HomeMy WebLinkAbout03-2105
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
2105
Permit Number: 2105 Issued: 5/28/2003
Permit Type: GENERAL BUILDING PERMIT
Class of Work: ALUMINUM PACKAGE
Proposed Use: MOBILE HOME SUBDIVISION
Sq. Feet: Est. Value:
Cost: 15,044.99 Total Fees: 200.00
Amount Paid: 200.00 Date Paid: 5/28/2003
Address: 37753 NEW HORIZONS
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: GRAND HORIZONS
Parcel Number:
Name: B & H CONSTRUCTION OF CENTRAL FL.
Addr: 11494 SEDATE ST.
BROOKSVILLE, FL. 34614
Phone: (813)782-1064 Lic: Phone:
Work Desc: SCREEN ROOM,SHED AND CARPORT
GRAND HORIZON M.H.P
37753 NEW HORIZONS
ZEPHYRHILLS, FL. 33542
(I ~J /03 ,pl'!
1/). ,{So
I ROUG L ALLE
PRE-SLAB ! CONSTRUCTION POLE : 2ND ROUGH PLUMB DUCTS INSULATED
LINTEL PRE-METER . WATER FINAL MECHANICAL
FRAME MISC I SEWER MISC
INSULATION WALL MISC MISC. MISC.
INSULATION CEILING MISC, .I MISC, i MISC.
DRIVEWAY MISC, . .. MISC, I FIRE DEPT, FINAL
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty-Five Dollars ($35.00) 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
'''Warning to owner: Your failure to record a notice of com'mencement may result in your paying twice for-
i improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
~ be!ore .~ecorct.ing your notice of commencement. ".~~ . , .
NO OCCUPANCY BEFORE C.O.
:;- --- ------ ~.. -
. tkN~C~NAT(jRE-- PERM~
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
:BUILDING DEPARTMENT '5335 8th 8'rRBlBl'f ZBJPHYRHII,I,S, P'i. 33540
Phone. 813 ~ 7 80 - 0,020 fax 1813 -7 80..0 0 ~;ATBI RIll<1Bl!VSlD -..!i:_tt:...~___?
PI,ANS RIllVIEW rIBl_,-,~:...."__,[!._._._,
ONNElR I 8 HAHFJ..{Y;f2AjY/!..__!dfJR.:J C.E;V .!!J~H___..e~__________ __no ______ PHONE! CON'1'Af~'L2f..?_T.__l"':'~~~ ~___
,TOB BITE! AtJIJRIlJSS _~3.:_7_1s 3--.-lV..f~_Ho..I!-Jl'f}(IlS.__'-OI.._ ~'!l~, $' I _________________.___..._.., ~_.,..
IJEl<1AL ])BlSmn PTION I LOT (a) BIDCK SUBDIVI8 ION C;:fzA.-tvIZ........l:/Qf?Le.fJ6!._l!l-1-1 ?
PARCEl. It! # _"~P(- 2t:;' ~-?-..L:.Q9J.Q~ O-u!~9 - DO 5:'/ - 5' L ._~~~TA-~~__~.ROM .!~~PIlJ~~.~_..'l~!__.~O~~_(lllJ_~__
NORK PROPBEIJ I rY1fEN c'ONS'rRl1CTION ~H'rrmT OALTElRATION [J RBIPAIR [J INSTAllI,
[]aWN
PROI,lOSEI1 USE I [~J F1\MrLY DWElLI1IHG
o MOVE
o DElMOI.ISII
[J~1Ut,'l'I - FAHU,Y
[] # OF UN ITS
[JSWU1MING POUL
(] MOB u'El ltor~1lI
AL..v/11/A/d 4'1..
