HomeMy WebLinkAbout23-6526City of Zephyrhills
5335 Eighth Street
Zephyrhills, FIL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
BGR-006526-2023
Issue Date: 07/31/2023
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.
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
0--E-
7
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received 6 Phone Contact &fPPermitting ;�r -- /,707
Owner's Name
k1a Xllawa
Owner Phone Number
,74
Owner's Address Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS Che,5& a— LOT #
SUBDIVISION PARCEL
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD/ALT SIGN 0 DEMOLISH
EJ_" I NF 4�A y 8 REPAIR
PROPOSED USE SFR COMM OTHER
TYPE OF CONSTRUCTION 0 BLOCK FRAME STEEL
DESCRIPTION OF WORK tV r jC462"n
41 COrani
BUILDING SIZE _ Vie" SQ FOOTAGE HEIGHT
- a IUILDING $ VALUATION OF TOTAL CONSTRUCTION ;7ij 6&0
[!t:_�ELECTRICAL AMP SERVICE PROGRESS ENERGY W.R.E.C.
PLUMBING
1$
MECHANICAL IN
$ VALUATION OF MECY-AN4 AL INSTALLATION
=GAS ROOFING
FINISHED FLOOR ELEVATIONS I
Address
SPECIALTY OTHER
FLOOD ZONE AREA DYES Nq
COMPANY 6061
REGISTERED FEE CURREN LLLN__j
License #
COMPANY
REGISTERED
Address 105-1 Z
PLUMBER COMPANY
SIGNATUIE—J� REGISTERED
I
Address
MECHANICAL COMPANY I I
SIGNATURE REGISTERED Y/N FEE CURREN Y/
Address License #
OTHER COMPANY
SIGNATURE REGISTERED YIN FEE CURREN Y/N
Address License #
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 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.
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 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 (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
Driveways -Not over Counter if on public roadways..needs ROW
0C
813-780-0020 City of ZephvrhiUsPermit Application pmx-813-780-0021
Building Department
NOTICE OF DEED RESTRICTIONS: 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: 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" ofthis
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 andRacn the nu of new buildings,change of use in existing buildings,
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 LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 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 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/OWNER'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 permit to do work and 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 ofEnvironmental Protection -Cypress Beyheadm. Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management Oiutrict-We||a, Cypress Bayheads, Wetland Anaas, Altering
Watercourses.
- Army Corps ofEngineana-Seovva||a.Docks, Navigable Waterways.
- Department of Health & Rehabilitative 8ervioea/Envirwnmental Health Unit -Wells, Wastewater Treatment,
Septic Tanks.
- U8Environmental Protection Agency -Asbestos abatement.
- Federal Aviation Authority-Runmmyo.
| understand that the following restrictions apply mthe use offill:
- Use offill ianot allowed inFlood Zone ^\runless expressly permitted.
- If the fill material is to be used in Flood Zone 'A"^ it is understood that a drainage plan addressing o
"compensating volume" will be submitted at time of permitting which is prepared by professional engineer
licensed by the State of Florida.
- If the fi|| material is to be used in Flood Zone ''/Y' 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, | certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect acUeoont propedime, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots |eea than one (1)
acre which are elevated byfill, onengineered drainage plan iorequired.
|r|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 aomparau, permit may be required for electrical workplumbing signs vmoa 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
OWNER OR AGENT
Subscribed and sworn to (or affirmed) before me this
Who islare personally known to me or has/have produced
as identification.
Notary Public
Commission
Name of Notary typed, printed or stamped
A75 by _t is
as identification.
\�) Notary Public
Name of Notary typed, printed or stamped
Notary Public State of Florid
A Laura D. Alareu Medina
AS BUILT SURVEY (FINAL)
WITH SELECTIVE SPOT ELEVATION$
LOT 1
HIDDEN RIVER. PHASE 2
PASCO COUNTY, FLORIDA.
PREPARED FOR AND CERTIFIED TO:
CALATLANTIC TITLE INC.
NORTH AMERICAN TITLE INSURANCE COMPANY
NY
EAGLE HOME MORTGAGE, LLC
ELBIN JOSE BEAUCHAMPS
S BT45'1 1" E
6 0. 00'
�PCP(P)
RADIUS
POINT
DAWSON CHASE q
DRIVE
(R/W VARIES)(TRACT A)
CIO
FIR 1/2' p
L84493
A LOT 2 -7'
2,
4v.0 cov
CON
ENTRY
P
2 STORY
MASONRY
& FRAME 6
RESIDENCE
#39988
LOT 1
An n*
lo J I d"m
0
Z z
Arp
FIR L1/2-2�
—....LB4493
PLAT
BOUNDARY TRACT A
HIDDEN RIVER PHASE ONE A
(PLAT BOOK 74,
PAGES 1 01-121)
CURVE DATA (P&IM)
CUM RADIUS ARC CHORD SWING I DELTA I
C207 170.00' 61.53, 1 61.19' N 70*66�5502'-'E _2044'I 3- 1
79*5
9 V 9
C288 6 84.98' fi45T��19'50W
DESCRIPTION:
LOT 1, MAP OR PLAT ENTITLED "HIDDEN RIVER
PHASE 2", AS RECORDED IN PLAT BOOK 79,
PAGES 102 THROUGH 110, OF THE PUBLIC
RECORDS OF PASCO COUNTY, FLORIDA.
Feet: 7176.74 ±
SEC. 24 1 TWP26 S, RNG. 21 E.
WEST BOUNDARY OF SUBJECT PLAT BEING N 00-23'02" E
THIS SURVEY IS SUBJECT TO ANY FACTS THAT
N MAY BE DISCLOSED BY A FULL AND ACCURATE
TITLE SEARCH, ALSO SUBJECT TO SETBACKS,
EASEMENTS AND RESTRICTIONS OF RECORD.
