HomeMy WebLinkAbout05-4231
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813}780-0020
RESIDENTIAL SWIMMING POOL
4231
Permit Number: 4231
Permit Type: SWIMMING POOL RES.
Class of Work: ROOF NEW
Proposed Use: SINGLE FAMILY RESIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 32,093.00
Date Issued: 5/17/2005
Total Fees: 265.00
Amount Paid: 265.00
Date Paid: 5/17/2005 Phone:
Work Desc: NEW INGROUND SWIMMING POOL WITH SPA
Address: 5629 PROSPER CT
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: RAY BARNES
Address: 5629 PROSPER CT
ZEPHYRHILLS, FL. 33542
A UALlTY POOLS, INC.
HAWKINS ELEC. SERVICE
A QUALITY POOLS,INC.
BUILDING FEE
PLUMBING FEE
ELECTRICAL FEE
~o ,/
. {' ()j-o 0 J
~\ ~~
\\/ R"--\
P OL STEEL
POOL PLUMBING/PRESSURE_
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."
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
~~~ ~-~
CONTRACTOR PERMIT OFF I
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
May 17 05 09:38a
A-Quality Pools, Inc,
813-888-5119
p,1
lO'd 1YJ.OJ.
~
~!
~"-.-},-;~ a
- ....:.,4 " .:.
~:. .i .-
"~~AfAlM.VII'
lMiE:
6/117 /()~
I
l'OWofQM "_IV ~EMt.
-~~~:t'd~ .. .
I...........U ~ . ....... FJ.E..c2 ""iU.f.l!L..
..... Iit_.... _eta..
.......... .. n h.... n.jaII...._
m'TECF ~Ia( da
COUtI'IYOF C\T1,\ ~ ?'.....m ry \l'\ill"S
I~_"'", _~__._:. 0"'~"","lIIio /rJti=-' $>
5~'" -ri'n.., kJV,'" 'So iiiO .-.tr'~ -
~.~"~t . - 'V~
-.J.~ .
...... ..... ..._-.,~
.~,.4~~-._-~._ ~I - .......,. _ lJ _ ....,.,..r""
-~"'"",J11 ... _-....:~ .--". el'llr U~....
T!:" -Q...,.."
~...
.111.
........ --
JO/~O'd
80:60 SOOZ-Ll-AYW
CITY OF ZEPHYRHILLS J:'.t!i.t<MJ. 'J." .l\.J:"J:".....~"-'.n.... ....."'...
BUILDING DEPARTMENT 53. 35 8TH st, Zephyrhills, FL 33542~
813-780-0020 FAX: 813-780-0021 ~ ~~
DATE RECEIVED H VfJ
M~~-?' ,/-:2-5011>
PHONE CONTACT FOR PERMITTING
OWNER'S NAME ~.Y 1!/9~/1t[s"
JOB ADDRESS 56';2 1&vf?~' C/.
LEGAL DESCRIPTION: LOT (S) CJ'770 BLOCK tJ()tJOO
PARCEL 10 # /.2 -Z$ ~ :2 j- ClJ/O-aJaX} - tJ'17cJ
PHONE flJ - "7 f;2 - ? 71.~
SUBDIVISION 0 .3}cJ
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: []NEW CONSTRUCTION
[]ADDITION
[]ALTERATION
[] REPAIR
$ INSTALL
[] SIGN
o MOVE
o DEMOLISH
PROPOSED USE: []SGL FAMILY DWELLING
[] COMMERCIAL
[]MULTI-FAMILY
[] INDUSTRIAL
[]it OF UNITS
J21SWIMMING POOL
[] MOBILE HOMJ
o OTHER
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK ..27> ~,.:./ / , ,..M7I~ Ou? Crt-<' ,<t SW'! '".-."" · ''''J /i, / ,..,;./ j ?'"
7'
BUILDING SIZE SQUARE FOOTAGE HEIGHT
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. rY
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED, · I ~
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION, jl~ ~l?l/
PERMITS REQUESTED '-1- ~ .t-
aBUILDING $ :> 2, t??I" VALUATION OF TOTAL CONSTRUCTP.Ai~~ p>J. ,.j I
.1<1 ELECTRICAL AMP SERVICE 0 Progress EnergyV~;: J,ti J. E ,c~j il~
d"I PLUMBING ~. to 'f1J"f
[] ~~
MECHANICAL $ VALUATION OF MECHANCIAL INST~LLATION
TYPE OF CONSTRUCTION: [] BLOCK
[] FRAME
[] STEEL
[] OTHER
JLl ')Y~~f)l
~)-{{ ~J~ l.-).>~~~
A~~ ~YE~"'2--~6
o GAS
[] ROOFING
o SPECIALTY
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE
BUILDER
.~~
SIGNATURE ~
****************************************************.**************
ELECTRICIAN
COMPANY
IIlIwt(~s
SIGNATURE
STATE CERT OR REGIST it
******************************************************************
PLUMBER
SIGNATURE ~
COMPANY ~~~1.{"Ab' he. '
STATE CERT OR REGIST # ~ /7'56'/' PI
******************************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST it
SIGNATURE
**********************************************
OTHER
COMPANY
STATE CERT OR REGIST #
f;riT>
A. NOTIC;E OF DEED RESTRICTIONS
Th~ undersigned understands that this permit may be subject to "deed restrictions" which
may be more restrictive than city regulations. The undersigned assumes responsibility for
compliance with any appiicable 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 po~tions of the "Contractor Sections" of this application for which they
will be responsible, If you, as the owner signs as the contractor, ydu 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 indica~ion 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.
