HomeMy WebLinkAbout05-4188
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4188
Permit Number: 4188
Permit Type: ADDITION/ALTERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: SINGLE FAMILY RESIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 39,500.00
Date Issued: 5/09/2005
Total Fees: 501.50
Amount Paid: 501.50
Date Paid: 5/09/2005 Phone:
Work Desc: ADDING BEDROOM,BATHROOM ,SETTING ROOM AND SCREEN ROOM
Address: 7237 HIGHLAND LP
ZEPHYRHILLS, FL.
Township: Range:
Lot{s): Block:
Subdivision: OAK RUN
Parcel Number:
Book:
Section:
Name: RANDY & VIVAN KRINGLE
Address: 7237 HIGHLAND LP
ZEPHYRHILLS, FL. 33542
.,
EAST PASCO ELECTRIC, INC
WILLIAMS (INDIVIDUAL)
BAHR'S PROPANE GAS & AlC. INC.
PLUMBING FEE
RADON
49.00 MECHANICAL FEE
7.80
49.70
P M
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.
REINSPEC110N 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. n
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
~-.
SIG TURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
~
fZ "i IV\~ CI;)~~ , .
~L~7 I~/~JJ-LAJ}) L~"'?
"'I~ 0
:Square Feet /1
,Dollar Amount
~
5~'\ 00"
U.
'Valuation
, ~
., 9, ')"Q 0 .~
I
Building
'3 Lfs.oC
'Electrical
~
....",-. ~- ........J
:J o~v
Plumbing
IftfJ .:, .G
~i)D~
LIe. 7Ci
'1' 1.
f, ~ ()
Mechanical
Connection Fees
!\Ijfl
Sewer
Water
Meter
School Impact Fee tJ )
,'fj
Transportation Impact Fee
N)y:r
I
Park Impact Fee rJ} it
Public Safety Impact Fee rJ/B
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8D St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IVED
Lj/z ~/oS-
I .
PHONE CONTACT FOR PERMITTING
OWNER'S N
PHONE ;f13-7~d--O?~~
JOB ADDRESS /~
LEGAL DESCRIPTION: LOT(S) 33 BLOCK ~ SUBDIVISIONW ~ ~~
PARCEL ID # g 1-.:<..s: - ::l-/ -D{c.X) ~O~_ 0:$8 D (OBTAIN FROM PROPF.RTY TAX NOTICE)
WORK PROPSED: oNEW CONSTRUCTION ~TION oALTERATION 0 REPAIR 0 INSTALL
oSIGN
o MOVE
o DEMOLISH
PROPOSED USE: oSGL FAMILY DWELLING
o COMMERCIAL
oMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
DE,SCRIPTION OF WORK A, I f:,e-frD-&ri'.;Se:#i hi /,00"'- . b<<-4, ~e."...,~O>>>>\-
cl&~~ . , ~ /
BUILDING SIZE 77"0 SQUARE FOOTAGE '790 HEIGHT g
I213UILDING
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. ();r..\:)~ ~ p~jT
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. Jr.-.
a I\S \. C i11i7 '-31 tL td(I ~_
PERMITS REQUESTED @ S i bl'l1i.D ?~4-Lf:P ~ V
?L-rW) f1..B.) \JjllhfJ
VALUATION OF TOTAL CONSTRUC.k\ON) .~ ,: " / l
(j) ~I./ (fi-L<.. '> i/ i-rr--
SERVICE 0 FLORIDA POWER O' W.R.E.C. r1h4-.JillJU)
$ ~q, OOOrD 0
$y~4-tln'j- AMP
ld"""ELECTRICAL
~UMBING
~CHANICAL
o GAS ~OFING
$
H,\)o D. 0;:)
.
VALUATION OF MECHANCIAL INSTALLATION
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION:~LOCK
o FRAME
o STEEL
o OTHER ~.Ae..-evL ~~
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAo YES 0 NO
~~~ I
SIGNATURE , '~ ~ ~ STATE CERT OR REGIST #~(Q.. ()~-,:; L:3 'f
EIBCTRICIAN *:;*H~"n*H **H";;*H~"~::::=*J::;:P:::::;;:EP" .
