HomeMy WebLinkAbout18-19576 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 19576
BUILDING PERMIT
PERMIT INFORMATION- - LOCATION INFORMATION
Permit Number: 19576 Address: 5903 14TH ST
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:'
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-03900-0080
Improv. Cost: 10,200.00 OWNER INFORMATION
Date Issued: 4/17/2018 Name: RAMEY, ETHEL
Total Fees: 95.00 Address: 5903 14TH ST
Amount Paid: 95.00 ZEPHYRHILLS, FL. 33542
Date Paid: 4/17/2018 Phone: (813)782-1911
Work Desc: REROOF SHINGLE
CONTRACTORS APPLICATION FEES
CLASSIC CONSTRUCTION LTD CO REROOF RESIDENTIAL 95.00
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DRY IN ROOF INSP Ins ections Required
TAPE JOINTS ROOF INSP
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 maybe 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.
"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 performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
AbNL-12(ZAACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
l� CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
s13-73U-0U2U City of Lephyrhills Permit Application rax-ola-rov-V„41
Building Department
Date Recelrred Plibno-Contact'.for"Permitting`�1,-
LAA"A
: C r
Owner's Name Owner Phone Number
OWnees Address. ' .O 3" 4 S LL 1 f kI\� �' Ow►b®r Phone Number
Fee Simple Titleholder Name owner'Ptione Number"
Fee Simple Titleholder Address
JOB ADDRESS S ( D l�h S� ZtG r Vl( l S LOT#
SUBQIVISIOM PARCEL-ID#:
r
� (OBTAINED,FROM PROPERTY TAX NOTICE) '
WORK PROPOSED ... NEW CONSTKE]. ADD)ALT 0 SIGN' Q 0 DEMOLISH
INSTALL REPAIR
A.
PROPOSED;USE• Q SFR = "Comm Q OTHER
TYPE'•OF CONSTRUCTION" 0 'BLOCK = 'FRAME: Q. STEEL:
DESCRIPTION OF WORK F 1Ma V C' (7 C�� Y d S � +
BUILDIWGSSIZE S4 FOOT/►GE "2J, HEIGHT:• ::.. S EOM
[BUILDING $ Zb O VALUATION'OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY 0 -W.R.E.C.
=,PLUMBING $
=MECHANICAL $ VALUATION OF MECHANICAL.INSTALLATION.
=GAS Q. ROOFING- Q SPECIALTY. 0 OTHER.
FINISHEDiFLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
:BUILDER] OMPANY
SIGNATURE REGISTERED Y-/ NCB, 'FEEZURREN
Addr®ss License:#' e C G 3 Z-7 �O
`.ELECTRICIML ;. COMPANY
'SIGNATURE REGISTERED Y/ N FEE CURREf•':. Y/N-
Address License#.
PLUI�BIR,; COMPANY';:
SIGNATURE" REGISTERED Y/ N,: FEE GURREfi: Y/.:N
Address. ; Licen'se.#
I .
'.'.MECHANICAL" ;.COOMPANY. _. ... I .
;.:
"REGISTERED FEURRESIGNATURE.-L! , Y/N .=: :- .•.
AildPe s} License.#
COMPANY •.
SIGNATURE; tf r ,- REGISTERED Y/N FEE CURREK
°License'#
-
E AID N it ,'cP' I" "F,B�ljl Plans ,1 elofEn' -Forms R0=1NPe" 'lt "raew.constuc_tion
R S E,.TAL�;�'>, :Att�cli,�(2),,Iot;P.,ans�•:(2)setsof, ul ng.r n ,( )�s er9y. ,�.• rtn f° ;�,>,, ,_
,: :.•a=: , ;:Mini um' 10.wvorkiii"'da"`aftefi. ubin ttei date sRe wired'onsite Construction Plans"Stolr�lwater Plans w/Sflt Fence'installed;
v±Sanitar:°Facilities;&r,1rdum ste, i Worlc<Permit.fo�sutidivlsidp§/fa. e° ro sets'.:,::
.< :rye. .-,�,,.: ; p. ;:. 4 ; ..,.,... .:-,:_.�s,.p, l....