Appli~ation 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 certity 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 d~y extension of time
may be allowed for the permit with fee charge of $15.00. ,The extens~on shall b7 requeste~
in writing to 'the Building Official. An approved inspect~on must be logged dur~ng each s~x
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 ~O 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 00 NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT",
~~ '~/
SIGNAT E: CONTRACTOR
SIGNATURE: OWNE OR AGENT
acknowledged
, 2U--
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
, 20_
(name of person acknowledged)
Dwho is personally known to me, .or
(name of person acknowledged)
[1ho is personally known to me, or
[] who has produced
(type of identification)
and whoD did Ddid not take an oath,
o who has produced
(type of identification)
and who Odid []did not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
04/27/2005 14:34 FAX 813 715 0824
ZEPHYRHILLS OPS CTR
~ Progress Energy
April 27, 2005
A-Quality Pools, IDe,
5420 Pioneer Patk Blvd,
Suite B
Tampa, Florida 33634
SUBJECT: PROPOSED SPAlSWIMMING POOL CONSTRUcnON AT:
LOT 77 - SUNSET ESTATES SUBDMSION
5619 PROSPER COURT
ZEPHYRBILLS, FLORIDA
Thank you for notifying us of your proposed swimming pool collStnlction at the above
location.
The pool proposed for cons1ruetioD at the above address does not conflict with any
tmdergn:>und or overhead fKilitics of Progress Energy. provided that the pool is instBlled
in the location shown OD the attached site plan provided to us by the pool contractor,
Please call Sunshine State One Call of Florida (1-800-432-4770) a miDimwn of 48 hours
before you dig_
If you have any questions or require any additional information, please call our.office at
(813) 783-6944,
Sincerely,
Progress EDel"lY Florid.
~4~
Darryl ~shce ,..,.
Service Coordinator
DF/mw
Pf1I!I1lH E_Sf F'ori_ In...
36453 Eiland Blvd,
Zephyrhill,. FI 3,1542
141001
" .-._-<_.-.._-...-.._._.-..,----~-----'-.._-
state of #
NOTICE OF COMMENCEMENT
County of &~ q/
111111111111 11111111111111111111111111111111111 11111 Ill/II
2005073825
TUB ImOERSIGNED hereby gives notice that improvement will be made to c~rt,
real property, and in accordance with Chapter 713, Florida Statutes!
following inforpation is provided in this Notice of Commencement:
Su (')-::,e+
of the property
1, Description of Property: Parcel No.
2 .
General Description of Improvement
3.
.~ '\ \(YYY"l 'rs yC""C) wi ~
(/!xlrr7eo )
Ovmcr Information: Name ~Y<JI d,.s /.",4 J5.4tf.l?t1:f'
F\ddressS6"' ~ 1 .fIlnf/lL~ C~ City ~1l?.( /1l.A.,/A State 5 3~
Interest in Property: '(')~-tn/"n5 (!nnC(..p-fe ..5lt")/mfhl~ 1>001 wI..:.
Name of Fee Simple Titleholder:
(If other th~n owner)
In ~-\n \ \ \"n'J \~ ['.L "') (10 ( 0YJC >( .o-\e
City
Sti.lte
Address
R4.
Contractor: NoJ.me 4k/:;: ~JfU
AJdres~f".20/~ ~~ ;aM"
(Robe.l+ J
6=ro%o)
State/?' ~
-
City /--.?~
~, Surety: NoJ.me
City
Stat.:::
r'\ddrcss
Amount of Bond: ;;
Rept.: 875185
DS: 0.00
04/18/05 _-,-
Ree: 10,00
IT: 0.00
Dpty Clerk
6.
Lender: Name
City
State
Address
tl ,-: lOt!
designated by O\oJner upon \
served as provided by SeC1
i1~ l~~~!MAri : fC:;O fOUNTJf C1.E~
OR BK 6325 PG 148E
7.
Persons within the State of Florida
notices or other documents may be
713.13(1)(a)(7l, Florida Statutes:
^ddreS5
City
State
8, In addition to himself, Owner designates
at to receive a copy of
Lienor's Notice as provided In Section 713.13(1)(b), Florida Statui
(). f'xpi..r;nt j,',n dnt.e of Hut-ice of Commencement. ('"the expLcatic.o d.ite i5 1
fr~m the date of recording unless a different date is specified.)
S"9nature of Owner' j Z- ,.:}~
~ CJLr16
Sworn to and subscribed before me this ~
20 ():; .
/1 t,SZ -7~/-Y7-~
day of 4~/'L 2-tI"tJ..!
NotJ.ry Publ.LC;
11 .NoIary PubIc. S1aeIdFlarida
(. . ~ Mr CoIOOIIIIkln ExplIIs JIn 5..