(B'Ot(fBlR
[J Cot~MB1R(! IA r I
o INDlJS'l'RIJU,
11BJBCRIP'l'ION OF 110RK
o R~8TAtJRAN'r & HB1Al'~T~'"ENT APPR~
!'!x 1S-1f!;e/<I~~rLlI_L'txl'L O~I1JY"""L________...~_
'-....---,---- SQUARE FOOTAGE _._7~t{,-:i~~ HELIGH'r h.__.____.______
BtJILfJIN(] SIZE
RES IDBlNTIAT, I
(~OMMIllR(!IJ\Tll
J\'I"rACH (2) PI,OT PIJAllS & (2) SElT8 OF BlJILlJING PI,ANS & (1) 8El'l' BlNElRm~ FORMS,
A'r'1;1\(!!i (.J) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,
PROPBlRTY SURVEY RElQUIRElD FOR ALL NEW CONSTRUCTION,
FERMITS REQUESTED
r01II LIHNC3
I~LIlJCTRlCJAI,
$ --L5i3.H. q 1 .
VAL.tJATJON OF 'roTAL CONS'rRlJCTION
------~_---.;.. AMP SElRVICEI
[] FLORIDA POWER
[]
W, R. E, n, wl/Zf- s:t+fO
[J pwr1e ING
U I1EUHANWATJ
$ -----~
VALUATION OF MECHANt!IAr, UISTAI,I,ATTON
[] (JAS
[J ROOFING
[] SPEJCJtAUry
o O'l'HER
'1"{Pl3l OF CON8TRUC!TIDN I [J BLOCK
o FRAl1El
[J STEEIJ
[] OTHElR
FINIBHElfJ Ff,OOR B1IJEV1'>TIONS
--------
IS PR(XTECT IN noon ZONE! AREA. [] YllJs D Ho
BunnBlR
8lGNATUREl __,__~ ,.--11~---~__,___
COMP AN Y -11t!i..(t?f.YS r(2vG Ll~_.ot::._c;;.!fC::!f!?!fc..E~_' ._
STA'I'B1 CElRT OR RElGI81' # f,,:B~Q2,2..2__'f~___,_,_~_.__.
CITY PROCESSING U~._...______,_.________._______.__.__
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EUIOTRICIAN
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COf-1PANY _.fkJ:-: --ifLf...~~(!;__._..__."._ __.,__
STATE CERT OR REGIST #
.-----.--.------ ...---_._--~-_._---_.,-...... --
CITY PROCE8SINl~ ~_J{'.1.._...___.___.. _____,___
BH31lATURE ..__....
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STATE CER'!' OR REGIST # _________,.._._____,__.
CITY PROCESSING #
8 WNA'l'tlREl
MIIlCHANICAl, coIVJPANY______________ .. .__...__,__...__._..,__
STATE ('HlRT OR REGIS'r # ---..--....n-____._____.___..____n_
srCUIA1'tJREI CITY PROCElSSING #
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OTltBlR
S,WNA'l'URE
(~Or.1PANY
STJ\TE ClllRT OR REGIST #----~._...__..___n'.___... ..-
CITY PROCESSING # -----.---.----.--__._'n.'____,
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CONDITIONS OF PER1'1l'f AFFIDAVIT
A. NO~ICE OF DEED RESTRICTIONS
The undersigned understands thqt lhi:;! permit may be subject to "deed restrictions" which
ffidY be more restrictive than City regulations. The undersigned assumes responsibility for
oompliance with any applicable deed re::ltriction::l.
B. UNI,ICENSED JCON'I1RAC'l'ORS AND CONTRACTOR RESPONSIBIl,I'I'IES
If the owner lias 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 contraotor may be oited for a miademeallor
violation under state laH. If the owner or intended contractor are uncertai,n as to \olhat
licensing requirements lfiay apply for the intended work, they are advised to contapt the
City of Zephyrhills Building Department, 813-768-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contraator(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, YQ4 are indioating that
you, rather than the contractor, are :responsible for the work. If the contractol: wishes
you to sign as contractor that may be an indication that he is not properly licensed arId is
not entitled to permitting privil~ges in the City of Zephyrhills.
