HomeMy WebLinkAbout04-3570
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
3570
Permit Number: 3570 Issued: 11/09/2004
Permit Type: GENERAL BUILDING PERMIT
Class of Work: WALL SIGN
Proposed Use: COMMERCIAL
Sq. Feet: Est. Value:
Cost: 4,061.00 Total Fees:
Amount Paid: 87.50 Date Paid:
Address: 38031 NO HAVE
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: LEMCO CONSTRUCTION C
Addr: 2117 W. SEWAHA
TAMPA,FL. 33612
Phone: 813932-8515 Lic: Phone:
Work Desc: INSTALLING CHANNEL LETTERS ON RACEWAYS
Name: CHRIST PHER MACCA
Address: 38031 NORTH AVE
ZEPHYRHILLS, FL. 33542
H EL 1
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.
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 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.
t/ <::/ ..:R - ~
CONTRACTOR ~GL~A; :~NSPECTION _ 8 HOUR NOTICE REQ~~~~T OFFI
PROTECT CARD FROM WEATHER
CITY OF ZEPgYRHILLS PERMII~ APPLICATION
BUILDING DBPARTMENT 5335 at.ll STUET 1~}!PHYRHILLS, FL 33540
Phone:B13-7BO-0020 Fax:B13-7BO-0021 , ~' ~
' DATE RBCEIVED -LL..- -0
PLANS REVIBW FEE
OWNER'S
NAME~r;~DyLr VnD..CC~
. f'-....\,or~ Av~
PHONE CONTACT g 1.3 - ""? 5' cl- g :;) 2 (...
JOB SITE ADDRESS ~ ~ 0 3 I
. -
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID # 0 ~.....:J ~_ ~ l.- () ooh ... 0 0 to 00 _ DO \ I:) (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION 0 ADDITION DAL'J~H:RATION 0 REPAIR 0 INSTALL
pJs IGN
D MOVE
o DBI"IOLISH
PROPOSED USE: DSGL FAMILY DWELLING
DMULTI-FAMILY
0# OF UNITS
o JIIIOBILE HOME
D OTHER
~ COMMERCIAL
o INDUSTRIAL
o SWIMMING POOL
DESCRIPTION OF
CJ RESTAURANT
WORK !n ~al\l ^ ~
"I 5 ~ 00'
& HEALTH DEPARTMI!:NT APPROVAL
BUILDING SIZE
cJ- o.~\ le..~s 0 r-.
SQUARE FOOTAGE 'IS 00
ra..~a.y >
HEIGHT I 5 .
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
ATTACH (3) SETS OF BUILDING PLANS & (1) mi:T ENERGY
PROPERTY SURVEY REQUIRED FOR ALL NEW CON~I~l'RUCTION.
PERMITS REQUES']'lI!:D
& (1) SET ENERGY FORMS.
FO._,,:::-'), _ Q
.I QZ-\~
/tJ D~ / '1 ')' .:- -~-I ~c.
.' j).~
~
iii BUILDING
$ 40 ~ I. Do
VALUATION OF TOTAl, CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o W.R.E.C., -5'
~' -'6;\
VALUATION OF MECHJINCIAL INSTALLATION l' q ~ :J.
o OTHER /
[]
FLORIDA POWER
o PLUMBING
o MECHANICAL
$
o GAS
o ROOFING
o SPECIALTY
TYPE OF CONSTRUCTION: [] BLOCK
[] FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT
[] NO
SIGNATURE
COMPANY_ J~t/1l 0
/ / ~ ~i'. .; STATE CHRT OR REGIST
D ....,~jt--t.-~?'l/tl/ CITY PROCESSING #
**** * * * * * * * **** * * ** * iIr ******* ** * ** ** * * ****~, j~ * ***** * ** **** *J'*** ** *
BUJ:LDBR.
BLBCTR.J:CIAH
COMPANY__
'~--'--' 'STATE-"CIrRT-~'Rl!;G.IST'"-#-
CITY PROCESSING #
SIGNATURE
******************.**********************~'.***********************
PLUMBER.
COMPANY--
STATE CmtT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************~************************
MBCHANJ:CAL
COMPANY__
STATE CgRT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHER
COMPANY
STATE Cm~T OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CONDITIONS OF PERMIT AFFIDPVIT
A. NOTICE OF DEED RESTRICTIONS
. .