~llI' ~'D03840t4
,,- Bonded NIIIanII ~
tw1y C ~;-;-li;1.i 5sion Ex
PC93053048/A
PASCO COUNTY BUILDING PERMIT APPLICATION
CENTRAL PERMITTING OFFICES:
Dade City: (352) 521-4279 Fax (352) 521-4298
14236 - 6th Street, Suite 203, Dade City
New Port Richey: (727) 847-8126 Fax (727) 847-8901
7530 Little Road, Room 210, New Port Richey
Land 0' Lakes: (813) 929-1266 Fax (727) 929-1307
4111 Land 0' Lakes Boulevard (U,S. 41), Land 0' Lakes
OCCUPANCY:
SEQ#:
NO. OF UNITS:
Fire District:
Permit#:
THIS APPLICATION MUST BE TYPED OR PRINTED IN INK
AND IS VOID IF NOT PERMITTED WITHIN SIX MONTHS
Type of Construction:
II
III
IV V VI
Date Received:
By:
Is this Application the.
o Owner's Name:
W Job Location:
N ParcellD#: S ~ T &l A R..2lL Sutt)~ BI~ ot cYJ"'lO>>roject #
~ Owner's Present Address: City: Zt-(h. lfh"' \ \~
N
Phone # ( )
Subdivision:
TAZ Lot Size
State: f=\ Zip:
x
~4.Q.
Fee Simple Titleholder's Name (If Other than Owner):
Address (If Applicable): City:
~ Description of Work: .In'bb \\l~ (' OrfeY'~ ~h "'ll~ I~ yt")O I
S Living Area: Patio:. Garage: Entry:
C
R # of Bedrooms: # of Bathrooms: Type of Construction: 0 Block
I
P
T
I
o
N
State: Zip:
u"\t+n ~)
Total Under Roof:
o Frame 0 Other:
Fill: Yes
No
FEES BLOCK
Plans Fee: $
If Mobile Home/RV, Make:
Wor1< Code
Model Name:
Valuation $ . ~ lcH''?:>. c.2P
Year:
Size:
Prepaid Plans Fees: $
Plans on File? 0 No
o Yes
Receipt #
Building: $
o Bonding Company:
T Address:
H Architect/Engineer:
E Address:
R
Mortgage Lender:
Address: City: State: _ Zip:
Contractor: A-Gun.\l~~"i~ \1\('. Print Name: KO~(t ~; br~')
Signature: ~ Phone # (1/.131) ~, tReo
Address:~ cne€~ "6\-<o.-@City: ~State:~Zip: ~~
State License # (if applicable) 14~'1 Pasco Co. ComputerlD# 0\ ~\rj .
Electrical Contractor: ~()~ E\eC::iY ic. Print Name: ~ (y U L
I Phone#(<613) qOl -<tJ~?
A~City: ~State: A Zi~~~
Pasco Co. Computer 10# 0'_
Sawpole: AMPS:
City:
State: _Zip: _
City:
State: _Zip:
Address:
State License # (If Applicable)
Power Co.:
Electrical
Fee:
$
C
o
N
T
R
A
C Address:
T
o State License # (If Applicable)
R 0 New 0 Alteration Valuation: $
Mechanical Contractor:
Print Name:
Mechanical
Fee:
$
Signature:
Phone # (
City: State: _ Zip: _
Pasco Co. Computer 10#
(Required)
Plumbing Contractor:A-CVU.0hb~~~ \('(print Name: "t?Cbt"ft..J. G((~umbing
Fee: $
Signature: Phone # (~J3> ) S <6 ~-~
Addres~:5t1. r'L \'1. -I City: Ill~tate: ,c, Zip: ~3l.f
State License # (If Applicable) , Pasco Co. C mputer 10# ~ 4Dlf I
# of Fixtures: _ Septic Per. #: Sewer: _ Water: _ ell:
Other Contractor:
Signature:
Address:
State License # (If Applicable)
Type of Contractor:
Print Name:
Other Bldg.
Fee: $
Phone # (
City: State: Zip:
Pasco Co. Computer 10#- -
Valuation; $
JOBS UNDER $2,500.00 IN VALUE DO NOT NEED TO
RECORD AND POST A "NOTICE OF COMMENCEMENT." TOTAL BUILDING PERMIT FEE
$
[;
l
I
f
I
r
Other Fee Type:
Amount: $
Receipt #:
Radon Fee: $
dv/pc93043032
. ..,- NOTICE --*
ONTRACTOR OF RECORD {ll
THE REVERSE SIDE OF THIS
RELEASED BEFORE 03/05 A
t
I
A. NOTICE OF DEED RESTRICTIONS
The undersigned understand that this pennit may be subject to "deed restrictions" which may be more restrictive than County regulations. The
undersigned assumes responsibility for compliance with any applicable deed restrictions.
B. UNLICI;NSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, he may be required to be licensed in accordance with State and local
regulations. It 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 is uncertain which licensing requirements may apply for the intended work, he is advised to
, contact the Pasco County Building Inspections Division, Licensing Section, at (727) 847-8009.
Furthennore, if the owner has hired a contractor or contractors, he is advised to have the contractors sign portions of the "Contractor Block" of
this application for which he will be responsible. If you as the owner sign 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 pennitting privileges in Pasco County.
C. IMPACT FEES/UTILITIES IMPACT AND RESOURCE RECOVERY FEES
The undersigned understands that Impact Fees and Resource Recovery Fees may apply to the construction of new buildings, change of use
in existing buildings, or expansion of existing buU~lngs.., The undersigned also understands that such fees as may be due will be identified at
the time of pennitting. It is further understood that Impact Fees and Resource Recovery Fees must be paid prior to receiving a "Certificate of
Occupancy" or final power release. If the project does not involve a Certificate of Occupancy or final power release, the fees must be paid
prior to pennit issuance, Furthennore, if Pasco County Water/Sewer Impact Fees are due, it must be paid prior to pennit issuance in
accordance with applicable Pasco County ordinances.
