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HomeMy WebLinkAbout04-3444 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT SINGLE FAMILY RESIDENTIAL 3444 Permit Number: 3444 Issued: 10/08/2004 Permit Type: GENERAL BUILDING PERMIT Class of Work: 434-ADD/AL T RESIDENTIAL Proposed Use: SINGLE FAMILY RESIDENTIAL Sq. Feet: Est. Value: Cost: 3,900.00 Total Fees: 75.00 Amount Paid: 75.00 Date Paid: 10/08/200 Address: 38323 13TH AVE ZEPHYRHILLS, FL. Township: Range: Lot(s): Block: Section: Book: Page: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: ALFRED & LORRAINE CHLEU 38323 13TH AVE ZEPHYRHILLS, FL. 33542 Phone: ND I L DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED LINTEL PRE-METER WATER SHEATHING FRAME MISC SEWER MISC INSULATION WALL MISC MISC. MISC. INSULATION CEILING MISC. MISC. MISC. DRIVEWAY MISC. MISC. REINSPECTlON 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 callecl (d) Work not ready for inspection when called (e) Permit not postecl 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 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." NO OCCUPANCY BEFORE C.O. 'l0 g~ ~~LV ~. CO~TRACTORS SIGN T RE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER OCT/04l2004/MON 04: 08 PM ZEPHYRHILLS WILDIN:: FAX No, 813.780-0021 CJ:TY . OF ZBPBYRBJ:LL8 PBRM:I:'l APPLICA!'J:ON BOIIDINQ DlIPAJI.'JHDft' 5335 8D St, lephyrhill., I'L 33542 813-780-0020 rAX:813-780-0021 . DA'.l'Z 1UI:Cl:1ftD . ...... ""'""'" "'" ~..... 8 [3 ~ OJ 1 (, - 9'1f:, S; rn OA.!; CA ,""',.'. """ 5'c.h l~ u SIlk~I1JF-..~.oj. L.,r~~~~ 01 ~ WdsON JOIlADDus.'3g~~3-1~~ ~l ~h~r~l~ "'33_0 . LEGJir. DESCRII'TION: LO't'(S) 1\..... '"'2- BLOCK ~q SUBDIVISION ~ t:rf" Zepn~ rk( lis PARCEL 10 t l(..J.b" 21"OlH l)402~DO"O 11 0 P. 001 IOB~ArN FROM E~np~RTY~AX NO?TCr.\ WORK PROPSED, ONEW CONSTll.UC'.!'ION' o SIGN o ADDITION OALTERATlON o OEHOLI!i8 CJ REPAIR CJ INSTALL o MOVil PROPOSED OSE: DSGL fAMILY DHELLING o COMMERCIAL DNULTI-l7IMILY o INDUSTRIAL 0, OF DNI-rs OSWIMMING POOL o MOBILE HOME o O'l'HER BOILOING SIZE CJ RE8TAURJINT .. HEALTH DI:PARTHENT APpR ce W. r\tJ.rwc; s j DBScatMIOII or 110M SQUARE FOOTAGE REIGU RESIDElIl'l'IAL: ATTACH (21 PLOT PLANS.. (2) SETS or BUILDING PLANS, (1) SET ENERGY FORMS. ClHtERCII\L: ATTACH (3) SEt8 OF BOILDING PLANS (. (1) 8E! ENERGY FORMS. IF SIGN PERMIT ONLY (~) SETS OJ' ENGIN1!:t1\tO PLANS' REQUIRED. ~ '-. - PROPERTY SURVEY REQUIIU:D FOR ALL NEGf CONSTRDCTION. / .J ~.c:. f?l-)) t. PBRMJ:TS RBQUIlS'rBD o ELECTIlIC)U, o PLUMBING o MECHANICAL ~ o GAS 0 ROOFING 0 SPECIALTY o Proqress Energy 0 If.R.E.C. "0.. \ u.. ..e... ~"31q 00 · 00 o BUILDING $ VALUATION OF TOTAL CONSTRUCTION , AMP SERVICE '. ~ ='~(JI;;~I~N~;.;;r4 ~ ~ I V- +n-- '5 i ~ TUE OF CONSnOCTION: 0 BLOCK . 0 FRAME FINISHED FLOOR ELEVATIONS o STEBL [] OTHER IS PROJECT IN FLOOD ZONE AREAD YES CJ NO SI ~. r< INc.. A '.fr~b W .I\'t~ STATE CEkT OR RJ:GIST t, Q~ C. 0 l d. S ~8 ................****.********... n.JICfiUCJ:Al( COMPANY SIGNATURi: STATE CERT OR REGIST t ......*........*.**...*.*.~*.*..***.***..*......*******.*.***..*.* ~ COMPANY' SIGNATURlt STATE CERT OR REGIST f ...w*w~**....*.+*.+*.*.*....**...*.........*.w***..*.....****..*** NSClUl:laCAL COMPANY 8IGNATORE STATE CERT OR REGIS! I ..*...+.........*~....**.*..................*~..*..*.*******...*. 