HomeMy WebLinkAbout19-20738 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 20738
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BUILDING PERMIT
} '<PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 20738 Address: 39737 MEADOWOOD LP
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: MEADOWOOD ESTATES
Est. Value: Parcel Number: 13-26-21-0140-00000-0560
Improv. Cost: 5,600.00 OWNER INFORMATION
Date Issued: 1/29/2019 Name: ALLURE HOLDINGS & INVEST INC
Total Fees: 70.00 Address: 19521 DEER LAKE RD
Amount Paid: 70.00 LUTZ FL 33548
Date Paid: 1/29/2019 Phone:
Work Desc: REROOF SHINGLE
CONTRACTORS APPLICATION FEES
KINGDOM CONSTRUCTION & DESIGNS, REROOF RESIDENTIAL 70.00
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Ins ections Re uired
DRY IN ROOF IN P
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. j
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 j
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.
-1 - - &___
CONTRAACThR 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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A. SETTLEMENT STATEMENT B. TYPE OF LOAN
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Pineywoods Title,LLC 1. ❑FnA 2.❑FWM 3.Qx CONV.UNmis.
100 North Tampa Street Suite 2165 4. VA 5.0 COW nos.
Tampa,Florida 33602 6.Fli eNumbw 7.L-N-be:
(813)489-6876 fax:(888)502-5660 19-PWT-002 19002
18.hfoaeege rna Cam No.:
C.NOTE: This form isfurnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agent are shown.Items marked
(poc)were paid outside the closing._77tey,are shown�here j_jnrdn-h&Tonal prirposes,.and,arerot included in the totals.
f�.AllutePHoldirigs_Bi,�Inyestment"s;In`c:a`Florida Coipoiation:W_:..:-"' i
D.Borrower. 1-9521-Deer-LakeTRoad �4
I.irta; d-da 33548---`-.`'1'
AppleCore Investments,LLC,a Nevada limited liability company
E.Seller. 6455 Sunstone Avenue
Alta Loma,California 91701
Pineywoods Capital,LLC
F.Lender. P.O.Box 172927
Tampa,Florida 33672
39737 Meadowood Loop
G.Property: Zephyrhills,Pasco County,Florida 33542-6779
MEADOWOOD ESTATES PB 15 PG 106 LOT 56 OR 6146 PG 1556
H.Settlement Agent: Pineywoods Title,LLC
Place of Settlement:r-100 North Tampa Street Suite 2165,Tampa,Florida 33602 Hillsborough County
�"I S-eitlerrierif;Date: . January 1i8,ZO,T9 -
J. Summary of Borrower's Transaction K. Summary of Seller's Transaction i
100.Gross Amount Due From Borrower: 400.Gross Amount Due To Seller:
_101. Contract Sales Price 72 500.00 401. Contract Sales Price 72,500.00
'102. Personal Property 402. Personal Property
103. Settlement Charges to Borrower line 1400 5,657.60 403.
Adjustments for Items Paid by Seller in Advance: Adjustments for Items Paid by Seller in Advance:
106. City/Town Taxes 406. City/Town Taxes
107. County/Parish Taxes 407. County/Parish Taxes
108. Assessments 408. Assessments
120. Gross Amount Due from Borrower: 78,157.60 420. Gross Amount Due to Seller: 72 00.00
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200. Amounts Paid by or in Behalf of Borrower: 500.Reductions in Amount Due to Seller:
201. Deposit/Earnest Money 501. Excess Deposit see instructions
202. Principal Amount of New Loan 77,500.00 502. Settlement Charges to Seller(Line 1400 6,345.87
203. Existing Loans) 503. Existing Loans)
204. 504. Payoff of First Mortgage
205. 505.,Payoff of Second Mortgage
206. 506. Purchase Money Mortgage
Adjustments for Items Unpaid by Seller: Adjustments for Items Unpaid by Seller:
210. City/Town Taxes 510. City/Town Taxes
211. County/Parish Taxes Jan 1,2019 thru Jan 18, 92.71 511. County/Parish Taxes Jan 1,2019 thm Jan 18, 92.71
_ 2019 2019
212. Assessments 512. Assessments
220. Total Paid b /for Borrower: 77 592.71 520. Total Reductions in Amount Due Seller: 6,438.58
300. Cash at Settlement from/to Borrower: 600. Cash at Settlement to/from Seller:
301. Gross Amount due from Borrower(line 120) 78,157.60 601. Gross Amount due to Seller(line 420) 72,500.00
302. Less Amount Paid by/for Borrower(line 220) 77,592.71 602. Os Reductions Amount due Seller(line 6,438.58
