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HomeMy WebLinkAbout20-1291 m oH"1111 . City Of ZephyrhillS �-RMffiNUMBER 5335 Eighth Street Zephyrhills, FL 33542 BGR-001291-2020 r Phone: (813)780-0020 H, ;1 Fax: (813)780-0021 Issue Date: 1v2s/2o2o Permit Type: Building General (Residential) .-s.Y- r ,F Prope'rty Nwmber - �,x Streef A;dd fi ss 11 26 210010 03900 0180 15910 5908 13Th St 38548 38550 38552 13Th Ave Owner Informations ,;: Pe m t Information> Contractor lnformatlop n h. ,,.-� Name: BUTTERFIELD INVESTMENTS INC Permit Type:Building General(Residential) Contractor: BUTTERFIELD Class of Work:Demolition INVESTMENTS INC Address: 31325 Amber Lea Rd Building Valuation:$21,000.00 DADE CITY,FL 33523 Electrical Valuation:$0.00 Phone: (813)973-5250 Mechanical Valuation:$0.00 Plumbing Valuation:$0.00 Total Valuation:$21,000.00 Total Fees:$100.00 Amount Paid:$100.00 'L Date Paid:12/29/2020 11:39:34AM P,�rojegct Desion - 4 HOME REMOVED AND SMALL LIVABLE SPACE /Application Fees Demolition $100.00 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. w* ONTRACTOR SIGNATURE PE IT OFFICE PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 12/29/2020 Physical Addresses 1 11-26-21-0010-03900-0180 1 Pasco County Property Appraiser Physical Address List for Parcel: 11-26-21-0010-03900- 0180 Displaying 5 records View in groups of: 10 25 50 100 500 1000 Street Number Street Name + Unit 5908 13TH STREET 5910 13TH STREET 38548 13TH AVENUE 38550 13TH AVENUE 38552 13TH AVENUE hops://search.pascopa.com/parcel-physadd.aspx?parcel=2126110010039000180 1/1 12/29/2020 11-26-21-0010-03900-0180 1 Pasco County Property Appraiser Parcel ID 11-26-21-0010-03900-0180 (Card: 1 of 3) Classification 00800-Mfr <10 Units Mailing Address Property Value ZEPHYRHILLS RENTAL LLC Ag Land $0 10125 SANDLERS PRESERVE CT Land $18,270 ]ACKSONVILLE, FL 32222 Building $101,946 Extra Features $95 Physical Address - See All 5 addresses 5908 13TH STREET, Just Value $120,311 ZEPHYRHILLS, FL 33542 Assessed (Non-School Amendment 1) $120,311 38548 13TH AVENUE, ZEPHYRHILLS, FL 33542 Non-School Taxable Value $120,311 Legal Description (First 200 characters) School District Taxable Value $120,311 See Plat for this Subdivision CITY OF ZEPHYRHILLS PB 1 PG 54 LOTS 18 19 &20 BLOCK 39 Jurisdiction CITY OF ZEPHYRHILLS Land Detail (Card: 1 of 3) Line se Code Description Zoning Units Type jPrice Condition alue 1 0100F 1_132-1 SFR 00112 8,400.00 SF $2.00 1.00 $16,800 2 010OR 1_132-2 SFR 00112 4,200.00 SF $0.35 1.00 $1,470 Additional Land Information Acres Tax Area FEMA Code Neighborhood Code(s) 0.29 30ZC X ZHLH View Sketch Building Information - Use 0800-Multi Family (<5 Units/ Bldg) (Card: 1 of 3) Year Built 1940 Stories 1.0 Exterior Wall 1 Aluminum Siding Exterior Wall 2 None oof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle nterior Wall 1 Wall Board or Wood Wall Interior Wall 2 None looring 1 Pine or Soft Wood Flooring 2 None Fuel Electric Heat Forced Air- Ducted /C Central Baths 1.0 Line Code IDescription ' q. Feet Value 1 BAS01� I LIVING AREA 896 $20,888 2 UOP01 UNFINISHED OPEN PORCH 224 $793 Extra Features (Card: 1 of 3) Line ,Code IDescription ::1 ear junits alue _ No Extra Features Sales History Previous Owner: MACDIARMID JOHN A& DIANA J LIVING TRUST Month/Year Book/Page Type - DOR Code Condition Amount 11/2020 10214 / 3731 Warranty Deed 11 Improved $0 09/2020 10214 / 3729 Warranty Deed 01 Improved $119,500 11/2013 8964 / 0986 Warranty Deed 01 Improved $150,000 01/2004 5688 / 1894 Trustee's Deed Improved $150,000 03/1993 3129 / ( _ Quit Claim Deed Improved $0 05/1992 3026 / 1743 I Warranty Deed ! i Improved— $38,000 https://search.pascopa.com/parcel.aspx?parcel=2126110010039000180 1/1 ?G 5 Block 24 Black-24 Legend 5 8 Street(Labels) parcel(Lines) Subdivision r �a (Bound - Labels) anes and D parcels ' NUE BClickable Info) h�A lacks (Boundai j and Labels) es ,.; . To N QF Lot(Labels) ZEP . ,. pe j p41/LLS Lot(Lines) 20 2 $tack 39 �T 11 .i� w Black 39 �5 4 15 s� r• 13 pR pJ01NER 1212912020, 11.32:33 AM ..ALP ER7 Y4 Pasco County 0� • �4►►SER tY Pro per Q00s 1 , � t 0.0� N tY Ap praiser 1 t t 1 °p2m► HOLD HARMLESS AGREEMENT STATE OF FLORIDA COUNTY OF PASCO DATED: 2020 THE UNDERSIGNED, ZEPHYRHILLS RENTAL, LLC, a Florida Limited Liability Company, hereinafter referred to as Seller, and BUTTERFIELD INVESTMENTS, INC.,a Florida Corporation,hereinafter referred to as Buyer, are selling and purchasing, respectively, real property described as 5908, 5910, 38548, 38550&38552 13"'Street,Zephyrhills FL 33542, and Seller and Buyer hereby acknowledge that Buyer is aware that there is an expired permit on the property and that there are additional notices of violations and/or liens filed by the City of Zephyrhills as set forth in Notices of Demolition as set forth in Official Record Book 10218, Page 2880 and Official Record Book 10218,Page 2881, all in the public records of Pasco County,Florida. The undersigned, Seller and Buyer, as to this agreement, do hereby agree to release, indemnify, save and hold harmless the said Settlement Agent, Larkin&Larkin Title Services, LLC, a Florida Limited Liability Company, as to any fees, costs,liabilities,litigation, attorney's fees, or other expense associated with the closeout of the Permit and Notices of Demolition as set forth and described hereinabove. ZEPHYRHILLS RENTAL, LLC, A Florida Limited Liability Company By: Pamela L. Husen, Manager Witness: Witness: (Witnesses as to Seller) SELLER: R: STATE OF FLORIDA COUNTY OF PASCO The foregoing instrument was acknowledged before me by means of physical presence or online