The undersigned understands that this permit may be :mbje,,::t to "deed restrictions" which
may be more restrictive than City regulations. The lmden:iigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBII~ITIES,
If the owner has hired a contractor or contractors to unde.rtake 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 cont;c'actor 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 contr~ctors, 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 toi'ork. If the contractor ~Iishes
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 Zephy'rhills.
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 E'lorida 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 permdt 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 perfor.med to meet standards of all laws regulating construction, C.ity
codes, zoning ,regulations, and land development regulations in the jurisdiction, I also
certify that'r 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-Well.s, cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corpa of Engineers-Seawalls, Docks, Navigable Waterw'ays
*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 submittE.d 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 Godes,
nor shall issuance of a permit prevent the Building Official from thereafter requining a
correction of errors in plans, construction, or violations of any code. Every pernlit
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 COMIV1ENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'TEND 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: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this_day of ,1!L-
by
(name of person acknowledged)
Dwho is personally known to me, or
STATE OF FI,ORIDA
COUNTY OF
The foregoing instrument was
Before me t,his ~day of
by
acknowledged
19
(nan~ of person acknowledged}
Clrho is personally known to me, ox:
o who has produced
(type of identification)
and whoD did.. Ddid not take an oath.
o who has produced "
(type of identification)
and who []did Q:iid not take an oat;h
Signature of person taking acknowledgement
Signature of person taking acknowl€.dgment
-
Name typed, printed or stamped
Name typed, printed or stamped
-_.~ ~"-"~.'
,...,.,~~"~
L~t> or\. r~~
__, PARCEL '# D~ .~to';;}.f -Dooo_
. Ob<Poo.oOIO-
e..h.:~~nr- fhdCt2..Q.. PHONE # (~)75.l-U~
~F:,~\-U~h~ P.-r .
--- ---- S'I'l\TE: Fl., ZIP CODE: 335("'(P_
OCCUPANCY TYPE: TYPE OF CONS!l'RUCTIo'N: N e.w SIGN VALUE: $ If-o ~ /. dc>
---
,PROPOSED USE OF THE BUILDING/SPACE (1\~+Otv'\o~vi
FEET: SQUARE FEET OF FACE OF BUILDING ,f I Z. 5
'GROUND MOUNTED SIGN~J
PROPERTY FRONTAGE SIDE S ETB.~,CK REQ.
ADDRESS: ~g O~\ ~Dr~ {~v-e-
DESCRIPTION OF WORK: "'J(\'~ka1\~ f'\ g ~~~
LOT # ZONING: ~p I
APPLICATI,9N DATE
--
---
OWNERS NAME:
ADDRESS:
CITY:
PROPERTY FRONTAGE:
PRIMARY SIGN:
ALLOWABL]~ SQ FT
-- .....-...--- -.-....- -----
--------..-------
LESS THAN 50'
50' - 99'
100' - 199'
200' - 299'
300' +
10 FE:E:T
10 FE:ET
20 FE:~T
5 0 FEj~T
50 FEET
24 SQ F~~
32 SQ F~~
64 SQ FrJ~
72 SQ F'J~
96 SQ F'j~
24 SQ' F'J'
SECONDARY SIGN:
MAXIMUM HEIGHT OF GROUND MO~NTED SIGN:
.,
PRIMARY GROUND SIGN THIS SITE
FT X FT = TOTAL SQ FT
, .
. .
MULTIPLE OCCUPANCY:
2 SIGNS NOT TO EXCEED 10% OF ~rHE FACE OF' THE BUILDING OR 100 SQ FT
SECONDARY SrGN = 24 SQ FT
PRIMARY WALL MOUNT SIGN
I 'l.:.:-FT X~FT ;::;: 51-.27.. TOTAL
SECONDARY WALL MOUNT SIGN ~
FT X' ,FT = TOTAL
- ----- --
NO:
ELECTRICAl, PERMIT?
LOCAL LIC. #
STATE;: .EL ZIP: 3-S ~l 2-
Y:
N"
"
(~/~/~
~ISCELLANEOUS REQUIREMENTS:___
~PPLICANT SIGNATURE:
)LANNING APPROVAL:
BUILDING ;~PPROVAL:
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~ILCOX, KIDWELL, & ASSOCIATES, INC.
