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Home My WebLink About19-21765 CITY OF ZEPHYRHILLS j. 5335-8TH STREET (813)780-0020 21765 BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 21765 Address: 38411 A AVE 4913 6TH 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: MOORES FIRST ADDITION Est. Value: Parcel Number: 14-26-21-0010-010000-007 Improv. Cost: 9,000.00 OWNER INFORMATION Date Issued: 9/18/2019 Name: WATERMAN PROPERTIES OF FL INC Total Fees: 127.50 Address: 4851 6TH ST Amount Paid: 127.50 ZEPHYRHILLS, FL 33542-5738 Date Paid: 9/18/2019 Phone: 813-714-3283 Work Desc: REROOF METAL CONTRACTOR(S) APPLICATION FEES BELCHER CONTRACTORS & ROOFING IN REROOF RESIDENTIAL 127.50 DRY IN ROOF IN P Inspections Required TAPE JOINTS ROOF INSP FINAL REINSPECTION FEES: (c)With respect to Reinspectio'n 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. leINTRACTOR 'SIGNATURE PERMIT OFFIVR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Building Department Date Received Phone Contact for Permitting .............. ... Owner's Name cy A, Owner Phone Number 9 4 Owner's Address 11 45�A*?0Ad 54 ZA�i i I Owner Phone Number Owner Phone Number JOB ADDRESS A A-4e- 4q 15 Lotb ZePlnlrWo I kjj:j�j4'ALOT# SUBDIVISION PARCEL 0D# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTRR ADD/ALT F-;71 SIGN- DEMOLISH I . - NSTALL REPAIR PROPOSED USE SFR Q Comm Q OTHER TYPE OF CONSTRUCTION BLOCK 0 FRAME Q STEEL DESCRIPTION OF WORK 80 of PEIR Mei-Al RAtkdsl BUILDING SIZE SQ FOOTAGE I OGKL> HEIGHT BUILDING 0 600 VALUATION OF TOTAL CONSTRUCTION (= =ELECTRICAL 1$ AMP SERVICE Q DUKE ENERGY 0 W.R.E.C. =PLUMBING =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION GAS ROOFING 0 SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD,ZONE AREA =YES NO HHHHHHHHHHH, .HHHHH! BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN LILN J Address License#- ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN L11 N J Address License# PLUMBER COMPANY SIGNATURE REGISTERED: Y/ N FEE CURREN, L Y�/N Address License# MECHANICAL COMPANY SIGNATURE REGISTERED Y N FEE CURREN Ly N L_J Address License-#'F OTHER COMPANY, cDab&ALKi rqx zmc SIGNATURE REGISTERED N. FEE CURREN LVLN Address License# 'T�M_ )0eAA)QCA bir.LASPAkisid.P I _:egl 13@7309 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 wl Silt Fence installed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/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. Minimumten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Felice Installed, Facilities&A 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. (AIC upgrades over$7500) Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarizedletter from owner authorizing'same OVER THE COUNTER PERMITTING (copy of contract required) Rerools if shingles Sewers Service Upgrades A/C , Fences(Plot(Survey/Footage) Driveways-Nat over Counter if on public roadways..neads'ROW NOTICE OF DEED RESTRICTIONS:-The undersigned.understands that this permit may be subject-to"deed" restrictions" which may be more restrictive than County regulations.'.The undersigned,assumes responsibility for compliance with any applicable deed restrictions. j UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a 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:law,, both the•owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended.contractor are uncertain as to what licensing requirements may apply for the 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 for which they will be responsible. If you, as the owner sign as 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 to the construction of new buildings, change of use in existing buildings, or expansion of existing.buildings, as specified in!Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned;also understands, that such fees, as may be due, will be identified-at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not.involve a certificate of occupancy or final power release, the fees must,be paid.prior.to permit issuance. Furthermore; if Pasco County Water/Sewer Impact fees are due, they must be paid prior.'to.permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIENIAW(Chapter 713, Florida Statutes,-as amended): If valuation of work is$2,500.00 or more, I certify that I, the applicant,,.have..been provided_.with a copy of the "Florida Construction Lien Law—Homeowner's Protection Guide" prepared..by the:.Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the"owner", I certify,that I'have obtained a copy of the above described document and promise in good faith to deliver it to the"owner"prior to commencement. CONTRACTOR'S/OIIVNER'S_AFFIDAVIT:,.I 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 a I.permit,,,to. do work..and, installation as indicated. I certify that no work or installation has commenced prior. to issuan'ce:'of-a permit;-and that all work will be performed to'meet standards of all laws 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 my responsibility to identify what actions.I.must take to be in compliance. Such agencies include but are not limited to: Department of•Envirom nental :Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,WaterMlastewater:Treatment:. Southwest Florida Water Management''District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. Army Corps of Engineers-Seawalls;Docks, Navigable Waterways. Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment; Septic Tanks. f US Environmental Protection Agency-Asbestos abatement. j Federal Aviation Authority-Runways. I understand that the following-restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone W"unless expressly permitted. , If the till material 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: material is to be used in Flood Zone "A" in connection with a permitted building using stem wall 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, 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 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 is required. If I am the 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. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a 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 issuance, 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 requested, in writing, from the Building Official for a period not to exceed'ninety (90) days and will demonstrate 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 A,NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTENID TO OBTAIWEPINIANCING,CONSUV --_ WITH YOUR LENDER OR-AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COIVIIVI EMENT. FLORIDA JURAT(F.S. 7.03) ^� OWNER OR AGENT (Q.l.r W CORITR Sub cri ed and sworn to for affirmed)before me this Sub c ed and so to or affirmed)b re rye Is c� by LoR1 V�/A-ie�'M� V1 �l by l�rN1E�j 1 2�1/ Wh rs re personally known to me or has/have produced Wh i re pe s ally known to me or hasihave produced N ZA as identification. as identification. I ��A��Notary �1 �+ . 1 Public ��'++ Notary Public Commission No. Q1L�1 QL 5�]3-7 Commission No.Gh `T LA"o- w 5��7 i Name a pe L 6f�ER Name of No tyyY .PrintedMA940MBELCHER ' W COMMISSION#GG 245531 +' „ MY COMMISSION#GG 245537 EXPIRES:December 3,2022 �;l Q EXPIRES:DecwdAr 3,2022 Bonded Thlu Notary Ruh1lC Undetwdtefs FOF Fl 4• )Bonded Thru Notary Public Undervmtets f. m ' fL°Ofl1Ufl .Sry• \l I r City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeo caner: C "Clov::wg— Date Received: Site: V3 Permit Type: •eA&L r e-r 4 Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑ This comment sheet shal e kept with the permit and/or plans. SEP y 7 2019 Kalvin SN4iWr s Examiner Date Contractor and/or Homeowner (Required when comments are present) Be c � eir CORMCTORS d 170"M Me.. RESIDENTIAL / COMMERCIAL 4025 TIMBERWOOD DR.- LAKELAND, FL 33811 License #CCC1327309 "Serving Central And Southeast Counties" Shingle, Tile,Flat, &Metal Roof Systems 813-770-5806 / 727-551-1579/Fax 863-816-5307 Proposal Submitted To: Date:August 14,2019 Waterman Properties Phone: 813-715-7383 38411 A Ave E-mail: office.watermanproperties@gmaii.com Zephyrhills,FL 33542 Belcher Contractors&Roofing,Inc.proposes to provide all material and labor required to complete the itemized work in the manner described below. All material installation will be consistent with guidelines provided by the material manufactures,the Florida State Building Code and codes.Any Roofing work included in this contract assumes the existing mechanical equipment is within the present code standards.Any updating to code by Belcher Contractors&Roofing,inc.will result in additional charges to buyer. JOB SPECIFICATIONS: METAL ROOF-OVER • FILING OF NOTICE OF COMMENCEMENT AND SECURE RE-ROOFING PERMIT • PROTECT SURROUNDING LANDSCAPE(WORK AREA)&ENTRY-WAY - • REMOVE EXISTING ROOF MATERIAL TO DECK,NUMBER OF LAYERS OF CURRENT ROOFING MATERIAL • RE-NAIL ROOF DECK TO MEET NEW(10/2007 CONUTY CODES) _ • INSTALL Rhino lb FELT 2 PLY DRY-IN OVER ENTIRE ROOF DECK.