HomeMy WebLinkAbout20-689 rlo ti v`e City of Zephyrhills nTM- .PERMIT NUMBER
5335 Eighth Street ,
' Zephyrhills, FL 33542 BNR-000689-2020
Phone: (813)780-0020
Issue Date: 10/06/2020
:1 Fax: (813)780-0021
f
Permit Type: Building New (Residential)
'Property:;Number :.,: StreetAd'tlress°.: : }°.:..
35 25 21 0140 01000 0180 7740 Davie Ray Drive
� � •_ :ram,...:. k. R��
:e �Owrier Information Permit Imd mafion . F aY.`.�' Contract lnfo�mation
Name: D R HORTON Permit Type:Building New(Residential) Contractor: D R HORTON INC
Class of Work:SFR Construct
Address: 12602 Telecom Dr Building Valuation:$105,000.00
TAMPA,FL 33637 Electrical Valuation:$7,000.00
Phone: (813)549-1968 Mechanical Valuation:$5,000.00
Plumbing Valuation:$7,500.00 /
Total Valuation:$124,500.00
Total Fees:$18,647.50
Amount Paid:$18,647.50 `' Z/
Date Paid:10/6/2020 1:53:55PM
CONSTRUCT SINGLE FAMILY 2,362 SQ FT r
ApplcationFees
«,
Electrical Plan Review Fee $37.50 Address Fee $30.00
Driveway Fee $45.00 Building Plan Review Fee $277.50
Mechanical Permit Fee $65.00 Electrical Permit Fee $75.00
Building Permit Fee $555.00 Sewer Connection Residential Fee $2,090.00
Public Safety Impact Fee-Admin $26.35 Irrigation 3/4 Meter(Galt) $473.78
Park Impact Fee-Single Family/Townhome $769.56 Water Connection Residential Fee $1,010.00
Mechanical Plan Review Fee $32.50 Plumbing Plan Review Fee $38.75
Public Safety Impact Fee-Fire $273.00 Transportation Impact Fee $3,595.68
School Impact Fee $8,328.00 Transportation Impact Fee-City $36.32
Public Safety Impact Fee-Police $254.00 Plumbing Permit Fee $77.50
3/4 Water Meter Fee(Galt) $473.78 SIF 1 percent Fee $83.28
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 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 permit 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 add fee 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.
CONTRACTOR SIGNATURE PE IT OFFICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
INVOICEo000
FOR •
BILLING CONTACT
DAVID GLIDE
D R HORTON INC
12602 TELECOM DR
TAMPA, FL 33637
INVOICE NUMBER INVOICE DATE INVOICE DUE DATE INVOICE STATUS INVOICE DESCRIPTION
INV-00001327 09/28/2020 09/28/2020 Invoiced, Past Due NONE
REFERENCE NUMBER FEE NAME TOTAL
BNR-000689-2020 3/4 Water Meter Fee(Calc) $473.78
Address Fee $30.00
Building Permit Fee (p�1 t �� $555.00
Building Plan Review Fee V )� $277.50
Driveway Fee $45.00
Electrical Permit Fee I 11�A $75.00
Electrical Plan Review Fee \ $37.50
Irrigation 3/4 Meter(Calc) J � $473.78
Mechanical Permit Fee �Vn"��v $65.00
Mechanical Plan Review Fee $32.50
Park Impact Fee-Single Family/Townhome $769.56
Plumbing Permit Fee I- $77.50
Plumbing Plan Review Fee l ` 1p{ $38.75
Public Safety Impact Fee-Admin $26.35
Public Safety Impact Fee-Fire $273.00
Public Safety Impact Fee-Police $254.00
School Impact Fee $8,328.00
Sewer Connection Residential Fee $2,090.00
SIF 1 percent Fee $83.28
Transportation Impact Fee $3,595.68
Transportation Impact Fee-City $36.32
Water Connection Residential Fee $1,010.00
7740 Davie Ray Drive Zephyrhills, FLORIDA 33541 SUB TOTAL $18,647.50
REMITTANCE INFORMATION TOTAL $18,647.50
City of Zephyrhills
5335 8th Street
Zephyrhills, FL 33542
September 29,2020 5335 8th Street,Zephyrhills,FL 33542 Page 1 of 1
IN,TR,2O2Oi59913OR13KlOi84PG2139 Page tof,
09125/202o 11:44 AM Rcpt-2208366 Rec:10-00 DS:0.00 IT:0.0
Nikki Alvarez 0
areowles,Esq.,Pasco County Clerk&Comptroller
Permit No. Percel ID No�2S-'LLMqj0 i csi
NOTICE 6F COMMENCEMENT
Stale of Florida County of Pa'900
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,and In accordance with Ohapter713,Florida Statutes,
the following information is provided In this Notice of Gommencement:
1. Description of Property: Parcel Identification No.I prV,
Street Address-, --RxLNP1!R zcku-X-3n- 2-oil
2. General Description of Improvement NEW-�Inqla F'am lhi Residence
M .,
3. Owner I*rmdon or Lessee information Ifthe Lessee contracted forthe improvement:
D.R. Hodon, Inc
Name
�)R 2 Talancim Drfyt-
Address I city = State
Interest In Property: 1:--ee sjm�e
Name of Fee Simple Titleholder.