UNDERGROUND FOOTER, STEM WALL, AND
II UNDERGROUND UTILITIES ARE NOT LOCATED OR
SHOWN.
DO NOT SCALE THIS PRINT. DIMENSIONS AND
NOTES TAKE PREFERENCE.
T
SNID
D",
'co
In
PLAT
BOUNDARY
PURPOSE OF SURVEY., TO OBTAIN HORIZONTAL
AND/OR VERTICAL DIMENSIONAL DATA TO SHOW
CONSTRUCTION IMPROVEMENTS,
STRUCTURE TIES SHOWN HEREON DENOTES
MEASUREMENT FROM FORM BOARDS/FOUNDATION
TO PROPERTY LINE,
. = 10' UTILITY EASEMENT
LEGEND*,
E-00.0' = EXISTING GRADE
LOWEST FLOOR ELEVATIONS:
LIVING AREA: 75,31'
GARAGE AREA: 74.81'
ELEVATIONS REFERENCED TO
NATIONAL GEODETIC VERTICAL
DATUM OF 1929. MEAN SEA
LEVEL= 00.00 FT,
LENNAR HOMES
NWAMO
LIN.. - -
CALCULATED DATA, (D)= DEED DATA, (M)- MEASURED DATA, (P)= PLAT DATA, (L- CENTERLINE, AIR CONDITIONER, ALF- ALUMINUM FENCE, APU-
PPARENT PHYSICAL USE, EIFE= BASE FLOOD ELEVATION, C/C- COV. CONC., C/S- CONCRETE SLAB, CORNER, CLF- CHAIN LINK FENCE, CONC.= CONCRETE,
DV.= COVERED, E/P= EDGE OF PAVEMENT, F/C= FENCE CORNER, FCM= FOUND CONCRETE MONUMENT.-'ViP= FOUND IRON PIPE, FIR= FOUND IRON ROD, FN&D-
)UND NAIL & DISK, FPIP= FOUND PINCHED IRON PIPE, MAS.= MASONRY, NCF-,",,NO CORNER FOUND OW�§ET, OR- OFFICIAL RECORD BOOK, PEl- PLAT BOOK, PCP=
-_RMANENT CONTROL POINT, PRM= PERMANENT REFERENCE MONUMENT, R/W= RIGHT OF WAY, R= RADIO SIR= SET 1/2" IRON ROD & CAP No. 4493, SN&D=
-T,.NAIL& DISK No. 4493. S/W= SIDEWALK, TBM= TEMPORARY BENCHMARK, V- VINYL F—ENCE, Wj ,f-CWOOG FENCE, MT., -WITNESS
Drown I HEREBY CERTIFY THAT THIS SURVEY WAS MADE UNDER MY
JOHN R. BEACH &ASSOCIATES, INC. SURVEYORS AND MAPPERS SMSN" ell RESPONSIBLE CHARGE AND MEETS THE APPLICABLE STANDARDS
Che Ed OF PRACT;CE FOP SURVEYS AS SET FORTH BY THE FLORIDA BOARD
j
911 WEST ST. PETERSBURG DRIVE R OF LAND SURVEYORS IN lCkAPTER 5J-17.051 THROLIGH 5J-17.053,
)NE OLDSMAR, FLORIDA 34677 F*LIDA, An�TRATIVE CODE, FURS T TO SECTION 472.027
UL
lAY(813) 854-1276 FAX (813) a55-8370 r E ATE S?yT.A
OF VALID WITHOUT ORIGINAL SIGNAILIKE uate:
ND SE NAT DATE
AL OF A FLORIDA LICENSED FINAL 2/19/20 DJB
JRVEYOR AND MAPPER
La, JOHN R. 8 a H
tevisions: FORM BOARD TIE IN 10/25/19 RTM, FOUNDATION TIE IN FLORIDA REG.. NO SURVEYOR No. 2984
2 JEFF
— 'M �Slott SURVEYOR & MAPPER No. 7123
m
LAST NAME: BEAUCHAMPS
ADDRESS: 39988 DAWSON CHASE DRIVE
CITY/ZIP: Zephyrhills, FL 33540
PHONE #: 732-731-9096 GATE CODE:
DESIGNER: John Lalley SUPER:
BOND BEAM: FINISH: JOB #:
- ------ ----- --- --- -- - -- ---------
ICONTRACT NOTE
F 001 E R
J(1) POOLSIDE ALARM INCLUDED
CONTRACT NOTE:
IRRIGATION SYSTEM CAP for
POOLAREAINCLUDED
ICONTRACT NOTE:
�REMOVE 20 scift of EXISTING CONCRETE
------------
12" BEAM
------ r-10" BEAM
-- — -------- 9' 41--t—il
nA/CA/
-2_fnifu v4
[A/C] f REMOVE EXISTING
CONCRETE
___._.___22' 7—
VAC PORT
POOLSIDE LARN
-------------
ELEC SUPPLY
Ln
Ln
U
SHUTTLE
P£}OL SPECS SCREErid SPECS DECK SPECS EtiU€Pt�rElYT SPECS FLiiM�IfVCr SPECS
PERIMETER: 59' TYPE/COLOR: MANSARD/BRONZE COPING TYPE: BRICK CIRC PUMP: Intelliflo D (1.5 HP) CONTROL PANEL- Pentair Home App RETURN: 28' MAIN DRAIN: 30'
AREA: 203 sqft SCREEN MESH: STANDARD "A" TYPE: STANDARD PAVERS PUMP #2: N/A REMOTE: Pentair Home A2p SPA: N/A Common Return: N/A
DifAENSIONS: 22'-7' x 10'-8` WALL HEIGHT (LF): 10' "A" AREA: 459 sqft PUMP#3: N/A SANITIZER: IN -LINE FEATURE A: _N/A
GALLONS: 5,930 WALL LENGTH (LF): 75' „B„ TYPE: N/A FILTER: Cartridge CC 150 AIR TYPE: N/A FEATURE B: _N/A
ROOF AREA (SF): 700 soft "B" AREA: N/A HEATER: N/A FILL LINE: N/A FEATURE C: - N/A
GUTTER SIZE: 7" TOP EX. TYPE: N/A CLEANER: Dedicated Vac Line OTHER: (1),Poolside Alarm FEATURE D: N/A
VGB ACT COMPLIANT INFINITY WALL: N/A ALL SUBMERGED SUCTION OUTLETS ARE ALUMINUM ROOF: N/A TOP EX. AREA: N/A POOL LIGHT: (2) MicroBrite Color LED OTHER: N/A PV3 VALVE to EQ: N/A
EQUIPPED wl DUAL DRAIN COVERS and/or ROOTER: 56' SPA LIGHT: N/A OTHER: N/A PV3 VALVE to POOL: N/A
SINGLE UNBLOCKABLE DRAINS WHICH L x W: N/A DOORS: (2)
ARE FAN BEAM: N/A TEAR OUT: N/A TURNDOWN: N/A OTHER: N/A OTHER: N/A ELEC: 50' GAS: N/A
BEAUCHAMPS
PAGE 1 of 2
ORIGINAL
■
Cody Pools
APPROVAL
I (ownei/s) have reviewed and approve this plan as correct within reasonable
tolerance. I understand that any changes to shape or location may result in delay of
project and additional cost.