notarization, this_day of 2020, by Pamela L. Husen, as Manager of ZEPHYRHILLS RENTAL, LLC, a FL limited liability company, on behalf of said company. He/she/they [] is personally known to me or [X] has/have produced his/her/their driver's license as identification. (Affix Seal) FL Notary Public My Cornniission expires: l �saoo2a� t3ity t € ptaji; `ills %mil pu a#ion, Fax-a : 902 , Buiidind QepartMent Date Received Phone Contact for PennitUn — ., is -• a .. ._ _. : t_ if.' i.t Owner's litame;;�; ?�r _ t!C Ue e' rriuiF ` 45j✓H` rirl£ ::%. 'st'>i�:"'-fit Ems:;' }��:.+ [t... :.i.; .9};•:.. - z •a; Ownef•si.dS tr :�•��.t� . - .... ... .4 rr. ' _ . {?:- Fee SI ' � tt r owl. .T-;---',�^-,:•)—, ;,:,n—T4-n+.r 777- ..i#%K ef.: e.Y i�...t I.i t,-n' ✓`' RI . 7. • - .. - a t-' <r .3:' �:° `J.i�� k..r rP r� Fee Sirripl s - "iYi 't- JQB ADDRESSi? �j��ifL.�ii� u.�..i'�.i�.+wilq.'i+•`3"t ii,l�..iY ,. _ .a - 07 77, _ r r r- t' SUBDiVIS16N :=•;��'�� :,1� �<: .. . .4,". . ., u;l. -<,' .. . .:� _ •S'f.., AARGEL)D/#` Wit.'. ._ ':>4..' S i.E/. "?•�. yq; i; '`'9 .. , ... _ -`.,y`�OTMRV.� PRO ..T;Y.�AX;N'QTI,�:C 'WORKPROPt ECG: 1 'CClI$STtt. `` -i40Lf%AL1_ "^ SIGN uu•, d. tt'siDEMOWSHyin, :s:- 5` `k 11�S`FRLL s'nil srI�PAIR PROPOSEa"tiSE':.�:+ - .�'" �'+: ,..;'t:;,•:. r^''�•1'ltl�f�'r,d.;'4t•.:,u^r. r;,ir:.v':...n .. ,:f. i• S.P..`iGr• �::• - •[, .-�� `(t::::' :'i' t... r C,r;i?i':, `.,`73777:_-.-sCSti? £:r�•�.,•,�,•e,; TYPE o4Qrlfi,CtiQ�l �;. >. `aabKY- w �wniie " .. •xt�� -• is •un',. arq.. -, -ae. . . •+; - ,.�+' DESCRIPTIC)N'sOF VUt)RK{'" : 6± , 4 ,.4�", _ y't• ,r° -BUILbiNd SIZE S F _ �5:•51'1.Mh•:'. '-�'�M•'. g,� _ ,;7�,'i� Ily:,'ri�' .;C•*':Y ,5,. _i'.,'y `�:r'•':'..r. •t .,. rY.. ,..''i- 'x - 0 OOT'A'G QBUILDlNG $ VALUATION OF TOTAL CONSTftUCTiON V j,tti•�ti, :.`a4='• EbEC1RIGAb_ ;s'a;i':� .:•T' s(r;i _,?:`> PSj=R1(IG lx,i .>',;• :„r -< ilr3r;�RQGRES IENFRGY.,i'; W.R.E.C. QPLUMBING �� ' • • . .., - r �i,.=T: . ,k•_' , .:.r ., . ;.. .. :+ �' .'.v ,QMECHANICAL $ OF MECHANI /U:`iN$`T #.ri4TION' VN'gSL`,�cK'; '" : 4•''�r77'".%i d FINI FLED FLOOR,ELEVATI.ONS_ FLOOD ZONE AREA r N.ESar• s,=.N'O s?: .. . i'T '' ',' s• ,�,., r _ _ Las 's i .-. .f�-•ir'+ir{Rse+s"!•'K„'2!' '.5:.<. _ ,r ;�..; ';rr;t _ $UILDI '., t:''' s:',• :'1'=; 3 -COMPAN�'� �i ;t SIGNA'[UREz lY4�, 14�:. .'. .{]i �24 h f .} ....� ,, 5: }„r /l1 l.r.• +� I' ot)�- STm :; f.,;tt r.X •4- :KF,E CURREP. a .r=.. � __ :It. .'G'. .. •t tti ?:`': ..:+,C.�. "±a. f':'. „r. 's`:n 'i5 .., rns .. ... Address s?'r r: t' rSizj'.ter: s si.'i'r,':t 4}.. ,;i .•4.• Cp��p# +.i f s:i . .. � .. _.e et'-•' Lw ELECTRIC,i/1Nsrt:>;: Y:.. e': . . ;:: �, �.is loop SIGNATURE `FEECl1W2E%: .....c,r.Y/:N,r.: .*...,. !V .t '•• .'�'Sif :,:!a.. 1. -`-.%3 Ji.s 6!i.:,:'x, f+:a st r„ r::`.iR7: . .,,r•^:' .4-;:.tss' .. .�.- Addr. '^' i f 1: •. 