COMMERCIAL Attach7j2)complete"sets oft0liding-Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction:
Minimum ten(10),working.days after submittal date. Required onsite,Construction Plans,Stomtwater Plans w/Silt Fence.installed,.
Sanitary Facilities&_1 dumpster.Site Work Permit:fo�all=new projects.All commercial requirements.mustmsat compliance '
PERMIT Attach( sets;o iEngin eted�Plaris;
""PROPERTY SURVEY required,i'or,aII,NEW construction:-..
-��-'Dire'gtloris:: :c•,,s c,>,-w3:. .. -.. _.
=:�'<;��= �:Ftlh'out�application.completely. •
:Owner`&Contractor.`sign:back ofapplication,notarised
>..
e: 'If"over'$2500;.a-Notice;of:Commencement Is required. (A/C upgrades over$7500)
"t" :/gent(fdr�the contractor)<.or PoWer:of Attori�(ey(for'the owine�)`wouid-66 someone with notadzed.letterfrom owner authorizing same
Q11ER;THE'COUNTE_R-PEI�EIALITIN_ Gw:-;r•_,..(coPYofbcontrachrequked)�
Reroofs.ifaliirtgles `Sewers :Service Upgrades NC Fences(Plot/Survey/Footage)
_ . :D�tireways-Not over Counter if on-publid roadways:neeiis"ROIN� - ,
NOTICE.OF:DEED:RESTRICTIONS: The undersi ned�.understands,.that;this= .ermit:ma be.,sub'ee.t to.;"'.deed1-'ydst�icl
whichil:,ma'[b'e.more'restricfivet `arts°Coin`:t°;<regulations=Tle�iriclers'i' ned`4ssurrtes: s onsitiilifor..coa .iiat�cir:with::aln.
y.,: . h . . n•y .g. _
appliciii deed'restrictions. '
UNLICENSED`::CONTRACTORS AND CONTRACTOR RLSP:ONSiBtLITIft, �lf�S.—owner has i iredua°eon#ractor or
contractors.to undertake work,.they Tgy�be,;required to beilicensed in accordance.with:state;and:focal:-reg latiar�s: iftithe«
contractor.-is=not.ilcensed,as:required ay'law,'both:-the owier:and'.`confract'd5e. tay.be..cited€ora'::misdembanor-.v:oiatiean
understate law. If the oavner fir intended::co tractor...:are.Uncertain as..to'what.licensing;;requirem6002rrtay a pry`,
Intended work .the. .are advised`to`coritactRtlae:'Pasco Couri Buitdin lns ecfion:-l�ivisioLi'censit `:Sect1on<at:727g47
80.09. •Furthermore,"if the oiivner has"°F}red'-a"contractor or c ontractors, he is advised ter 1have the-,contra�tor(s)A:sfgn,_^
portions of the °contractor Block'-of this,•appiication•._for.which.they.will be.responsible;-.4f_you,-.as`the:owhier sign
contractor.; that may be an indication Ahif-he=is.riot properlylicensed'arid-is riot"entit 6' to permitting priv}leges.irx Pasco4 M
County.
TRANSPORTATION IMPACT/:UT.]LITiES:°IMPACT AND RESOURCE RECOVERY•FEES: 'TIid undersigned-understands- .
that7tansportation Impact Fees and Recourse Recovery. Fees may'apply tc t, e.construct onr.of_new bulldirigs,.;change<of
use.in j existing"build expanslon-of },stt'il,buildings, as specified in Pasco County Ordinance nurnber:8947 and
90-07„as amended. The°undersigned ai"so understands,:that such.:fees,,as,may�dbe!,due; will-be identified a+:t�iae11iof.•. A-?
permitting. -=1t is furtheruridersfood that- hiTransportation Impact fees and Resourt e4�Recovefy;.Fees must be paid'prior:to
receiving:a:"certificate of occupancy" or final,:,power release: if the;_prpject-dbds nottinvolve:a:c rtifcate ofoccupatcy
final p6wer releaser-#h'e fees:must'be:pald prior to.perMit'issuance... Furtherm'ores,If•:Pasco:County WStc r./Sewer,;lrrfipact.
fees�ar`;e;due;:they mtist.be:.paid prior to!permit issuance.-in-accortlance withapolicable,•Pasco.Couraty ordinances.