D. CONSTRUCTION LIEN LAW (Chapter 713. Florida Statutes. as amended)
If valuation of work is $2,500.00 or more, I certify that I, the applicant, has been provided with a copy of the F/orida Construction Lien Law -
Homeowners Protection Guide prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other
than the owner, I certify 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 infonnation 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 pennit to do work and installation as indicated. I certify that no work or installation has commenced
prior to issuance of a pennit and that all work will be perfonned to meet standards of all laws regulating construction, County codes, zoning
regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government
agencies may apply to the intended work and that it is my responsibility to identify which actions I must take to be in compliance. Such
agencies include, but are not limited to:
. Department of Environmental Protection: Cypress bayheads, wetland areas, environmentally sensitive lands, and water/wastewater
treatment.
. Southwest Florida Water Management District: Wells, cypress ~ayheads, wetland areas, and altering watercourses,
. Anny Corps of Engineers: Sea walls. docks, aDd navigable waterways.
. Florida Department of Children a'nd Family Services, Environmental Health Unit: Wells, wastewater treatment, and septic tanks,
. U.S. Environmental Protection Agency: Asbestos;abatement. '"
. Federal Aviation Authority: Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone "V' unless expreSSly pennitted.
If fill material is to be used in ,FlOOd Zone "A," it is und,erstood that a drainage Plan, addres,sin.Q a "compensating volume" will be
submitted at the time of pennittingwhich is prepared by a profe~ional engineer Iiqensed by the state \>f Florida.
If fill material is to be used in FlOOd Zone "/Ji' in connection with a pennitted b~lding using stem,wall construction, I certify that fill will
be used only to fill the area within the stem wall. '
If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties, If use of fill is found
to adversely affect adjacent R.roperties, the owner may be cited for violating the conditions of the Building Pennit issued LInder the
attached penn it application. For lots less than one (1) acre which are elevafed by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the pennitting conditions set forth in this affidavit prior to
commencing construction.
.
.
.
.
I understand that a separate pennit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not
specifically included in the application.
A pennit 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 'r'equiHng a Correction of errors in plans, construction, or
violations of any codes. Every permit issued shaH become invalid unless the work authorized by such pennit is commenced within six months of pennit
issuance, or if work authorized by the pennit is suspended or ,abandoned for a period of six months after the time the work has commenced, An
extension in writing, may be requested from the Building Official for a period not to e.x~ed ninety (90) days and will demonstrate justifiable cause for the
extension. If work ceases for ninety (90) consecutive ~ays, the job is considered abandoned.-', ,"
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN PAYING lWlCE FOR IMPROVEMENTS
TO YOUR PROPERlY IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT.
SIGNATURE: ~s:::---
~ER OR AGENT
STATE OF FLORIDA COUNTY PASCO
The foregoing instrument was acknowledged before me this ~:.d
~l \ 200$by t2t~(~ U. ('Yn.<""~b
(name of person acknowledging), who is personally known to me or who
has produced Dt
~
' CONTRACTOR
STATE OF FLORIDA COUNTY PASCO
~~ing ""rume", ~dged before meth;. r
() L 20USby ol::Jt!'t'-r ,-J .. ~1'::6S
(name of person acknowledging), who is personally known to me or who
has produced l>l
SIGNATURE:
(type of
(type of
identification) as identification.
. 3/1/05
NOTARY
dv/pc93043032
A Quality Pools. Ino.
li,rx.r,k )r.sor75~{(
GENERAL POOL SPECIFICATIONS:
Shape A':~/).d J/ length ;2"7
Depths: Shallow End 3
Elevation Desired ,-
Returns '3
Decking Type ~~ f
Design in Topping -
EQUIPMENT:
Filter ~V ~/.V} (/
Automatic ChIorinalor(T ypel
Skinvnerwith leaf Basket
Stainless Steel Handrail
Auta Overflow & Vacation Value
6" Waterline Tile (choice from stockl ~yc::
Automatic Controls
Additional Poollnformotion
SWIMMING POOL
CONSTRUCTION AGREEMENT Dote ~;2- 1/5"'
Ovmer ~v 131h/l~J
MdressS,,;;'? Aoj#4P1 d ~~-<Y4!./A. /1
Cily#4.-G1h ~ ZipCode J? 5~2
Telephone(H)7?..2- ?7/) (WkI7rP-?Y7~ (Celll~t""?- 5" JS2
Job Address
LegoI Descri lion
CountY ~f'~
WKlth / 2-
Deep End at Drain 6"
Shallow End Steps J
Therapy Jets ~
Deck Color ~p<'"
lanai Topping -
State License # CPC1456781
P.O. B,x 340154
"., F133694
Ph"" (813) 927-0815
fix (al3) 926-Sa67
i,,"@v,,;zolllttp,rp,gu,um
Area
5% Tolerances
9tJ 5? ,/r
~F/r 6,c....