0'!HZJl COMPANY r, SIGNATOP.E STATE CERr OR REGIST I OCT/04/2004/MON 04:08 PM ZEPHYRHILLS BUILDING FAX No. 813-780-0021 P. 002 A. N@TI~E O~ DEED RESTRICTIONS The undersigned understan~ th.t this permit may be subject to "deed restrictions" which m.y be more restrictive than City regulations. The undersigned aesumes responsfbility for conpliance with any applicable deed restrictions. B. UNLICENSED CONTIlACTORS /\NO CONTRACTOR RESPONSIBILITItS It the owner has hired a contractor or contractors to undertake work, 'they may be required to b~ licensed in accordance with state and local reoulations. If the contractor 1s not licensed as required by law, both the owner and contractor may be cited for a ~sdemeanor violation under state law. If the'owner or intended contractor are uncertain 8S to what licensing requirements may apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, 813-780-0020. Furthermore,. if the owner hils hi1:ed a cOntraotor or conr.ractOl:.s, he is advised to have the contractor(s) sign po~tions of the "Contractor Seotions" of this application for whiCh they will be responsible. If you, .as the owner signs as the contr~ctor, 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 bean ind1oa~ion that' he is not properly lioensed and is not entitled to permitting privileges in the City or Zephyrhills. C. TRANSPORTATION IMPACT Fli:ES AND UTILITY CONNECTiON FEES D. CONSTROCTUION LIEN LAW (ClIAPTl!:R 713, FLORIDA STATUTES, AS NlENDED) I certify that I, the applicant, haye been provided with a copy 'of ~Florida'. Construction lien Law - Homeowner's.Protection Guide" prepared by the Florida Department ot Aqr10ulture and Consumer Affairs. If the applicant is eomeone otker that the ~ownerh, I,cerify that I hilve obtained a copy of the above described document and promise in oood faith to deliver it to the ~oimer" prior to comencement. E. CON'l'RACTOR'S/OWNEIl'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 construotion, zonino, and land developnent. , Appll~ation is hereby made to obtain a permit to do work and installation as iDdioated. I certify that no work or installation has oommenced prior to iasuahoe of a permit and that all work will be performed to meet standards of all laws requlating construction, City oodes, zoninq regulations, and land development regulations in the jurisdiotion. I also certify that I ,understand that the regulation8 of other governmental aoenciea may apply to the intended work, and tnat it 18 my responsibility to identify what aotions I must take to be in oompliance. Such agencies include but are not limited to: *Oepartment of Environmental aequlation-Cypr~ss Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater ~reatment *Southwest Florida Water Management District-Welle, Cypress Bayheads, Wetland AZeas, Alterino Watercourses *Army Corps of Engineers-Seawalls, DOCks, Navioable Waterways *Department or Health , Rehabilitative Services, Environmental Health Unit-WellS, Wastewater Treatment, Septic Tanks *U.S. Environaental Protectiori Agency-Asbestos abatement I also certify that, if fill material is to be used in Flood Zone ~AH or ~A,etc.", it is understood that a drainage plan addreseino a ~compensating volume" will be submitted which is prepared by a professional enginee1: registered in the State of Florida prior to permit issuance. A permit iss~ed sball be construed to be a license to proceed