(If diffemritfrom Ownerllste4 above)
Address city State
4. Contractor. -D-R. Hortm Inc
Name
12 2 Telecom'Drive, Tamp;i INN Fl-
Address city state
Cordmctor`s Telephone No.:
5. surety: N/A
Name
Address city State
Amount of Bond- $- N/A Telephone No.:
5- Lender.
Name
Address city state
Lender's Telephone No.:
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:
David Gude
Name
12602 Telamm Drive Tampa 33637 FL
Address city state
Telephone Number of Designated Person, M-740-9720
8. In addition to himself,the owner designates MIA Of
to receive a copy of the Lienar's Notice as provided in Section 71113(t)(b),Florida Statutes.
Telephone Number of Person or Entity Designated by Owner.
S.. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction and final payment to the
contractor,but mll be one year from-the date of recording unless a different date Is specified):
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 I SECTION 7*13.13, FLORIDA STATUTES AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENT.- TO YOW PROPERTY. A NOTICE Or- COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION, IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,I declare that I have mad the foregoing buce f commencement and that the facts stated therein are true to the best
of in)(knowledge and belief.
STATE OF FLORIDA
COUNTY OF PASCO
Sig tune of Owner or Lessee,or Ownees or Lessees Authorized
OfficerIDIrector/PartneriManager
Assistant Sacretery/D.R. Hoft On,.-lno
The foregoing Instrument was acknowledged before me thlsWAday of 20 1,, by
as Assistant-bgecrate[y ---(type Of authority,e.g.,officer, In fact)for
D.R. Hgdon,'Ing (name of party on be If Thom I st twas executed).
OR Known R Produced Identification[3 Notary Signature
Type of Identification Produced Name(Print)
;LN it PublirStatsofFlorlda
e?AM"llc'h,a U b Mayes'P r
wpdatWbcs/noticecommencemL,nt--Pc-053048
' �a»D13�8V�02�
_ ---- ui�/ ot i\ Permit/\op�C8tOD
Building Department
Date Received
Phone Contact for ffRermitting
Owner's Name )nc-. owner Phone Number
3S owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address LOT#
JOB ADDRESS
SUBDIVISION 7R �AR EL ID
. . .
WORK PROPOSED . wewcowsTm ADD/AJLT F--� SIGN �—� [--� DEMOLISH
| | INSTALL [_] REPAIR
PROPOSED USE �—� aBR �—1 COMM [--1 OTHER
TYPE OFCONSTRUCTION E2— BLOCK F—� FRAME �--� STEEL
DESCRIPTION OF WORK q- wecl
BUILDING SIZE SQ FOOTAGE HEIGHT .
=BUiLD|NG VALUATION OF TOTAL CONSTRUCTION
F--��LE�TR|CAL AMP F--1 PROGRE8GENE�GY F--1 YV.R.E.C.
__--
=pLUMB|NG
YY
F--l�E�HAN|�A� ' MECHANICAL
___'
F--l�AS r�� ROOF|N' F—� � �P�C\8�'Y �--\ OTHER
�--^ ' �--^ — �—� �---^ \
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA F--lYE8 NO �
BUILDER COMPANY
SIGNATURE REGISTERED �_y/_N_]' psEounnsx [_Ym�]
Address License#
` ELECTRICIAN COMPANY
SIGNATURE nen/arsnEo ^ peEuunssx —
Address
PLUMBER COMPANY
SIGNATURE nuo/srsRso Y1 N 'rEEtURmEN
Address License#
MECHANICAL �o�PANY
SIGNATURE neoIarsneo r1tECunnEN\/ ���------
Address
OTHER . COMPANY
SIGNATURE nsa/nrsnso peEounnsN
Address Uoonsu# I cc
n x u x I x o I x it u x x 1111 x x n x x x x n K x x x U D x
RESIDENTIAL Attach(2)Plot P '
Minimum ten(1u)working days after submittal date. Required onsite,Construction Plan�Stormwater Plans wl Silt Fence installed,
Sanitary Facilities&1dumpnter Site Work Permit for subdivisions/large projects _) _
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fo"r'ms.R"O-W Perrrit for new construction.