CONSTRUCTION VEN LAW(Chapter 713;'Flarida:Statutes,as amended): If valuation of work is'$2,.5r00 0;0;or:more des,.
certify,Aat 'i,•'the.applicant,,have :been.;provided with--a -copy:::of.*the:,"Florida Consfeuction:.I",ien.•.Laini=.'Homeowner's
Protection Guide" prepared-by-the-Florida:Department of Agriculture and ConsuKner:Affairs. If the applicant is.;someone.;_}
other than the"owner",;l certify that:l.-have-obtained a copy of the.abovedi3chetl;`:documeflt`and:;promise=in;:gootl:fajtnto::;:;.:,
d
deliver 11:16`tlaer':ouuner"{piiar,.to:cdtnmL,,ndtmetit ...
CONTRACTORVOWNER'S AFFIDAV!'T:,:;I�,dbdify,-that'ali.the irifo'rmitiori in this application is accurate and'that aihi ork
will be?done'!n compliance with all applicable laws regulating construction, zoning;arad,land:development. Application..is
herebymade to.obtain•,a::,permit::,to-,°:do utiork-and.:,installation.,as-"ind'icated: 'I'certify that no work or'.insta1fafionHlhas'
commenced prior to issuance of'a permit and-,that all work will be performed-to-.meet::standards-9f all laws regulating
construction, County and City codes, zoning regulations, and land development regiiiatioiis 14 the jurisdiction:-s.,11also
certify that I understand that the regulations of other government agencies may.apply.to the-intended work, and.that it is.
my responsibility to identify what actions.1.must,take_to.,be;.in,compliance::Such.agencies include;but=are nat;limited=to:'
Department of Environmental.,'Prot'ecf low Cypress'Bay heads; Wetland Areas and EriViironmentally Sensitive
Lands,Water/Wastewater Treatment.
Southwest Florida Water Management.:District:Welts;.' Cypress= '.Bayheads,- Wetland Areas, Altering
Watercourses.
Army Corps of Engineers=Seawalls,Docks;Navigable Utlaterways.
Department;:.of Health;.4:Rehabilitativ! ;Services/Environmental.�Health-Unit=Wells;;Wastewater.Treatment,
_.;
Sepfc Tanks:: :
US Environmental Protection Agency-Asbestos.abatement.
Federal'Aviatian:,Authority-Runways. .
I understand thatTtiiei'foliowing':restr'ictions apply to the use of,fill:
Use of fill,is not aiiowed,}n-Flood Zone"V"unless expressly permitted.
If the fllmatenal is-to='be used in,Flood Zone "A", 'it is understood that a-drainage plan addressing,_a
"compensating volume" will be submitted.-at time-of permitting which is prepared by a professional engineer "
licensed;by'the'State°;of Florida.
- If the,fill"materlal:ls-to be used in Flood Zone "A"-in connection with a permitted building using..stem wall,,
construction, I,certify.:that=fiil'--MI-be used only to fill the-area within the stem wail. .....