Lanai Color
Pump&Motor .ffiyt.v/~
Ye~ No D underwater Light (Wattsl
Yese NoD WoIerproofTimedock
Yes D NoQ EledricHookupfoMolor,Light, rllT1e"Clock& Translonner
Yes D No&( Some Color light
Yes ~ No D Fiber-optic light
Yes D No Ja Risers Lineal Feet
Size / .s--
/?V WI1I1
Yes~
Yes,B'
Yes~
YesD
YesD
YesD
NoD
NoD
NoD
No-EJ
NoB;(
No~
pool Edge: Cantilever D Brick Coping U- Cop Tile D
Cleaning Equipment: Vacuum Hose and Head, Pole, Brush and Test Kit
Love Seat Yes D No,e
Child Safely Fence Yes D Nog
Automotic pool deaner Yes D No J6.
Solar Heat Yes D No ~
HeotPump Yest2J No D
Swim Out Yes~ NoD
Gas Heater for Pool Yes D No iiil
SPAS: /~
Size f
Lineal Feet
Yes;;a No D
Lineal Feet../" h7 k.A'1
tv'tocIeI
Number of Panels
Model ~v _/7/);O tJ {/
Color
Gas Type
Propane D
Natural D Heater Size BfU
Raised Yes~ NoD L~ Flush YesD No~
Acrylic YesD No&J
Number of Spillways /
Spa Light Yes~ NoD
Blower Size '
Natural D Heater Size BTU
Shape ~""".....o
Concrete
Number of Spa jets ~
1 Pump System
2nd Pump Size -
Gas Heater for Spa
Additional Spa Information
MISCELlANEOUS:
Yes l;4...
NoD
Yes J;;a
NoD
Nol;a,
YesD
Gas Type
Propane D
Excavated Fill Remaved from Site Yes Ga
Site deanup by Pool Controclor Ye~
No Sod Replacement No Underoround Utilities Repair
Pool layout plans and structural engineering supplied by contractor
Contraclor sholl provide 0 minimum three yards ~ring Rock
Additional Charge for Stump Removal Yes D N~
Layout plans ore included ond are a port of this Agreement. (Minor variations in dimensions of the Pool, Patio, or Elevations, sholl not affect the validily of this Contrad, nor the
owner's obligation under this Controct), YeeB:.. Shuttle Dig Yes D NqJ2J'
#1 SEE BACK Small Equipment Yes D No~
All pool plumbing sholl schedule 40 PVC noncorrosive piping Yes ~
Contractor to Finish interior with hand traweled waterproof material Ye~ Type~7i/.1 J (
SCREEN ENCLOSURE: .
Roof Style /~~';' ~ ~ r::.4'3Jr. A1uminumColor ~/f ~rl
=~~~ &r)_A':/~a/y~D 4;~7 un,~., ... ... ... Heght ~ ?rt
TERMS OF PAYMENT: It is understood that the terms ore cash and payments as set forth below ore due on billing unless special armngements are
otherwise mode and herein set forth, CONCRETE
FUll CONTRACT PRICE: 3 .2. VI 9' -::7
(-I Final payment of $500 3/ ',S9 :5 1"'t7. e;V' i //0 </-"2.~(J'r
SCHEDULE OF BIlliNG: Deposit 10% f / 5' .7" 30
Coo_ Sholl pj~~1 ""'~ @' ",.
Upon Installation of Tile 35%"Ij' 5.. .s:!'
Screen/Finished Deck 15% ~ __' ~v
Final Payment Due Day of Plaster Final $500 . S-OO '
A~-QU RESPONSIBLE FOR ANY DAMAGE TO ANY EXISTING SPRINKLERS, THE CAPPING OF ANY SPRINKLER, OR REPLACEMENT
OF A SPRIN R.
The her knowIedges Ihot ' , I s complete as 10 all essential provi.ions before signing ".,00 J copy thereoI was delivered 10 the owner at the time the inslrumenl was signed
Ovmer ~ Date L..::- 0 2.. -efl..r--
Presented by A-Qualily Pool & Spas, Inc. Representative, Dote ~.2 -0..)
No D If Fillta remain on site ta be spread by Ct:;:)I? ~
No D Grode and Rake Site and Access Ye.;I.a. No D
No Sidewalk or Driveway Repair or Replacement No Fence Repair or Replacement
Yes&- Pool permit obtained by contractor Yes Eiit
Yes e' Retaining Wall Lineal Feet Yes D No .121
Color
?
You have a IeaaI right ederallaw fa cancellhis inslrument, il~ desire 10 cia so, withauJ ~ IJenally or obligation excepIfor actual cosh incurred in your behalf for building permits or SUIW)'>,
wilhin three 6usine.. days Itom the above contract date. Cancelation must be in writing & nolotized.
\
, PRIVATE sWIMMING POOLS & SPAS
RBQUJRBD JNPORMA11OM JlOB.
JNSP)!C'l1ONS &POOLAPPLIfA11ONS
424..2 FBC-2001
OIl J.~Y 1.2002 dID ~ 1JecMn8, ~.-.. tiJr' eou'...a.". to"
.....~ 8Bedo- of 424.2 F.B.C. -" .
- .
-
Spoa~, BuiJdiqg ~Aof!I wiD be'~." tbr1he tbrce levels ofaoti-
..~~ .._~ ....,.8Ie.cr~8d'to pmvicIe aod ~of.fety ..GteCtion..