1 s: t3i i,: ,rs,t : li.�Ferff PLUMBER COMPANY ` SiGygT4ftE ► z 'w;.s '-- •:„ : f ..; �:., K..; EG}S7FRED .:Y N, cuwzEr Y/N 777 Address `•r I'« =•d_% • t :i,,; t-.: :, .,:' iv. MECHANICAL COMPANY SIGNATUREK:ttErlsritl: Y/ N FEE CURREn Y/N Address :k• 'zh 'p.r%'✓:'.- r. ', ,. CJ rot •.ii. OTHER COMPANY._ SIGNATURE REGISTERED Y/ N FEE CURREN LY/N Address _ ... _ _ >:;.Ucense ._{. 1...1_;1 RESIDENTIAL Attach(2j Plot Plans;(2j sels of Bir`ildirg Plans,(1)set of Energy Fonns;R=O,-W Permit farnew-construcdon; - ..,::,Winimu.... _(10):woricing d ,jafter submittal'date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, -Sanitary Facilities&1 diimp teiG S brlu#3 rji{t r fir�tidhr7§ioasliargs pro]eets_,.. ... COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of•Energy Forms.R-O-W Permit for new constriction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sankant Facilities&1 dumoster.Site Work Permit for all new projects.Ail commercial requirements must meet compliance si3r so=oitio" ' City afiY t� ill[' �, 1iit " rti pli -8uI1�fE1 b ,� N011E' 'bEED ttE7`RiCT10NS. ,lin�erst ne 'u 'c1`rtan�s tlia bits`� 1r�iii ni M1 o.:.tied.re�ti'li;�iop��RtiP �rYiay:F�:m�re l�fttie . than County'regulaeons=The:undersigneli;es 6nj'es,•;stes so,�isib( ;forig6mpllance with any opplicable.:cleetl;restriCt<Cns. UNLIGENSJ:Q.CONT,RACTOitS ANt�CONTRACTQRat2TE43FiONSrIILtT1ES if tltovu��e_ra $ Fttndoorltrkcr;trtrconiractcrs>to undertatie;W�PMC;#ity: ` may:be<required:to'be'Ifbensed in acx ordance•with state:arid:local;regulatiorls'li`tha contrdctor is n tcltcefl'se a regiiit d.iy?I'Q y; bfh-:ifie`dwiiet:and contractor,may,be.cited..for a,misdemeanor.vib a`lion' ri�>rt i if ii �a�lfthe'O�yr)eror:intendeti.co tea0tbr are ui� rtaln as to what'licen5ing gtA tie maY; PP1Y. a irifertilei7'inroHi;they are?advised..to coritocfttie'.Pasco Countyi:B011 ing;,Ihspocli�t�'�i�sipn L nsing:�Om�i€�� 4�:'�00�: Fuitfiemtore, 11 if tlie:owrier has:hired.a coiitragoror,,Q i� ,;c rs�,t �(sLadvise t to:have the contractor(S)'st ii:poitiOns;dlhex,; rtitraditkBlo�cktA, • 'is appltc tton;fo�whTcFti tlie�i:Vvlll'bt'responsible If you;as a owner:si jn.as.file.ccrtittactor,'tFiaEi�ay��;an4ndit�atior�that lea is o not ehtitle�J'fd"enititting':,privileges TRANSPORTATION IMPACT/,UTII:iTIES IMPACT AND RESOURCE RECOi/�RY FE�E5 Theyuntle ignedru: e, Santis,. that?`ranspoi'tatlon`.Irri(iact'Fees and;'Recayfse:Rec�veiJ= e ;i►aq ([iply)�te6itrttt�lHClfff It _ 'Biiildfn'"gsip8 �s rfdasf) g"6a gas;oP expaiislon of wftffng4butliltngs,,as specified h'Pasco-CoVhh.:Ordmang' nuihber 89-o7•hd 90-07as arrie rtde :Th�turTc�e�signt d afsd'undets'taft s;. at sucfi'ifees;•as•may:betdue�vtil:be iddhbfloo.' t:the:time:O4Orill(ttlQg t(sl titly{��� F,.ind8isto„Oq;ttiatTrans �rt itioh;lin aat ees:attd%Res tiice;R boV N�_:�:.: -. Fees.Mum76 paid.prior'to'receivinga .certificate of occCipancy"or'ftrial:povreP release if the:' ro ect qes noftirivulv�::a'iae "tte f.00c�ip2n:cy or;ftnai"'' !.