Minimum ten(1o)working days after submittal date. Required onniba.Construction Plans,Stormwater Plans vl8l\t Fence Installed,
Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All commercial requirbment5'must meet compliance
SIGN PERMIT Attach(2)sets nf Engineered Plans,
* °°PROpERTY SURVEY required for all NEW oonobucUon. -
o/m000na* ^- ' - --�--------
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over*25oV'a Notice of Commencement inrequired. (A/S upgrades over*750O) '
� Agent(for the contractor)or Power nfA0omog(for the owner)would bo someone With notarized letter from owner authorizing' aoma
OVER THE COUNTER PERMITTING (copy nf contract required)
Ramofs if shingles Sewers Service Upgrades A/O Fencee(P|nV5umey/Foobgo)
Driveways-Not over Counter ifon public roodvnayo..noodaROW
i
. '
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.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: |f the owner has hired a contractor or
contractors
*tounde�ahavvork. they rnaybe required tobe licensed in accordance with state and local regulations. If the
contractor is not \imanaod as.required by \ovv, both the owner and contractor m V ay be cited for a misdemeanor violation
under state law. If the owner or intended contractor are unbertoin 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, Furtharnnore, if the ovvOar has hired m contractor or coOtraotnre, he is advised to have thb contractor(e) 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 |s notpropedy]|oenaod and is not entitled to permitting privileges in Pasco
County. /
TRANSPORTATION TD8P'AG7UT|L\T\ESIMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buUd\nge, change of
use in existing bui|dingn, 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 Feea'and Resource F{aonvary Fees must be paid prior to
receiving o "certificate of occupancy" or final power release. \f the project doesOotinvolvaaoerbfioateofoocupanoymr
final power release, the fees must be paid prior to permit issuance. FVrthernnora, if Pasco CountyVVater/Sswver Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713. Florida Statutes, osarnended): |f valuation of work\a$2'5DO.00or more, |
certify that |, the app||oent, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and
i 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\tto the"ovvner"prior tocommencement.
CC]NTRACTOWS/OWN ERIS /\FF\OAVlT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable \evva regulating uonotruction, zoning and land development. Application is
hereby mode to obtain a permit to do work and installation as indicated. | certify that no work or installation has
nonnnleDoed prior to issuance of permit and that all work will be performed to meet standards of all |nvvs regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. | also
certify that I understand that the regulations of other g o*vernment 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 ofEnvironmental Protection-Cypress Bayheods, Wetland Areas and Environmentally Sensitive
Lands,VVater8WaotevvnterT[eetmant.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, VVetiand Areas, Altering
Watercourses.
- Army Corps ofEngineena'8eovvaUa. Docks, Navigable Waterways.
- Department of Health & Rehabilitative Gerv\cea/EDv\nonmenbs) Health Unit-WeUo, VVoetevvator Treatment,
Septic Tanks.
' UG Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authoritv'FlunvVaye.
| understand that the following restrictions apply to the use offill: '
' Use of fill \e not allowed |n Flood Zone"\p unless expressly permitted.
- If the fill rnoteho) is to be used in Flood Zone "A". it is Understood that a drainage plan addressing a
"nonDpensot\ng volume" will be submitted at time of permitting vYh\oh is prepared by o professional engineer
licensed by the State ofFlorida.
' If the fill nnatedo| in to be used in Flood Zone ''/Y' in connection with a permitted building using stem vva||
construction, | certify that fill will be used only tofill the area within the stem wall.
- If fill rnmteda| is to be used in any area, | certify that use of such fill vvU|' Dot adversely affect acU8oant
properties. If use of fill is found to adversely affect ecUaoeOt 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 cornnOeDoinQ construction. | understand that a separate permit may be required for electrical work`
plumbing, sigDs, vveUa' poo|e, air conditioOing, goo, or other installations not specifically included in the application. A
permit \nouod shall be construed to be a license to proceed with the work and not as authority to violate, nenoe|, alter, or
aetaa|deanypnovinionoofthetaohnica|todna. DoFshoUiaauanoaofapermitpneveOttheBVUdlngOfho\a\fronnthenacdter
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 cV0Dlanned vv|thiU-G\X months of p8[nn|t \sauance, or if work authorized by
the permit iasuspended or abandoned for a period of six(6) months after the time the work is commenced. An extension
may be requested. in vVht|Dg' from the Building Official for B period not to exceed ninety (SU) 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 8 NOT�E 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 OR AGENT comTRxcTo
Subscribed and sworn to(or affir ed)b for�me this Subscribed and sworn to(or affirmed)before me this
Who islare personally known to me or has/have produced Who islare personally kno%�n to me or has/have produced
as identification. as identification.