If'fiI rmater}ai"Is--t6-be used In any area, I 'certify that.use of such fill will not adversely affect adjacent.:-...
properties. If.use of.fill,is found-.to adversely affect.adjacent properties, the owner may be cited for violating;--
the conditiaras_ofrfhe`t uilding perm t issued under-the.-attach , permit.--application, for,lots',less-than one;(1)
acre wh[bK.are elevated by fill,an engineered drainage plan is required.
if I am..the:AGENT;FOR-TME:OWN.ER:a',:promise in„goad faith to informJhe pwner-ofahe:perniitting,condition- set forth in
this affidauit'pilar-fo`commencing`construciioni..'I.understand that 4a,_separate permit may be required for electricai.work;;...
plumbing, signs,.wells,-pools,-.air;,;coaditioning,;•;.gas,-:or4'otl er''trnstallations not specifically included in the application+,.A.,-.
permit i$suedstaa}iybe construeditobe'a'licei se to.proceetl.'iiruitt .,ttie.work:;and'noV,aS.authority-to violate;:caricel;-after, ar
set aside any.provisions-of"tie°technical codes, nor shall issuance of-a permit prevent the Building Official from thereafter. n
requiring,a:correction+',of�.errors,-ln�plans;;construction•,or.,violations-of,any-ea:des:'.,Every permitissued,shail•=become invalid
unless:--the work authorized`bysuch permit is commenced Within,six,months of permit issuance, or if work authorized Eby
p time the work is commenced, .An-.extension
din ; Icia1 for a eriod:not to:ex
the permit is-sus ended or-abandoned for.:a- priod.;of�six 6 'monfhs:.after the t Y,
may be requested, in_writing, from the Buil g Off p reed ri}riety(90)daays and vvili'demonstrate
justifiable cause for.the extension...if wack_ceases for ninety(90)consecutive days,the job is considered abandoned: ! _
WARNING'TO`OWNER:. YQIJR,;FAILURE-TO;RECORD-A:;NOTICE:vOF.COMMENCEMENT''MAY RESULT'-!N'YOUR`
PAYING TWiCE'FORy IMPI�OYEM NT$T 1fOUi3 RROPSRTY.,.rIF YOU INTE'EV,G�OB'f�AiN:?FiNA ICING"CONSULT
WI VYt>t1RLENDERORANA'1'TORNEY -OFt3RE'R -CORD1NGr:0U1t--Nw>TIGE"BF'�Cf�1UiNtENCEI�IEi�T:' --- ----
FLORIDA.
URAT<(F�S::F1:7,:Q3)-: :.—�_ :•_
OWNER Ott AGENT. CONTRACTOR l
Subscribed and-swoin td(or affirmed)before me this S bscrlbe nd& o to or a eii•befbreFrietthis'.-
who Is/are personall_ aave. roce_d or, producedkmown,ta.meor du ho nt :
as7denUficatiom. as ldentilication. _.
Notary' PublicNotary Public
Commission No. Gam iss Zn No.
mmission=#FF 150422
18
Name of Notary typed,printed or stamped Name of Notary _ F,n,ns aae919
.' P�44a0._` Bonded
G 04/17/2018 6:44 AM 14154847068 ->18137800021 06
Classic Constructelonitd. co.
Tampa,FL 1813435.83381 Lk#CCC13278561 CRCVAM7
www.ClassicRFG.com
Estimate
DATE:03/05118
Contact:
Client Name:Sheryl Stire
Ow
Site Address:590314TH STREET
City,ST ZIP:Zephyrhills,FL
A preferred Nutech applicator Phone:
Check out more at Classic FG.com I Email:
-Tear off existing roof surface
Renail sheathing per code requirements
-Apply a Peel&Stick type underlayment to the deck
-Apply 3-tab shingles to pitched am and modified torch down to
the flea area 1 $10.200.00
Replace all vent stacks and fluAings where needed
If hidden wood replacement is discovered,a change order will be
!Presented
1 Y
Wood replacement,if needed,is not included in this quote.W a �
replacement will be charged on a time and materials basis,not to- 1
exceed$50/hr lus cost ormateri s
'Debris dis sal oral clean 1 Incl.
.... ....
1 enhuttiva—TSD{esdmatcd about S 150.00) 1 in
Total $10,200.00
Paid .00
Balance dui AaO.00
TW=W COW08 er
Cianlo ConeWeBan Ltd Coh not fHpaMElf�l�olaaMkldden damapaa,durtpe b atlecli0n a!�trrle,or d+enpn m Un Peep.of wars.