C. 'I'RANI3I?OR'I'ATION IMPACT IfEES AND U~ILITY CONNECTION !fEES
D. CONBTRUC'rUION LIEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
J 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 applic1:lnt 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
jt to the "owner" prior to corrunencement.
E. CON'rRAC'rOR' S/OWNER' S AFFIDAVI'r
I certify that all the information in this application is accurate and that all work will
be done in compliance with all applicable laws regulaUng constnlction, zoning, and land
devl?lopment. .
Applioation is hereby made to obtain a permit to do work and installation as indi.oated. I
ce~tify that no vlOrk or installation has commenced prior to issuance of it permit and that
all work Hill be performed to meet standards of all laws regulating construation, City
codes, zoning regulations, and land development regulations in the jurisdictjon. I also
certify that I understand that thl? regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I muat take to
be in compliance. Such agencies include but are not limited tal *Departmant of
Environmental RegulatiQn-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Witter/Wastewater Treatment
*Southwelit Ii'l,odda Water Management District-Wells, Cypress Bayheadsr Wetland Areas,
Altering Watercourses
.Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Departn~nt of Health & Rehabilitative Services, Environmental Bealtll 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 Ii'lood Zone ~A" or "A, eta.", it is
undeJ:.stood that a dralnage plan addressing a "compensating volume"'will be submitted which
is prepared by a professional engineer registered in the State of !florida pdoI' to permit
lssuance.
A permit issued shall be construed to be a license to proceed Hith the work and not as
authority to violate, cancel, alte!:., or set aside any provisions of the technioal codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
cor~eotion of errors in plans, con~truatioqr or vio~~tions of any gada. Svery p.,roit
iSliued ahall become invalid unleas thlil work authori:z;ea by !Such permit' ia oommltnoedwithin
slK'months of issuance, or if work authorized by the permit is suspended or abandoq,d for a
period of eix months after the time the work is corrunenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be reques~ed
in writing to the Building Official. An approved inspection must be logged during each elx
lfionth period, or the project Hill be conaidered abandoned.
WARNING TO OWNER, YOUR FAILURE TO RECORD A NO'rICE OF COMMENCEMENT MAY REBU!}!' IN 'fOUR
PAYING TWICE FOR IMI?ROVEMEN'l'S TO YOUR PROPERTY. IF 'fOU INTEND TO OB~AIN FINANG1N'l' .c'JNtUL'I'
WITH YOUR LENDER OR AN A'r'rORNEY 8EH'ORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOaS UNDER
~2,500 IN VALUE DO NOT Nl!lED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
)4 ll~
SIGNA'l'\~ OWNl!lR OR AGENT
S'rA'l'lll O!f H'LORIDA PA5 '
COUNTY OF C 6
The foregoing Jnstrument was acknowledged
Before me this _j_ day of ARZtL , ~ '3
by' tA<EG. Becl?E
(name of person ackno"l~dged)
~o is personally known to me, or
STATE OF FLORIDA VA S(
COUNTY OF ~o
The foregoino tns1rll~ent wS\~aoknowl edge<i
Before me this ay of' elL , .,uv.>
by {;jJC'& f3F:;:;/I~ . __
~~(name of peraon acknowledged)
~o is personally known to me, or
o who ha!:! produced
(type
and who[] did ~ not
_~ fA, ChJJ~
Signature of person taking acknowledgement
Owho has produced ,
Ltype of identifioation)
and vJho Ddid B11d not t,ake an oath
~A,~
Signature of person taking acknowledgment
of identification)
take an oath.
_._-B!2-Lf~_ll. f+ 5B E L
Name typed, printed or stamped
~..".., ii\. Bruce A Asbel
,~ .: MyCommissionDD116710
0, ,.:.!' Expires June 22, 2006
Name
13 Rver::: {J. A 5fJtE L-
typed, printed or titamped
""" ~~ Bruce A Asbel
!~ .: My Commission D0116710
~ 0,"'',/ Expires June 22. 2006
IS 5- [4 (~T
;7753 rJt2t,J tleru2-~)
ff1-UUCNVM. ~
SQ. FT.