FLOW THRU SPA
NO SKIMMER SKIMMER
TYPICAL GR. FOR #3 SKIMMER REQUIRED FOR
�REBAR, 2" OUT WITH SPA WITH INDEPENDENT
#8 CU TO PUMP FILTRATION SYSTEM
#
OPTIONAL 12V LIGHT
W/ TRANS, r BRASS <
OR PVC (SEE NOTES) RAIL OPTIONAL -
NO LIMITATION TO
SHAPE EXCEPT FOR
= DIVING
STEPS —
OPTIONAL
SWIM -OUT OR LADDER ENTRY REQUIRED ./
REQUIRED (GR/#8 CU) (SEE NOTES) CIRCULA11ON---
WHERE DEPTH OVER LINE -MAIN DRAIN REQUIRE
5' DEEP (SEE NOTES) (TAMPER PROOF/SEE NOTES)
-LIGHTING & BONDING SAME
AS POOL
RAIL OPTIONAL-J-NO LIMITATION ON SHAPE
RAIL OPTIONAL
GENERAL POOL PLAN GENERAL SPA PLAN
N.T.S. • •
2'-9" MIN EXCEPT FOR
SLOPING ENTRIES. 4'-0" MAX. SEE NSPI 5 RE:
HANDHOLDS
®� •I • . " :
in
PIPES, VALVES, PUMP(S) OFF SWITCH.
EXCEP11ON: ROPE & Im DETERMINE SYSTEM FLOW RATE:
FLOATS INSTALLED IF - MINIMUM FLOW RATE REQUIRED: 35ga1/Min. SKIMMER (REQUIRED: 1 Skimmer per 800sf)
LESS THAN V-6'
7F1 �-
3 MAX. 8`
1� MIN.
TO
SLOPE
CHANGE
POOL SECTION DETAIL
N.T.S.
SB2836, 6-20-07
FOR BONDING & GROUNDING SYSTEMS FOR SWIMMING POOLS, THE
USE OF AN UNDERGROUND BONDING CONDUCTOR MADE OF #8 AWG.
BARE SOLID COPPER WIRE BURIED TO A MINIMUM DEPTH OF 4" TO
6" BELOW SUBGRADE, & 18" TO 24" FROM INSIDE WALL OF A
SWIMMING POOL OR SPA, IS DEEMED A PERMISSIBLE ALTERNATIVE
OR EQUIVALENT TO COMPLIANCE WITH s.680.26(c) OF THE NATIONAL
ELECTRICAL CODE.
PAVERS OR 4" DECK DECK FINISH
2500 psi (MIN.) CONC. PER CONTRACT
W/ FIBER MESH—r (NON-SUP)-
11
POOL FINISH -
PER CONTRACT
�t12"x12" FOOTING BEAM & "7=�
W/ (2) #3 BARS BAR OPTIONAL
_OR (1) #5 BAR
6" MIN. WALL & FLOOR THICKNESS. 3500 psi (MIN.)
CONC. #3 BARS ON 12" CENTERS EITHER WAY, TIE ALT. 6.
INTERSECTIONS 15" MIN. OVERLAP. 2" MIN. COVERAGE ON
STEEL W/ CONC. TO ASTM A15.A16, ASTM A30-5
(Structural subject to suitable sail conditions)
.o# , W11141, #
POOL VOLUME: 500 Sq. Ft. x 4 Ave. Depth x 7.481 gal/cf = 15,000 Gallons
TURNOVER TIME IN HOURS: 6 Hours x 60 Min/Hr = 360 Minutes
FLOW RATE: 15,000 Gallons / 360 Minutes = 42 gpm
PIPE SIZING CHART (MAXIMUM) s-022-3/al
PIPE SUCTION PRESSURE
J
3.
135
t
PUMP PENTAIR • J HP
OR INTELLIFLO
TURNOVER• .r
• »# »^ # r
s !