Certificate of Authorization #8121
Paul D. Kidwell, P.E. Reg. #52683
1802 E. Busch Blvd., Tampa, Florida 33612
813 936-5090 813 936-2180 Fax
CLIENT: BAY AREA SIGNS LOCATION:
JOB ROADRUNNER OIL & LUBE
SHEET NO, 1 _ OF
CALCULATED BY PDK
CHECKED BY
SKA # 04-03334 JOB # 1
WIND = 34.8 PSF 130 MPH HEIGHT = 30
RACEWAY DIMENSIONS = 2.60 x 17.34 T
SIGN AREA(SF)* P (K/SF) = P (K)
45.1 0.035 1.57
T = P/BOLTS =
0.261 K/BOLT
At = T/20 =
0.013 SQIN
GRAVITY:
est.
20 #/SQFT
P = A*Wa=
0.902 KIPS
T=
0.326 K/BOL T
At = T/20 =
0.016 SQIN
SHEAR:
V=
0.075 K/BOLT
Av=V/I0=
0.008 SQIN
BOLT OPTIONS TO SUIT WALLS:
3/8 "rjJ ALL THREAD THRU BOLTS
3/8 "rjJ TOGGLE BOLTS
3/8 "rjJ THUNDER BOLTS
3/8 "rjJ LA G BOLTS W/ SHIELDS
2 ROWS AT
" 5INr 8INr
'MAX.
1.67 FT
f-:'J J' 1> '-'
L"\iE "'" ) r ,'j .
C!}IJ ~--:,~--"
.-- ..Ii\.:l Dr: oT~' '._
'-I J..lriV\/EO---'-
-_.>-
6.0 BOLTS EACH AT
At =0.078 in^2
Av =0.110 in^2
3.5 +/- O.c.
6
DATE _10/14/04
DATE
I
6IN
WIND = 130 MPH EXPOSURE = B
COMPLIES WITH "2001 FBC - ASCE 7-98 FOR THE 3-SECOND GUST VELOCITY INDICATED ABOVE"
CALCULATION AND ENGINEER'S SEAL IS FOR WALL ATTACHMENT ONLY V.N.O.
~~
SILCOX, KIDWELL, & ASSOCIATES, INC.
Certificate of Authorization #8121
Paul D. Kidwell, P.E. Reg. #52683
1802 E. Busch Blvd., Tampa, Florida 33612
813 936-5090 813 936-2180 Fax
CLIENT: BAY AREA SIGNS LOCATION:
JOB ROADRUNNER Oil & lUBE
SHEET NO, J, OF
CALCULATED BY PDK
CHECKED BY
SKA # 04.03334 J( JOB # 2
6
DATE _10/14/04
DATE
WIND = 34.8 PSF 130 MPH HEIGHT = 30
RACEWAY DIMENSIONS = 1.40 x 12.60 T
SIGN AREA(SF)* P (K/SF) = P (K)
17.6 0.035 0,61
T = P/BOLTS =
0.153 K/BOLT
At = T/20 =
0.008 SQIN
GRAVITY:
est.
20 #/SQFT
P = A*Wa =
0.353 KIPS
T=
0.191 K/BOLT
At = T/20 =
0.010 SQIN
SHEAR:
v=
0.044 K/BOLT
Av= VIlO =
0.004 SQIN
BOLT OPTIONS TO SUIT WALLS:
318 "rjJ ALL THREAD THRU BOLTS
318 "rjJ TOGGLE BOLTS
318 "rjJ THUNDER BOLTS
318 "rjJ LAG BOLTS WISHIELDS
2 ROWSAT
4.0 BOLTS EACH AT
., 5INr 8INr
'MAX.
1.40 FT
/'
I
6IN
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WIND = 130 MPH EXPOSURE = B
COMPLIES WITH "2001 FBC - ASCE 7-98 FOR THE 3-SECOND GUST VELOCITY INDICATED ABOVE"
CALCULATION AND ENGINEER'S SEAL IS FOR WALL ATTACHMENT ONLY V.N.O.
At =0.078 in^2
Av =0.110 in^2
5.0 +1- O.c.
10/1:)/04
WED 15'4
. 0 FAX 8136772154
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SILCOX, KIDWELL, & ASSOCIATES, INC.