with the work and not as authority to violate, cancel, a~ter, or set aside any provisions of the teohnical oodes, nor shall iasuanoe of a permit prevent the Buildino Offloial from thereafter r~iring a correction of errors in plans, oonstruotion, or violations of any code. Every permit iss~ed shall became invalid unless the work author1zed' by suoh permdt is commenced within six I1lOnthe or issuance, or it work authorized by the permit is suspended or abandoned for'B period of six months after the time,the work is commenced. One 90 day extension of time may be allowed tor the permit with fee charge Of $15.00. The extension shall be requested in w1:itinq to 'the Building Offioial. An approved in8pection'must be logged during each six month period, or the project will be considered abandoned. WNlNING TO OWNER: YOOR FAILURE TO 1\ECORD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOOR PROPERTY. IF YOU INTEND TO OMAIN 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 ~NOTrCE OF COHHENCENENT". SIGNATURE: OWNER OR AGENT SIGNATURE I CONTRACTOR STATE OF FLORIDA COUNTY OF The foreqoing instrument was acknowledged Before me this _ day of , 2L by (name- or person acknowledqed) o who is personally known to IDe, or o who ha" produced (type of identification) and wlioD did Ddid not take an oath. STATE OF FI.OIUDA COUNT~ OF The toregoing instrument wae Before me. this --1iay of by acknowledged ,20_ (name of parson aoknowledged) ~ho is personally known to me, or o who has produced (type of identification) and who Ddid Oiid not take an oath Signature of person taking aeknowledoement Signature of person taking aoknowledoment Name typed, printed or stamped Nama typed, printed or stsmped Sears Ho~e Impl"ovement Products, Inc. License No_ GB C039161 P,O, Box 522290 . Longwood, Fl32752-2290 ~ -_-..aUGT8 Location: --rAmp~ 010 Phone H:( ~OO) :?3o - q (O~ Job No. : 1(0 ?, "1 ( 9-,1S Name IJLPrflW Address 351 3 a. 3 Replacement Windows Sc:.kU2.1.A5~Ul. !t.~M {J"J~- S~(..C."'s~one: Res(gC3/5<rt,,- 0 f 5", ~~ / ~ . I :3 t:J. r/lL CitY.: 2..Q. p~.y ~ ~ I , I " Bus. St.: r:: L Zip: 3~"iy~ I/Vlle, the owners of the premises described below, hereinafter referred to as .Purchaser" offer to contract with Sears Home Improvement Products, Inc. hereinafter referred to as "Contractor", to furnish. deliver, and arrange for Installation of all materials necessary 10 improve the premises located at: (Streel) ~C:; AML.. 0.5" ~&~ (City) (State) (Zip) AccordIng to the following speclllcatlons: 1, 2, Remove existing units to be replaced. (NOTE: Removed units are likely to be damaged.) Prepare openings as necessary to receive replacement units. (No finish work other than normal installation is to be done unless othel"(Yise noted below.) Install Sears W~j\.<<.I'- 13c.di:L;..II jIVJ ~ Windows In openings described below to the following specifications: Color: ri While 0 Beige 0 White/light Woodgrain 0 White/Dark Woodgrain Type rPf DH 0 SH 0 2.lR 0 3.lR 0 PW D Other Qty.!i Qty_ Oly_ Oty Oty_ Oly_ EE EE 1-1-1 EEE ~, ~~cnher D Other 3, Oty_ o Other Q~- a.I.iI..a.IL o Clear []t" low EO/Argon o OBS ~ o OBS Full o Keepsafe NOTE: Tempered glass will be installed to meet building codes. o Bronze o Gray Screens' CHECK IF OTHER THAN FIBERGLASS' (On Sashes Only) 0 Alum o Solar ~ Bevel Col Sculp Col Flat Diamond Clear White ., 1 'l'. 