HomeMy WebLinkAbout00-9388
BUILDING PERMIT
,.,....
If} 0
g E~ P~~At
Pmperty Owne' V..L Vah-4!./~-#~ a~
Job Address: -.:3 57 S /I 4 - ~-r.!! ~_.
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
09388
Date
11-/0 -00
Sewer Conn
Water Conn:
,~
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
DescriPtion of Work
Radon Gas:
FINAL
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or
Contract Price
IS; :l3. 9 '
-
Permit Fee
Inspector
C;'y Ucen.e Reg;''''';on . I~
State Certified License# oe c3 7iJ07
Com~-~-~y --1 <l.. 0 0
Address
C T~"lePho~
~
ELECT
Tp. Serv,
Rough In
Meter Can
Const, Pole
Pool
Pre-Meter
Final
..----
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM,
Insul. Cl
Wl
SlB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
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 ($ 25.001 shall be made for each trip for each trade:
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.
MAR-29-oo 12:02
FROM-
,-
fi'
~,"EJ
IDUTHLMa
CORPORATION
Purchase Order
2711 North HI.e" Avenue
De'''', nc 75204
Ffl IT I .L ~_:eo
PO BOX 1128
LAKELAND, FL 33802
Fax:941 6874274
Cu-lfOmfl, Acet NO
IV.^~~~41
or.o, OOIBIPurcnas,nD ll.pr....oIllG". ls..yorj
20-JAN-OO SMITE, C
P.~meN "o,ms
Sn.p v,.
NET 30
SES~ AVAILABLE
Fr.. gnl Ter"",
PREPAY ANP INVOICE
Daliwc( TQ
CBADWICK JR, JAMES
Hom
O.,cnp!i()t\ . Pan ~o . 5,.)(1041 NO
C_8nQt,
I!:J 1J~~t" Date.
1
00661202 20-FEB-OO
ROOF REPLACEMENT
(SHINGLE PLY!DUROLAST
o INSTALL AT: 20-FEB-OO
STORE 0016533
38544 5~H AVE.
ZEPBYRBILLS, FL 335404331
United States
F=wm.!.neG In .tCerO"l!C. wHn In' Te,..,,, a"o COttc:!of,Ot'I.. II:. c.grQGG ...~n ,n pro..,o..,J:ly :'0"04 COf"lG"4Cr or octacne1J
nertlo MOwever. Ir In.s Ora" 19 'or M8(8t:a.I C(ht~(8Q 0)' & CCl~tr'(:r e.,rre1"ll1)' 11'1 6Hoct b~lMIn yOl.i ma Tho
Suuf/'ll61'V'l COrl"1.Qf61lCr"I rOr the rnator,lt/i oe~cr,QDa In (MI" OrQDr rnn T~rrn!!: ,)nn Cnnalllon" of rMII( C~tr.{( Aeal
Please contact CYNTHIA SMI~B at 214-828-5534 with
any questions.
T-737 POllOI F-BSo
-..,
~ P"rcnoo. ~ NO
r 0....10" rp-aQi
83493
ThIS PuRCMIISE ORDER NUMBER MUST APPEAR (Jill All 'NyOIC~~ PAC><'NC li S
CARTONS ANO CCIlFlESPONOf:NCE R€\....TEO TO ThiS CADEll
SHIPTO 0016533
38544 5TH AVE.
I ZEPBYRBILLS
FL 335404331
United States 08137829279
DELIVER DATE 20-FEB-00
81LL TO The Southland Corpo.ation
Attn: Corp. Cqnstruction
P.O. Box 711
Dallas, TX 75221-0711
United States
R....o. O."'IP..-cnsslng Ropre<enl..... \o",or)
FO 6
ORIGIN
Canhrm Tonal NO
(941) 6823363
Urhl
Un.~ Pr,c;ClI
E..cran"ao Am~a,lnl
T..