Notary Public Public
Commission No. Commission No.
813-780-0020 City of Zephyrhills Permit Application Fax-819-780.01
Building Department
€ Date F2eceived Phone Contact for Permittin
Owner's"Name Owner Phone Number
..Owner's Address Owner Phone Number
Owner Phone Number
. LOT#
JOB ADDRESS'
SUBDIVISION PARCEL iD#
(OSTAINED FROM RikOP,ER1l'TAx;tGtT.tGE)•:
WQRK PROPOSED
NEWCOtJSTR ADD/ALT [�� SI'GN Q -;DEMOLISH'
e INSTALL 8 kEPAIR
PROPOSED USE. SFR Q COMM OTHER
TYPE OF CONSTRUCTION BLOCK Q FRAME STEEL C]
DES.CRIPT.ION OF.WORK _
BUILDING SIZE SQ•FOOTAGE;= HEIGHT .�
i
OBUILDING $ VALUATION OF"TOTAL CONSTRUCTION,
=f ECTRICAL $ AMP'SERVICE DUKE ENERGY- Q W,R.E,C,
OPLUMBING �-� • ,
=MECHANICAL VALUATION OF MECHANICAL INSTALLATION
=GAS ROOFING SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS FLO.OV20NE'AREA ��. YES . NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
ELECTRICIAN. COMPANY
SIGNATURE REGISTERED' Y i':N FEE CORREt V%N J
Address . 'License# I
PLUMBER '� COMPANY "
SIGNATURE t •REGISTERED• Y 7-N' FEE'CURREA
Address License.#
MEt-HANI.CAL ;' ,COMPANY
SIGNATURE' REGISTERED I Y/ N I FEE CURREN Y/'N• '
Address License•#,,
OTHER COMPANY
SIGNATURE REGISTERED Y:/. iV,,,.: ..• FEE CURRR'E`R�•
Address License*# 1, r
RESIDENTIAL Aktact%(2)'Pio#Plans;.(2�'setsofi3uildit�g:Pfaris.;,{1}',set of Ene[gyForms;'RA0�1N_Rerrriitfornew:construction,,
'mum:ten;(10),vrorl%irigdoys-aftar stibrtita'Isdte Reduiced otrsite;'Co`nstrctioCi Plans,StartTir�°/ater Piatt's vi+!Siit Fenae installed,
Sanitary:Facilities&;1�.durnpsterf Site Work-.:Permit fbr'silbdivibions/isrge-projects'
COMMERCIAL Attach(2).complete,sets•of;Building-Plans plus'asLifei$af,ety„Page,($y.set•oB+Energy%Forms.R-O-W Permit fdn.new construction.
Minimum ten(1D)tiworking;d ys,after;submittai,date,y Re„q''uwiredtgnslte;Construction,Rlanpi,Stormwater,Plans•w/Silt'Fence installed,
Sanitary Facilities&1 dumi56te'r.Bite-Work Permit for a`lI new projects.All commercial.requirements must meet compliance
SIGN PERMIT Attach(A)'sets.af E'ngipeere"Plana.
****PROFERTY SU'k '\ FY.'requleed for all'NEW construction.
Directions:
Fill out application completely.
Owner&;Contractor sign,back of,, ppiication,notarized
"if over$25d11,a Notice of m:Comeneement is required- (A/C upgrades.aver$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�RERMITTING (cgp, 'of'contract,required)
Reroofs if shingies Sewers Service Upgradest A/C Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs 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.
UNLICENSED CONTRACTORS AND- CONTRACTOR RES'PONSIB'ILITIES:" 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..understand's,'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-LIEN LAVA(Chapter 71.3,•Florida Statutes; as amended): Ifvaluation of work is $2,.5.00.00 or more, I
certify that 1, 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•applican.t 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'SIOWN,ER'S;AFFIDAVIT: l.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,lan'd development.. Application is
hereby made to obtain a permit to,do work arid installation 'as indicated, I 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 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 Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of :Health &,'Reha'bilitative Services/Environmental Health Unit=Wells, Wastewater Treatment,
Septic Tanks.
- US.Environmental Protection+Agency-Asbestos.abatement.
Federal Aviation Authority-Runways.
I understand•that•the following restrictions,app'Iy•to-the•use of fill:
- Use of fill is not allowed in Flood Zone W" uhless-expressly permitted.
- If the fill 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:whieh -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 areavithi.n 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 fora 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.IMPROVEM15NTS TO'YOUR•PROPERTY.. IF—YOU'-INTEND TO'OBTAIN FINANCINO, CONSULT
WI•TH"YOUk LENDER.OR AN ATTORNEY'BEPORS RECO:RDIN:G.YOUR NOTCCI=.OF-CO1V11 E.NCEMENT.
FLORIDA JURAT'(F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to(or affirmed)before me this
by by
Who is/are personally known to me or has/have produced Who is/are personally.known to me or has/have produced
as identification, as identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
't
D
Single Family Dwelling
Plan Review Comments
1. F.F.E. shall be a ininimum of 8"above the road elevation and an engineered site plan.
2: Lots shall be graded to comply with„R401:3 of the F.B.C.
3. Compaction test required if 24"or more of fill dirt is brought in at any one place.
4: Tie in survey required before pouring concrete.
5, Driveways require.a R.0M.-use permit. All 4 sides_ of driveway thra the sidewalk shall have
expansion material.
6. All setbacks shall be met.
7. All,propertymarkers shall be uncovered'and marked at time of first inspection.
8. All A:D.A.-requirements shall be met:
9. No electric,.plumbing;mechanical, or framing shall be covered without an inspection and
approval first.
10. All Garages shall comply with section R302.6 of the F.B.-C. (Fire Separation).
1.1. Appliances shall not be installed in a location where subject to mechanical damage unless
protected by approved barriers. M303.4 of the F.B.0
12. Water heaters-shall comply with section P607.3 of the F.B.C:
13. Foundation supports for A/C units shall be raised at least 3" above finished grade. M1308:1
14. Return air in all bedrooms. F.B.C. M162.0.4
15. Smoke detectors are to be installed;in accordance with R313.1 of the RB.C-.
g
16.All lazing requiremeiits are to be in accordance.with R308.4 of the F.B.C.
17..All means of egress are to be in accordance with R311 of the F.B.C..
18: "Green gypsum-board" shall not be;used as a backer in showers or tubs. R702.:4:2 F.B.C.
19. Combination-type AFCI,breakers are required at all locations requiring an AFCI type breaker.
20. Carbon monoxide alarms will be required in new construction that uses fossil-burning heating
or-appliances or an attached garage. They shall be installed in accordance with the F.B.C.
21. All plumbing,mechanical. and electrical shall be separate from unit to unit: This includes all
underground plumbing and electric.
22. All 2016 N.E.C. Codes will be enforced.
i
23. Tamper- Resistant Receptacles in accordance with 406.11 of the 2016 N.E.0
24. In accordance with the Land Development Code, lots shall.be sodded before_ final at least 10
feet around the structure.
25. R403.5.3Hot water pipe insulation
Insulation for hot water'pipe with a minimum thermal resistance (R-value) of R-3 shall.be applied to the
following:
Piping V, inch (19.1 mm)and larger_in nominal diameter.,
Piping serving more than one dwelling unit.
Piping located outside the conditioned space.
Piping from the.water heater to a distribution manifold.
Piping located under a floor slab.
Buried in piping. .
Supply and return piping in recirculation systems other than demand recirculation systems.
25.Blower door test shall be provided hefore C.O.
26.A copy of the energy cacls shall be with permit at all times
27. Copy of flinal insulation report shall be provided ivith permit before fnaL
28. No fence,pool or screen enclosure .is issued witkthis permit
F.F.E.-Finished Floor Elevation
F.B.C- Florida Building Code 6th Edition
R.O.W.-Right of Way.
A.D.A.-Americans with Disabilities Act N.E.C.-National Electric Code(2016)
PLOT PLAN
DESCRIPTION:(AS FURNISHED)
LOT 18, BLOCK 10, ZEPHYR LAKES SUBDIVISION PHASES 1A, 2A, 2B, AND 4A
AS RECORDED IN PLAT BOOK 80, PAGE(S) 37-48, OF THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA.
ON LOT CALCULATIONS
!LOT — 5.750 SO. FT.
Une Table LIVING AREA = 1,828 SO. FT.
GARAGE ee 430 SO. FT.
Line t Direction Length ENTRY = 16 SO. FT.
L1 NOO-3V5YE 39.49' LANAI = 88 SO. FT.
'PATIO = 0 SO. FT.
DRIVEWAY = 432 SQ. FT.
Curve Table ;A/C PAD = 12 SO. FT.
Curve/ Length Radlue Delta Chord Bearing Chord ,WALKWAY 28 SQ. FT.
IMPERVIOUS = 49%
C1 39.48' 25.00' 9028'18' N44-39.17-W n50' = 2834 SO. FT.
SOD = 2,916 SO. FT.
OFF LOT CALCULATIONS
RIGHT OF WAY = 2327 SQ. FT.
DRIVE APRON = 152 SO. FT.
PC PUBLIC S/W = 979 SQ. FT. z
SOD = 1,196 SO. FT. 1" = 30'
,TOTALS GRAPHIC SCALE
AREA = 8.077 SQ. FT. 0 15 30
DRIVEWAY = 584 SO. FT.