303. Cash From Borrower: $564.89 603. Cash To Seller: $66,061.42
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May 2007
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Settlement Date:January 18,2019 Loan Number 19002 File Number.19-PWT-002
L. • Settlement Charges
` 700. Total Sales/Broker's Commission: I Paid from Paid from
Based on Price $72,500.00 ® 6.00% _$4,350.00 Borrower's Seller's
Division of Commission as follows Funds at Funds at
701. 2,325.00 to Realty Executives America,Inc, Settlement Settlement
702. 2,025.00 to Pineywoods Realty,LLC
703. Commission Paid at Settlement 4,350.00
809.Items Payable in Connection with Loan:
_801. Loan Fee to Pineywoods Capital,LLC 2,325.00
802. Loan Underwriting Fee to Pineywoods Capital,LLC 995.00
803. Hypothecation Fee to Pineywoods Capital,LLC 400.00
804. Loan Set-Up Fee to AmenNat 200.00
805. Monthly Service Fee to AmenNat 23.00 1
806. Tax Service Fee to Pineywoods Capital,LLC 69.00
807. Document Custodian Set up Fee to Pineywoods Capital,LLC 15.00
808. Document Custodian Maintenance Fee to Pineywoods Capital,LLC 15.00
900. Items Required by Lender to be Paid in Advance:
901. Daily interest charge from Jan 18,2019 to Feb 1,2019 @ 23.3600 /day 327.04
902. Mortgage Insurance Premium
903. Hazard Insurance Premium
904. Flood Insurance Premium
1000. Reserves Deposited with Lender:
1001. Hazard Insurance
1002. Mortgage Insurance
1003. City Property Taxes
1004. County Property Taxes
1005. Annual Assessments
1100. Title Charges:
1101. Settlement or Closing Fee to Pineywoods Title,LLC 250.00 250.00
1102. Abstract or Title Search to First American Title Insurance Company 75.00
_1103. Title Examination
1104. Title Insurance Binder
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1105. Document Preparation
1106. Notary Fees
1107.' Attorney Fees
(includes above item numbers:
Title Insurance to Pineywoods Title,I.LC
1108. (includes above item numbers: 53.75 416.88
1109. Lender's Coverage 77,500.00 Risk Rate $53.75
Premium:
1110. Ownees Coverage 72,500.00 Risk Rate $416.88
Premium:
1111. Endorsement 8.1 45.00
1112. Endorsement FL Form 9 47.06
1200. Government Recording and Transfer Charges:
1201. Recording Fees: Deed 18.50 Mortgage 129.00 Releases 0.00 147.50
1202. City/County tamps: Deed 0.00 Mortgage 0.00
1203. State Tax/Stamps: Deed 507.50 Mortgage 271.25 271.25 507.50
1204. Intangible Tax to Clerk of the Circuit Court 155.00
1205.
1300. Additional Settlement Charges:
1301. Survey to Exacta Land Surveyors,Inc. 310.00
1302. Pest 19spection
1303. Electronic Filing Fee to SIMPLIFII.E 9.00
1304. Assessment/Lien Search to Exacta Lien Search 102.50
1305. Utility Lien to City ofZephyrhills 143.99
1306. Final Utility Meter Reading-Held on account to City of Zephyrhiils 500.00
1400. Total Settlement Charges(Enter on line 103,Section J and line 502,Section K) $5,657.60 $6,345.87
May 2007
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Settlement Date:January 18,2019 Loan Number.19002 File Number 19-PWT-002
A. ' SETTLEMENT STATEMENT
Pineywoods Title,LLC
100 North Tampa Street Suite 2165
Tampa,Florida 33602
(813)489.6876 fax:(888)502-5660
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I have carefully reviewed the Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and disbursements
made on my account or by me in this transaction.I further certify that I have received a copy of Settlement Statement
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fflum,Ho� 'In - - _ AppleCOMPAMR&Nevada limited liability company
Borrower. _ Seller.
r. Itoleif H..l41cCo'y,.Cresideni. Bob Lewandowski,Managing Member
1 have reviewed the Closing Disclosure,the settlement statement,the lender's closing instructions and any and all other forms relative to the escrow funds,including
any disclosure of the Florida title insurance premiums being paid,and I agree to disburse the escrow funds in accordance with the terms of this transaction and Florida
law.