SIGNATURE ~ ~ STATE CERT OR REGIST # ER (:I)1'i591
********************************************************~******:** ~~
6 ~COOPANY~ ~~~
SIGNATURE "~~~*~"*H"*HH:~~~~*~~:;~*:~~':~~*H::* / ~s.
MECHANICAL / f"'oo/'/....... COMPANY ~~'t"'~~
SIGNATURE (~~~ STATE CERT OR REGIST i:'iJ.e,-O<f5<jiz:?
************* ':***********************:z::J*******************:
OTHER COMP~ .,
PLUMBER
SIGNATURE
STATE CERT OR REGIST #~ /~t>~~
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictionsH which
may be more restrictive than City regulations. The undersigned assumes responsibility for
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, 813-780-0020.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor SectionsH 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 GuideH prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownerH, I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "ownerH prior to corrunencement.
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 corrunenced 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 "AH or "A,etc.H, it is
understood that a drainage plan addressing a "compensating volumeH 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 corrunenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned fora
period of six 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 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 NE D TO RECORD AND POST A "NOT E OF COMMENCEMENTH.
STATE OF FLORIDA
COUNTY OF
The foregoing inS~~dged ~
:~~b~}~~d~~~ 20{Q "
(name of person acknowledged)
~o is personally known to me, or
S
edge~
, 20_
Dwho has produced
(type of identification)
ot
Dwho has produced ------
(type of identification)
.E:f'(lTd' not a ke a th.
signaturerof p rson taking acknowledgment
'ii--
. . ~ CornmiUIO" 00188811
Name type'S,or .~~'~!'V~l:~ped
gnature f p~~ ing acknowledgement
~=:=
Name typed~~t3ri ea or stamped
SEC.
34, TWP. 25 S., RNG.
PASCO COUNTY, FL(
LAUREL HAMMOCK L
CE--FntL ;K&D/U--
#4281 "
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FOUNDATION SURVEY
A SURVEY OF:
FIR 1/2" .
#3555 ~
FIR 1/2"
#3555
LOT 33. OAK RUN SUBDIVISION. IN ,",
SECTION 34, TOWNSHIP 25 SOUTH, R.~N.CE.
21 EAST, AS PER MAP OR PPLAT THEREOF
RECORDED IN PLAT BOOK 137, PAGES 128."
AND 129 OF THE PUBLIC RECORDS OF
PASCO COUNTY. FLORIDA. >0.'" d:~J.rf~~L.n.. '?
r., c:;:s 2T'APr..~..J~ DI
32 I
FIR 1/2"
#3555
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THIS SURVEY NOT VAllO
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NOTES:
1. FOUNDATION SURVEY ONLY. BOUNDARY SURVEY
PERFORMED 02/18/00.
2. LEGAL DESCRIPTION FURNISHED BY CLIENT. (WT
NUMBER GIVEN OVER PHONE)
3. BEARINGS BASED ON N 00010'32" E (PLAT) ALONG
'T'T-lE r. E}J7' Ii' Tn. TAlii' n'li' 'U'Tf"!.1.fT, A 1Jn T.nn p
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FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
FORM 600B-97 Residential Component Prescriptive Method B CENTRAL 4 5 6
Department of Community Affairs
Compliance with Method B Chapter 6 of the Rorida Energy Efficiency Code may be demonstrated by the use of Form 6ooB-97 for single and mult~amily residences of 3 stories or less in height, and
additions to existing residential buildings. To comply, a building must meet or exceed all of the energy efficiency prescriptives in any ~ of the prescriptive component packages iIIllI comply with the
prescriptive measures listed in Table 6B-1 ofthis form, An alternative method is provided for addftions of 600 square feet or less by use of Form 6OOC-97. If a building does not comply wfth this method,
It ma still com I under other sections in Cha ter 6 of the Code.
O-Y\. o.-lU.