8»
FILTER: STARTRITE PTM50, 50 CFM OR
HAYWARD C751, 75 GPM CAPACITY
FINISH
MAIN DRAIN: WATERWAY 640-130XV
MARCITE OR
CLEANER: HAYWARD VAC LOC
-EXPOSED
VENT SCREEN: WATERWAY 640-290OXV
AGGREGATE
MAIN SUCTION PIPE SIZE 2"
SKIMMER SUCTION PIPE SIZE 2"
CLEANER/VAC PIPE SIZE 1-1/2-
RETURN SUCTION PIPE SIZE 1-1/2"
am
- I
2-1/2 SLIP INSIDE
2" SOCKET
1. 20' ROUND PVC SUMP
2. 2" TAPERED THREADED PIPE PLUG
3. 20" ROUND OUTLET COVER PLASTER
SHIELD
4. ROUND CENTER CAP PLASTER SHIELD
5. 20" ROUND ANTI -ENTRAPMENT SUCTION
OUTLET COVER
6. ROUND CENTER CAP
7. 10-32XJ FLAT HEAD PHILLIPS, 316 SS,
QTY 10
-MAXIMUM WATER DEPTH V, Maximum SEAT DEPTH 28", MAX.
-FLOOR SLOPE 1.12
-STEPS: MIN. TREAD 10" X 12", 7" MIN. RISER, 12" MAX. RISER EXCEPT
THE BOTTOM STEP MAY BE 14" IF IT IS THE SEAT. INTERMEDIATE TREADS
AND RISERS TO BE UNIFORM, IF THE SPA IS OPERATED INTERMITTENTLY IT
SHALL HAVE A SIX HOUR. TURNOVER. IF CONTINUOUS A ONE HOUR
TURNOVER.
-MAXIMUM TEMPERATURE 104 DEGREES.
-MEET ANSI/NSPI ARTICLE XVII, SAFETY INSTRUCTION/SAFETY SIGNS.
-PRESSURE TEST PIPING AT 35 PSI FOR 15 MINUTES OR
MEET LOCAL CODE IF GREATER.
-WIRING AND BONDING AND ALL ELECTRICAL TO
COMPLY WITH CHAPTER 42, FLORIDA BUILDING
CODE APSP/ICC 2020 AND NEC 2017.
-NO OUTLET OR OVERHEAD POWER WITHIN 10' IF
WITHIN 15' PROTECT BY GFI, TRANSFORMER MIN, 10'
FROM POOL, 8" ABOVE WATER, J BOX 4' FROM POOL,
BRASS TO J BOX OR TRANSFORMER MMICH EVER IS
FIRST EXCEPT WHERE PVC IS APPROVED.
• r •
• =•r •
• •• `♦ •
• •
ff # • #,. N .,
11ME SWITCHES OR OTHER CONTROL METHODS THAT CAN
AUTOMATICALLY TURN OFF AND ON ACCORDING TO A PRESET
SCHEDULE SHALL BE INSTALLED FOR HEATERS AND PUMP MOTORS.
HEATERS AND PUMP MOTORS THAT HAVE BUILT-IN TIME SWITCHES
SHALL BE IN COMPLIANCE WITH THIS SECTION.
-DESIGN, CONSTRUCTION AND WORKMANSHIP SHALL BE IN
CONFORMITY WITH THE REQUIREMENTS OF APSP/ICC 3, APSP/ICC 4,
APSP/ICC 5, AND APSP/ICC 6 AND APS/ICC 7 BASED ON THE
POOL TYPE.
-SEE-NSPI FOR DIVING WATER ENVELOPES.
-SLIDES SHALL MEET THE MANUFACTURE'S INSTALLATION
REQUIREMENTS.
-ALL POOLS WHETHER PUBLIC OR PRIVATE SHALL BE PROVIDED
WITH A LADDER OR STEPS IN SHALLOW END WHERE THE WATER
DEPTH EXCEEDS 24" (610 MM),IN PRIVATE POOLS WHERE WATER
DEPTH EXCEEDS 5' (1524 MM) THERE SHALL BE LADDERS, STAIR OR
UNDERWATER BENCHES/SWIM-OUTS IN THE DEEP END. WHERE
MANUFACTURED DIVING EQUIPMENT IS TO BE USED, BENCHES OR
SWIM -OUTS SHALL BE RECESSED OR LOCATED IN A CORNER.
-CIRCULATION SYSTEMS, COMPONENTS & EQUIPMENT SHALL COMPLY
WITH NSF 50.
-THE MAXIMUM TURNOVER RATE IS 12 HOURS.
-FILTERS SHALL HAVE AN AIR RELEASE AND
PRESSURE GAGE.
-PUMPS 3 HP AND LESS SHALL MEET ANSI/UL1081 CORROSION
RESISTANT WITH STRAINER & MEET THE REQUIRED FLOW.
-APPROVED MANUFACTURED INLET FITTINGS FOR THE RETURN OF
RECIRCULATED POOL WATER SHALL BE PROVIDED ON THE BASIS OF
AT LEAST ONE PER 300 SQUARE FEET (28 m2) OF SURFACE AREA.
SUCH INLET FITTINGS SHALL BE DESIGNED & CONSTRUCTED TO
INSURE AN ADEQUATE SEAL TO THE POOL STRUCTURE & SHALL
INCORPORATE A Convenient MEANS OF SEALING FOR PRESSURE
TESTING OF THE POOL CIRCULATION PIPING. WHEN MORE THAN ONE
INLET IS REQUIRED, THE SHORTEST DISTANCE BETWEEN ANY TWO
REQUIRED INLETS SHALL BE AT LEAST 1V (3048 Mil). -HEATER
SHALL MEET ANSI-Z21.56 OR UL 1261 OR UL 559.
-DISINFECTANT EQUIPMENT SHALL COMPLY WITH NSF 50.
-PRESSURE TEST PIPING AT 35 PSI FOR 15 MINUTES OR MEET
LOCAL CODE IF GREATER.
