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HomeMy WebLinkAbout97-7214 BUILDING ~AL ~. · a. · P,"perty Owne' f-: ~~ 'T# ~.J>1dtt: Job Address: . -. Parcell.D. # 1/::' :;~, :/1/-0 % - O(P5"O-Og./V BUILDING PERMIT 721 OTY OF ZEPHYRHILlS Pe,ml'. ~ (813) 788-6611 '" liD PLUMBING /n q~ !;J '6 . Date 11- /~-91 NI1 Water Conn: /11 ~ ,4 00 Water Meter: -;y ,1 .".. /9lJ. - T,I.F.'s: ~ ~ 'I/f" j. 9 Sewer Conn /rfLr~ liD ,/ Jf;j.9 ELECTRICAL Zoning: DescriPtion of Work Complete Plans, Specifications and Fee Must Accompany Application, C.O. All work shall be performed in accordance with City Codes and Ordinances. Inspector Valuation or Contract Price ~.s- -I S~ 9,~o' :~;:::.:~~~~~d. ~~, >-- Ftr. Pre SLB Lintel FRM. 1/7/11 (?:l \ Insul. CL WL City License Registration # c!< 71 State Certified License# c...$ (! 0 '35/.!J~ a;AQ#Al (j9n~ ~~~ ~';G ELECTRICAL 9 \J 1>/ C,1 !?o<< O/s-/t; 1 (fog , Company Address Telephone# Cz~~ t.)~ ~() --- PLUMBING Tp. Servo V5: I Rough In 1/'7/98 (; LL Meter Can Const. Pole /2 - I j.. Cfr; ~ Pool Pre-Meter Ilso/9~ Final '2 Iii Ie, ~ B,'I/ ~otu bo~J IJ./ '1 /91 gog SLB /~.. ~_~fttL~ Tub Set I fi .t( Water Sewer Final "/Ii/?'i f?,'t/ Breakers Ducts Ins!. Compressor Final Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Fifteen and 00/100 Dollars ($1-5':'66) shall be made for each trip for each trade: L::"1"'\ I/'.JZ~ dL~-,fTi) 0/1$I""C /I,~dl-7; 155tJ~l/ {I ~ a, Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. ~. Car';;'eil_En91I1eerlng,p'J\:-:~~-~~ Cwd, I'r'Wi/UJ""''-'IIIU" b~ e"r;.."*'""''1 t~I!h,"'1 2225 FAW Ed..s:.;ew()odDrive, Suite 5 fake/and, }iL 33803 (941) 666-3727 Pm': (9-11) 666-.5747 March f 3, 199~ Bill Burgess City of Zephyr hills 5335 Eighth Street lcphyrhills, FI 33540 Re: B & B Auto Repair PN: 2274 Dear Mr, Burgess, We have review the constructed site of the above mentioned project and have found that it has been modified from the approved site plan. We also have checked the modifications with the necessary requirements and feel confident that the site is weJl within all of the requirements as constructed. Specifically the stormwater retention area has been checked to see jfthe req, amount of storage area is available and has checked OK. Attached is a copy of the asbuit construction plan (8 Y2" x 11") (large size being mailed to you) If you have any other questions or concerns regarding this project please feel free to call me, Sincerely, .. /' ~ ,~~~/l' 2 ../~_~?/C~?1 U,/ I //i.m:: ;.rnicel~.I'E. {/ / President ./ -- Cr: William Cimorelli Robelt Tackett Kevin Ryman G0"d L-r.L~;; ';'99 L-o.------------,::--;,..--..- __ lJ i g~ ~ ~ ~ ~ ~ ~~-~~i H~;; ~i:i~ JI! j ~ l ,1; t.: ~ i i ~ i " 1 OJ ~, R ~ f\ f~("} Ill; ~" . ...:t- l; ~ ~!sg" ~ ~f"~ - f., ~g~n~lJ too .n!~!ler ~;;: i!I ' ."" "r,; ~ ~ ~ :>J '~ O. ~ CI'o r to;, y 1>6 ~It~ I ~33"'~ I ~'13 ""3H;:~H:1;) G0: g J IJt I ~;:;::.'y IIRIII --w::~~::::~-~~-~~("~o 'III. :'l;' ("HI A'_ll' __ ~i " /1\ i;J; ~ ( ..; t. ( \I) . T") rfJ I:,,,:>) -'--~ r. ~ ~ ~~ ~ ~ 'i ii e in ~ ;:01 ~ f ~~ ~ r ~c ,~: =~ ~CB . a~ ~~ ~;uS"" &;0 ~"WW~'~Y~Wn". ~.! IIlJI. j li:l: ii' b illl'I,... dilll h. Q 7' 17" r-- - ;, I~ J i ~A :J ~ I o I f ~ z :1"- ~ ~ ~ ~ '. ,~~.