1-,. II r c./ Tan ~ Wd Grain Brass Top o F~ Bottom o ,,=~/-J:Lcc-b {l.J->f' eUI'-C'ING~' APPROVeD ~-- /" '() Warranty Manufacturer's Warranty sent upon completion. 4 Existing units NOT to be replaced: -:s....if ~e.(Ja.(.;..~ q l..J'~<v~ ~'- 5-r.coU,t/L- CZVl.~ I~.gtl 5, If applicable, after completion 01 project. the '!lpplication and removal (s,torage) of shutter pa~els sha". be the responsibility 01 the purchaser. In the 0 event the project requires the ,nstallatlon 01 storm .;'hutters or egress Windows. Contractor WIll not re-onstall any eHected security bars, I ~ ~h Special Instructions: (,..,,/oorf) ((1~ CIA) ~#I'SI~_ ___ 6 7 Clean up job related debris and provide necessary permits and Insurance, 8, If applicable, in the event that Contractor is unable for whatever reason to obtain the proper permits prior to the commencement of any work, Conlractor shall refund any previous payment and this transaction shall be automatically cancelled. 9, AllOW approximately 3-6 weeks lor Installation, NOTE: THE WARRANTY PROVISIONS AS STATED ON THE REVERSE HAVE BEEN EXPLAINED AND IIWE UNDERSTAND THEM FULLY. ADDITIONAL PROVISIONS AND WARRANTIES ARE STATED ON THE REVERSI! SIDE AND ARE A PART OF THIS CONTRACT. I X~, e {l 1 Please read the following bold type and initial corresponding line. Verbal understandings and agreements with representative shall not be binding. All understandings and agr_menta mrst be set forth in writing in this Contract. Due to climatic conditions, interior conden_tlon may occur. Purchaser Initials: LlC?~ l' J{. I The TOTAL PRICE for all labor & Materials (including any applicable discount) is $ ::JOQ .00 Down Payment $ ,00 Contract Price $ Balance Payable $ 3"00 .00 Terms: Credit Cash State Sales Tax C_ %) $ (If applicable) Total Contract Price $ ~qoO ,e} 3~QO ~ (Subject to the approval of the Credit Department) o (Final Payment payable to Installer upon completion) Funded by: Bank City Acct # 10% Preferred Customer Discount (peD) awarded for any future Sears Home 1m provement Products purchases. Current pricing available for one (1) year. If thIS IS a credit transaction. the agreement for credit is contained in a separate document which is Incorporated herein by reference and mede a part hereof. I/We the undersigned are hereby authorizing Sears Home Improvement Products, Inc, to verify and review my/our credit record with an independent credit reporting agency and relei;ise them from aU liability incurred from inadvortent omissions or errors. IN WITNESS WHEREOF Purchaser(s) have hereunto signed their name(s) this '30 day of S" ~ f I , 20.....a...Y.. and acknowlQdge receipt of a true copy of this Contract and unless othelWise speCified. it is understood that the owner is ready lor work to begin. THIS MESSAGE APPLIES TO DOOR-To-OOOR SALES ONLY: You the Purchaser(s) may cancel this transaction any time prior to midnight of the third day after the date of this transaction. See accompanying notice of cancellation form for an explanation 0 this right. Signature _nixed below ecls as receipt that Purchaser(s} received separate cancellation lorms. SI. Date Dale 9 - >0-04 Date ,,- ?o - If)t( Date " - _~O - 0 '( E2. SO . Rev. 08/02 'en "0 m (') ;; r Z en ... ;0 c C1 -i 5 z fJ! ~. ...~ ~ ... ... ... ... ... ... ... -' ... 10 (l) "ol0l Ul ~ WN III Cll "ol0l Ul ~ W N-' 0 s: a. a. = g ~ l: !!!. \J K) ~ 0 Iii ..... ~ 0 r:r Sl ...... m r .. " ... c. 9- '" ~ C1 .. P- O ~ ,,\ t\' ~\ r 0 CD ;0 ~ ~ ..... ... ~ :J 0 c ~ r.\ ~ G'l ~ 1--' S; ~ III ~ III III C1 ;0 m m z G'l ;0 5 -I c;i m s: I>> "0 ; Cl !ll " , . .. /: ~ ' . ! " [I :,' ; . ,J , I: I r ;'-'j I r z -l "11 o ., III CD 8 :I a. III S C !II CD I>> a. a. cr. o ~ ~ ~ (II :I" ! 'It~J xx (f) CD :J. tIl !II I 'It 'It 'It 'It 'It 'It II I I I I ~ o xxxxxx r;; " -I :z ... ~ ~, - \'" I-- I tII )- I 0 ^ f1 .\ -cD Il } "11 ;0 o Z -I l/)1l "O(f) 0 00 olil -I" 00 lllG'l ~ It olil o~ !'~ (') llltII Cl:t ~p 0'''' ~~ mN o"ir ~~ m(') -I "11-1 "IIi!! mm lIItI1 ~~ r~ ~ o~ ~o ::or <r :tOO ;DC C s::m :c.o ~Cl ::0 ;0 C ~ "" C m~ f ~ ~ " Z . m m r 0 '< it z " ~ r ~" "O(/) 0 o(')~ i " 00 lllCl ~ III 0 ~~ r~ Cl if~ (') (')(h (f) J ~ f 0" iil 1! ii -0 l r:rC' g~ gf OJ I>> !i hi o III i 3 III 00 ~ lot 01 ~i a Ii : * c <:!: 3 - B 2.2. . g r:r0 g ~ ::l i ~.. If CD 3 <D r ~8 CD CD ::;: ii .. " Ql III " gd " CD CD(/) * C CD a. Q,-- iD' a ~ a :l g: i ;0 .. ~ "c;i" Q, a c;i 0 &; ~ "CD 2- c .. ~Itl ~ 3 r ;0., ~ f5 ~. (J !iil CD 9: ~ ~ ;:It 2- 3' :r ~ CD .. 'It 'It 'It 'It 'It 'It II I I I I x x x x x X .~/ (');O'Tlm omOz :II'll:Il-i ill~~!ll ~~C1~ oOJ:o z>c... oZ~J: zO-ill' om-ix z~om cmUl(5 ~;vm~ m ;0 (') (') " 0 ~ t f ~ ~ ~ C'l 8- ~ ~ 'It 'It 0 J: -i xx ~ n .. 'It 'It 0 r- jO '- ~~ J: 0 -i C' Z 0 ~~ xx ? CD III III a. :I ~ Z a. '-'ltO !' ~ J: -i xx ~ '. 0 .. ;0 Gi I. -J: ~ J: -i I I PROJECT NAME SCHlEUSNER PROJECT ADDRESS 38323 13TH AVENUE SEARS PROJECT # 4034188A , STATE OF FL PRODUCT APPROVAL CATEGORY SUB CATEGORY MANUFACTURER NUMBER WINDOWS DOUBLE HUNG SIMONTON FL143 , PLEASE NOTE: ALL WINDOWS HAVE AAMA APPROVAL WITH DESIGN PRESSURE ON THE WINDOW f{w . Be R W Building Consultants, Inc. Consulting and Engineering SerVices for the Building Industry P.O. Box 230 Valrico, FL 33594 Phone 813.659.9197 Facsimile 813.659.4858 ENGINEER'S NOTICE OF EVALUATION # SR-I0IF-R Sears Home Improvement Products 1024 Florida Central Parkway Longwood, FL 32750 Phone: 800.222.5030 Fax: 407.332.8216 DESCRIPTION OF UNIT Model Designation: Sears Double Hung Vinyl Window Series 7000 (SeriesIModel 07-70 as mfg. By Simonton) Maximum Overall Nominal Size: up to 52":J: 71" Usable Configurations: ~ X General Description: Vinyl Double Hung Window with welded mitered comers. The head and side jambs are extruded vinyl with an exterior wall thickness of 0.070". All frame profiles allow optional inside and outside use ofUV09 snap trim, The insulated glass is two lites of 1/8" annealed glass. Overall nominal thickness is 3/4". The Insulating glass is set onto a double-sided adhesive tape and secured with dual durometer snap-in vinyl glazing beads. Steel and Aluminum reinforcements are used in the exterior/interior meeting rails and topIbottom sash stiles & rails. FBC Section 1707 Materials and Assemblv Tests: (1707.4.2 Exterior Windows and Glass Door Assemblies) Test Descriotion Test Location Date Report No. C ,... . Fno;neer ASTM E 330 Uniform Static ATI - York, PA February 08, 2002 05-30349.01 Steven M Urich, P.E. Air Pressure FL #57795 AAMA 1302.5 Forced Entry ATI - York, PA February 08, 2002 05-30349.01 Steven M. Urich, P.E, FL #57795 ASTM E 547 Water ATI - York, PA February 08, 2002 05-30349.01 Steven M. Urich, P.E, Penetration FL #57795 ASTM E 283 Air Infiltration ATI - York, PA February 08, 2002 05-30349.01 Steven M. Urich, P.E. FL #57795 Desien Pressure Ratinl!s: Configuration Glass Maximum Size Design Pressure Ratings Double Hung Window ~ 1/8" Ann. - Air Space - 1/8" Ann. Up to 52" X 71" +50.00 psf -50.00 psf X Installation and Anchorine: See reverse side this page SEARS SERIES 7000 (as mfg. by Simonton) EXTRUDED VINYL DOUBLE HUNG WINDOW MAXIMUM SIZE UP TO 52" x 71" #10 x 3 1/2" FLAT HEAD SHEET METAL SCREW, 1YP. #10 x 3 1/2" FLAT HEAD SHEET METAL SCREW, 1YP. #10 x 3 1/2" FLAT HEAD SHEET METAL SCREW HEADER #10 x 3 1/2" FLAT HEAD SHEET METAL SCREW #10 x 3 1/2" FLAT HEAD SHEET METAL SCREW. 1YP. #10 x 3" FLAT HEAD SHEET METAL SCREW 6"11 =l : to #10 x 3" FLAT HEAD SHEET METAL SCREW, 1YP. INTERIOR SASH TRACK RAIL EXTERIOR SASH TRACK . to =t SILL DWG. #SR-101-BM IIIIIID "'" III This Instrument Prepared by: Name: SEARS HOME IMPROVEMENT PRODUCTS, INC. P.O. BOX 522290 LONGWOOO. Fl327S2-22QO 1-407-551-5376 '/11111111111111111I111111I1111I1111111111111111111I1111111I 2004188043 NonCE OF COMMENCEMENT State: F L County: f /1 )'(. 0 Rcpt: 821512 OS: 0.00 10/07/04 Rec: : 10.00 IT: 0 . 00 Opty Clerk ThE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the fOllowing infonnation is provi~ in this notice of Commencement, rqAuj I D- 1/ - ;l.~-J 1- Cb 10 - OdVD () -40 II 0 I. Description <;If property: (legal description of pro , and street address ifavailable) , - 3+1, JED PITTMAN. PASCO COUNTY CLERK 10/07/04 01: 55pRl 1 of 1 OR BI< 6058 PG 397 2. 3. ~e~end c,lescpiption of improvemepts: IA1, I ,ud'2ou~r . ~~ jUf}~~ Owner infonnation Loll./l4; V..(. Sc.kl.".I.\JAJelL' a. Name and address: I1L.P/J..o..lJ Sc.IJL€J.'5AJUJ- b. Interest in property: 0 {~ AI ~/L ' c. Name and address offee simple titleholder (if other than owner): ?',83a3 13"1\ Ave. 2 llf/.Jy.tLl-lt/15 f(- 3""j5Vd 4. "..-- Contractor: (name and address) ~' SEARS HOME IMPROVEMENT PRODUCTS, INC. ~ P.O. BOX 522290, LON~WOOD, FL32752-2290 1-800-222-5030 Surety a. Name and address: NA 5. b. Amount of bond $ 6. Lender: (name & address) NA 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(I)(a)7, Florida Statutes: (name and address) 8. In aQdition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.I3(1)(b), Florida Statutes: (name and address) ABOVE NAMED CONTRACTOR 9. Expiration date of Notice ofConunencement (the expiration date is I year from the date of recording unless a different date is specified) tJ (S~~ L,Lt:<,,~~ J' !~~ef5f A;u<',&,,-~.JY DriversLicense#: S- y 85" -0<)5"- ,30 '/0" -0 5 C{ d 5" - 5" O)d - ,35 - S 6'1.0 '. Owner's Name: tJLh'l..~l) 5C/.,JLel..,vl./l..- L.O/l..!1..p-';AJ(.. 5c::..~LeL.s-,v~__ Owner's Address: .> ~ .3 0)3 I ~ -z1. fI v~ 2 " fl.. 0~ JJ tll s- Pc 3 .3> y d All infonnation must be typed or printed legibly to comply with recording requirements. STATE OF FLORIDA COUNTY OF fJIJ 5co - The foregoing instrument was acknowledged before me this 9 . 30 . Q ~ by A t. M Q.I) S C.h l..i? (,\ N~Jt whoispersonallykn eor p uced tJRI/;e.IL /.../C~~<-. as identification an whodid (did not) take (Signature of person taking acknowledgement) ~~~-:. R<?b. A. Bale :*:~= Commission #DD289ns ;'~M ..,! &pIres: J<eb 10, 2008 ',,';:0;' "..- BoudedThni IIIIl' ~tlAntlc ~"'<IiBg Ce., .. M9 - Rev. 08/03 (Name of officer taking ackno:\\,I~_~gement - typed, printed or stamped) (Title or rank) ---, (Serialnutnbe~ifany)