SIDEWALK — 1007 SO. FT.
SOD = 4.112 SQ. FT. O
a N
�I I ;, LOT 17 1
w BLOCK 10 m
0.
}a Ir I 5b s
a¢ I N8925'08'W PP6 a 6g
W��CL Lr 25.00__ S89'25 08 E 115.00r
S w I _ I 5'D&AE —
Q G —?27.0' —283'---
p 00.0 c ,r:, 59.T I V
PROPOSED CO.—
':t _, co
127.0' '� a FINISHED FLOOR M HI U y U
t ? I I ELEVATION�93 9D' DI O ,1 z J O
na —.1888 o I o &0' M 6 >; m
PUT BOUNDARY PI — i I I b �; I 04
t 51.7 ''O -•
28.3 29.3'
%I \\ -- --- —----------—d--—---- N
10'UE
PLAT BOUNDARY _
I PROPOSED INLET
NOT FIELD LOCATED
_ ' ZEPHYRHILLS COLONY
COMPANY ._..................
PREPARED FOR: PLAT BOOK 1,PAGE 55
iwuto �aca 'e
I
BUILDING SETBACKS
FRONT: 22'
GARAGE: 27'
REAR: 13'
SIDE: 5'
SIDE STREET: 15'
NOTES: LEGEND:
1. PROPOSED ELEVATIONS SHOWN HEREON ARE — •— — BUILDING SETBACK LINE PI POINT OF INTERSECTION
BASED ON THE APPROVED ENGINEERING PLANS PC POINT OF CURVATURE
PREPARED BY HAMILTON ENGINEERING & ——— CENTERLINE PT POINT OF TANGENCY
SURVEYING INC.. —— —'— RIGHT OF WAY LINE RP RADIUS POINT
2 PRC POINT OF REVERSE CURVATURE
ELEVATIONS ARE BASED ON NAVD 1988 XX•XX PROPOSED ELEVATION PCP PERMANENT CONTROL POINT
DATUM. TYP TYPICAL
i PROPOSED DRAINAGE FLOW CS CONCRETE SLAB
THIS PLOT PLAN IS INTENDED FOR PERMITTING PURPOSES <ri.:i. CONCRETE (Pj PER PLAT
CALCULATED
ONLY. THIS IS NOT INTENDED FOR THE CONSTRUCTION OF A/C AIR CONDITIONER (c PLAT BOOK
THE PROPOSED STRUCTURE THE CONTRACTOR AND/OR PGS PAGES
OWNER ARE REQUIRED TO VERIFY ALL SETBACKS, BUILDING S/W DRAINAGE do ACCESS EASEMENT SO. FT. SQUARE FEET
DIMENSIONS, AND LAYOUT SHOWN HEREON PRIOR TO ANY F.EM.A. FEDERAL EMERGENCY MANAGEMENT AGENCY
CONSTRUCTION. F.I.R.M. FLOOD INSURANCE RATE MAP
NAVD NORTH AMERICAN VERTICAL DATUM
THIS IS NOT A SURVEY D&UE DRAINAGE&UTILITY EASEMENT
DE DRAINAGE EASEMENT
THIS IS A PLOT PLAN ONLY UE U-nUTY EASEMENT(PUBLIC)
FLOOD NOTE: SURVEYOR NOTES:
I HAVE EXAMINED THE F.I.R.M. MAP NO. 1210100293F. 1- THE SURVEYOR HAS NOT ABSTRACTED THE
DATED 09/26/2014,AND FOUND THE SUBJECT PROPERTY APPEARS TO LAND SHOWN HEREON FOR EASEMENTS, RIGHT
UE IN ZONE'X',AREAS DETERMINED TO BE OUTSIDE THE 0.2X ANNUAL OF WAY, RESTRICTIONS OF RECORD WHICH
CHANCE FLOCOPLAIN.THE SURVEYOR MAKES NO GUARANTEES AS TO MAY AFFECT THE TITLE OR USE OF THE LAND.
THE ABOVE INFORMATION. PLEASE CONTACT THE LOCAL F.E.M.A. AGENT
FOR VERIFICATION. 2. NO UNDERGROUND IMPROVEMENTS HAVE BEEN
BEARING BASIS: LOCATED EXCEPT AS SHOWN.