PRICE
Main
Other Area
Under Roof
V 3luauon:
/5";0# .c;tl
Building: /05'. ~":;)
EleCtric: '35- ~::;,
:~:;:)J tr
Radon:
--lo~ Y.)-l-
11 u:>
'ZOO,
=01 Impact fJ h
C, onnecrion .. {(LL
~ees: /~ (t/.(
~=- fmrrdct rJ 4
B&H CONSTRUCTION OF CENTRAL FL. INe
402S MORRIS BRIDGE ROAD
FREE ESTIMATES ZEPHYRHrLLS, FL. 33543 J .800.224./206
Lioen.s · Bonded · IftMhlS. Skinin.. s"., · 1toClIII Add~ · AI\Dft.inwn · Concrd~
LOl .5O-S-1 Subdivision 37s'S3NL~........Mr~/rCrA.lr 13ivl:lt:tblt""ef ~I ZOAI.J Oate J -..11 ~.3
Lap 10 ~ 6' dh1~ GLASS R.OOM WALLS
Pan Color WaUJ.. + ... ... · lJF:l 4~,16
Trim Color , R ".. JDiij;'e.s -;- ... Sq ~ i. 86
a.am Color tep SJdIna . , *-LVf x 6.2. I ~IJ(), ~
All alumirt\U\1 roo6 inc.lude: PIau. Trim. ~. [)oiltn. Hanel biJinl-"~- ~'.I1....LF x 17./6 ~/H) 1/
spouu )Jl;J PosII. ~~~ ScuI, .nd $h~ Fl.",. .. a.w.., _'lA: "10.0' 1MlI.o. ~
1'1 PIAs.J.J:ft ~S4 P\ x' 3.01- 3.53 0IrIp Doaf _x_liAx_
~~~ OInpDoorH.Mw- ~_EA x_
1.1:-Pvat..H_,t l--', ~Slt PI:II( 3.01- 3.~3 .., -.. - Ouqe~Op.ter -"';"EA 1;_
_hM_Pll.oDI...-.Sq JIl x 3.01.3.53 MiM: ., oq AI
~""_ft l..<la&...-Sli 1ft x 3.0'. '''' ALUMINUM TOT~L
VaIuac:o-- - .~JAx ..O~
Ouncr ClD Homo. - .iSll-UF x .U' 14'!Ji;. . . CONCRETE AND BRICK WORK
Oable s.m WClI'k OCI'twIt J..oM. IJ 1.56 IJJ/,j it Patio Slab-- .d,....fl.. -1lt. Sq Fl K 216 ..,,, ..0
2)(4 SM Bam~ ...!..- Uf z !..so /.,,,,~ hUo sr.o-.4...~ · ...1tA..Scl Fl II 2.16 ~~ I~
h6 SM I... . . . '_16. ..U No S~ Lx -.t.!LSq Ft x 2,16 .." ,7"t
2x 7 SM 8elIa ~x S,IS [~.31. 'J~ picfq Slat!-- ..L...ll..tt... - ~Sq Ft x 216 3lrl , ~ (;
2x' SM '-rt _JAll 6." Side WaJk-- Lx.1!L-11L.Sq F\ x 2,16 t' ,,,,~ ,..
1x9 SM BIR1---.- _!IF x 7..... t)rIWWI',Y LLx1L- .~Sq Fl Jl; 2.16 ~ ~?I' 9 2
2:1 10 SM Bellm _LIF It 10.17 Dri""'Y P1.ir L~.IL.." ~Sq FI .It J.j'f 'C ~?1.
SCREEN R.ooM WALLS RaiMd UdUt,)"-- _I 1f2" -L- 4" I; )2040 _'J2,VC
Lap t:.P J!L + IL+ _ + _ -.J.LVf ll3'.31 1JI,~, 9" biNd Patio 'C. LxL .. -v....Sq F't lC 1.02 .,-~ L,."