GENERAL DIRECTIONS
1. New construction including additions which incorporates any of the following features cannot comply using this method: steel stud walls. single assembly roof/ceiling
construction, or skylights or other non-vertical roof glass.
2. Choose one of the component packages "A. through "F" from Table 6B-1 by which you intend to comply with the Code. Circle the column of the package you have chosen.
3. Fill in all the applicable spaces of the "To Be Installed' column on Table 68-1 with the information requested. All "To Be Installed" values must be equal to or more efficient
than the required levels.
4. Complete page 1 based on the "To Be Installed" column information.
S, Read "Minimum Requirements for All Packages". Table 6B-2 and check each box to indicate your intent to comply with all applicable items.
6. Read. sign and date the "Prepared By" certification statement at the bottom of page 1. The owner or owner's agent must also sign and date the form.
Please Print CK
1. Compliance package chosen (A-F)
2. New construction or addition
3. Single family detached or Multifamily attached
4. If Multifamily-No. of units covered by this submission
5. Is this a worst case? (yes / no)
6. Conditioned floor area (sq. ft.)
7. Predominant eave overhang (ft.)
8. Glass type and area:
a. Clear glass
b. Tint, film or solar screen
9. Percentage of glass to floor area
10. Floor type, area or perimeter, and insulation:
a. Slab on grade (R-value)
b. Wood, raised (R-value)
c. Wood, common (R-value)
d. Concrete, raised (R-value)
e. Concrete, common (R-value)
11. Wall type, area and insulation:
a. Exterior: 1. Masonry (Insulation R-value)
2. '!Jood frame (Insulation R-value)
b. Adjacent: 1. Masonry (Insulation R-value)
, 2. Wood frame (Insulation R-value)
12. Ceiling type, area and insulation:
a. Under attic (Insulation R-value)
b. Single assembly (Insulation R-value)
13. Air Distribution System: Duct insulation, location
14. Cooling system
(Types: central. room unit, package terminal A.C., gas, none)
Mctl.(i ~
$, V\ ~/ -€-
S9tD
Double Pane
sq. ft.
sq. ft.
lOa.
lOb.
10c.
10d.
10e.
R=
R=
R=
R=
R=
Iin. ft.
sq. ft.
__ sq. ft.
__ sq. ft.
__ sq. ft.
R= s: t.f
R=
R=
R=
11 a-l
lla-2
11 b-l
11 b-2
__ sq. ft.
__ sq. ft.
__ sq. ft.
__ sq. ft.
R= ,;J.:;-
R=
R=
Type: ~'I.s'i- l ~1r
SEER/EER: '0 S ~e/"'
Capaci~Yi H
Type: ~ e.G..-+ t...-w....p
HSPF/COP/AFUE:
Capac~:i 5D -~, ( -t~4J~r
Type:~~'~I~
EF:
12a.
12b.
13.
14a.
14b.
14c.
15a.
15b.
15c.
16a.
16b.
__ sq. ft.
__ sq. ft.
15. Heating system:
(Types: heat pump. elec, strip, nat. gas. L.P, gas, gas h.p., room or PTAC, none)
16. Hot water system:
(Types: elec., nat. gas, L.P, gas, solar, heat rec., ded. heat pump. other, none)
PREPARED BY:
I hereby cenlfy thatlhlS
OWNER AGENT:
DATE:
-1-
Revised 1998
TABLE 6B-1
COMPONENTS
MINIMUM REQUIREMENTS
PACKAGES FOR NEW CONSTRUCTION
BCD E
F
25%
UJ
UJ
:s
(!)
Max, 'loaf glass to Floor Area
Type
Overhang
A
15%
15%
20%
20%
25%
Double Clear (DC) Single Tint (S1') ouble Clear (DC) Single Tint (S1')
2' 1'4" 2' 2'
Double Tint (01') Double Tint (01')
2' 2'
Masonry
EXTERIOR AND ADJACENT MASONRY WALLS R-5
COMMON MASONRY WALLS R-3 CH IDE.
UJ
..J
...J
<
:i: Wood
Frame
CEILINGS
E COMMON CEILINGS R-11.