BEARINGS SHOWN HEREON ARE BASED ON THE CENTERLINE OF DAVIE A!5hA 3. NOT VALID WITHOUT THE AUTHENTIC
RAY DRIVE BEING ND03452'E,PER PLAT. ELECTRONIC SIGNATURE AND THE AUTHENTIC
(FIELD DATE:) REVISED:
A M E F21 CA N SURVEYOR ASEAL OF AR FLORIDA LICENSED
SU RV EYI NG "Van
SCALE: 1' 30 FEET .,DIiam lyaIgnedbykme,WB.L—n
D ,,aFbdda ISMAPPING INC_ ' =AMERIGN SURVEYING&MAPP
ING,
APPROVED BY: JB CERTIFICATION,OF AUTHORIZATION NUMBER LBa8393 eNc��=iameaweo�man,
190901 LOT 18, BLOCK %,`,�., ,,/ .: malr_lboleman@aamco,porate.com FOR
10 3191 MAGUIRE BOULEVARD, SUITE 200 ,n^,.+ Dacr.2020.0u915:2550-0aoa THE
JOB No. ORLANDO. FLORIDA 32803 FIRM
DRAWN BY. 058 07 27 2020 JC WWW!AMERICANSURVEYINGANDMAPPING.COM JAMES W. BOLEMAN PSM 6485 DATE
PLOT PLAN
PASCO COUNTY, FLORIDA
Permit No. I
Date Permitted �27"za
` 0 Builder Name/Owner Name 1 Control W .
k� /
County Parcel No, 35---2.�••zIr 0/q0- 0(Cb 0-61 f�SubDiv: _X-WAYwz,_4
Address/Location 7 71L)
Classiflcadonlrype of UsQ
TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 21 3(o2_
Exempt ❑Yes ❑.No How Determined
Impact Fee Amount -$. 32 &3 , Zone No. TAZ:
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House Amount $ �r �t'��
(057); Mobile Home
(058)- Other Residential
23)i Collection Fee.
Exempt a Yes. .❑No How Determined
PARKWAND RECREATION FEE
Land Account j Land Credit Land Total
Recreation Account Recreation Credit -Recreation Total /
r Zone TOTAL AMOUNT $, 7
Exempt ❑Yes ® No How Determined
LIBRARY FEE
Land Acbeunt Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt ❑Yes ❑ No How Determined Total Amount
RESOURCE FEE ERU
TOTAL AMOUNT
Prepared By Checked By
NO CERTIFICATE OF OCCUPANCY WILL.BE ISSUED.OR FINAL INSPECTION
PERFORMED.IJNTILTHE TOTAL AMOUNTS LISTED HAVE
'. ' BEEN.PAID.ANt)'
RECEIPTED FOR BY A CENTRAL'PERMITTING OFFICE.OF PASCO.000NTY
Acknowledgement below does not Imply acceptance of concurrence,but simply recelpt ON copy of this form,placing
aymantfor s
the building permit owner on noUce of this assessment and the conditions of pame.
DATE RECEIVED BY
RECEIPT NO. DATE BY
city of Zephyrhills Permit Application Fax B13-780-0021
Building Department
,ter N
Date Received
-2,1 Phone Contact for Permitting I t I a a a a I I I
Number Pho
ne one
Owner's Name L
Owner's Addressl Jr owner Phone Number F_
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
Pf JOB ADDRESS yp I C L. N_
�A LOT
y
0/000-Dfeo
SUBDIVISION kj ARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTRF7 ADD/ALT SIGN = DEMOLISH
INSTALL REPAIR
PROPOSED USE 0 SFR COMM OTHER
TYPE OF CONSTRUCTION BLOCK FRAME STEEL
DESCRIPTION OF WORK.
BUILDING SIZE S Q FOOTAGE' HEIGHT
A A A A
=BUILDING VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL AMP SERVICE = PROGRESS RGY Q W,R,E.C.
=PLUMBING,
=MECHANI'CAL $ VALUATION OF MECHANICAL INSTALLATIO
GAS 7� ROOFING' SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
L
BUILDER COMPANY
SIGNATURE REGISTERED YIN FEE CURREN Y
Address y Licenseo F rR C103s,i:�
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y1 N FEE CURREN I Y 1114
Address. S Q6 S:V-, ilA IQ 564A3 Licensei
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEEICURREN -(/N
Address 3I-6 k, S-4-2 10M IRA License#1 C C
MECHANICAL COMPANY
SIGNATURE REGISTERED Y VN FEE CURREN\J
Address 1'5_10' - DxSley- (4- b6z �A L-6_q :34" License# FCA U,33 W 9
OTHER COMPANY r(l Ia 0— K�6
SIGNATURE REGISTERED Y/ N FEE CURREN
Address W" 3Cy31 License# Is S3
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&I 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 Per*rrit for new construction.
Minimum ten(10)working days after submittal date. Required onsItei Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&I dumpater.Site Work PermItfor all new projects,All commercial requhmenti 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 (copy of contract required)
\iroois it shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
.