, Certificate of Authorization #8121
Paul D. Kidwell, P.E. Reg. #52683
1802 E. Busch Blvd., Tampa, Florida 33612
813 936-5090 813 936.2180 Fax
CLIENT: BAY AREA SIGNS LOCATION:
JOB ROADRUNNER Oil & lUBE
SHEET NO. 1 _ OF
CALCULATED BY PDK
CHECKED BY
SKA # 04.03334 JOB # 1
6
DATE _10/14/04
DATE
WIND = 34.8 PSF 130 MPH HEIGHT = 30
RACEWAY DIMENSIONS = 2.60 x 17.34 T
SIGN AREA(SF)* P (K/SF) = P (K)
45.1 0.035 1.57
T = P/BOLTS =
0.261 K/BOLT
At = T/20 =
0.013 SQIN
GRAVITY:
est.
20 #/SQFT
P = A *W a =
0.902 KIPS
T=
0.326 K/BOLT
At=T/20=
0.016 SQIN
SHEAR:
V = 0.075 K/BOLT
Av=VIlO=
0.008 SQIN
BOLT OPTIONS TO SUIT WALLS:
318 "r/J ALL THREAD THRU BOLTS
318 "r/J TOGGLE BOLTS
318 "r/J THUNDER BOLTS
318 "r/J LAG BOLTS WISHIELDS
2 ROWS AT
6.0 BOLTS EACH AT
~INr 8 INr
MAX.
1,67 FT
I
61N
!)~I:~
I!')', .'::: p/
f,-'l/1";~. ''-'1/ :('"t.
, :... !/\/r. "',,,-,>. ~ I.) r-.
~ D,~~ ;'jf
'-..,"',' -';..-""",
"i",/::/?(:~,
WIND = 130 MPH EXPOSURE = B
COMPLIES WITH "2001 FBC - ASCE 7-98 FOR THE 3-SECOND GUST VELOCITY INDICATED ABOVE"
CALCULATION AND ENGINEER'S SEAL IS FOR WALL ATTACHMENT ONLY U.N.O.
At =0.078 in^2
Av =0.110 in^2
3.5 +1- O.c.
SILCOX, KIDWELL, & ASSOCIATES, INC.
< Certificate of Authorization #8121
Paul D. Kidwell, P.E. Reg. #52683
1802 E. Busch Blvd., Tampa, Florida 33612
813 936-5090 813 936-2180 Fax
CLIENT: BAY AREA SIGNS LOCATION:
JOB ROADRUNNER OIL & LUBE
SHEET NO, 'J, OF
CALCULATED BY PDK
CHECKED BY
SKA # 04.03334 J( JOB # 2
WIND = 34.8 PSF 130 MPH HEIGHT = 30
RACEWAY DIMENSIONS = 1.40 x 12.60 T
SIGN AREA(SF)* P (K/SF) = P (K)
17.6 0.035 0.61
T = P/BOLTS =
0.153 K./BOLT
At = T 120 =
0.008 SQIN
GRAVITY:
est.
20 #/SQFT
P = A*Wa=
0.353 KIPS
T=
0,191 K./BOLT
At = T/20 =
0.010 SQIN
SHEAR:
V=
0,044 K./BOLT
Av=V/lO=
0.004 SQIN
BOLT OPTIONS TO SUIT WALLS:
3/8 "rjJ ALL THREAD THRU BOLTS
3/8 "rjJ TOGGLE BOLTS
318 "rjJ THUNDER BOLTS
3/8 "rjJ LAG BOLTS WISHIELDS
2 ROWSAT
4.0 BOLTS EACH AT
" 5INr 8INr
'MAX.
1.40 FT
lii ~_- ",
It> "
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DATE _10/14/04
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WIND = 130 MPH EXPOSURE = B
COMPLIES WITH "2001 FBC - ASCE 7-98 FOR THE 3-SECOND GUST VELOCITY INDICATED ABOVE"
CALCULATION AND ENGINEER'S SEAL IS FOR WALL ATTACHMENT ONLY U.N.O.