--DRY-IN SYTEM,ROOF PITCH 3.6 /12 • INSTALL 1 ,3"& 1 ,2"LEED FLASHINGS FOR PLUMBING STACKS_,4"GVR 10'GVR • INSTALL WEATHER-WATCH IN THE VALUES&ALL PENETRATION AREAS • INSTALL 22 SQUARES OF STANDARD PBR METAL ROOFING"PANELS IN CUSTOMERS CHOICE OF COLOR • INSTALL 48 FEET OF RIDGE VENT �t • INSPECT&REPLACE ROTTEN DECKING"EXTRA COST"OF,,$45.00 PER 1/2"4X8 SHEET&47.50 PER '/s"4X8 SHEET RATER TAILS&FASCA @ 4.00 PER FOOT! • REMOVE AND HAUL AWAY ALL WORK RELATED-DEBRIS AND DISPOSE • PERMIT AND DUMP FEES INCLUDED IN THIS PROPOSAL BELCHER ROOFING OFFERS A-F6CL'FIVE(5)YEAR WORKMANSHIP WARRANTY BELCHER ROOFING IS PROVIDING A WARRANTY BY IKO ON MATERIALS PRICE:$ 9,000.00 — NINE THOUSAND DOLLARS. Our terms:Down,50%=$ 4,500.06,I)wIvn&the remaining balance due in full upon completion of roof project. '1 Officer or Seller: This proposal may be withdrawn by us if not accepted within 15 days. Acceptance: The above prices,specifications;and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will be made as outlined above. Authorized Signature: Date of Acceptance: IKO JDM2019 Belcher Contractors &Roofing, Inc. Note:All work performed by Belcher Contracting&Roofing,Inc.,Inc will meet or surpass The Florida Building Code. Warranty:The warranty stated on the reverse of this contract is expressly in lieu of all other warranties and guarantees,expressed or implied. Contractor's liability for Its warranty shall be limited to remedying,at its own expense,any defect in the workmanship proximately resultingfroni the failure of the Contractor to perform the work in a skillful and workmanlike.Contractor reserves the tight to remedy any defect Contractor car? authorize the Owner/Buyer to hire others but assumes no responsibilitvfor work perfornned by others and shall not pay for labor and material expense in connection with the hiring of others that exceeds written agreement between Belcher Contracting&Roofing,Inc,inc and Owner/Buyer. 1.owner must consult at Owner's expense an engineer or architect concerning design factors such as slope,drainage,insulation,specification at field walls and equipment details. 2. The following conditions are hereby made a part of the proposal on the reverse side of this document and are to be considered a part of the contract entered into between both parties. Upon signing the acceptance on the reverse side,this proposal becomes a contract 3. This contract is subject to review by management personnel of the Contractor.Contractor reserves the right to cancel this contract prior to the start of the work to be performed in the event we find the cost to complete the work varies from the initial standard pricing do to human error orl behalf of the representative of the Contractor.In the event of this occurrence,Contractor shall advise the Owner and adjust the price accordingly. In the event the Owner is not in agreement with the adjusted price,the Contractor shall notes the Owner of the cancellation of the contract.In such instance,Contractor will return any deposit Owner has made toward the job in full. 4.Should concealed or unknown conditions in an existing structure be at variance with conditions indicated in the description of the work to be performed,or should concealed or unknown conditions in a»existing structure of an unusual nature,differing materially from those ordinarily encountered and generally recognized as inherent in work of the character provided for in this Contract be encountered,Contract price shall be equitably adjusted?upon notice thereoffrom Contractor to the Owner. 5.Belcher Contracting&Roofing,Inc,Inc.assumes no responsibility whatsoever for oral promises.All terms and conditions must appear in writing and appear on this contract.There are no promises,representations or understanding outside of this instrument unless provided in a written agreement and signed by both parties.No representative or employee of Belcher Contracting&Roofing,Inc,Inc shall have the power to waive or to be deemed or held to have waived any provision hereof,unless such waiver shall be in writing and signed by Belcher Contracting&Roofing,Inc, Inc or Its duly authorized representative. 6.L-Flashing in wails and chimneys will not be removed.(Should the L-Flashing have to be replaced,the additional charge will be determined as needed.) 7.Soffit repair or replacement is not a part of this contract unless otherwise stated Screened enclosures are to be removed and replaced by the Owner.Solar units are to be removed and replaced by the Owner. 8.Belcher Contracting&Roofing,Inc,Inc.assumes no responsibility whatsoeverfor liabilities arising from roofs not meeting 118"in 12"minimum slope as required by The South Florida Building Code or any other municipal,county or state requirements.Belcher Contracting&Roofing,Inc, Inc accepts no responsibility for ponding or standing water. 9.Belcher Contracting&Roofing,Inc,Inc assumes no responsibility for damagess arising from acts of nature such as hurricanes or toniadoes, lightning,etc or any other acts beyond our control. We also assume no responsibility for damage caused by plants,termites or negligence on the part of the Owner. 10.Contractor shall not be responsible for or liable for any damages to Owner If Contractor Is delayed at any time in the progress of the work by any act or neglect of owner or by any separate Contractor employed by the Owner,or by changes ordered by Owner in work,or by labor disputes, fire unusual delay in transportation,adverse weather conditions,unavoidable casualties,or any causes beyond the Contractor's control,or by delay authorized by the Owner. I L Due to the nature of the work to be done at the Owner's request,_Belcher Contracting&Roofing,Inc,Inc will not be responsible for any cracks in the ceiling or walls.Belcher Contracting&Roofing,Inc,hie will not be responsible for cracks in drivewi vs,curbs and sidewalks,for falling insulation,cracked or falling plaster,for damage to flowers,shrubs and other plant life,for damage to interior fixtures or contents,or for debris filtered through exposed beams ceilings,due to the loading,unloading,removal or replacement of the roof. ' 12.During the course of the roofing work,the customer agrees to not hold Belcher Contracting&Roofing,Inc,Inc liable for leakage or damage to interior contents that might occur from the date of commencement of roof repairs,re-roofing,or other roofing services through the date of completion ofsuch work. 13.Contractor shall not be held responsible for damage to pool or patio f urniture or any other exteriorfixtures.It is the Owner's responsibility to take necessary precautions to cover or conceal such items before the roofprocess begins. 14.Belcher Contracting Be Roofing,,Inc,Inc shall not and cannot be held responsible for any roofing material such as cement tile,shingles,metals, woods,etc.changing color or shape. _ 15.Belcher Contracting&Roofing,Inc,Inc shall not be held responsible for water lines,copper tubing,electrical wiring,pvc piping,etc in attic space If damaged do to roof nail penetration through the decking. 16.Payment ofail or part of this'contract shall be due as stated under the payment terms on the reverse side of this contract.Payment to Contractor shall In no way be contingent upon?acceptance of workperformed by others.Payment shall not be contingent upon inspections by local building authorities or any other Inspector.Payments due and unpaid under the Contractor shall bear Interest from the date payment is due at the rate of eighteen percent(18%)per ann«m.If the Owner does not pay the Contractor the payments specified under this Contract the Contractor may stop the work until payment of the amount owing has been received.In such event,the Contract price shall be increased by the amount of the Contractor's,reasonable cost of shutdown,delay and start-up.If it becomes necessary to incur any expenses in the collection of any money due herewider,including reasonable attorney's fees,these expenses will be paid by the Owner/Buyer or his Acting Agent 17.Service warranty and/or punch list work will cease and not be performed by Contractor If owner's payment as set forth in this contract is not made in a timely manner. 18.If contract is cancelled after 3 days from the date ofsigning,the Owner/Buyer shall forfeit 50%of any deposit that has been made. 19.It shall be the sole obligation of the Owner to determine the existence of any restrictions contained in deed%subdivision or neighborhood rules and regulations which might relate to or restrict the improvements outlined in this contract.Contractor shall have no liability or responsibility for any such nonconformity to or with such restrictions or requirements.Contractor shall be entitled to payment fronh Owner/Buyer of all sums due hereunder notwithstanding any injunction or prohibition against the work as a result of any violation ofsuch restriction or requirement. 