/. I. AN1I-~COYIlItS.MIiV'4~" .......~X/Il!<t>7.i"/ kIP '3S /I"
2. J.()t"ImGCOVIlIIlI........... f .,..... ....~..."o -..... NiJ,./~/w IIf'
3. TWO MAIN IaAINS -.- lIT ,I. ~ · .. . ':Lof3. },O
4.. VENT... VA.CUlJM.t.k r 1f ~ MJk. tLQ.YW;t1/U) Modal No.. VLjO;? /9 W n'-
s.. SAJlEl"YBAtOtJRItS..... ~I ~1J/Vl~'6i1 .-wNo.
. . Ci. AlARM SYS'I'&t8 fill' ..df .. ~ MI.... doOis. Mfa. - UodBl No_
AppIv-n will beI~ 10 prcwide" Ja.youtslJawing
..~'. 1'1:1.
.
.nc...,...... provide twO caPa ofall ~ iaIiJrmI(ioD; Ibis iDb..-inn is.
_ 4 )Iur ~ o. · III ....- ...1 .,.......... ~ q.a Me; ~A J at in1aIre
-
RESIDENTIAL SWIMMING POOL, SPA AND/OR HOT TUB SAFETY ACT
NOTICE OF REQUIREMENTS
I (We) acknowledge that a new sWi"lllJing pool, spa or hot tub Will be construe/ed or installed at
s. :t. !i': At-q- R C;/. ~~.o4~,(, ~ C/ 33.5 "',g and hereby affirm that one of the following
(Please Pon Street Address)
methods will be used to meet the requirements of Chapter 515, Florida Statutes:
The pool will be isolated from access to the home by an enclosure that meets the pool barrier
requirements of Florida Statute 515.29;
The pool will be equipped with an approved safety pool cover that complies with
ASTM F1346-91 (Standard Performance Specifications for Safety Covers for Swimming Pools,
Spas and Hot Tubs);
All doors and windows providing direct access from the home to the pool and located within the
enclosure/fence required by the Pasco County Land Development Code, Section 530.4(0), will
be equipped with an exit alarm that has a minimum sound pressure rating of 85 decibels at 10
feet;
All doors providing direct access from the home to the pool and located within the
enclosure/fence required by the Pasco County Land Development Code, Section 530.4(0), will
be equipped with self-closing, self-latching devices with release mechanisms placed no lower
than 54" above the floor or deck;
I UNDERSTAND AND AGREE THAT NOT HAVING AT LEAST ONE OF THE ABOVE INSTALLED AT
THE TIME OF FINAL INSPECTION, OR WHEN THE POOL IS COMPLETED FOR CONTRACT
PURPOSES, WILL CONSTITUTE A VIOLATION OF CHAPTER 515, F.S, AND WILL BE
CONSIDERED AS COMMllTlNG A MISDEMEANOR OF THE SECOND DEGREE, PUNISHABLE BY
FINI;S UP TO $500 AND/OR UP TO 60 DAYS IN JAIL AS ESTABLISHED IN CHAPTER 775, F,S,
I FURTHER UNDERSTAND AND AGREE THAT THE OWNER AND/OR CONTRACTOR WILL
COMPLY WITH THE FOllOWING REGULATIONS CONCERNING SWIMMING POOL, SPA AND/OR
HOT TUB ENCLOSURES, IMMEDIATELY UPON COMPLETION OF THE SWIMMING POOL, SPA
OR HOT TUB, IN COMPLIANCE WITH SECTION 530.4(D}, PASCO COUNTY LAND DEVELOPMENT
CODE:
1, Construct around the swimming pool, spa or hot tub a MINIMUM FOUR FOOT HIGH FENCE with self-
closing, self-latching gates, The fence must not have any gaps, openings, indentations, protrusions, or
structural components that could allow a young child to crawl under, squeeze through, or climb over the
fence. Gates must open outward away from pool area. The releasing mechanism of the latChing device
must be located on the poolside of the gate and so placed that it cannot be reached by a young child
over the top or through any opening or gap, No opening in the fence may be large enough to admit a
four-inch sphere.
2. Construe/ a screen endosure around the SWimming pool, spa or hot tub with self-dosing, self-latching
screen doors. Latches on exterior screen doors must be minimum 54 inches from the exterior access
standing surface. All screen enclosures require Building Permits.
3, Provide and utilize an approved safety swimming pool, spa or hot tub cover that complies with ASTM
F1346-91 (Standard Performance Specifications for Safety Covers for Swimming Pools, Spas and Hot
Tubs), Such cover must be capable of being securely fastened over the swimming pool, spa or hot tub
when not in use.
I FURTHER UNDERSTAND AND AGREE THAT one of the enclosures described above will be completed prior
to final inspection of the pool, spa or hot tub.
ADDITIONALLY, I FURTHER UNDERSTAND AND AGREE THAT the owner will require his/her pool contractor
and his/her screen enclosure contractor (if app!!cab!e) to requGst and sliccessiuiiy pass a final inspection
immediately following the completion/installation of the swimming pool, spa or hot tub.
IF THE SIGNATURE of the Contractor, acting as agent for owner, appears below, the Contractor promises in
good faith to make the Owner aware of the above-described requirements and penalties before commencing
construction, C2 6:
SWORN AND SUBSCRIBED BEFORE ME THIS #
drd,DAYOF Jf7Y7L ,200S , ~
OWNER OR CONTRACTOR SIGNATURE
( Ztse~PR~:~
~'!!<.r-.. JENNIFER SANDlER
~mk.' NolIry Public . StIlI fI FIarIdI
I: .\MrColAlI....ElpRaJln5,.
\\.~" CoIIlI....,' DO 3840t4
"q~ Bonded NdonaI ~
FILUDRA1NAGEITREE AFFl DAVIT
DADE CITY
LAND 0' LAKES
NEW PORT RICHEY
(352) 521-4279
(813) 929-1266
(727) 847-8126
CENTRAL PERMITTING DIVISION
WEST PASCO GOVERNMENT CENTER
7530 LITTLE ROAD, SUITE 210
NEW PORT RICHEY. Fl 34654-5598
NOTICE
Under Section 700 of the Pasco County Land Development Code. all new reSidential construction or
substantial improvement thereto within the 1 OO-year flood zone must have Its lowest habitable floor or.
when applicable, its lowest supporting structural member elevated in accordance with approved
construction standards to or above the base flood elevation plus one foot (1') free board, All new
nonresidential construction or substantial Improvements thereto within the 100-year flood zone must
either have its lowest habitable floor. or when applicable. Its lowest support structural member elevated
In accordance with approved construction standards to or above the base flood elevation plus one foot
(1') free board. or must be flood-proofed to or above the base flood elevation plus two (2) feet In
accordance wIth approved construction standards,
I n accordance with the stormwater procedures manual. prior to constructing a structure on one upland
acre or less, or within areas which have experienced stormwater flooding concerns, the applicant shall
be reqUired to provide an engineered lot grading plan with the Building Permit application that does not
create any adverse impact on adjacent or off-site properties, An engineered lot grading plan (two
sealed copies) shall also be required to be submitted for accessory structures which produce
imperviOus area in excess of 500 cumulative square feet and are located on one upland acre or less,
I hese permits Include additions. poots. slabs. etc, In addition, the driveway connection with a site plan
shall also be shown and reviewed as part of the Building Permit application for new reSidential units.
Site plans shall also indicate all existing trees, and trees to be removed,
Any parcels affected by EI Nino (1998) or the 2003 Spring Rains. will be subject to the follOWing
conditions for any new or replacement structures:
1 , Location of the property and proposed structure on a SWFWMD contour elevation map,
2. Drainage basin delineated,
3. Statement as to whether or not fill is to be used, In the event fill is used, the plan will need to be
signed and sealed by a Florida Registered Engineer The fill will also need to be compensated for
in the same drainage basin,
4, Proposed finish floor elevation,
Prior to release of the Certificate of Occupancy or final inspection where no Certificate of Occupancy IS
issued, the developer/owner/builder shall execute an affidaVit provide an as-built survey prepared by a
registered surveyor and mapper in the State of Florida of the lot and the driveway construction. and
return same to the Central Permitting Division, The as-built survey shall be in conformance with the
approved Stormwater Management Plan and Report, Any deviations from the approved plan must be
noted and will be reviewed for compliance with County codes and ordinances,
Further. if fill material is to be utilized. the applicant shall be required to submit, concurrent with the
Certificate of Compliance. an Engineer's certificate as required by code. Such certification shall be
prepared and sealed by a registered professional engineer in the State of Florida. and shall attest that
the construction will not create an adverse impact upon adjoining property as a result of stormwater
runoff,
Check two (2) boxes and initial in the appropnate space:
Initial
~
o 1, the applicant, ~ proposing to utilize fill material in the amount of
~he applicant. am not proposing to utilize fill material.
~e applicant. am not proposing to remove any trees.
feet
o I, the applicant, ~ proposing to remove
number of trees remaining on the lot.
trees, which will leave
1-r1-OS-
Date
~
Building Permit Application Affidavit of Intent
I, ~)tJe(-t ~. bros.~c~. " do hereby state that this building
COntractor . '
Permit application for .;3t l1~ rl-D~( , C C"i '\ ( ~ is for a .
, LocaUon
New' customer m~~nes or is a Spec unit.
I also will have the building permit application picked '
" up within 30-days of notification that the application is
, ,
Ready. I can be contacted at -.2J~;- 9,<2<6 J fHn{) or '
'~ .
I , . I further understand that
E
in order,to pick up the application and have the permit
issued I will need, as a minimum, to bring the
Following: ;
~ . l'
1 ~ Deed showing ownership of the lot
2.' NOe or affidavit required by Section'713, Florida
Statutes .
3. Utility Receipt or where applicable the Septic
Permit from Health Department
Signature: .1'---.
Name: 1?Ober+ J. bJ1)SS 0
Contractor No':-b J VD / '7
t::"
f1
'"
\, VI-I III n
"'.-rl/Vl. -r,-rI/IVV'VVVVVIIV,.1 I
Official Reco.rd, Book: 1625 Page: 89, Pasco Counly, Florida (NOl a Cel1ified Copy)
Page 2 00
.- '. '-.. --" ..
_-2791
'56.100.00
PLaIt ..... W, 'AD 'IQU. De, B
7" .. 'AD AWl.
IVUB ,
IlMlI Clft'. fLA. 13' ._ ..
.HI.2i
00
"1l.Z!.
"...&fIf'''' ....
_ma..;........