-. t.... .,:.:, •.,is a-A'... power release,the:feesmust be paid.prior:to.perrnit Issuance:•Furthermore,if,Pasco County:W ter/5ewerfinpA�t fees are dUd'., iey:ntuSt betpaid.oilor.; to-permlYtssparictin-accordancewithapplicab4e;Pssco;Coun ;dr<llnancess' '°'•a --,s CbNSTAUCTION_LiEN_I:AIIII(CAapte`r.`:7`��;�loi'�����t�','asatttendiin lf.valuatlorrofworii:is-$2;50000:orrtion3,lc�rfify�that`Cjii6 applicant, have.•been pm deli:vrltti:a.copyof the"Florida Cori tructiORfL';[ett:LaW+="1.1t ieovVttie[ EFt!Qtectio tiltf@gip patod Y_Mi#'Ftb idebepatlii! j ,Qf`, •,::;.F,� ,: AgriculWre'and.ConsumerAffairs:.if the applicant is someane other.th rt'tlid'owner� ;c airy:th E rMa4e�`o t`a ii l a co►y of re.above de3 be l r docurhent atid;promiseti►�good-faith to deliver It to2e bwner":prior t ,00tpmencemeh r.. CONTRACTOR'S/OWNER'S AFFIDAVIT 1 certifyathat aYltNtltilformtiQthts;apjill'taeort is1iirate and tfiet all'worlcwilbe:done.In:corppliat;9�wJtIY. all a piica"tiie'laws;regulatii�g`co"ri,wuptiun,-zoning',pttlt.land himpllcatlo,:is l reby na e, :o Ndi;`epenni o Wo d : C�Jatibn:as.`y in JIdWd l;ceftify:ttiatiio:>ivoHr cf installae0nhis+i 'et iicx3d`prlor tti�tssu is of n rrfi aind�h t 11':ipti f+ill`:f eperfmm�e°d tb ties t#o}4`i`;i jai - lawsiregulatlng.constriction;.Countyand'Ciry"c�des�zonihg,reguladons,•aatdland-d6Velop�ili %ulaonsirr:iti uri dii li:Iralro cetiifj►that'1 unddtstand:thgt the:tegulationsvofother government' 'd 's�may applyy Eo tfie Intentled woork;arid'fat itfls my n3spori§tbiti[y to_ident aV�rtt t adtoQs:R�;7. musttAe to bOwbomplianee Suchragendes iridude bUtare:notlimltedtor Departti,ent of Environmental P�'Qt coon-Gypre. s. Ba9heads,a W. tland:,A eas .and..En ironfneiital y Sensfive:, ,, •• �,' 7 - �t�,';�. Nye::�,_-.;: �. ,.�T,a:J rt.rr:�•Y"�� "y.�Sr1- '..i':;' _ cr.t': rn.4._,rk''' �-. •'.��r.:,,'s;':,LaAi.� 1i''•}.�ak' ARM _,�:: .,. Southwest. Florida-'11Uater :iVlanagement Di trict�..el s, C eat( :: 111�t1a s Af at~n Watercourses. a. Army C"orps of Engineers=S.eawalls;¢D•pcks;.Navlgabie.Watelways. n n,;, ; �: S 1�vt�+ mental a ast C Uepartrn'etit'of F4eaCth &Aliabilatty ervices/ leait#i_'Unit`-ViI`'lls�. 11` "ewdtel treatriten f;. Septic Tanks. US`Environmental Protection'Agency-Asbestos•abatement. FederafAviation Authority-Runways. (understand.that:thefollowingresMctions apply-to the yseeff:,fill:,.;,;.:. .:y :+:;� Use.of.fll is not alloweitin' �od lbne"�"untess`expres'slyperiiiitted:.. if the'fill- material is to be:used:ir►y flood: Zocie aA",:.:it:is. nncleirstobd;"thAf,e drslirt ge;;plan:addressing a °compensating volume°wilt be°s Siiiit�ad et='tifin'a`'if' 'ei 'i ing tiich��i � Y ared