1. OC EAC!
15239.42
15,239.42 t;
1 . 0 (] EAeE
1\
Total
15.239_42
? .- C\O\L\'-l F
~v~
"
APPLiCATiON FOR PERMiT
CITY or ZEPHYRHILLS
BUiLDiNG DEPARTMENT
DATE RECEiVED /1- itJ-u()
PLANS REVIEW I'EE
OWNER'S NAME
~~--tfJ~ ~/2.
S&7 6-/(~ - 6- <ELI' t?4~
PHONE
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
WORK PROPSED: [JNEW CONSTRUCTION
[J SIGN
(OBTAIN FROM PROPERTY TAX NOTICE)
[J ADDITION
[JALTERATION
[J REPAIR
[J INSTALL
[J MOVE
[J DEMOLISH
PROPOSED USE: [JSGL FAMILY DWELLING
[J COMMERCIAL
[JMULTI-FAMILY
[J INDUSTRIAL
[J# OF UNITS
[J SWIMMING POOL
[J MOBILE HOME
[J OTHER
CJ
HEIGHT
DESCRIPTION OF WORK
BUILDING SIZE
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 REQUESTED
[J BUILDING
$ /5::<:3 9.
VALUATION OF TOTAL CONSTRUCTION
[J ELECTRICAL
[J PLUMBING
[J MECHANICAL
AMP SERVICE
[J FLORIDA POWER
[J W.R.E.C.
$
VALUATION OF MECHANCIAL INSTALLATION
[J GAS
[J ROOFING
D SPECIALTY
[J OTHER
TYPE OF CONSTRUCTION: D BLOCK
D FRAME
D STEEL
D OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES
[J NO
BUILDER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
******************************************************************
ELECTRICIAN
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
******************************************************************
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
MECHANICAL
***********~******************************************************
COMPANY:
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
SIGNATURE
**************************************~*********************
COMP~---,.(
STATE CERT OR R
CITY PROCESSING
OTHER
****************
********************************************
CONDITIONS OF PERMIT AFFI9AVIT
A. NOTICE OF DEED RESTRICTIONS
Tne undersigned understands that this permit may be
may be more restrictive than City regulations. The
compliance with any applicable deed restrictions.
B. 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
City of Zephyrhills Building Department, 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 signs 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 may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION 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 - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the ~owner", I cerify 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.
E. 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, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~A" or ~A,etc.", it is
understood that a drainage plan addressing a ~compensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
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 code. Every permit
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month 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".
-
subject to ~deed restrictions" which
und,::!rsigned assumes responsibility for
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
19_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____ day of
by
acknowledged
19
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
[1ho is personally known to me, or
Owho has produced
(type
and whoO did Odid not
of identification)
take an oath.
o who has produced
(type of identification)
and who Odid [)::iid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
~
..JHr'l-':::J.-' ~.na rru J.;:J;;:Jl !U:
It:.L NU:
1:*291 P03
. FLA;.Jm lAWI
P.7I1ot1
. oo' L
, I.."...... 1M -",,"I.ATII.
Stete 01 "orlde }
County 0' \
Th. undanlgned hereby Informs ell aonnmed thet Improvemenu will b. mede to certeln ,.e' property, and In accordance
with .actlon 713.13 of the 'Iorlde Scetu18s.!he 'ollowlng Informetlon I. .uted In th~ NOTICE OF COMMENCEMENT.
Oe.arlp,lon o'property '" .3.8'5.'-;l.~... .5~. .A:v~ ..... ).Z..Q...\tlr.l1b\\\~.) .Fk.... .3~~~.Q.:.7l.~_~,I,.. ,...
NOTICE OF COMMENCEMENT
IIMINaLl ,aAM 408
.. ,.....11........................ .......................... ................... t......,...,.. .,. II ..4............... ........... 0......
....................."....,............. ........ .1.. ........................... ......... .1.................41..... t II" ............
ganer.1 d..crlptlon of lmprovemenu do..l D.~.l.l. .bu..r:o::. Lo..~+ _ Ro:>A 0.9. :S.y~m. . .'. ,. . .. . . , . .
Owner. .':J.:-.ELa.vQ..h. ,~,Y1.L. ......,...................,...."._.,., ,_ _, _._"'............................".., _".,....