Sc:recn l)oQr ,I.aeludol: J.aiJed hde 6 C.. _ll_. _Sq Pr l( 8,0'2
CklIer and ThreIhoJd---_UP x 1.5,10 15/~ Ovw f ,.. ft ,..- ""'''.L. · H....Vf )( 2,13 m.1 .,~
G.ble....i11 cae S~-,_Uf x 1',1) ,- bl)~wd--~UF ); 3,78 ,,_e "
Insu1.led JOck: 1-111. _UP J[ 1.30 rOOt4f J~12ltM~-.. LH II S,61 i'if. l,...
'VI s.m (nol wiRd}-- _EA J[ .n.20 ,r?..3J1 Focar SkiJtfna---- .tLLlFx 2,70 ;:! ~,' .,;'
UTILITY ROOM WALLS J rr.d $twp _!A lit 61,90
W.lJs~.8- +~+ ""- -..:L1.....1A x 30." /S"If/", 2 TIW4 Ie. ----LEA ll. 137.&0 .I~?,,~~
.zx4 Scuds 16'" OC 3 1"re.d St..., --LEA x 206 7 I J/ IJ.. Y,l
Shed [)cao aftd I W'lftdow-- -L-UFxl37.2. .I'.~~ 6- 4x4 Seocp _f,A x 219.71
SinJ.le Windo\lr CEXh)-- -L-,EA x SUI _h' Bri* Stii1In, ~ S High
ByC Shield- ....:1..-UF x 4.56 tn;i C 0... , ,. a,. ........_lJf x 1.90
Mi8c: Split'lrick AJ1 Stadc-- UF. 9,SO
vn-rYL R.OOM WALLS Split Bride Sofi6-~ICJIF x 10,69 ,,~...A L.,
Virtyl W.U_+_+_+_-_UFIA'_16 Over 5,. fl per ~JZJ/f J: 2.13 /'2.1, </1
wide Kick Plar.e> --- ---JJF x 5.29 FIJI DUt- , .......LJ.OIdsx 100,00 ~~Oj
L.ep Top wide IIId 0IIl- -JA x 1).13 ~......_----_... 10<1,00 ,-- ..-.
fJorida (i_A - _VF 7. 9.15 Miac:
Insulate Top md B<<tCD-- _In x 4_~ ~~~~ 2.29'>; t3:
Doors inc:kIde (2) 2 Tndc \JGits ~,.. oD "'--J
Threlbokl U\CS C1cIMr _EAx 131.56
e..t.H will aGe be Alf,pClGliWe tar mlelb FAXTO 715.6515 ~~T .is''2) .ao
in VlNYL ROOMS X
POll ENOlNBBJUNO Tor AI.. !/s-cq&(. "
All .........4IIIIlIIlIp ud _llINb... fWlr 'III'" _,..,. A PIM~ ~OB of t,~~ -... ...u.. ...-m
.. .., II..... __ ia.,.."., ~ PIJlCINT 11.01 IATI of 1l1' .... ~', .. i'~ ..,.lIcl,
lOd ,
~
W~~'g ~-I~-~
LEONARD G. "GEOFF" WOOD. P.E.
4034 THE FENW A Y
MULBERRY, FLORIDA 33860
(863) 646-5517
Date: 4-1-03
B & H Construction
Zephyrhills, Florida
Re: 2003 Jacobsen
Address 37753 New Horizons
Zephyrhills, FL 33540
Mod# CL 7561
Lot # 50 - 51
Dear Sirs,
This letter is to certifY that I have reviewed the above referenced project to
determine the structural adequacy of the existing structure to receive the attached
structure. The proposed structure is roughly a 14x29 Carport, a 14xlS
Screen Room, and a l1x13 Shed.
The existing mobile home, to be considered an adequate host structure, should
be blocked and anchored in accordance with the manu&cturers suggested and
permitted set-up permit.
Therefore, it is my opinion that the marriage of the proposed structure with the
addition will not compromise the structural integrity of the host structure, if the
addition is constructed as per the attached aluminum engineered drawings.
As always, should you have any questions, please feel free to call me at any time.
t;;f/t~
4034 The Fenway
Mulberry, Florida 33860
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WORKSHALLCv,\L'i.. Y WITH ALL ~ :y )
PREY AlLING CODES. FLORIDA BUILDING ~
CODE, NA 110NAL ELECfRlC CODE ANC k
OTY OF ZEPHYRHILLS ORDINANCES ~ ~
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LEONARD G. 'GEOFF' 'WOOD
ENGINEER
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This space for use by Clerk of the Circuit Court only.
1111111111111111111111111111111111111111111111111111111111II
200309~874
STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COpy OF THE DOCUMENT ON FILE
OR OF PUBLIC RECORD IN THIS OFFICE,~ITNESS MY
HAND AND OFFICI L SEAL THIS4- DAY OF
2 /D..J
F CIRCUIT COllRT
. DEPUTY CLERK
Rcpt: 684~18
DS: 0.00
0~/29/03
Rec: 6.00
IT: 0.00
Dpty Clerk
i!92;~~l"Arr.PASCO COUNTY CLERK
~.40.m 1 of 1
OR BK 5375 PG 1437
~OTICE OF COMMENCEMENT
Stale of Florida
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 In the NOTICE OF COMMENCEMENT.
~. Legal Description of property (street eddress required): '3 7 S~3 IV [:w HtJ/u ?otv' j,.o r 5"z, -~-I
'?tf-2--~- 21- not 0 - ON60 - () 0-';-1
2. General description of Improvements: ifL.<...-/1/1 I/'/,.I/Vl Pfk.f(fl(,E
3a. Owner Name: c:.f2A-NIJ HOIll C() /V
Owner Address: 7(c~~ ?tdi3v .?"IAJPE
;rI/-fp
Dll... 7J:'Jlf! Yjl(.{ I U j r- L .
"5 :;f;l./ 1- 1/"60
3b. Owner's interest in site:
3c. Fee Simple Tille holder (of other than owner)
Address:
f~~:":f.\~~
~:.'~'Y 4
!II 't\.i .
",-, all
Contractor Name: Br;../ (0fV>f72..-L,b-(f o;v of Gr;l/7tVfe FL <
Address:'i-Oz...t; fYlofl./ll,,5 &lJ1}i'tf' Po, 7/5jJlI712/..{I(.(,,? FL. '3354:3 Phone: 6'13- 76'2 - /06 'I
5. Surely Name: Amount of bond:
Address: Phone:
6. Lender Name: Contact:
Address: Phone:
7. Person within the State of Florida designated by owner upon whom nollces or other documents may be served as provided by
Section 7.13.13(1)(a)7, Florida Statutes.
Name:
Address: ",
Phone Number:
8. In addition 10 himself. Owner designates the fo.llowlng person to receive a copy of the Lienor's Nollce as provided In Section
7.1313(1)(b). Florida Slatutes.
s
Name:
Address:
Phone Number:
9. Expiration date 01 Nollce of Commencement (expiration date Is one (1) year from date of recording unless a different date is
specl(ied).
STATE OF FLORIDA
Q ~~ Q~ CWNCtZ /J.66VJ
p(C H ft(l.o L. /2Ei-l[5ffI.!J Slgn;l~re of Owner 0--
The foregoing instrument was acknowledge before me this :L 1
'[ZJ C UI+I2.O J... I2rfI ffil26
produced Pr:r.~ Sc NA-L l. r /(;v~ w:;./
(Drlver's License #)
date of mfJ Y' . 2oll. by
who (\s) (are) personally known to me or
as Identiflcallon, who did/did noltake an oath.
Bw.~ fl~ ~
Signalure . Notary Public
i'-' a\. Bruce A Asbel
;.~ .; My Commission D0116710
~OI,..'" Expires June 22, 2006
'(A copy of any bond must be allached atlhe time of recordation of this Notice of Commencement)