-RESIDENTIAL SWIMMING BARRIER REQUIREMENTS TO
MEET SECTIONS 454.2.17
-WASTE DISPOSAL TO COMPLY WITH SECTION 454.2.10 IT HAS BEEN
CERTIFIED THAT THESE DESIGN REQUIREMENTS ARE IN CCA
ANCE
WITH THE FLORIDA BUILDING CODE R4501, 7TH EDITION ,
ANSI/APSP/ICC 3, ANSI/APSP/ICC4, ANSI/APSP/ICC 5,
ANSI/APSP/ICC 6 & ANSI/APSP/ICC 7.
2810 NORTH 10TH STREET
TAMPA, FL 33605
Office: (813) 616-3301
Mobile (970) 703-3284
Leo@BerlProjectEngineering.com
F&EVENONS
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BUILD IN
ACCORDANCE WITH:
FLORIDA BUILDING CODE,
7th EDITION, 2020
DESCRIPTION
EXISTING & PROPOSED
LAYOUTS & SECTIONS;
DEMOLITION LAYOUT and
NOTES
Illiti.....n r5lltl
#
SLOPE
OF #
BELOW)
I BERYL eumffm
I in_m
a i
M
it
i
#4 ® 12"
N Q
� 3 #3 957 COMPACTED
j 1
0Z
� e
#4 ® 12" FILL MATERIAL
J E
ffl=— /s z
_ ¢ ' HORIZONTAL &
VERTICAL REINFORCED
1
^
#4 0 12"
EIGHT OF�
REINFORCED CONCRETE
-----WALL (MIN)
STEM WALL SECTION
STEM WALL
N.T.S.
PAVER DECK
CORNER R/ C D ETA I L
1— # 3 BAR CONCRETE
COMPACTED
N.T.S.
CONTINUOUS POOL DECK
MATERIAL
10
t
COMPACTED
SUBGRADE
UR—O—WALL EACH TWO
8"x8"x16" CMU BLOCK LINES (TYP.)
o
'z
CMU WALL
1—# 3 BAR
VERTICALLY
FINISH GRADE AT 30" O.C.
8"x8"x16"
2 — 3 BARS
#4; 100� CMU WALL
CONTINUOUS
FILL CELLS
PAVER DECK SHORT RETAINING
CMU BLOCK
WALL DETAIL
WALL CORNER DETAIL
N.T.S.
N.T.S.
WALL SECTION
N.T.S.
5 VERTICAL
-E TABLE
)R SPACING
5 HORIZONTAL
.E TABLE
)R SPACING
5 0 9" C/C
CONCRETEOUTLINES
'�.wI�W�
TOGETHERTIE ALL STEEL (WALL & FTG
CONCRETEALL STEEL 27* MIN.
ALL ►0
GRADEALL REBARS SHALL BE •
1. BEFORE STARTING CONSTRUCTION, THE CONTRACTOR NEEDS TO
VERIFY THE EXISTING CONDITION & DIMENSIONS.
HORIZONTALOR DIAGONAL
CONNECTED - CONNECTORS.
f O• SHOULD COMPLY WITH ACI 301,
EDITION
REINFORCING4. THE f .s
CONCRETE5. THE ► -• OF 00
CONCRETEW/C = 0.55 FOR 28 DAYS FOR REINFORCE CONCRETE STEM
WALLS
6. THE •." OF •••
MASONRYW/C = 0.55 FOR 28 DAYS FOR REINFORCE CONCRETE MASONRY
WALLS
7. CONCRETE •COMPLY
REQUIREMENTS OF ASTM C90. MORTAR FOR MASONRY
CONSTRUCTION SHAH • O ► THE REQUIREMENTSOF
C270. RH ALL MASONRYCONCRETE.
8. CONSTRUCTION • s NO GREATER THAN 20'
•
JOINT9. ALL •* OTHER ACCESSORIES
BE RESISTANT TO CORROSION.
10. WERE SOIL UNDER FOOTING CONSIST OF SOFT MATERIAL, PLACE
TO OF ► STONE OR
PLAN FOOTING
REINFORCED
I I I Im1 m 110 10
VOLCLAY
WATER ♦•
2810 NORTH LOTH STREET
TAMPA, FL 33605
Office: (813) 616-3301
Mobile (970) 703-3284
Leo@Ber} ProjectEngineering.com
Na DESIXiiP
BUILD IN ACCORDANCE WITH:
FLORIDA BUILDING CODE,
7th EDITION, 2020
EXISTING &PROPOSED
LAYOUTS & SECTIONS;
DEMOLITION LAYOUT and
NOES
STATE O �
F"1p(tlf tk74tEt1144
-
iR • I
APSPThe Association of
Pool & Spa Professionals'
ANSI/APSPACC 15a ENERGY EFFICIENCY COMPLIANCE INFORMATION FOR RESIDENTIAL SWIMMING POOLS
PROJECT NAME: Beauchamps CONTRACTOR NAME Cody Pools
AND ADDRESS - AND ADDRESS:
39988 Dawson Chase Drive 6846 N. Dale Mabry
Zephyrhills, FL 33540 Tampa,Fla. 33614
IWN":Beauchamps CONTRACTOR PHONE: (813) 886-9119 DATE: 6/20/2023
This information sheet was prepared by the APSP-15 Residential Swimming Pool and Spa Energy Efficiency Standard Writing Committee of the Association of Pool and Spa
Professionals (APSP). It is not part of the American National Standard ANSI/APSP/ICC-15a 2011 but is included for information only. Contractors should acquire and comply
with the ANSI/APSP/ICC-15a 2011 standard which can be purchased at www.apsp.org.