CEILINGS ALLOWED)
UJ
a:
a
a
...J
u..
Slab-On-Grade
Raised Wood
Raised Concrete
R-O
NSTRUCTION ALLOWED EXCEPT PACKAGE D)
R-5
DUCTS
SPACE COOLING (SEER)
!;( Elect.
~ Gas/Oil (AFUE)
Electric
Resistance**
R-6
12.0
STRIP
R-6
10.0.
6.8.
R-6
10.0.
6.8*
R-6
10.0*
6.8*
R-6
10.9
7.6
EF .90
EF .90
NOT ALLOWED
(SEE BELOW)
NOT ALLOWED
(SEE BELOW)
a:
w;:E
....w
<....
:i:UJ
....>-
aUJ
J:
Gas & Oil **
MINIMUM EF OF .54
NATURAL GAS ONLY
(SEE BELOW)
Other
Any of the following are allowed: dedicated heat pump.
heat recovery unit or solar system.
Climate Zones 4 5 6
TO BE INSTALLED
%
DC: 0 DT: 0
FEET
00: R=
ADJ: R=
COM: R-
EXT: R=
ADJ: R=
COM: R=
UNDER ATTIC: R = -
COMMON: R =
R=
R=
R=
R= - CONDo 0
SEER =
COP=
AFUE =
EF=
EF =
DHP: tj EF= -
HRU:
SOLAR: 0 EF= -
Single package units minimum SEER=9,7, HSPF = 6,6,
Minimum efficlenCles for gas and electnc hot water systems appiy to to 40 gallon water heaters, Refer to Table 6-12 for minimum Code efficiencies for oil waler heaters and other sizes,
DESCRIPTION OF BUILDING COMPONENTS USTED
Percent of Glas. 10 Roor Area: This percentage is calculated by dividing the total of all glass areas by the total conditioned noer area,
Overhang: The overhang is the distance the rool or soffit projects out honzontally from the face of the glass, All glass areas shall be under an overhang of at least the prescnbed length with the following exceptions: 1) glass
on the gabled ends 01 a house and 2) the glass in the lower stories of a mufli.stol'f house.
WIll, Ceiling Ind Floor Insulation Vllues: The R-values indicated represent the minimum acceptable insulation level added to the structural components 01 the wall, ceiling or floor. The R-value 01 the structural bUilding
malenals shall not be included in this calculation. 'Common' components are those separating conditioned tenancies in a multifamily building. 'Adjacenr componenls separate conditioned space from unconditioned but
endosed space, .Exterior" components separate conditioned space from unconditioned and unenclosed space,
Floor: Slalron"9rade floors without edge insulation are acceptable, Raised wood noers shall have continuous stem walls with insulation placed on the stem wallar under the noor except Package 0,
Ducts: "CONO" indicates that the ducts must be installed within the conditioned space; that is, the ductwork shall be located on the conditioned side of the Insulation, Ducts in conditioned space are acceptable for any
prescriptive package,
Space Cooling System: Cooling systems shall have a Seasonal Energy Efficiency Ratio (SEER) lor central units or Energy Efficiency Ratio (EER) for room units or PT AC's equal to or greater than the prescnbed value,
Electric Spice Hllting Option: Heal pump systems shall be rated with a Heating Seasonal Performance Factor (HSPF) equal to or greater than the presenbed HSPF, Heal pump systems may contain eleclnc stnp backups
meeting the criteria of section 608.t.ABC,3.2.1,2. No electnc resistance space heat is allowed for these packages.