~ '/ ~ DJ:, Ot':, - '~~ W,;, ~ "~" ,<t';~~! :U'...6' .t" -:0 ~'" ~ , , (1 d ; : I ~ 8 _! : i ~ ~-l ';;j 8 i 1 !')"~ 11 ~;~ ~ I. r ~~;q. ~ / : n!;~ 0 ,~~'t /.II n~ tIl ~"JI! n ~d~ III 'V~~ C ~\1' '. ~;;l~ ::! \ ,,'/ ~1~li ii:: ~~! ~ A~.<';,:;0:,,';". 5V1~::j ...:.~.'t:'!i \t >ii = ".j'."'\y\\ 00 0, > zOo ." ~Q n ~ ~ ~ : J!i f ~ >! ~ g '~j II E tIl:.l ~~. n ~ ",p..,raf\,l.a.U'._ tJJ c: II t 0- 'r '-'-"'\5~"~ -'/I Ii ~~~~~o~~. ~ , ~ ~ o . ~~~bP6~g ~ Z i g 'j ~~'J~o~1d ~ f ~ iff __!.[*I."4: ):;~'~I; ~ \j! 0 ;'l ~ ~ ~ , '" .. M ~ I~eriaL Testino Labo(alorie6 3905 KIDRON ROAD · LAKELAND, FLORIDA33811 · TELEPHONE: (941) 647-28n FAX: (941) 647-1no SOIL TESTING - FIELD DENSITY - PERCENTAGE OF COMPACTION REPORT Project: Client: Job No,: Date: Permit #: 5540 6th Street Ryman Construction 6547 12/04/97 7214B Lab No.: Technician: Contractor: Weather: ID A. McGhin Client Clear Page 1 ofl 1 Building pad area; northeast 13.5 111,5 90 comer - ade level 2 Building pad area; northeast 10,2 115,7 115.8 99.9 90 comer - l' below ade 3 Building pad area; northeast 10.9 114.4 115,8 98.8 90 comer - 2' below ade 4 Building pad area; center - grade 11.7 114.4 115.8 98,8 90 level 5 Building pad area; center - l' 10.8 115.9 115,8 100 90 below ade 6 Building pad area; center - 2' 11.5 111. 7 115.8 96.5 90 below ade 7 Building pad area; southwest 10.9 113.6 115,8 98,1 90 comer - de level 8 Building pad area; southwest 9.8 115.8 115.8 100 90 comer -1' below ade The percentage of compaction for the in-place density tests are based on laboratory Moisture Density Relations Tests D698A as follows: Report Distribution: Client City of Zephyrhills File Environmental Consultants, Soil, Concrete and Materials Quality Control Testing 12/84/1997 13:48 :::1:::1:0.47: 770 mF'EF'IAL TESTIHI3 LAB PAGE 02. ~ I~eriat Testino Labo(a~rie6 3905 KIORON ROAD . LAKElAND, FLORIDA 33311 . TELEPHONE: (~1) 647-26n , , R l' f S 'I FAX: (941) 647-1 no MOIsture-DensIty e attons 0 01 Laboratory Compaction Test ASTM 0698 Method A Client: Project: Permit #: Ryman Construction 5540 6th Street 7214B Date: Project No: Lab No: 12104/97 6547 IP 116 lIS (Dry Density -Ibs./cu.ft,) 114 Max. Dry Density 115.& pef Optimum Moisture 10.6% 113 112 I 8 9 10 11 12 13 14 MOISlURE (%) Date Sampled: 12/02197 Sampled By: Looation Sampled: Building pad ar~ composite Visual Classification: Light gray sandy clay AI McOhin Report Distribution: Client City of Zephyrhills File Tested By: Checked By: Al McGhin /~ AI M - ratory Manager frooT...t.1bl Environmental Consultants, Soil, Coocreh, and Materials Quality Control Testing 12/04/1997 12:48 :::: 1::: lOA 71 77 >:1 H'lF'EF'IAL TE'::;TIiK, LAB F'AGE 03 ----..-----..