1. §5.2.1: Calculated pool volume
a. Gallons: 5,930 ; or
b. Calculated Gallons: 203 (surface area) X 3.9 (average depth) X 7.48 (g,j1ftA3) = 5,930
2. §5.2.1: Calculated filtration flow rate
(Pool volume + 360 or 36gpm whichever is larger)
3. §5.5.1: Pipe sizing:
a. Minimum suction pipe diameter
(Enter the smallest pipe size from Table 3 with a 6fps flow capacity the some or more than item 2.)
b. Minimum suction branch pipe diameter
(Calculate: Item 2. 49 - (gpm) -.' Branch Pipes I (quantity)= branch flow rote. 36 (gpm).
Enter the smallest pipe size from Table 1 with a 6 fps flow capacity the some or more than the calculated
suction branch flow rate.)
c. Minimum return pipe diameter
(Enter the smallest pipe size from Table 1 with a 8fps flow capacity the some or more than item 2.)
d. Minimum return branch pipe diameter
(Calculate: Item 2. 49 - (gpm) -.- Branch Pipes I (quantity) = branch flow rate 36 (gpm).
Enter the smallest pipe size from Table I with a 8fps flow capacity the same or more than the calculated
return branch flow rate.)
4. §5.4.1: Filter type and size:
a. Filter type: (Cartridge, DE, Sand)
b. Minimum filter area
(Calculate: item 2. 49 - (gpm) - filter factor 0375 (gpM1ftA2))
Filter factors: Cartridge=0.375, Sand=15, Diatomaceous Earth=2
5. §5.4.2: Backwash valve: r1yes, _allo?
(When using a backwash valve, enter result of item 3c or 2 inches whichever is larger)
Table 1
Pipe Size;
Nominal GPM @ 6 fps
1,6"
2"
2.5
138
3.
185
238
374
540
Nominal GPM @ 8 fps -
51
84
191'9
184
1 247
1 317-
6. Single -speed pump selection (when used):
§5.IA, 5.3.1: For single -speed pumps with a total horsepower 0.99 or less, find and enter a compliant pump from the Pool Pump
Database.
a. Pump model
b. Total horsepower
7. Multi -speed pump selection (when used):
§5.3.2.1: Pools 17,000 gallons or less, select pump* from the database with a Curve -A gpm flow equal to item 2 or less.
§5.3.2.2: Pools 17,001 gallons or more, select pump* from the database with a Curve-C gpm flow equal to item 2 or less.
*Multi -speed pumps must have one speed listed that satisfies this requirement.
a. Pump model
b. Pump flow
(§5.3.2.1, 5.3.2.2: Applicable Curve A or Cgpm flow listed in database)
1. 5,930 gallons I
2. 36 gpm I-
3a. 1.5 inches I
3b. 1.5 inches I-
3c. 1.5 inches I
3d, 1.5 inches
4a. Cartridge
4b. 96.0 sq. ft.
5. 2 inches
(When used)
6a. pentairlIntelFlo VS
6b. 3 1
Ism
7a. PentairintelFlo VS
7b. 18 gpm
3/17/15 ANSI/APSP/ICC- 15 Standard Writing Committee Form 1 of 2
--Component
Section
Requirements
Check
4.4.1.1
Heater has no pilot light
4.4.1.2
Readily accessible on -off switch mounted outside of the heater
Heaters
4.3.13
No electric resistance heating unless for inground spa with tight fitting cover with R-6 insulation,
or for pool with 60% of documented pool heating from on -site solar or recovered energy.
4.3.2
Heater efficiency: gas/oil fired heater efficiency at least 78%, heat pump COP at least 4.0
5.1.1
Pool filter pump listed in database
5.3.1
Pool filter pump with total horsepower 1.0 or more is multi -speed
Multi -speed pump controller programmed to default to the filtration flow rate when no auxiliary
5.3.3
pool loads are operating within 24 hours and programmed with temporary override capability for
servicing.
Pool systems
5.3.4
Single -speed pump controller capable of operating pump during off-peak electric demand.
5.5.2
Pipe before pump has at least 4 diameters of straight pipe.
System installed with solar, or setup for the future addition of solar heating equipment by
5.5.3
installing 18 inches of horizontal or vertical pipe after the filter and before a heater, or built-in or
built-up connections, or dedicated pipe to and from the pool.
5.6
Directional inlets for mixing pool water,
3/17/15 ANSI/APSP/ICC- 15 Standard Writing Committee Form 2 of 2
AS BUILT SURVEY (FINAL)
WITH SELECTIVE SPOT ELEVATIONS
LOT 1
HIDDEN RIVER PHASE 2
PASCO COUNTY, FLORIDA.
PREPARED FOR AND CERTIFIED TO:
CALATLANTIC TITLE INC.
NORTH AMERICAN TITLE INSURANCE CONIF
EAGLE HOME MORTGAGE, LLC
ELBIN JOSE BEAUCHAMPS
S 89'45*11" E
60.00'
\-PCP(P)
RADIUS
PONT
DAWSON CHASE
DRIVE
(R/W VARIES)(TRACT A)
FIR 1/2-
m
LOT 2
1( 6 1 CA
UJ
ss
(LO) 0:
Z:
FIR
LH
PLAT*
BOUNDARY
WTN!Tq+ ,
SEC.24
, TWO. 26 S, RNG. 21 F.
BEARING —BASIS:
WEST BOUNDARY OF SUBJECT PLAT BEING N 00-2:5'02" E
THIS SURVEY IS ;SUBJECT TO ANY FACTS THAT
N
MAY BE DISCLOSED BY A FULL AND ACCURATE
TITLE SEARCH, ;ALSO SUBJECT TO SETBACKS,
EASEMENTS AND: RESTRICTIONS OF RECORD.
UNDERGROUND FOOTER, STEM WALL, AND
II
UNDERGROUND UTILITIES ARE NOT LOCATED OR
SHOWN.
DO NOT SCALE THIS PRINT, DIMENSIONS AND
NOTES TAKE PREFERENCE.
ca
ul
+
PURPOSE OF SURVEY: TO OBTAIN HORIZONTAL
AND/OR VERTICAL DIMENSIONAL DATA TO SHOW
CONSTRUCTION IMPROVEMENTS.
STRUCTURE TIES SHOWN HEREON DENOTES
MEASUREMENT FROM FORM BOARDS/FOUNDATION
TO PROPERTY ONE,
SN&D
0.4'
S,
10' UTILITY EASEMENT
00
01
Ld
C cot4c
WALK
Z
CA p
CO
Z; xw
I- LLD-
COV
CONC
.6. ENTRY &Wr,
C
2 STORY
MASONRY
V)
W,
FRAME
RESIDENCE
5"
LOT 1
fe
400
PT
BOUNDARY
V
TRACT A
HIDDEN RIVER PHASE ONE A
(PLAT BOOK 74, PAGES 101-121)
DESCRIPTION:
LOT 1, MAP OR PLAT ENTITLED "HIDDEN RIVER
PHASE 2", AS RECORDED IN PLAT BOOK 79,
PAGES 102 THROUGH 110, OF THE PUBLIC
RECORDS OF PASCO COUNTY, FLORIDA. I
Feet: 7176.74 *
FCM
4'X4"
#7013
�PRM(P) r"n"
(TYP) 4�-
C, i
rn
3�,
014�-
M X,
C rf-
"y')
Z, rn
L E NOD:,14,
E-00.0- -41iXrGMNG GRADE
3
LOWE$T FLOOR EVATIONS:
LIVING AREA: 7 N""i
GARAGE AREA: 74.81'
ELEVATIONS REFERENCED TO
NATIONAL GEODETIC VERTICAL
DATUM OF 1929. MEAN SEA
LEVEL= 00.00 FT,
:GEND:
CALCULATED DATA, (D)- DEED DATA, (M)- MEASURED DATA. (P)- PLAT DATA, QL- CENTERLINE, A/C= AIR CONDITIONER. PPARENT PHYSICAL USE, EIFE- BASE FLOOD ELEVATION, C/C- COV. CONC.. C/S- CONCRETE SLAB, COR.,- CORNER, CLF- CHA
DV,- COVERED, E/P= EDGE OF PAVEMENT, F/C= FENCE CORNER, FCM- FOUND CONCRETE MONUMENT, FIP- FOUND IRON PIPE.
)UND NAIL & DISK, FPIP- FOUND PINCHED IRON PIPE, MAS.- MASONRY, NCF- NO CORNER FOUND OR SET, OR- OFFICIAL RE(
-RMANENT CONTROL POINT, PRM= PERMANENT REFERENCE MONUMENT, R/W= RIGHT OF WAY, R= RADIUS, SiR= SET 1/2" IRON
zT NAIL & DISK No. 4493. S/W= SIDEWALK- TBM= TEMPORARY BENCHMARK V/F= VINYL FENC -, W/r= WOOD FENCE
:
JOHN R. BEACH &ASSOCIATES, INC. rown yI HEREBY CERTIFY sms RESPONSIBLE THAT THIS
CHARGE AND tv
SURVEYORS AND MAPPERS OF PRACTICE FOR SURVEYS AS
911 WEST ST, PETERSBURG DRIVE Checked By. OF LAND SURVEYORS N,Z1-QkP1
)NE OLDSMAR, FLORIDA 34677 FL D-1, AnSTRATIVE CODE,
r
Scale; r
iAY (813) 854-1276 FAX (813) 855-8370 1 F ATEL: S(U
3T- VAUD WITHOUT ORIGINAL SIGNATURE Date; NAT
NO SEAL OF A FLORIDA LICENSED FINAL 2/19/20 DJB
IRVEYOR AND MAPPER JOHN R. tcvtsions: FORM BOARD 7IE IN 10j25j19 RTM, FOUNDATION TIE IN 9� 1
19 DWB 74 rFLORIDA
1".. S A
= ALUMINUM FENCE, APU-
LINK FENCE, CONC.- CONCRETE,
Z= FOUND IRON ROD, FN&D-
0 BOOK, P6- PLAT BOOK, PCP-
0 & CAP No. 4493, SN&D=
VEY WAS MADE UNDER MY
S THE APPLICABLE STANDARDS
r FORTH BY THE FLORIDA BOARD
Si-17.051 THROUGH 5J-17.053,
RSUAAT TO SECTION 472.027
RVEYOR & MAPPER No. 7123
DATE
LAST NAME: BEAUCHAMPS
ADDRESS: 39988 DAWSON CHASE DRIVE
CITY/ZIP: Zephyrhills, FL 33540
PHONE#: 732-731-9096 GATE CODE:
DESIGNER: John Lalley . SUPER:
BOND BEAM: FINISH: JOB
12 i'0- 0 r: R 12'BEAM 10' BEAM
CONTRACT NOTE: �
INCLUDED
[ N OF NOTE:
-- — ----------- — — --- ------ — ----- — -----------
=0 T 0
0 T C
IRRIGATION SYSTEM
M -ZAP for
POOL I LUUE a
POOL AREA INCLUDED
CONTRACT NOTE:
REMOVE 20 sqft of EXISTING CONCRETE
10" BEAM 4'9"
3'
21 FOO TERI_ -------------------- ILL -----------
MICRO
POOLSIDE ALIARM
PAVER -DECKING
FA/C
------------------------ ------
REMOVE EMSINNG 11 --------------------
CONCRETF—�
POOL PANEL w/ GFCI
OUTLET for Service
EOUIPMENT PAD
2'x 3'
T
RESIDENCE 50,
�cRan�PEs
�.�CK �_IIECS
UMIUNG S
,��,�_�PECS�
PERIMETER, 60'
TYPE/COLOR.- MANSARD/BRONZE
COPING TYPE., BRICK
CIRC PUMP: Intelliflo i3 (1.5 HP)
CONTROL PANEL: Pentair HoTf_ Ap2
RETURN: 28' MAIN DRAIN: 30'
AREA: _�22 saft
SCREEN MESH: STANDARD
"A" TYPE: STANDARD PAVERS
PUMP#2; N/A
REMOTE: Pentair Home App
SPA N/A Common Return: N/A
MMENSIONS: 23'-0" x 12'-0.