AddNewl deegnbkhalkpq rdd D.addreofod Per dlanpe order,le a Wv�owdaY iM avlher4krp peAy and Wfan work WV1 b§PeAmmed.TM
uwkrtipned epwnlo Pay in IUD Bw.pprawd work aeder rA Clkttata ComWdim Itd oo.Pmgrea PRE to M paid.whetl epppahte.per
adKltdhd dteal rerunb(arpn anorrerkpsd frtew.dkedkAe debrpAned.t th.den aN eantreal egn'np).AU watkaana>slpand wemMy Iar IaLor
prodde wpibe faro pamd Drone pw from tM&W ooaWbOm of work.
ACCOROWTO FLOR='S CONSTRUCTION LIEN LAW(SECTIONS T13O1.N31T,PLORIOA 01ATUTES1.THOSEMAIO WORK ON YOUR
PROPERTY OR PROVIDE MATIRIALS ANDSERVtCES AND ARE NOT PAID IN FULL NAVE A RIGHT TO ENFORCE THEIR CLAN FOR PAYMENT
AOAMTVOURPROPIRTY.THIS CLAIM 4 MOM ASA CONSTRUCTION LIMW YOUR CONTRACTORORA SUBCONTRACTOR FAII,{'TO PAY
SaSeaolrRAcroR>1,SW.IWCONTRACTOW ORMATtxiY1L SUPPLM IS.THOSE P&OPL1 WHO ARE OWED MONEY MAY LOOK TO YOUR
PROPERTY FOR PAYMENT,EVEN IF YOU HAVE ALWAVY PAID YOUR CONTRACTOR IN FULL IF YOU FAIL TO PAY YOUR CONTRACTOR,YOUR
CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY.THIS MEANS IF A LIEN M FILED YOUR PARTY COULD BE SOLD AGAINST YOUR
WILL To PAY I=CABOR,MATMALB.ON OTHER SERV=THAT YOUR CONTRACTOR OR ASUDCGHTPACTOR MAY HAVE FAILED TO PAY.TO
PROTECT YOURSELF,YOU SHOULD STIPULAWIN THIS CONTRACT THAT BEFORE ANY PAYMENT 11 MAOF,YOUR CONTRACTOR IS REQUIRED
TO PROM YOU WffHAWRITTEH RELEASE OF LRN FROM ANY PERSONOR COMPANY THATHIAS PROVIDED TO VOU A*WM TO OWNER.•
FLORmk*s CONSTRUCTION t1ENLAW IS COMPLEIL AND IT iS RECOMMENDED THAT YOVCONSULTAN ATTORNEY.
I agree to the scope of work and terms of this agreement,and authorize Classlc Constmallon Ltd
Co to proceed with the scope of work herein.
x
Author tgnature
�l� his
PdntlDate
®04/17/2018 6:44 AM 14154847068 ->18137800021 05
Classic Construction Itd. co.
10 0 Hampton Rd#123 Clearwater,FL 33759 813-435-83381 Lie#CCCt327M f CRC458037
www.Class!cRFG.com
To whom it concerns,
This letter is to confirm the persons authorized to applylpick up permits for Classic Construction Ltd Co under license
CCC1327856:
1)License holder—Jeffrey Lodermeler
2)Brian Lodemteier
For questions or concerns,please contact me at the below.
Regards,
Jeffrey Lodermeier
Classic Construction Ltd Co
813-435-8338
0 3 F
r
�n
tigERVFCp
610MM
Aug 18=�
M48AM
' • �°aServeXd
IN THE CIRCUIT COURT Off'THE SIXT'kI JUDICIAL CIRCUIT
IN AND FOR PASCO COUNTY,nOR)(DA �
PROBATE DMSION o
• n
0
IN RE: The Estate Of ,
a,
ETHEL RAMEY Case No: � n
a
Deceased. Division: cn to
x
h .
g ER APP1a.1NTING ffl4S0NAL REERPENT�
a
v (Intestate-Multiple) ;
.n
On the petition of Sheryl Sure and Richard J. Coleman for adm inistraticm of the estate x
-n
of Ethel Ramey, deceased,the court finding that the decedent died on May 8, 2017, and.that � a
Sheryl Sti3re and Richard J.Coleman are entitled to appointment as personal representatives by g o
reason of the majority beneficiary have agreed to their appointment and are qualified to be �
personal representatives, it is
0
ADRJDGED that Sheryl Stirs and Richard J. Coleman are appointed personal
representatives of the estate of the decedent, and that upon taking the prescribed oaths, filing
designations and acceptances of resident went, and posting bond in the sum of
letters of administration shall be issued.
a
ORDERED on
CTRCU1T JUDGE
i.
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1 r)vr,+rr Intr,rmgt✓r1•.v i r4ertM ,il9rrnrf,r,r•iI n,q{tfLL9 L't.ar;r'�yj?rr f•ur i!'r;r'i+�"t�d _ .,__ ---' -- ---
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I itndors relephono Na! -- s Lf- �= ? , 1
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y Persona within the Slate of Florida designated by the arvrur upon v/ry tTA nUX cr *e•d:o rrmr,!3 Tay be se reed as :ritd 7y ,tUj
Soction 713 13{1)(iii f'lorida 3latutes
Nil—me
Zc;kyrh.Fts
Ft
5AA5 C;enavleve Glr �."1
AddreSs—... _-- --- -- ^-- Cty Fate
Taiephane Number of Doalgnated Perron, 1373 810�303D �'r -
a In addition to hlrnsotf,the owner designates
to receive a eoV/office lyerofs Note 33 P:ov ded to act-,,)71 W.t;(t;{o),FL•ida; ex _' •
Tefephone Number of Person or Entity Designated by Ownem.
s
g. Expiregon data of Nor ce of Commencement(the expiration date may not oe bwforo t)ne CCrrz�t r l o1 ca s'.r `ten ar S fa sJ fa rst to tt•eit }
cpntrador,but will be one year from the date of recording unless a dlffererrt date Fs sperafzd).
WARNING TO OWNER- ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE t:OTZCE OF,OVIIE4CEME! ,
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 711, PART I, SECTION 713.13, FLORIDA STAT s- P'1D LAfti r►
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEq to ftUS a g
,G
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECT70N. IF YOU INTEND TO G3TAtH FIdW" C'.NG,COtiSUL-T
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR PECOftCING YOUR t10TiC£OF Crjw-►cs1itT,
Undar penalty of perjury.I declare that i have read the foregoing natice of commencement and that the facts stated Lhere�n are:am to the best '�l3
of my knowledge and belief.
STATE OF FLORIDA
COUNTY OF PASCO
/ + 5TM0MGEoFa 5+gnatur Owner or Lessee,or t7drrier6 of Lessee's AuL7to4xed
! ,�M "Pdsg-3uteofFW& officer tiector/Partner/Manager
�`a 4 € fana'.Icbn t GG 1791JI
�^.,�f N1rCOnIm.Eaprr�4JW11.2021
Sigrrut�ory,',6,TitldOffice -
The fttrorkV 1.vtnlment was adutowfedged before me this day of.t�UI f 1 2ds-by
qflc
(typeof auf'rc.,y,e g,officer,trestae.aComtey Lr,fad)f:r
(n arty on behalf of ter trt nxrre A vras exeWmd).
Prrtonaayr Known 0 DR Produced IdenUnclitlart Notary Sgnatur rf'
Type of Idertt&-*Vn Prod,WT* y )1 Name(Pant) kt7
PAULA 6 O'NEIL,Pn 1) Pasco CLERK 41 Ct)r'�*Ta4LLE!5
04O1312014 ;Ze 1 �t�
OR 0 PU i
r'