Electric Resistance Hot Water Option: For packages designated "Not Allowed", an electric resistance hot water syste:n may be installed only in conjunction with one of the "Other Hot Water System Options", See below,
Other Hot WIler System OptJons: My dedicated heat pump, heat recovel'f unit, or solar hot water system may be installed. Solar systems must have an EF of t,5 or higher, E1ectnc reSIStance systems haVIng an EF 01 ,88
or greater, or natural gas systems with EF ,54 or greater may be used in conjunction with these systems,
TABLE 6B-21 MINIMUM REQUIREMENTS FOR ALL PACKAGES
COMPONENTS SECTION REQUIREMENTS ICHECK
Exterior Joints & Cracks 606.1 To be caulked, gasketed, weather-stripped or otherwise sealed. t/
Exterior Windows & Doors: 606.1 Max ,3 cfm/sa.ft, window area; ,5 cfmtsa.ft. door area. ,/'
Sole & Top Plates 606.1 I Sole plates and penetrations through top plates of exterior walls must be sealed. ! V
Recessed Lighting I 606.1 Type IC rated with no penetrations (two alternatives allowed).
Multi-story Houses 606.1 Air barrier on perimeter of floor cavity between floors. I
Exhaust Fans 606,1 Exhaust fans vented to unconditioned space shall have dampers, except for combustion IV"
devices with integral exhaust ductwork.
Water Heaters 612.1 Comply with efficiency requirements in Table 6-12. Switch or clearly marked circuit breaker (electric) ;/
or cutoff (aas) must be orovided. External or built-in heat trap required,
Swimming 612.1 Spas & heated pools must have covers (except solar heated). Non-commercial pools must have a
Pools & Spas oumo timer, Gas soa & 0001 heaters must have minimum thermal efficiency of 78%.
Hot Water Pipes 612,1 Insulation is required for hot water circulating systems (including heat recovery units),
Shower Heads 612.1 Water flow must be restricted to no more than 2.5 gallons per minute at 80 PSIG. V
HVAC Duct 610.1 All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached,
Construction, sealed. insulated and installed in accordance with the criteria of Section 610.1. Ducts in attics must be V"
Insulation & Installation insulated to a minimum of R-6. Air handlers in attics shall be within 5' of an attic access, have a radiant
barrier installed above the ahu extending 10' in all directions & meet requirements of other codes.
HV AC Controls 607,1 Separate readily accessible manual or automatic thermostat for each system, t/
-2-
II11II11111111111111111111111111111111111111111111111111I11I
2005093636
NOTICEOFCOMMffiNCEMENT
STATE OF FLORIDA
COUNTY OF PASCO
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,
and in accordance with Chapter 713, Florida Statues, the following information is provided in
this Notice of Commencement:
1.
Description of Property:
2.
General Description of Improvement:
Parcel No. 34-25-21-0100-00000-0330
7237 Highland Loop Rcpl: 883454
Zephyrhills, FL 33542 DS: 0.00
05/12/05
598 sq. ft. room addition
Rec: 10.00
IT: 0.00
Dpty Clerk
3.
Owner Information: Name:
JED PITTMAN~ PASCO COUNTY CLERK
Randall and Vivian Kringle 05/12/05 1", : 0~m 1 of 1
7237 Highland Loop OR BK 6361) PG 1485
Zephyrhills, FL 33542
Interest in Property:
Name of Fee Simple Tittleholder:
If other than owner: Address:
City
State
Zip Code
,
R4.
Contractor:
Address:
Ryman Construction, Inc.
36413 S.R. 54 West
Zephyrhills, FL 33541
5.
Surety: Name
Address
City
Amount of Bond: $
State
Zip Code
6.
Lender: Name
Address
City
State
Zip Code
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 (1) (a) (7), Florida Statutes:
Name
Address
City
State
Zip Code
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. Expiration date of Notice of Commencement (the expiration date is one (1) year from the
date of recording unless a different date is specified.)
Signature ofowner:f-t.,.ll/? ~
5-y'-v'5-
Printed Name
Sworn to and subscribed before me this $da
(
(f;
Notary Public State of ~Iorida
Elobbie J Knight
My C~ion 00416222
Elpires 0313112008
STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
flOCUMENT ON FILE
OR Of.PU8L1C RECORD IN THIS OFFI'~WITNESS MY
HAND AND OFFICIAL SEAL THIS ~ DAY OF
/)),9'/ 2~
JED PI ~f CLERK OF C~aC~T COURT
BY ~ DEPUTY CLERK
Notary Public'
My Commission Expires: