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HomeMy WebLinkAbout96-6004 , u CN~ d-'1o.c-V ~ Pmpe~yOwoe' ~arg3. u..J" Job Address: h '? / BUILDING PERMIT (I CITY OF ZEPHYRHILLS Permit N4? [;v.Y' (813) 788-66\'l ~atl~ !I-c2 b -7-b '&--t? . OZ> tt:r .. crv {/IJ-v 90:,-' o-v 0ECTRI~ ~MB~ CME~HANI~ Sewer Conn Water Conn: .(JJ~ }Ju..~Water Meter:; TlE~~: ~ Y rf'.~o ref ... 600413 Parcell.D. # Zoning: Energy Code' ~don Gas: Description of worr-J? O..A'\..-(.'>V?:l L:v.. =f-. /Z..~ LJ~/ - u..<Y-- NO OCCUPANCY BEFORE C.O. FINAL / D-- DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Signature Company Address Telephone# t.J(J 7 - <? (, ') -? <is :) 'L Valuation or '- Contract Price ~S / t:9-fr-o . cr-D City License Registration # ;L '1.9 State Certified License# ~Pnr&.~ Of!)f /7~ j/Mr ~"3<~~ )/~/l./J1~ ~cf02 BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr, Tp. Serv, SLB Pre SLB 1- 2-9_ q ~ Rough In Tub Set Lintel Meter Can Water FRM. Const. Pole Sewer Insul. CL Pool Final n WL Pre-Meter P~?""ILf- il,,!,Jif3 r~~-v\ Aj ~ b~O Final p~~ 8r~ZJ -fv tElB {L -\" fl ^ - \ - ,. Driveway r~ ~ () .v _ Il ~ ~~.t1- ~~-'1-:11"'91, J5.o B-S--z.-~~ gtl.6 5'-I5'-tfJ(,~6{3 \ aJL.A.v<V'o 8 ~ - . J),"2-I-I/f,.81!;6 ') -'2-'\.... t ~ -1-3l....Qtp ~'- ~...z... (, B~8 ~....'5'-1' iJtrf3 REINSPECTION FEES: When extra inspection trips are necessary du to anyone of the following reasons, a charge of Fifteen and 00/100 Dollars ($15,00) shall be made for c;Ch triP, fo~ea~hntradtt;e:" IJ fiJ-t /.... It P a. Wrong Address ~~ ~ b. Cond.emned work. resulting from faulty. constr~ction. t. , ... J 1 "I.' 'I r-f / - t~ c. Repairs or corrections not made when Inspection called. \AJ~~ d. Work not ready for inspection when called. Q ~ ~. /! e. Permit not p~ste~ on job site. ~ -J-' -1/" /? 9'-/;2 -..9b ~ Ak~ f. Plans not at Job site. r~f-. C/ g, Work not accessible. Breakers Ducts Insl. Compressor Final The payment of inspection fees shall be made before any further permits will be issued to the person owning same, '" APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT "EAST ./If.fC(J $~./t'A't tGIJ7t!:e OWNER'S NAME .:Jt/,IV A1E,i)/(At. 'St//Lj}/A"t; OWNER'S ADDRESS ?i6lJ 6},~ ~v.:P ~VM1/a.t;" 71 t JOB ADDRESS ~9/f tlt1tL-- Bill? PHONE LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION , PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition --A..Alteration ~epair _Install _Sign -'love Deaolish - , PROPOSED USE: _Single Faaily Leo..ercial _KIF _' of Units _M/H _Indust. _Swia. Pool _Other Restaurant & Health Departaent Approval DESCRIPTION OF WORK: \ ~ ~~ BUILDING SIZE: x Square Feet, Height RESIDENTIAL : COMMERCIAL ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED ~ BUILDING ..LELEGTRICAL ~CAL _PLUMBING $ /~/tFd. Valuation of Total Construction AtIP Service Florida Power Corp. W.R.E.C. $ Valuation of Mechanical Installation GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FDiISHED FLOOR ELEVATIOBS: Fr. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** RITII.DER CONTRACTgB s~ ~ =~ rt. or ~ ~~7816 City License Registration' ~I ~ .' ****************************************** / Signature RT.RGTRICIAN COMPANY State Cert. or Regist. , SionAture City License Registration , ****************************************** PLUMBER COMPANY State Cert. or Regist. , Signature city License Registration . ****************************************** MECHANICAL COMPANY State Cert. or Regist. f Signature City License Registration f ***********~****************************** OTRRR COMPANY State Cert. or Regist. f Signature City License Registration f ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit lay be subject to Ideed restrictions I which lay be lOre restrictive than City regulations. rhe undersigned assUles responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR ~SPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they lay 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 JaY be cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licenSing requireaents JaY apply for the intended work, they are advised to contact the City of Zephyrbills Building DepartJent, (813) 788-6611. FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have tbe contractor(s) sign portions of the .Contractor Sectionsl of this application for wbicb they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of IFlorida's Construction Lien Law - HOIeOWDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and Conslller Affairs. If the applicant is sOJeOne other than the "owner", I certify that I bave obtained a copy of the above described docUJent and proaise in good faith to deliver it to the "owner" prior to cOllenceaent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the inforJation in this application is accurate and that all work will be done in cOJpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has CDIIeDced prior to issuance