Settlement Agent:
I n Date: January 18,2019
Farida Spmtley
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i May 2007
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Prepared byfitetmn to:
Farida Spradey
Pinemods Title,LLC
100 North Tampa Street Suite 2165
Tampa,Florida 33602
File Number. 19-PWf-002
Consideration:$72,500.00
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General Warranty Deed j
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Made this January 18,2019 A.D.By AppleCore investments,LLC,a Nevada Malted liability company,whose post office address is:
6455 Sunstone Avenue,Alta Lome,California 91701,hereinafter called the grantor,to Alllure�Notdtugs8c3lnvestme"ats;.lue;aFlonda J
Corporation,whose post office address is:1,v9521cDee,T.;e1te:Road;I:utz,:Florida-33548,hereinafter called the grantee:
(When—uwd beam the(am-gi nroP end graded ivdadc e0 the tcmim to aria inmumrm and the hda,.letal rrgraanutiva cad assign or
individuds,and the rrmee>sora and as*s ofwrpmetimo)
Witnesseth,that the grantor.for and in consideration of the sum of Ten Dollars,($]0.00)and other valuable considerations,
receipt whereof is hereby acknowledged,hereby grants,bargains,sells,aliens,remises,releases,conveys and confirms unto the Unarm
all that certain land situate in Pasco County,Florida,viz
Lot 56 of MEADOWOOD ESTATES,according to the Map or Piat thereof,as recorded in Plat Book 15,Page 106,of the
Public Records of Pasco County,Florida.
Parcel IDNurnh.Fl[ 2&.:21-01q,0=0g000;0560�
Together with all the tenements,hereditaments and appurtenances thereto belonging or in anywise appertaining.
To Have and to Hold,the same in fee simple forever.
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple;that the grantor has
good right and lawful authority to sell and convey said load;that the grantor hereby hilly warrants the title to said land and will defend the
same against the lawful claims of all persons whomsoever,and that said land is free of ail encumbrances except taxes accruing subsequent
to December 31,2018.
In Witness Whereof,the said grantor has signed and sealed these presents the day and year fast above wrium
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Signed,sealed and delivered in our presence:
AppleCore investments, LLC, a Nevada limited liability
company �
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1 (Seal)
Witnaa Nand Nam. �V` IkA1440[440 by:Bob Lewandows)d
its:Managing Member
Add- 6455 Sunstone Avenue,Alta Loma,California 91701
Win Pdn
Stateof C4Vi�grtrl�
County of Le 6
The foregoing instrument was acknowledged before me this 18th day oflanuary,2019,by Bob Lewandowald,as Managing Member of
ApiLeCaj t7stments,LLC,a Nevada limited liability company,who is/am person known to me or who has produced i
O(k as identification
P.Gzi�an,;
Notary Public
JEMMY E5CAfl91LLA PrintName: SQ,n" Fi cam:a(,
COMM.#2154223 z My Commission Expires: MrAr,d Z 2'� aZ-M
Notary Public•California o (Seaq �—
z Los Angeles County
My Comm.Expires May 22,2020+
DEED Gm®1 Warranty Deed firm U.0
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813-780-0020 City of Zephyrhills'Permit Application Fax-813-780-0021
Building Department
Date Received
Phone Contact for Permitting 1(
-
Owner's Name 66��aK�-/ YV V00� Owner Phone Number
Owner's Address i L 2( mat Zxl�P j L vTz Owner Phone Number
Owner Phone Number
JOB ADDRESS gklf �o 2 LOT#
PARCEL ID o)
SUBDIVISION # 6/v-
Oroo
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR a
ADD/ALT SIGN DEMOLISH
e INSTALL REPAIR
PROPOSED USE Q SFR F7 COMM OTHER IR-e/mo
TYPE OF CONSTRUCTION BLOCK ffQ FRAME STEEL
g rl
DESCRIPTION OF WORK 9 2�ellmf-ra -A��SU-171t re 744,1 t1-14 e/>'WA��r) "L44,1
BUILDING SIZE SQ FOOTAGE HEIGHTF_ I
=BUILDING
>I (0 Le) VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL 1$ AMP SERVICE DUKE ENERGY W.R.E.C.
=PLUMBING
=MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION
=GAS Q ROOFING SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
1 1 1 2 1 1 1 1 1 a 1 1 1 2 11
ly
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN L)L/N
-Address License#
PLUMBER COMPANY L
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED [ Y/ N FEE CURREN
Address License#
ow
, L
OTHER COMPANY 6W
SIGNATURE 2 2 y REGISTERED FEE CURREN
Address 33 License# =e-cc# 0
HHHHH 111 1 il 111111111111111 H-H 14`41 I I I I I I I I I
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivislons/large projects
COMMERCIAL Attach(2)complete sets of Building 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,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
****PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING °'(dopy,of'coritract required)
Reroofs if shingles Sewers ervice- 0grades A/C Fences(Plot/Survey/Footage)
Driveways-Not over Counter if,on pdbllb1:r66dWays.:needs ROW
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NOTICE OF DEED The undersigned understands that this permit may ba subject0o~dmad^restrictions"
which may be more restrictive than County regulations. The undersigned mesummsrempmneibiUforoomnp|ianmmvithony
applicable deed restrictions. I �
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired o contractor or'
contractors to undertake work, they may be required to be licensed in accordance with state and local-regulations. If the
contractor is not licensed as required by |avv both the owner and contractor may be cited for m misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may app|yfmrthe
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application�tion for which they will be responsible. If you, as the ovxnersign
' 'o the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply bothe construction of new buildings, change of
use in exioUhg buUdingm, or expansion of existing buildings, as specified in Pasco County Ordinance number8S-D7 and
Q0-O7. asamended. The undersigned also understands, that such fees, om may be due, will beidmntifiodat the time cf
permitting. It hm further understood that Transportation Impact Faoa and Resource Recovery Fees must be paid prior to
receiving o ^oertifioetegf occupancy" or final power release. If the project doaenotinvo|vea certificate ofoccupancy or
final power ne|eamm, the fees must be paid prior to permit issuance. Furthermore, if Pasco Counb/VVotmr/Sevwar Impact
fees are due, they must bepaid prior bopermit issuance|n accordance with applicable PamomCounb/ordinanoms'
CON
STRUCTION LIEN LAW(Chapter 713, Florida Statutes, sssmmemded): |f valuation mf work ia$2.5OD.00ormore, |
certify that [ the applicant, have been provided with a copy of the "Florida Construction Lion Law—Homeowner's
Protection Guide" prepared by the Florida Department-of Agriculture and Consumer Affairs. If the applicant hosomeone
other than the"owner", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver dto the"ovmner"prior bmcommencement.
CONTRACTOR'S/OWN ER"S AFFIDAVIT: | certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain o permit to do work and installation as indicated. | certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all /avve regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. i also
certify that I understand that the regulations of other government agencies may apply.to the intended work, and that it is
nmy responsibility tm|d�rd�vvvhsdaoUmno | rnuat take tobeinmmnop|ienoe. ��uchsgeno�»ainclude bu� limit
ed
Department epa�m�ntmfEnvirpmmenta| Protection-Cypress Bayhemds, Wetland Areas and Environmentally Sensitive
Landa. VVaterMaahswat* Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, VV*t|ond Aream, Altering.
Watercourses.
- Army Corps ofEngineerm-5eaxvaUm. Docks, Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unit-WeUn, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authorty+Runwa
1 understand that the following restrictions apply bo the use wffill:
- Use mf fill ia not allowed in Flood Zone^Vp unless expressly permitted.
- If the fill mmeb*ha/ is to be used in Flood Zone ^A", it is understood that o drainage plan addressing o
"compensating volume" will be submitted at time of permitting which is prepared by professional engineer
licensed bvthe State ofFlorida.
- If the fill mobmha| is to be used in Flood Zone ^A" in connection with o permitted building using mbam xmaU
construction, I certify that fill will be used.only to 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 mcUaoerd
properties. If use of fill is found to adversely affect adjacent properties, the mvvnmr may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan isrequired.
If} amthe AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. | understand that a separate permit may be required for electrical vxmrh,
plumbing, aigns, vva||s, pmo|m, air conditioning, 0ms, or other installations not specifically included in the application. /\
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
met aside any provisions of the technical codes, nor shall issuance ofo permit prevent the Building Official from thereafter
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 permit is commenced within six months of permit iesuonoe, or if work authorized by
the permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. An extension
may be requeotmd, in whUnD' from the Building difUoia| for period not to axummd ninoty (00) days and-willdemonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD ANOTICE 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,,-
OWNER"RAGENT som/m*c/w '
Subscribed and sworn uo(or affirmed)before mothis Subscribed and swom to or re me this ~ `
Who isfare personally known to me or has/have produced WhpfaT5peksonall k wn to-me or has/have produced
Public Lia —Notary Public
Commission No. Commis ion
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I(IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII �
2019013530
Permit No. Parcel ID No 13.28.21-0140-00000-0580
NOTICE OF COMMENCEMENT !
State of Florida County of Pasco
THE UNDERSIGNED hereby gives notice Out Improvement will be made to certain real property,and In accordance with Chapter 713,Florida Statutes,
the following Information is provided in We Notice of Commencement
1. Description of Property: Parcel Identification No. 13.28-21-0140-MOO.580
Street Address: 39737 Meadamod Loop Zechvrhi9s.FL 33542
2• General Description of improvement Tear off old roof,fir any rotten wood,Install new shingle roof
Rept:2023242 Rec: 10.00
3. Owner Information or Lessee iMomutien If the Lessee wMreaed for the InrprovemeM:_ DS: 0.00 I T: 0.00
Allure Holdings B Investments f Robert McCoy President 01/25/2019 J. R. , DPW Clerk
Name
19521 Doer LakeRd Lute FI-
Address City state
Interest In Property: 100%owner
Name of Fee Semple Titleholder.
(I}different from Owner Gsled above)
Address City Slate
4. Contractor. Walter Espinoza-l(Ingdom Construclion S Design Inc,
Name
+� 4�3 Formlen Lane Tampa FL 33824
Address City state j
Contre"s Telephone No.: (8131846-4080
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S. Surety:
Name
Address City state
Amountof Bond:E Telephone No.:
8. Lender. Na
Name
Address City State
Lender's Telephone No.: t
7. Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)(7),Florida Statutes:
Name
i
Address City stale
Telephone Number of Designated Person:
8. In addition to himself,Ore owner designates Of—
to receive a copy of the Lienora Notice as provided in Section 713.13(1)(b),Florida Statutes.
Telephone Number of Person or Entity Designated by Owner.
9. Erglratlon date of Notice of Commencement(the expiration date may not be before the completion of construction and final payment to the
cont actor,but wt0 be one year from the date of recording unless a different date is specified): SO Days
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE ExpiRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE j
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
NTH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NO F COMMENCEMENT.
Under penally of per)ury,I declare that I have read the foregoing notice of eomm a ant at stated therein are true to the best
of my knowledge and ballet.
STATE OF FLORIDA
COUNTY OF PASCO
Signature dF Owner or Lessee, r'a or Lessee's Authorized
OliicedDlrector/ParmadManage
z:-
Signatoys TitlefOlHee V
.t
The foregoing Instrument was acknowledged before me lhle day of 2011 by f'T
as l be-Wr (type of authority,e.g.,officer,trustee,attorney in fact)for I'
ftkli`J 7• 0L.;b(tkCnc, � I K1.4s6'Tiyt t!2�0S (n beh twh trOtAentwasexeeuted).-. .
Personally Known 0 Q$Produced Identification CC>,}� Notary Signature —
Type of Identification Produced��1�LCrli' Noma(Prim) w,t _
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DENN{S JAYAGNOTARY PUBLICPAULA S.0-NEIL,Ph.D.PRSCO CLERK f COMPTROLLER: STATE OF BLIC A01/25/201 2:1 in PG �j4 �' Comm#GG210225
OR 9K 4� biExpires 6=022
wpdatalbcslnoticecommencement pW53048
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STATE OF FLORIDA,COUNTY OF PASCO
®� THIS IS TO CERTIFY THAT THE FOREGOING IS A
RUE AND CORRECT COPY OF THE DOCUMENT
N FILE OR OF PUBLIC RECORD IN THIS OFFICE
I ES Y HAND ND OFFICIAL SEAL THIS
f DAY 0 2_ ___
�7 ALA S. 'NEI�/ ERK&CO TROLLER
R
S C DEPUTY CLERK Y
F1-®� c
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City of Ze h rhills
Y p Y
5335 W1 St.
Zephyrhills FL 33542
(813)780-0020
ROOFING INSPECTION AFFIDAVIT
Permit No.:
w
I, licensed under Chapter 468, Florida Statutes as a(n):
Contractor Engineer.. Architect_Building Inspector_
License No, C-Ccg o 3 D Qi
On or about_ lq did personally inspect the:
Check: Roof Deck Nailing '� Dry in °� Flashing and Drip edge
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Check which was used: 30#felt_Peel and Stick_Other(List) - C
At the following
address: 7 -7 F-4 P U1,24 Lovos
Based upon that examination, I have determined the installation was done according to the Hurricane I'
Mitigation Retrofit Manual(Based on Section 553.844, Florida Statutes).
Signature:
STATE OF FLORIDA 111.1111l
\`��I /s�
COUNTY OF PASCO
Sworn to and subscribed before this day A
••,
: �mrn.ExP�res• .
BY: �'a S� Gct -f 1�4 C' 12,2021
s JanueN
• Nc.GG 62516 Q
Notary Public State of Florida . Q
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�F OF F,
1111111
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