NOTICE OFDEED RESTRICTIONS: Theunders|gnedunderotendethatthiapermitnnaybasubjacttp "doed" raathntione"
which may ba more restrictive
'than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
uontractzns.tu undertake work, they may be requiredtoba licensed \n accordance with state and local regulations. If the
contractor is not licensed as.required by |avv, both the owner and contractor be cited for a misdemeanor violation
under state law. If the owner or intended contractor are undorte}n as to what ||oeno\nQ requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing-Section at 727-847-
8009. Fu[ther0o[e, if the ovvOe[ has hired 8 contractor Or ooO1ractorS, he is advised to have thb contractor(s) sign
portions of the "contractor B|ock" of this application for which they will be responsible. If you, as the owner sign as the
oontroctor, that may be an indication that he is notproparly]icenoed and is not entitled to permitting privileges in Pasco'
County. /
TRANSPORTATION |K8P&CT8JTlLIT|ES |K8P&CTAND RESOURCE FlEOOVERYFEES: The undersigned understandsthatTranopor�dion |nnpaotFeeeandReooureoFlecoveryFeeonnayapp|ytothauonstruct|onofnevvb4Udihgs. changeof
use in existing bui|dinQo, or expansion of existing UuUdinga, as specified in Pasco County Ordinance number 89-07 and
00'07. as amended. The undersigned also pnderatande, that such fees, as may be duo, will be identified at the time of
permitting, It is further understood that Transportation Impact Feea*and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy' or final povva[ release. If the project does not involve e certificate of occupancy or
final power.release, the fees must be paid prior to permit issuance. Furthermore, if Pasco CouDtyVVeter/Sevver Impact
fees are due, they must be paid prior to permit issuance \n accordance with applicable PauooCountyordinanoea.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, aaarnendad): \f valuation of work ie $2,SOO.00ormore, |
certify that i' the appUosnt, have been provided with o copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and
iConsumer 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|tto the"ovvOe[" prior tocommencement.
CONTRACTOR'S/OWNERIS 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 a permit to do work and installation as indicated. | certify that no work or iOete\|etioO has
commenced prior to |eauaDoe of permit and that all work will be performed to meet standards of all iavva regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. \ also
certify, that | understand that the regulations of other gbvernment agencies may apply tb the intended work,
*nd that itie
n�yreaponsibi|�vto\deDt�vvVhat actions I rnUettake tobeiDcompliance. Such agencies in�udebut are not\|0itedto:
- Department ofEnvironmental Protection-Cypress Bayheads. VVe�aDdAreas and Environmentally Sensitive
LoDdo.VVater�VaatewoterTreetmeOL
- Southwest Florida Water Management Diatr|ct4WeUa, Cypress Bayheadn, Wetland Areas, Altering
Watercourses. '
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health & Rehabilitative 8erviceu/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- UG Environmental Protection Agency-Asbestos abatement.
- Federal Aviation/\uthodty-Runnvaya.
| understand that the following restrictions apply to the use of fill: '
- Use of fill \s not oUovvedin Flood Zone"V"'unless expressly parnoi�ed.
' If the fill material is to be used 'in Flood Zone 'YY'. it is understood that e drainage plan addressing a
"coOopeneoting volume" will be submitted at time of permitting vvbiuh]S prepared by a professional engineer
licensed byfho State of Florida.
- If the fill material is to be used in Flood Zone "/Y' in connection with a permitted building using atann vva|\
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 vv|||' not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent propadjas, the owner may be cited for violating
the conditions of the building permit \aoVed under the attached permit application, for lots |ooe than one (1)
acre which are elevated by fill, an engineered drainage p|oD 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. | understand that a separate permit may be required for electrical vvorh,
p\urnbing, a\gns, vva||o, poo|o, air coOditioDing, 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
setsaidoanyproviaionaofthetechnica|'oodes. no[sho|| ioouonoeofoporrnitprevonttheBui|d\ngOffio\a\frornthe�eafte[
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 iooueooe, 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 [equasted, in vvrit|Dg, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
' justifiable cause for the-ex1eDsioD. If work Ceases for ninety(90)consecutive days, the job is considered abandoned.
.
WARNING TO OWNER: YOUR FAILURE TO RECORD /\ NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR l|0PROVEK0 QNSOl-T--AJNJ_ATT_0_RNEY_BEJF_b_Rff__REC___0R_ biN_ GYOUR NOTICE OF: COMMENCEMENT.
---
OWNERORAGENT— CONTRACTOR
Subs *b d "d ad)bqfor�me this Subscribed and sworn to(or affirmed)before me this
Wh6 is/are personally known to me or has/have produ�ed Who is/are personally knov�n to me or—has/have produced
as identification. as identification.
Notary Public Notary Pubic
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
_
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