of a pertit and that all work will be perfoIJed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other govemaental agencies JaY apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to: t DepartJent of Environaental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands, Water/Wastewater TreatJent t Southwest Florida Water Manageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Oepartlent of Health & Rebabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US EnvirODJeDtal Protection Agency - Asbestos abateaent I also certify that, if fill laterial is to be used in Flood Zone IAI or "A,etc.., it is understood that a drainage plan addressing a "cOJpensating volllle" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to pertit. issuance. A pertit 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 perlit prevent the Building Official froa thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued sball becOle invalid unless the work authorized by such perait is cOllenced within six IOnths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of six IOnths after the tile the work is CDIIeDced. One 90 day eltension of tile, Jay be allowed for the perait with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection lUst be logged during each six IOntb period, or the project will be considered abandoned. WARNUIG TO OWNER: YOOR FAILURE TO RECORD A NOTICE OF COMMENCKMBIf1' MAY RESULT IN YOUR PAYING rwlCE FOR IMPROVEMKIft'S TO YOUR PROPERTY. IF YOU IIf1'IlIfD TO OBTAIIi FIIWfCING, CONSULT WITH YOUR LJlIfDIlR OR AN AnORNIlY BEFORE RIlCORDING YOUR IIOTlCE OF COMMENCRMKIf1' . JOBS UliDER $2,500 IN VALUIl 00 NOT HEED TO RIlCORD AND POST A "NOTICE OF COMMEHCKMBIf1'''. ~ ~ <~~ ?i? . S AfORE: ONIIER OR AGEIf1' /" SIGNATURE: If1'RACTOR Sf ATE OF FLORIDA COUIf1'Y OF Pasco The foregoing instrument was acknowledged before me this oJll1 y 1 , 19~ by David Hauqen who is personally known to me UONtmXllas podul!d{ N/A as identification and who ~/did not ~~~:.L~\ '\:::\~~~ ~) . STATE OF FLORIDA COUHTY OF Pasco The foregoing instrument was acknowledged before me this ,Julv 3 , 19~ by Charles Poole who is personally known to me C01011llllDS pQ:lQI1H<<ed{ N / A as identification and who ~~/did not ~\~~~t~, 'c~~ ~ureJ . (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC N,otary Public, State of Florida JUNE M. HERNDON My commission Exp. Feb. 1, 1997 Comm. No. 252632 Notary Public, State of Florida JUNE M. HERNDON My commission Exp. Feb. 1, 1997 Comm. No. 252632 APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER · S NAME PHONE OWNER · S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BWCK SUBDIVISION PARCEL LD.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign ____Move ____Demolish PROPOSED USE: ____S ingle FaJIlily ____M/F ____# of Units ____M/H _COIIDercial ____lndust. ____Swim. Pool ____Other ____Restaurant & Health Department Approval DESCRIPTION OF WORK: BUILDING SIZE: x Square Feet. Height RESIDENTIAL: COMMERCIAL ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. _KECHAlH.GAl. $ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FIlUSHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. I City License Registration # ****************************************** Signature ELECTRICIAN COMPANY State Cert. or Regist. # City License Registration # ****************************************** SiRnature ..,. PLUMBER /J . . -r-Signature~ COMPANY I?.teP~,e l/1,Ecf/d-.NJC~~ C!OIZP. L /J,-1~~ ~ State Cert. or Regist. t C,F CO.3 ~g. " G /rt-~~ City License Registration I //S' :~<r3 ****************************************** COMPANY OTHER COMPANY State Cert. or Regist. I Signature City License Registration I ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City regulations, The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they lay 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 lay be cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireJents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813) 788-6611. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "Contractor Sections" of this application for which tbey will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Hoaeowner's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOIeone other than the "owner", I certify that I have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the "owner" prior to couenCE!lent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the infortation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perlit and that all work will be perforJed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other goveInlental agencies lay apply to the intended work, and that it is ty responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: * DepartJent of Environmental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands, Water/Wastewater TreatJent * Southwest Florida Water ManageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * DepartJent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater TreatJent, Septic Tanks * US Environaental Protection Agency - Asbestos abateJent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating volUte" will be submitted which is prepared by a professional engineer registered in the State of Florida prior to perlit. issuance. A perlit 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 perlit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becOle invalid unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day extension of tile, aay be allowed for the pert it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OVNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUIlTY OF The foregoing instrument before me this was acknowledged , 19__ by STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19_____ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAME PHONE OWNER'S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1.D.# (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign _Move ____D~olish PROPOSED USE: ____Single Family ____H/F _* of Units ____M/H ____Connercial _Indust. ____Swim. Pool ___Other ____Restaurant & Health Department Approval DESCRIPTION OF WORK: BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction ____ELECTRICAL ____MECHAHlCAI. AMP Service Florida Power Corp. W.R.E.C. $ Valuation of Mechanical Installation _PLIIMBING G..4S ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? .......................................... YES NO I' CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. # City License Registration # ......*.......*************.*.*.********** Signature ~::~ T: u e~~~D rl W- COHPANY AP~ f:L&:::r'fzt'--;li;!;/' / State CerL. or RegisL. t; ~ ~es~ ,/ City License Registration tt ~ &./8" *...........................*...*****.**** PLUMBER COMPANY State Cert. or Regist. # City License Registration # ..**.**.*..*********.********************* Signature MECHANICAL COMPANY State Cert. or Regist. # City License Registration # *********.*~*.****...*..*.**...**********. Signature 2l'.I.mR Signature _,_ COMPANY State Cert. or Regist. # City License Registration # ***.**.*..******************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pel'lit lay be subject to "deed restrictions" which lay be lOre restrictive tban City regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they lay 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 lay be cited for a .isdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireJents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitUng privilegegintbe- City of Zephyrhills. , .. " '''''"':-'_.' C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES JUt 1 7 (:" ..~j D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeowner's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is sOIeone otber tban the 'owner", I certify that I bave obtained a copy of the above described docUlent and prolise in good faith to deliver it to the "owner" prior to couenceaent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a pertit to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other goverDIental agencies lay apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: * Departlent of Environmental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater TreatJent * Southwest Florida Water Managetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways * DepartJent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater TreatJent, Septic Tanks * US EnviroDlental Protection Agency - Asbestos abatement I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating volUle" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit 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 perlit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becOle invalid unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is suspended or' abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day extension of tile, aay be allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LBNDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19~ by STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19_____ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oCith. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC \ I\Cl. "; )(:- ~ ,I rL ~ l (, ~.: ;"':\ ~.~ )''/ r/(:.) 1;) ( , , . r'" '_ i . I ~ " (~-;,~;t -'.....-;> 'L.....~^; b- ~'. /r,' J1\.~-Di(:~"1L_- r;L~C_ -...::>', /' t' fit... . -.' ,~ .. "'." ..... '-.' ~.\..... ---,. , 6-:/L.0C0T ~-~ 'I ( r - r . 1_ lV ~ -i( ~'i.. .' V ,r-' I: " /j- _ l_ .;- ~-.;I\.' I: I~. I ('-' r -f'~ "" I ' . flifl I). t., r !- '\ 1 ,,/1 ./-: ( I I \ \. \\ ,\, .'- ? /~ 11'1 C:(l> ~h~ / "J t ( ., ( /..:/ ~-" -'/~" // --..-- b )~, : ", I" 'fe ~ ~ t . ;:> r I ! r i , 7. _-I-I) ., ~-r,''\-- \...__ " ,C i /('/ /; '-l7CI (~\ . . I I ( . I /) :~, i '~.. (.,2.",; Iii /L ? . r 1'-42/1 '\ ~ iJ h (.