Addr... .J;;:OO.. .l.Q..Q..... Road... .~. .Q\.\Qoda",.. F.L~,........ :3b8 .1.0.........".. _'" _...,
Owne,'.ln,e,..t In .It. of thelmp,ovement .. c.cy\V U)~.Q..Y.).<!JL.. ~ r~.................... . . ... _, _ .. . _.. . .,
F.e Slmpl. nile hold.r IIf ather than owner)
Nem. .............;......,...."",...._,.,....."",._,,___'__,._"',.....,....................,.........,..".,_.....,.....,.
Addr... .......,..,.,'.......... ~ . .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . , . . , . , _ , _ . , _ , . . , _ , , , , _ , , . . ' . . . . , . . . . . . . . . . . . . , . . , , . . . . .
R.. ........, ...... .D~.fu. i{\. <;:"~J:"" ~.~q.\. !>.~. j....... .:.................. ............... .................
ddr... .....}?r;:..I~.~.l....I.~.~.~.. .....4A.K.~~~'f\.AL.d,...~+.(t...~ .$.9;9.:0...,. '" ...... ........ ... ..,...,.
Surety (jf Iny) .................. '. . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . , , . . . . . , . . , . " _ , , , , . _ _ _ , . _ . , . . , . , . , , , , , , , . . ,
Addr... .............,.. - . , - , , , . . . , , , , . . , . . . - - , - . , . _ . . , , _ , _ , , _ . , , , , . _ , , , . _ , , . ; , , . , . . , . . . . . . , , ,Amount of bond S . . . _ . , . . . . . . . . .
Any P....o'" making'. loen far the construction of the improvements:
Name .,...,.,'_...,................."..............................".,.".,.,...".."..,."".,............................."
Addr... .,.. _ , . . . . . '.' . . . . . . . . . . . . . , . . . . . . . . . . . , . . . . . . . . . . . . . . . . , . . , , . _ , , , . _ , , , . , . . , , , . . . , . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . .
P.rson within the State of Florida d..'gneted by owner upon whom notic.. or other dOGument. mey be .erved:
Nem. ...."...,__'_',......................,..".....,.....,...............,......,...,.......,............,........'....... ".
Add,... ".....,....,..., _ . . , _ . . _ . _ . . . , . . _ _ . . . . . . , , . . . , . , . . , , , , , . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . .
In addlcion to himself. awner de.lgnates che following person to receive 8 GOPY of the Lienor', Nottce .. provided In Section
713.13 (1) Ih). Florida StatuI... IFill In et Owne,', optlonl. . '. .'
N.me _,. ..,.. ..,_, .__. _.,. """"'~."_'_"_"", .".....,.. .,... ..... ..."...,. ,_... ._. ,_,_,.,. .., _'_'" '___. ._. ._"...,.....
Add.... ';;,~~~~~~;~~'~~~~~~~~.~'~~~~~:;,."""""" ................ ~.~~...... ~. . ,.. .............................
...~,.~",....................,',..,.....,...
1111111111111111111111111111111111I1111111111111111111111111 . · e<.. ::.:.... .. .. '.'~""
2000038531 Sworn to and subSCribed before me this..... _\: -~:.."S\' .1"... _.,. _.,..
............~,. .:..~;;LIN /..~L""
Rcpt: 402091 Rec: 10.50 f FrL,., '^ rv ~ ~', .:,;\";:... 17. .. "',~. l[ ~ ..,
OS, 000 IT: 000 ........................d.yo ,......~\~...,...,(,....r:~.~...'.<.I:.........-...e.O.........
. '. : I..: <... ,5?;;:, .,.. ...: :
03/29/00 __~__ Dpty Clerk "......,...", J~:d..~?:-:-.~.-~. :".. ]..)$...",..,
JED PITTMAN. PASCO COUNTY CLERK NDt~'.P.U~"r;f, if.:...-?:....."" ~
03/29/00 11 : 49am 1 of 2 ~ >-:,.~.: -':' ,- .. .S.....~
OR. BK 4337 PG 1051 ", fJ1.:. . ",.:\.\'(.........