-. . ~ l~crial Tcstino Labo(atoricc:, 390S KIDAON ROAD. lAKELANO. FLORIOA33811 . TELEPHONE: (941) 841-28n FAX: (941) 641-1770 SOIL TESTING - FIELD DENSITY .. PERCENTAGE OF COMPACTION REPORT Project: Client: Job No.: Date: Permit N: 5S40 6th Street Ryman Construction 6547 12/04/97 72149 Lab No.: Technician: Contractor: Weather: ID A. McOhin Client Clear P18e1of1 D2937 DAlE MADE 1 BuUdU1g pad ar~ northeast 135 111.5 115.8 96.3 90 corner . e level 2 Building pad ar~ nortbcu: 10.2 1157 115.8 99.9 90 comer - I' below e 3 Building pad area; northeast 10,9 114.4 115,8 98,8 90 comer - 2' below e 4 Buildina pad area; center - grade 11,7 114.4 11 5.8 98.8 90 level 5 Building pad ar~ ca1ter - I' 10,8 115.9 115,8 100 90 below 6 Building pad ar~ center. 2' 11,5 11 1.7 llS,8 %.5 90 below e 7 Building pad area; southwest 10.9 113,6 115.8 98,1 90 comar . &de level 8 Building pad ar~ southwest 9.8 115.8 115,8 100 90 comer -1' below e 111e percentage of compaction for the in-place density tests are based on laboratory Moisture Density Relations Tests D698A as fonows: 'l Report Distribution: Client City of Zephyrhills File -- Environmental eon.ultanta, Soli. eoner.t. and Materia.'- Quality Control TMtlng " " .; ~ R,CI :i 'i 8.VIl1a/1 Cr,111structioll l/1e. CBC :: ("3.'5134 i: ,I " " 11-11-12 ;j ZEPHYRHILLS FIRE DEPARTMENT 38410 6TH AVE ZEPHYRHILLS, FL. 33541 , , i ~ ~ . I j I ' ' 1.... ,. i ',i I ' I t ~ i i, ' ~ I , . ! !! : I 1 ,I j .' j 4 '~ i I j I ,; l AFTER REVIEW OF THE ITEMS ADDRESSED BY YOUR ~GENCY CONCE;RNI~G B ABOVE PROJECT, RYMAN CONSTRUCTION AGREES TO qOMPLETE ITEf1S #;Ii , U #5 AS REQUESTED. THIS LETTER IS TO INFORM ~OU OF OUR fN'r.SW'i TO COMPLETE THE REQUESTED ITENS DURING Tf{E CONS'rRUCTION PHASE OF.~IS PROJECT, I F YOU NEED FURTHER ASS IS'l'ANCE. PLEA~E CALL AT ot itrIFE., ) Ot I I ',i i ' I ,j I ,1' (,<:"p-~, j ,..~;0.,.~~I. *,~ . '* My CofT\O'knOon CC~3871 I . , ' ~, ,<i" f:xplr01t Mar. 3 1. ~ooo . ~ . j r 01 'C~" 1 l j '; i j I i i i; i I , !' j ! ., REF. CONSTRUCTION FOR B & B AUTO REPAIR MR. HARTWIG THANK-YOU~--\ , -_" l...,../"'''-:--' ~-+___.J '-'-'lL ), \L/-" _---- n -,-- RW.N co~tSribCTION, INC. :::7:~~;.; .c: n C..1 'I'j . 7~,"'.h'If'hili.:: r"'I.-\fi,-',=, ~'1=:'::: i F' . ():=: i' I ! j , ; i i ! I ! , , j ! i i , I I ; , , .r l j ! . i , -I j I , ! j I ! I ; i 1 ! i 1 i , j I I , i , ! i j i j I I I I I I 1 APPLICATION FOR PERMIT . E;{J CITY OF ZEPHYRHILLS / BUILDING DEPARTMENT / OWNER'S HAHK W', ll; Avv< em mo i2Ji'\.\ ; / OWNER'S ADDRESS 5 \ 3~ \...\-A.\s'bcc-J D~ 56~O-6 7/ -U- II-.)G<). ( - cclt- 6(,sco-R).!V ..-'t? 'l L/ / f7j' b6~f 10 '-d-1. ~ONE r7 ~ 2. 'i- 301 &-~ JOB ADDRESS LEGAL DESCRIPTION: LOT(S) :J,7-"2 :> -z-tr BWCK GS SUBDIVISION ~ I ~..I PARCEL 1.D.# \ I - 'Z..<C -<;:l \ -(;C.J In - 6G rD. 62/0 (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:~ew Construction _Addition --..Alteration ---.Repair _Inst~l _Sign --1fove _De.olish DESCRIPTION OF WORK: BUILDING SIZE: lto PROPOSED USE: _Single F8JIlily _KIF _, of Units ~eo..erCial _Indust. _Swill. Pool ---.Restaurant & Health Department Approval - CLu-.~ ~c~ X~c:: \ '60D Square Feet. lD r Height ---..Ji/H _Other ,. .