iy A pp essidnii e�gi ►'aei: licensed.by the State of Florld , ,':,,,_ :1•:.. .: ;V ;r :>>. If the.fill.material is. to be..used-:In-Flood:Zgne:W in-connection,with::; permitted'.b A ding-.t using stem'wall. MR��Nill b� setl rtl eta f l t :Bar ea�� it�ti�eisfcr�; ='ebiibtcuction,•I°certitytthat 1. y !. ,tt._ -,.,,.,... rJ.. . s.. , ,. Cf fill material is to•be use8,tn. �iy.':'aree':l certifji.'fhat useµef;stair= ill not�advesely<a#teCt'adjacert'' of`:fill.:is:"f and .# atlt�eis''1 at'fect dd'ac eht-,properties; tlie.;owner rrt y be;cifotl or:viol2t ng ;. •.:Q,,.:.;.ets9..y 1. ttt'iesueid•Wri `tlattaFie,d..,perrt�itapPltcatioFr foi':totsles tkor eons-otlthe condt < tY . _ acre'wiiich are:elevated•b. :.fill alt'engineere�).d' : g 'plan Y,`'"' infoCtri.ihe er'dittie; rfiittin ;co d on'sset:.forth;inthls:affidavit rio:to.. f. If I am.;therAGENT;FORTHEJOWNER;>I Ornritiee irt:gooil faith to gwrt pe g �f iq ,M P Jv .M Sirs T_'a.r S t'OlSberstaitid.thcira se araEe': itrr a be regi lred`; r:elecfiioalni�vbi ;4piurrib i}g1' i i e efls;;poblln a"iaoon_C ori.... commencing,cori"sfio4loi: Y:�,• d" eti'to tia..lcensesto roc:eed;�vitfi`tli i�otk a'd;:riot'as; , WSP1.11 :. ..::authgflstgi7ibTate,:FhC9t�ttter;;or set astda anyproiiistns € fie-lethnl . I.�Sor;s0.iasuance.of a perti�lt p[eveetth6:BuIIding:OJN ,altrroiio%reQtid4 o errors to plans;co st&t6lrrorvlolatio bl� � .'J=;vetydpet itFi , ell tieoti a ibvair Yr nioi�C authbrized'b such: eiiriit'is`commenced' 'ghln stz.mofift°f. emt(t IssuA;ce,:or if: aliifi"orYze .. e; r 1 5as't ttetf'o itfJd ed:fora Y t? p. k bjtg tti n1Hs after..the;time th'e.wofk.ts`.66"hi ielyi:ed:`An:extensto m�iywb®:regUe��d,iAwii itirig,f�i `;:tli�euiiding�Ofl teal' �'�a p��riotitti�di{�. � excee(1 nine�y:(90jdays`:2i id viiilt?leiiidntt►'ate'juattRa6to Cause forthe.e5ctenstori::ifiwork'ca3esAfor�ninaty9bnseCfie'tYay ;:,;._,jdE3?7sroonsid . ab6fidoned. z :..r.,, -OtESt1L: '::1N;wCiCi2ss,��.: WARNING-TtOWNER. YOUR; Adi+UR '�° zRI=CORD CIt±EaCOMIVIENGE. t'.M,` :•. v N: �: ovRaPL dP KTTi:li ou� 't uw. :; IRAI16:TWICE FOR.IMPBo.. M Y. ¢�./,�: j��y y. :. .gars. _..s,. ..;.i: -,`,A %:i i: 'N •flErURlt~ IC{s�,IR�IIt. Y�NJRti���,Galr^.,<s�MIlAIC1Yl'31Y1'G°�.7 WiI r d 1R I" hi�&MOR�f,AEI t �--- FLORIDA JURAT_(F.S:-117.03) OWNER.OR AGENT - CONS ►CTOR s '' SubscHbed:and swom�to(or'affirmed)`before me this Subs'cTtbed`alttlswom-to'. r'a$iirned��ti" re me:flifs��'..-:c��;`�;?,'•� Who'ifslare persorlally>tildtvri'to'me`6rFiaslhave:.protluced- Who.is'/are:persor�ol�linovdi ttltesails7ti�VpTt�tllrciet;' as-identificaeor: as identiftcaffon: ,:Notary Public °t `ry ... -,.. N Public r ., _. ,. t :. . Ill($ IY :. t .- - ✓ . "�.s a. T.:� .. Commission No. Corn sion. o:. ' Name-of Notary typed;printed or stamped '''Name"of Notary typed,'+prfrlted or stamped:.: �