.constdered aba�doned. ��
WARNtNG TO OWNER: YOUR;FAiLURE�T+G�:.,R�EC.O�2Q:A�-t�OTICE:OF��COMMEMCEMEM?�.NFAY=RESULT IN YAUR �
RAYING TWICE;FOR�IMRROVEMEN'�S-TC1:YF3Ut���PRCCiPER�TY:;�1��Ytf.U�1��MD���• ��OBI"'AiN��FIN�t�E1NG;�C.t3NSULT t!�
W17 � AI+� �`TO N d.E� - =� O I,,
FL4RIbA_JURA� F.&�1.17.03 , .._.,. ....:. ..:-�: _ --- - - --- —_- .-- __ k--� � -
. :.
.._ .. .,_.�:.;�����__� _
, ..,.. ,, ,,. . . ,_
( �-.,__,_._ _.__�_._,_.__,... ,__ . �;
OWNElt OR AOEN7 COAITRAGTO ' (�
Subscdbed and swom M(or aHinned)before me thla Subecribed snd' (ot rtned)�before me'tlii� ��
�y ,.�y..., .. .
Wf►o Is/are personaily knowtt to me or.haslhaue.produced Who.fslare;p.erson&i!y#tnowrt•to.ntetaachaafiave:pmdiiced �
- a�i id'entlflcaeon: as Identlflcatlon.
Etntary Fublic . . Notary Publtc
;ommisslon No:` Coinmleslon.No
�tame ol Ftotary typed,phnted ar stamped Neme of Notery typed,printed or atamped
� � -� I IIIIII IIIII lilll illll IIIII IIIII IIIII IIIII IIIN IIIII IlII IHI
2017138932
�Pertnit No. Parca!ID No �� ^� �I 1�O�O vDOOOO���O
NOTICE OF COMMENCEMENT
S�tea ��OK��G c�,n�ra �2SC� : a�ov�ie
7HE UNDERSIGNEO heretiy gives notice fhat Improvement wpl be made to eertafn�eal rty,and in a nce wilh ter 713, tahrtes, W���
the Tdbw7ng Informatlon i6 provided In thla Notice of Canm a�c 2-2fo-��1��-O-oo�-o/�I��pAyv t��°`riq��s�Q�� , ,..m..
1. Desaiption of Propetty:Parcel idenUflcatlon No.��� QG `�17 Lo9- �y or S7S9 �!� 7�-3 ; N m o�o
StreetAddrosa:390� ! /17QAOR .�jQ Z�l.{���,I��S' FL 3.3.S�f2 ' �m(O
i ►+ r
2. GenerelDesalpNonMlmprovement bf ��+��"G Q(�� �-{�1LC 7� N
�M
3. Oxmer I aUon m Lesaee InTormeUon Ii Ihe Lesaee contracled fm the ImprovemenC • ��
�e � Fra i. � 3��
�qoI�O�YIa�o� �Q. Zl R i r �Z, 33�ri�� � � m�
Address Clry �� � ���
Interest In Property. � �
Neme oi Fee Slmpie Tftlehdder, n
Qf ddferen!han Owner Iisted above) r-
�
�N Sfete �
AOQresa IV�Ci ��I C C �
4. COflV3Cl�
�;"� �c'ftQcl LrU- L�/D�y/' f �. 3�5�'
Addresa Gty State
�►��aT�a►�.: A3- 779 7�'9•r
5. Surery:
Neme
Address Cib Stete �a
Amant oi Bond: S Tefaphone No.: �p w D
e. lender: F+y
Name X N o
O '
Address Cfly State �/��-'m
Lende�e Telephone Na: �/{i�,/J r=
7. Persons withln the Sfete ot Florida desl8nated by the owner upon whom noUces or other dowmeMs may be served as provided by �V,F'7
Sectlon 713.13I1)Ia)()I,Florlde SteMea: :�N o
v
Nama I 3 n
,� o
Address City Stefe ��+r"-
Telephone Number W Oesfgneled Parson: z
x
B. In additlon to hlmaeH,Me owner designates a� � ++Q°
to receive e copy of tha Liena'e Notke es provlded In Sectlon 713.13(1 xb),Flmlda Stetutes. �F+o
Telephone Number of Person m Entlry Daslpnated by Owner. �
i� � '
9. E�lratlon dete oi Notice of Commeneement(the e�IraUon date may not be beforo Me eompleUon of eonsWcUan and flnal paymeM to the �r
contractrn,but wlil be one year hom Ihe date of�ecordbg unleas a diflereirt dete la specfflad); �
WARNINO TO OWNER ANY PAYMENTS MADE BY THE OWNER AFfER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT `
ARE CONSIDERED IMPROAER PAYMENTS UNDER CHAPTER 773, PART 1, SECTION 713.13, FLORIDA STATUTES AND CAN
RESULT IN YOUR PAYINO TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENf'MUST BE
RECORDED/WD POSTED ON THE JOB SITE BEFORE THE FIR9T MSPECTION. IF YOU INTEND TO OBTAIN FlNANCINO,CON3ULT
WITIi YOUR LENOER OR AN ATfORNEY BEFORE COMMENGNG WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penelry oT pehury,I dedara Ihat I have read the toregoing naUee W eommertcement end Ihat the teds stated tAereln ere we tn the best
of my,knowfed e and b
srnre F HAARIETJOSEY �'1„ I !U4
cou �y�pM�610N+�GG087128 n_�'�tJ ��-�`-'
�(�j�S.��1�12y�Zp1� STp�ure of Owner a Lessee,a Ownels or Lessee's Authwized
�*� Bonded Nrough ist State InsurenCi ��'m�'�Of�artna/Mene9er
Signatoryre Titlel0lfice
The foregWng InaWment was ecknowledged 6efore me this°ZS day ot�2D�1 by ��'
as (rype of euthmlty,e.g.,of8oer,Wstee,ettomey In feet)(w
(nem�e of�partyo,.�f�behatt oiwhom InsWment wss exewted).
Pereonalty Known�gg Produced Wenllflcatlon❑ Notery Signeture_`�-�-"
Typa of Idrntificallon p}oducad Name(Print) l�-�v�n.� oS�
wpdatalbcs/rwticecanmencemeM�c053048 .