~ RESIDENTIAL: ATTACH (2) PWT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS:'; COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. _BUILDING PERMITS REOUESTED $ 4-~J 56 e) Valuation of Total Construction 1-00 AMP Service V Florida Power Corp. ll.t" _ELECTRICAL ~W.R.E.C. _MECHABlCAL $1UfA- . I Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fr8lle ASteel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ;'j'l \~ ;'~ YES NO ~ rJ ;;2- ~'" o')!'Vl> .,!.j CONTRACTOR SECTION '1 ~.:!} BUILD~ COMPANY Q~~ ~~~ ~';./' ~~ State Cert. r Regist. '~f-03SI~4-~" Signatur - " City License Registration f ~~ - , ****************************************** ****************************************** =~- /~ COHPAIIY'-~~ ~(~ . State Cert. or Regist. # L-(Z.'-66I .' 4- -~ ",--"-;;;J, : . / City License Registration t ..It ~~ q 7 ****************************************** \. ~ COMPANY \) L~ "-.) \,~ \.-0-, \ \i Il--w-> ') jJ~~ . State Cert. or Regist.' <LF.OS2.k..:;J City License Registration' Jq ******* ********************************* . ". .Ii. l'.l ..--......., PLOOER (' .,) S ignatur';;----Utf/>1A.A )/ MECHANICAL IJ I A - COMPANY State Cert. or Regist. , City License Registration * ****************************************** \\< :0 ;'-'.. Signature ~.! '~ :'~ . 'J' , OTHER r~ COMPANY ~c.-.- ~ --cJt;~ ~ <:J ........ ~ State Cert. or Regist. , I2-C -oOCo (<0 4'b,f....,-/. Signa~' I City License Registration' ~ :L ? h'- ).H ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS !be undersigned understands that this peIlit lay be subject to "deed restrictions" which lay be lOre restrictive tban City regulations. !be undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES ..~lf the owner bas bired 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 Zephyrbills Building DepartJent, (813) :':"'788-6611. ..-FurtheIlore, 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, 'j"rjOU are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign ::.a& contractor that laf be an indication that be is not properly licensed and is not entitled to per.itting privileges in the (feity 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" p{epared by the Plorida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than 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 cODellceJent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT ..I certify that all the inforaation 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 perf oIled 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 If responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to: t DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Vater/Wastewater !reatJent t Southwest Plorida Water ManageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t AllY Corps of Engineers - Seawalls, Docks, Havigable Waterways t DepartJent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater TreatJent, Septic Tanks t US Environaental Protection Agency - Asbestos abateJent I also certify that, if fHllaterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a .cOIpensating volUle" will be subJitted which is prepared by a professional engineer registered in the State of Plorida 