10/1~/04 WED 15:40 FAX 8136772154
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PERMIT NUMBER
NonCE OF 'I~OMMENCEMENT Ol._Z"-2"
, 0000- OOfo o.
n PARCEL 1.0. NUMBER ~ 0
l
11111111111111111111111111I111111111111I111111/ 111111111111I
2004210651
STATE OF FLORIDA
The UNDERSIGNED hllrll.' givIs nolicl th,lt Improvemen1 wiD be made to oblain rl,al jlroplrly
and In accordance with Chapter 713. FLOHIDA STATUTES, Ihe lallowing information is provided
in Ihie Notice or Commencement.
LEGAL DESCRIPTION (Mud inc:lude either lO:l blOCi, .ulllllvislon or llcUon lawn"'ip. fluoel
3 ;--0 31 A./t,JI~'r"Jf tl...'t;'>, ,?lfP';.Y/f! iI/t,L-.( PL
P-tJ 'r., '''r' S.G1I'~ Sv. /)///ISa/l.>'v /'P) 'tho'} p~<;~..") c(.v'!:!.!l/F'I.
. v D If 7 .. c: ? . '. Ie } AI ~~/t!..e; '2e. UI .0'" f.$VC-e.'7"7~-r
all( fl',;,><''': '\-- f'i46:1tF f;7:.J.Y/~~3
')5<.'.-TtolV '2.. Tvcv,t/5/f I f> ..?.f.:, S. / fU~-tVi.-6 .2-1 G.
'S~yo~! ): .^ 'L, . ';c'''''/~h /(c.; ..:;;;;(
OWNER INFORMATIoN ,.., '-
NAME r:~#tf(' 'r-CJPH-C1"'I1 r>1ACeA- ADDREljS ol.~J/,f"
INTEREST IN PROPERTY
NAME <<. ADDRESS OF FEE SIMPLE T1TlEHOLDER(1I other than owner)
Rcpl:830254
OS: 0. 00
11/10/04
Rec: 10.00
IT: 0.00
Dpty Cler'k
I
JED PlrrHAN, PASCO COUNTY CLERK
11/10/04 12: 43pm 1 if.l.
OR 81< 6104 PG .1.1.",16
11I1/1'M2c>c/C ()R. tlLAIVr"' <-('r-)' Pi- 13S-0(
,
~/3) 7-1'.).- 7J-'l1
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-
TRAL DESCRIPTION Of IMPROVEMENT
c.~t1..tl /.e44 .r~ LXl ..J.t,
&~I !rl.~cl
'"It, f'):),',
n
NAME,
BOND AMOUNTS
Leroy E. Mc..lver
CONTRACTDn. '
ADDHI::;S' 2117 W. Sewaha St. Tampa, FI33612
NAMriSADDRESSOFSURETY
LENDING ORGANIZATION
(name & add/'!!ss)
Persons withinlhe StIle at florida. dcsitMtef by awner upon who nol/ces or ollieI' MCllmenls may be semd as provided by SECTION 713.18 (1) (iI) (7).
FLORIDA STATUTES
NAME Debra Me.h,er
, ,
ADDRESS 2117 W. Sewahc~ 'SI. Tampa, FI 33612
In Iddilia n Iv "illllclf, owner deslgnaled ,
_af
(Nalllel
to receive a Gapy of Lienor'18Il provided III SECTION 713.13 (1) (b), FLORIDA Sl'ATUES
EXPIRATION DATE NOTICE OF COMMEN':EMENT
(Addrm)
'SIgn81preotowner ~~-LA h~ ~__~
Printed Name LJ-I1l 1.5. 7" at> 1-1.0 L. fYJ II LC.- A
(One yecl' from dale or recording, unless specified)
CERTIFICATIOII
STATEOF r:-\nr;rla .CDUNTYOF ~..;1rr::x.....~ _
Tbe faregoing ..slrument W8SICknowlerlmed before me Ih;. Q.JdaV of ~ b.<J.... , 20~ bYf'4--r~p.l... 0 r- .Iii a ,. c.C'.....
~h JII cflon,lIv known ~ r'rf, has pr~d. . . " as,ldenllflcalion aad who (did) (did nol) faftean olllh.
~y!f7/'116~ 1--1. ~L- CDRllftlllOn Number
\\111I" (S--.l:-
........ y pt!,,, l!I'e'~e M. Co
-a" 1ZE Notary Public-State at Florida
~~J., __ ~.:o...~ Com.mission # DD185665
'"Co-OF 'r\.~ ,.... .
',,",\.,,\ ExplI'eS Feb. 19, 2007