'" VI1L/C . ':. \ ,,"
,"'" II """'
OR BI< 4337 PG 1052
2 of 2
~AN-21-'00 FRI 15:50 ID:
I
TEL NO:
COND%'I'%ONs or PZRM%l" ArrXDA,\"
~.' B~%e2 or D&&I> 1Ull82;'RXl :lBS
The ~nder.~gn_d uad.~scan._ ~h.e eh~. po~t may b. .ubjea~ ~o ~de.d reser~ce1obS-'~~ch
..y be more re.tr~a~~.. than c~ey regu1Qt1one. 'l'h. Uftd.~a~gn.d a..u... reapona~b111ey for
ca-O~~.nce v~eb any app1~a.b~. deed ~e.tz~ct~ona.
B. UHLXCBHSBD CQN'I'~CTORs ~p CONTRAcToR RESPON8Z8X~ZT~29
%E the DND.. h.. h~red - contr.c~or O~ aont~aotoz. eo underea~e VQrkr they ..y b. ~.qu~~ed
to b. 1~~n~~ ~D .oe.~.nc. v~t~ .t.~o and 1oc~1 ~.~1at~oA.. ~~ the cODe~actOr ~e not
1~o.n.ed .. requ~r.d b~ 1aw, baeh the owner ~nd contractor m.y b. a~ted ~D~ a ~.dem.anor
vLo1aelon under .eae. 1aw. Z~ the owne~ oc ~ntended cOntractor .re uncertain as to what
lLaeft.lng requ1remente may apply Eo~ tha ~n~ended work, they .re adv1sed to con~aat the
c~ty o~ Zephyrh111s BU11d~n9 D-p.~tmen~, 813-788-6611.
Furthe~r.. 1f the owner h.. hL~.d a aont~aator or contractor.. he ~. adv1.ed to have the
aontraococ(a) .1gn port1oae o~ the ~Cont~aotor 'Section.- of th~s .pp1lcat1on for .h~ch they
w~11 be e..ponS1b1e. X~ you, .. the own.~ aLgns .. the contracter, you .~e ~n~cat1ng that
you, eathez than t~e contractor, .~. ~e.pon.ib1e ~oc the work. l~ ~he contr.ctor wiahe.
~ou to .~9n as contr.eto~ that may b. .n Lnd~cat~gn that he 18 noe prope~~y 1~cen.ed and i.
no~ .nt~~1.d CO p.~ttin9 pXiv11ege. in ~h. C~ty o~ zephy~~~~..
C. TRU.PORTAT%OJf DlPACT RES IUfD U'l'XLZTY COlflfEel"%OIf FEE.
D. COHSTRUC'TU%OIl' L%EIf LAW (CHAPTER 713. FLORIDA S'I'ATU'l'EllIr All AMIDIDII:D)
z cext~~y that' X. the app1~oaDt, have b.en p~v1~a~ w1th a copy o~ -rlo~~da'a Conatruct1on
~~cn Law - Homeowne~'. .~oteat1an Gu~de- prepared by tbe ~~or1da Departmen~ o~ A9ric~1~ur_
and Consumer ~f.1re. %~ th. app~~a.nt ~. someone other thae tbe ~oWfter-r X cerify that %
ba.. obta~n.d . copy or the above do_c~~bed ~oaument and prami.. 1n good ~aitb to ~.1iv.r
~t to the ~own.z- prio~ to commencement.
E. CONTRACTOR' ./OWHERr II ArFJ:DAV;J:T
Z cortiry that a1~ ~~e in~oEmat1on 1n th~. app11cation ~. .ccur.e. andth.~ .11 work w111
bo done in oomp1~.nae with all app11cab1e 1aws r.qu1at~ng conatruction, zoninv, and land
devo~o~nt. '
App1icat1on i. hereby ~d. to obta1n a p.~t to do work and ineta11at1on a. ~nd1c.ted. %
Cert1ry tbat no work or in~~.llat~on haa commenced pr10r ta i..u~nee or a per.mit and that
811 work Wi11 be perro~ to maat standard. Df .11 law. z09ulating can.truct~on, City
aodes, .on~ng r.9u1at~on.. and 1and devel~nt re9u1.t~on. ~n the jur1sdict1on. z a1.D
aart~ry that' X underst.nd that the requ1at~on. D~ oth~~ governmental agenc~o. may .~~1Y to
the Ln~.nded wo~k, and that 1t ~. my re.pon.ibi1~ty to ~deb~~Ey wh.~ aat~ona % ~.t take to
be in comp1Lanc.. Suoh a~enc~e. 1nc1ude ~ue ~re not l1m1ted to: ~D.p.r~m.ft~ oE
~nv~ronment_l Regu1.~1oD-Cyp~e.. BaYheads, ..t1and A~e~. an~ 8n~ronmenta11y Sens1tive
L~n~8, .ate~/W......te~ Treatment
.souchw..t r1or~da W.~.~ Xanagement Di.t~ict-We11., Cypre.. sayhe.ds, w.tl.n~ Ar....
A1t.rin9 ..~ercourse.
*A~y Corp. a~ Bn9~ne.r.-Seaw.11., Dock., HavLgab1e Water..y.
*ceparemen~ of Hea1th . R.bab111tat~ve Serv~ae.r Env~~onment.1 -.a1th Vn~t-.e11.,
.a.tewa~er Treatment, Septic Tanka
.V.8. Environmental Protect1on Agency-Aabesto. ab.t~nt
~ ~~.o aert~~y that. ~f f111 materia1 ~. to be used 1n F100d Zone -~ o~ -A,@ta.-, ~t i.
und.~.tood ~h.t . dra~nage p~an .ddr...~ng a ~eo~en.Q~in9 vo~ume- w111 be submitted wh1cb
i5 prepared by a prof...iona1 en~~n..r reg1st.red 1n the Stato of F10rida prior to perndt
J.88uance.
A pOr.M1t i.sued .b.11 be ~onstru.d to be a ~ioen.e to proce.d w1th the work and not ~a
authority ~o v101ate, cance1, ~lt.~r o~ .et aa~de Bny P~ov~.~ons or the techn1e.1 code..
nor eha11 1..uanc. or ~ pe~~ prevent the Bu~1~ng oEE~c~~1 E~~ th.~ea~t.~ ~.qu~~~Dg a
aoeeeeelon of errors in p1anG, construct1on, or v101ationa o~ any code. Bve~y p.~~
~.sued .h.~~ become 1nva11d un1e.. the work Quthor1zed by such pe~t ~. commenced w~th1n
.~~ months o~ ~.au.nce,' or 1f work aUthor1zed. bV the pe~t ~~ auspended or abandoned ~Dr Q
per10d of 81x month. .Et.~ ~he ~~me the wack ~. oammeneed. One 90 day exteneion of ~ime
may be ~11owed for the perndt _i~h E.. Ch~r~~ o~ '15.00. The extension sha11 be reque.ted
~n wr~tinq eo the Bui1~n9 OffJ.ci.1. An approved ~n.ped~~on must be 10 ged du~~ng ..ah eLx
month per1od, or ehe pro~.et w11l be con.~dered abandoned.
WARNXNG TO OWlfI!:.R: YOUR FA:I:LVRJ!: TO RECORD A NOTXCB 01' CONMDIC
PAY%HG nrXCE J:MP 1;1 "1"0 YOUR PROPJ5RTY. IF YOU XNT
"%'I'H YOUR LBH AN ToIUU:y BE~RJ!l RJ!lCORDXlITG YOUR NOTX
~2,500 ZN N NEED TO RECORD ANn POST A ~NOTZCE
y QSULT ~N YOUR
N F%RalfC%NG, CONSULT
CBMJDI"I' . JOBS UHDI!lR
JQIBN'T- .
1:i291 P02
1
1dent1~1c.t1onJ
e.n oa'th
nature o~ p xaon t.k1D~.akDow1edgment
, --- rO';:I~..'-"~~~;~:-::.~"-. --. . -~".
~ \..I V i, ,.-,... I ,.. 'I' i
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