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 per.it prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall becOle invalid unless the work authorized by such peIlit is cOllenced within six IOnths 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, laY be allowed for the perJit with fee charge of $15.00. !be extension shall be requested in writing to the Building Official. An approved inspection lUst be logged during each six lOoth period, or the project will be considered abandoned. WARNING !O MER: YOUR PAILURE !O RECORD A HOTICE OF COMMEHCEMBNl' MAY RESULT IH YOUR PAYIHG !WICE FOR IMPROVEMmS TO YOUR PROP !O OB!AIN PIIWlCIHG, CONSULT WITH YOUR nORHE CORDING YOUR HOTICE OF HCBMM. JOBS UNDER ,500 IH VALUE 00 HOT HEED TO RECORD POST A "HOTICE OP COMMEHCEMB I o~ was j\,knowledged , IfJt..L by STATE OF FLORIDA ~___ 0. _~ COUNTY OF 0 CL- ~ The foregoing inst~ent was acjnowledged before me th.s /Vj-Ly' , 191::2 by ~ who is ersonally produced as identification and who did/~id not take an oath. o is personal produced as'identification and who did/did not take an oath. c has (Signatu (Ham~ Typed, Printed r NOTARY PUB\f,I~ ".."~-~(.-. ~~.. *.* '" ~ -4 ~~ ~~QF f~\1 BOBBIE J BUPlKI My Commission CC~S8'1 Expire.. Mar. 31. 2000 (Name Typed, Printed r S NOTARY PUBLIC ~~~~~ ~ co BOBBlE J BURKE *.* My Cornrninion CC643871 Expire.. Mar. 31. 2000 "'... .,.~ "~~ OF f~\I"~ uz:r--" ~~ I-I JIll I-IIV# RYMAN CONSTRUCTION B & B AUTO REPAIR TO BE COMPLETED BEFORE PERMITTING FIRE DEPARTMENT APPROVAL NOTICE OF COMMENCEMENT RETURN FOR REVIEW SHOULD THEY WANT AlC ENERGY FORMS SHOULD THEY WANT AlC Fire Chief Robert Hartwig Assistant Chief Jim Johnston J}/vl ^ fA, ZEPHYRHILLS FIRE DEPARTMENT Zephyrhills Florida 33540 38410 6th Avenue Bus (813) 782-8184 Fax (813) 788-3293 November 07, 1997 Ryman Construction Contractor of B & B Auto Repair Zephyrhills FI. Ref: Construction Plans for B & B Auto Repair Reference to Standard Building Code and NFP A Life Safety Codes the following items must be addressed before plans can be finalized. 1- .. Item # 1. A one hour rated fire wall will be installed if the building is 0' feet to 10' feet from the property line. . '. Item # 2, All repair garages will be continuously ventilated by a mechanical system with' , Ji,~lt\ tA..... positive means for both inlet and exhaust of at least 0.75 cfm per sq ft of floor area, /" controlled from a location close to the entrance door. ( Item # 3. A smoke wall separating the customer area from the storage and work area. r> Item # 4. Two certified fire extinguishers with a minimum rating of4A40BC. - vn\~ Item # 5. Install two electrical operated smoke detectors wired in series. ... C> \0-.. Item # 5. Install one exit sign over customer area exit door. -.VJlp a... If the Zephyrhills Fire Department can be of any assistance please feel free to call at 813- 782-8184. Captain Jimmy E. WiUiams r1 "'" "^--; C. <--t) L L ( ,~~- Zephyrhills Fire Safety Inspector B & B AUTO REPAIR RYMANS CONSTRUCTION 5540 - 6th STREET SQ. FEET PRICE MAIN OR LIVING AREA 1,350 $ 40.00 OTHER AREA UNDER ROOF - $ 15..00 OTHER 5801 $ 0.85 VALUATION $ 58,930.85 FEE SHEET $ 306.00 ADDRESS $ 20.00 DRIVEWAY $ 20.00 BUILDING: $ 439.00 ELECTRICAL: $ 58.98 PLUMBING: $ 40.00 MECHANICAL: $ - RADON: $ 13.50 CREDIT: $ 60.00 TOTAL $ 551.48 SEWER I $ WATER: $ TOTAL: $ : I 3/4" WATER METER I $ 180.00 I TI F'S: $ 1,844.69 99% $ 1,826.24 1% $ 18.45 ~-;--;~;;.17-~ IRR~N METER: $ ~. TOTAL: $ 2,756.17 I mIll 11111 11111 lml llDunl1ml nlllll~ nil Cn1221&O NOTICE OF Rcpt: 1431456 DS: 0.00 10/29/97 COHHBNCEME~ County of AsC!..-C;; Rec: IT: &.00 0.00 Dpty Clerk State of +=l, THE UNDERSIGNED hereby gives notice that improvement will be made to c2rtain real property, and in accordance with Chapter 713, Florida Statutes, the follo\\,ing inforr:1ation is provided in this Notice of Commencement: 1. Description of Property: Parcel No. / j-;J:. ~ -.:;.; - ~ (0- O,,~OO ~O 2 . (Legal description of the property and street address if available) General Description of Improvement - ~ ~~~~ fg~2~~JiM~~!~ASCO COUNTY CLERt< OR BK 3827a. 1 of 1 PG e,. 9 e,. I' W~!~;r,AM C1MORM!1 ' Owner Information: Name@ \...A..J~~ ~\.A'vvuJ~ l~ddress S\~q ti~cQ \)-12-- CitYf~4~ State \=- ' Interest in Property: (')lAS'{\.Jl.A- Name of Fee Simple Titleholder: (If other thgn owner) 3. Address City Stutc 0:-"""""""""":') ~ ~f\'."). Contractor: Name " '~.llt -. ~ i Address 171?~ ~ R RYMAN r.()N~'rRTT(,'rT()N,TN(, ~<1 WR~'T' City ZEPHYRHILLS State .ia 541 5. Surety: Nume Address C:ity ------- S tCl L: Amount of Bond: $ 6. Lender: Name Address City State 7 . Persons within the State of Florida notices or other documents may be 713.13(1) (a)(7), Florida Statutes: designated by Owner upon whcrn served as provi.ded by Section Name Address City State 8. In addition to himself, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. 9. Exp~rntion d"te ot NotIce of Commencement (the expIration date is 1 year fr?m the date of recording unless a different date is specified.) Signature of Owner: X W L.flJ,;;.. j ~. tAl:I,,':;"'" L.e;""ore/l: Sworn to and SUbs~ibed before me this ~ ct~~y of ~ ( 19 9) . .2 ~ Notary Public: ~J~.._.~_' '~ r = '. ~ BOBBIE J BURKE My Commission Expires.: . ~'_" _. *~* ~=-' ~~~, .,,.~ Of f\.O"" 1 ~ r ~~\ ~ST (g -1:,,- sf: 00- g ~rD rilq>r~c' v,~. ;.fD.OC X 1,15"0 _. ___~~F+~ · 1;'5' 'f.... ~ 'b {) I, -,:>5f.! _r-+. __, , BLDG-, : PLuwi g,. 4-0. u \) . IV\ fLti. JJ! (\ , €-LfC.. 5g" 'f8 I , : j :CAI~P\T_loO.~~ ." CoNNrLc.... TlD~ F&\i.. ~ l\l /(1 L fiLl':;.. U\T (~i^\ 0t<:inf'is fA.0liLUNG- - . ~ _. ._. .._~. -. -.-. ~_..--._- - RA lbtJ &A os 1,~S- () ~1. F--C --rR:ANS POrl- LAl(O,.J 11M pACI ftZ:12. S _ ... ____.__.._______._ : ' ! 2. \. 0 c -:-2..- -:::; { O. 5 -;.. 7?-'1 q = .. 00 I tf 3 S 5" X- 5 ~ I, 0 U'7.-- .. ----- I ;:;::- n<;: 771 >L 4-. fa"if -= 3'111. '.f{ )G. '><':> := &3"32. cf. ~ 4' ... ----- ~ - ~ .-.. -.- ._,. ..~._--~_..~_. j, 3~ ?2.<.f~ ~ t1 t2sf""ltL5Ttl71~___.__.____ .- , i t.f(30. {.; 0 Ii.Xi~II~ D~L~& _ _ '___'._ ___' _____ il etfLf. f.,q 1OTA-L -n f I ~'- ~ ..- .._--."".-~_."