20.In the event that state,county or municipal codes or regulations require work not expressly set forth in this contract and/or differing materially fn•om that generally recognized as inherent in work of the character provided for In this contract,as a condition for approval by such authority,any extra cost for Contractor's labor and materials shall be the sole obligation of the Owner.In the event the substrate roof condition results in ponding pursuant to the Standard Building Code and modifications are required to correct the current substrate roof so ponding will not occur,Contractor will notify the Owner/Buyer upon learning of such requirements. 21.Purchaser agrees to pay Belcher Contractors&Roofing,Inc the cash price(plus 3.2%surcharge if sales Is a credit sale that specifies interest charge INSTR#201'%148681 OR BK 9966 PG 437 Page 1 of 1 09/03/2019 01:115 PM Rcpt:2086607 Rec: 10.00 IDS:0.00 IT:0.00 Nikki Alvarez-Sowles, Esq.,Pasco County Clerk&Comptroller AFTER RECORDING-RMMN TQ PERMIT NUMBER: NOTICE OF QMMENCEMENT The undersigned hereby gives notice IW improvement will be made to certain real propefty,and in acoordatice with Chapter 713. -. Florida Statutes,the following information is provided in this Notice ofComme cement. 1 (]/�� ./� �~ 1. DESCRIPTION OF PROPERTY(Le gal dcu ription of the property&and address,if avat•fable)TAX F�Ouo NO Q t+�r0 y7�r SUBDIVL110N S ADD gBLOCV IQ TRACT LOT YLDG U\rT �rrr---•O 3�qI 1AAve,PSCRIPTiONOP1MPR �-I�t1/i Y,Sr 7'S�l �• 'T—I�� &iIs ;:i2. RE-ROOF -E. 3, OWNER INFORMATION OR LESSEE INFORMATION IF THE LESWECONTRACIt4D FOR THE IMPROVEMENTt v.Name and adbesx LA b.tntateerinpropatr, 100% ZeP i(rh.1 I s,F 1 335�_a,� * . c.Name toed address or to;simple tkkbokkr(irditrercat anm Owner Bated aboroY. GV`, •• a, a.CONTRACTOR'S NAME:Belcher Contractors&Roofing Inc 91 caaet aar•a.w...,'402511mberwood Dr Lakeland FI .33811 813-770-5806 S. SURETY tiro • Lu pp8 K o e>tPy ortlp paymad band taaaacanip sNamoandaddees .:•� _N/A... .. .... -:. LL c r b.Pterme number: e.Amoora A W4 oY 6.a.LENDER'S NAME- N/A 1.aedv'saddten b.Phow wtnbam.. w. 7. Persons v*hin the State of Florida designated by Owner Upon whom notices or olhcr docu nets may be saved as provided by (�j z O 2 J Section 713.13(1)(a)T.Flsida Statues Q'- U (/) J N O F- Qf a.Nameaod address N/A C- � o I=- w w b.Pboeee number,ofdaiaraw pe rsorm 0 O = Z ._l 8.a.In addition to himsciror herself.Owner designates or F- 1~i W U O to receive a copy of the Liem's Noliec as provided in Section 713.13(1)ft Jgerida Statutes. 2 = O O U b.Platte number of F U perms or emiry'desi�utcd t7 U9mmv: \ Q O 9. Expuati dato ofnotice ofcommnDcenatt(tbe expiration date will be I year rrom the date of recording unicss a different date ism,eZ O U J specified): 1`�*20� } U m Q LL � � aZ O ARE CONSIDERlfij ORROPER PAYMENTS UNDER CHAPTER 713,PART c MON 713.13•FLORIDA 47 A l�tt�_Aut�CAN 1 Q � � = Q R T RV YOLHt PAYRVCi no FOR IMP%t0Md NPS TO YOUR PRGMTY, A NOTICE OF MMMEMEMM b4 ST c � tl.t O O � p RRl_ 11DED AND PQCTMi ON THE)OD SITE R=RE nffi FBt_rT DaSPECTiON, IP)m INTEND TO OBTAIN FINANCING.CONSI�T- Wr1Ti YOIm l 1�NDER OR AN ATTORNEY RF RE COMMENCING W=OR RECORDING YOUR Nl?fI.^E OWCOMM19faMIUM a Q z O 1L8 <J box \rJA�rMA t,� �-��'" �. (Signature of Qwmer or Lcaseea or OwaerS or l essee's �(Print Name and Provide Signatory's T ldc/OfHce)pgg O 3: m Authorized 0Mcer/Dlrertor/Yartner/Mampr). stoic of 1:lM( A County of Y>ASCQ ��'' '' //�� The foregoing htstwnent%veer acknowledged before me this 9 day ofA IO by LQ�i\ �t��rMA iJ ,as H[� t- r)ei1� (name ofpease>tt) (type o authority,...a.g.ofcer,trusteeattorneyinfeet) (name ofpaity on be halfofwhom instrumtatt was executed) \Personally Of Identitiesion Prodttad N/A DUWAREEDBELCHER MY COMMISSION fi GG 245537 ?°S = EXPIRES:December 3,2022 Bonded Thrit Notary PUbk Uttrle:raM0s (Signature of Notary Public) `• - (Print,Type,or Stamp Commissioned Name of Notary Public) Rev.10.1 S•12 g ' f f� # y:te',.t;';i�';:> .i «�s•:'�S'Y'-�z�i.s24i �.°��a':i;,R„�j•,`.'�c�.a��.a^;h. 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