WALL HEIGHT (LF): 10'
'A" AREA, 507 sqft
PUMP #3: N/A
SANiTIZER: httelliChloriC20
FEATURE A: N/A
WALL LENGTH (LF):_Z9'_
"B" TYPE: N/A
FILTER: Cartrid P CC 100
AIR TYPE: N/A
FEATURE B: N/A
GALLONS: 6,485
ROOF AREA (SF,. _ZZO ssq�_
"B" AREA N/A
HEATER: N/A
FILL LINE: N/A
FEATURE C: N/A
GUTTER SIZE: 7"
TOP EX. TYPE: N/A
CLEANER: N/A
OTHER: (1).Poolside Alarm
FEATURE D: N/A
VGB ACT COMPLIANT
INFINITY WALL: _N/A
TOP EX. AREA: N/A
POOL LIGHT: (2) MicroBrite Color LED
OTHER: N/A
PV3 VALVE to EQ: N/A
ALL SUBMERGED SUCTION OUTLETS ARE
ALUMINUM ROOF: N/A
EQUIPPED w/ DUAL GRAIN COVERS and/or
FOOTEA S5'
SPA LIGHT: N/A
OTHER: N/A
PV3 VALVE to POOL: N/A
SINGLE UNBLOCKABLE DRAINS WHICH
L x W: N/A DOORS: (2)
FAN BEAM: N/A TEAR OUT: N/A
ARE
TURNDOWN: N/A
OTHER: N/A
OTHER: N/A
ELEC: 50' GAS: N/A
ELEC SUPPLY
ii
U
U
SHUTTLE
2" BEAM
H OIER
BEAM
BEAUCHAMPS
PAGE 1 of 2' SCALE 1/'8'= 1707'
IE:::� _�PLAN�REK�SIP�N_
REVISED: 7-18-23 (r2)
Qody Pools
APPROVAL
I (owner/s) have reviewed and approve this plan as correct vith'n reasonable
tolerance. I understand that any changes to shape or location may result in delay of
project and additional cost.
C OPERATIVE, INC.
one
l s
Your Touchstone Energy' Partner KIt',111A
Date : July 20, 2023
Address: 39988 Dawson Chase Dr
Zephyrhills, Fl 33540
Account Number : 1407 440 606 060
Approved : Yes u No
If "No", reason :
Inspected by : Heidi Stephens
Approved by: Heidi Stephens
Pool Company: Cody Pools
Comments : No Conflict
WRFC Release No.
Date : July 20, 2023
Date : July 20, 2023
1 '-
NOTE : This approval is only a confirmation that the described pool location conforms to the "National Electrical Code"
concerning clearances between pools and electrical conductors. For identification of W.R.E.C. facilities, notify
Sunshine State One -Call �(a, 1-800-432-4770 or 811.
P.O. Box 1278, San Antonio, FL 33576 Phone: (352) 588-5115 / Fax : 352) 567-4376
INSTR#2023135097 OR BK10860 Pc,1397 Page i.fi
07/28/2023 1110 AM Rcpt: 2608926 Rec: 1000 IDS: 0.00 IT: 0.00
Nikki Alvarez-Sowles, Esq., Pasco County Clerk & Comptroller
Permit Number
Parcel ID Number
NOTICE OF COMMENCEMENT
State of Florida
County
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and In accordance with Section 713,13 of the
Florida Statutes, the following information is provided n thl OTIC F COMMENCEMENT,
1. Description of property (legal description)
a. Street (job) Address
71;
2. General description of Improvements IgE, ri,Ue'n
3. Owner Information of
a. Name and address
J. Name and address
c, Interest in property
4. Contractor Information
a. Name and address 3614
b. Telephone No, 813-886-9119
5. Surety (if applicable, a copy of the payment bond Is attached)
a. Name and address
b. Telephone No.
c, Amount of Bond $
6. Lender
a. Name and address
b, Telephone No. _
7, Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section
713.13(1)(a)7, Florida Statutes
a. Name and address
b. Telephone No,
8. In addition to himself or herself, Owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713,13(1)(b), Florida Statutes,
a. Telephone No, 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 will be one (1) vear from the date of recordIno unless a different date issnerdfind on
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my
knowledge and bbfief.
X
(Signature o nerori essee, or Owners orLessee's Authorize OfterlDkoctorlIP 'Me
Y, nager) (Prini and Provide Signa6ys Tifle/Office)
er The foregoing Instrument was acknowledged before me by means of physical presence or 0 on-line notarization, this day of
202'5 by 7
(type of authority, e.g. officer, trus , attorney in fact) for a authority,
ty a*' officer,
ru e
c
(name of on behalf of who ' strument was executed). P
Person ly aw
n ORP u Identification �� of Identification Produced(�
SIGNA URE OF NOTARY PRINT NAME
'TA STAN:' Notary Public State of Florida NOC Revised 10-2022
Medina
L'au.,io D. Abreu Medina Notary
t"Ou M 8
m My Commission
no 1. 2
y Commission HH 322024
A. = E pireS 1 6
Expires 10113/2026
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