.. ....... Ifd ,'w..,A. 14t1l
lIMe'S .. -1ftU ... l8nULft B,
..., a' 1111, A. ,). It I' .,
""'01.1. \t. wtflllOO2 II mt 01.1'-17
1:07
RtqJlrll/lMaU
01 GO 40
1A1 !'. ..... ... ~ L. ...... lit. rif. IlIEC .. .,. I'UNI
.. _11,_ -~~- . ., 00 42 I
..'-:- _1..,.-- - ,. 702 'ro,~... en.. '~Jdlu"'_
"-...It.. co.&../. "'" -,..., 01 Ie 41 1 >>S. 5
::-::: ;::1 ='::I':~'=:" ~...'~"~ ~..:..!":::G:- ..~M. 1 ill.
lilt II &: TIo... .... _..... ,., oaJ ... _.......... ., .Iw _ ., '--10.00- .." ..to..
...'-''- ~-, -... ~ I. ...., ..........."""". "-6, _... ~ ... ........ ....
..... ""'-w. "'''..;.. ...1 ......,... - ,... ..-..., "" IIo.. C_i" '-J ........ I.. '..eb
C"-.,. ........... ilia:
CIN
..001...,.... ...,1..1 ,.... _101... Ie
5. .
1.
l,at 17. .11%.-rATa 12. .. 1lH' .. _ ,I.a tIlohof ~.IIII 111
.1." ~ It. ..... 3 .... 4. lYUle .._.. of ...co Cvuty. l1orUa.
0.-..,.......... .. .AP-~. _
· -----..........- ...."'r~.... ,,-= N.
.............. '~.f:II't... c.;.t~
II, _ -6-":~ I w:ll,A '" Dlt~l~ 'M"
Sullfact to ~t.. "'tI'lCICiofaa ... ....rwU... 01 ..ao....
T...... .....II.... _la. .........._ ..... _____ "'-.. .......... ~ In _'
we... .,............
I. .... 1M II 1IIId. .... _ .. ,.. "'-'- 1__
... .... ........ ".....,. ---.. ... RIll ...... .,.. .. ...- .. .....,.,.. __ ., -.I .....
III ,.. ....,.: rlo., fIw..........."'" __....,., ....., ........, -. -.lJ ....;.... It..
-- ....., ,.. - .". ...,. .. .ItI '-J ..... ... ~.... ... _ ........ .... ...... ...... .,
.II _. .A, ___, ..." ,,.., .... ...., ;, ,.. ., .d _.......... _ ...- _"" ...........
Ie '''''''''' ')1. .....
. .... ..aI. ",. ..tJ __ ,,_ ...- -' -W ~ ~_ ....
,.,.. ..... --
,
, .-1.~_~.~,.
'._u___
t
I ......" CD'rI'Y _ .. oil. ...... __ .. . .m;.. ...,
...-w ill .. .... ........ .. .. ... c:-.a.. .......... .. ..
"""~ . TL __...................
JUircl8 P. .-,..., ... Gllian.. a. ""_1.
.1. rif.
.. _ a-. .. .. '" ...... __ .. ... ... _ ..
- ....... ......-... .... ....-............... - ... ....~.
~- ," -
P- . .~. w
...,... .. \ ~ .: .
f ~
. 'i
.- - CCII
... .-
I!I: . (; ..
http://www.appraiser.pasoosov.comlscan:hldcedsldeed.asp?bpo-162S0089
4/412005
.J r"\
....
...I 4:
49'~ 't ' (\j') ~
.. ... 'V '_..L-. 2
~ ..J -J '-..) ~ rJ
<t ..J ""' <- (J- ,50
~ \.: N e:
,- f'. ~)
.... ~
~ f,j ...;
1: I~ J ~ "':~ ..!!
~~ '8 ~, s
(. l- .J 3 \~
.- ~ \.~ -. ,~.,)
--- ~ ~~
L ,~
,J 7- ~ --J .J ~
~ -.J 1:. ~
(' ~ r~
~ ['~ ?. '........ '-
" ~ ....... ~
d \ ''-'"\ -
'oJ \-=.
'..J .- Q ,6 )
'5 .J
) ~ 9:: /) ..J .~
(~ ;t- z ~ \.J
~.J ~ ~
\fI
lEE -
M
....
"-
:8
~
....
-
6' '<T
....
:3
;7 1\0
- X
v :!;5!
...., ....:3
~~
c: E
~.g
rJ
'T
c<.l
'.:;r-
~
1= .
-; I~
.->
.,1
?
?
rlI
L?':
zL
~ "')
Q.. .c. - ". "--'-
O.~ LL.
UZO
~-~
~ \ Zl
ml~~l
0:: 0:: ~ I
W:3XJ
~~:: ~ I
. ~ I
b . Ii
0:: u..; I
U') ~ U') I
W U') .:..J I
ZO"'" '
o::o::~
~Q..~
~:t:
~>- N Q..
~W
Lon N
~
~ll ~
lti r5
I' ,
II ...~
~.=-
\0
~ I
,-l-
26 .
-
0\
_) 0-
jQ)
NOTICE OF COMMENCEMENT
County 0 f 45' a.;
1/11I1111111 111111111111111111111111I11I111111111111111I1111
2005073825
State of /'~
TUE UNDER51GNED hereby gives notice that improvement will be made to c2rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
[ollo",~ing inforI:1ation is provided in this Notice of Commenccmcn t:
Sun-:,e+
of the property
1, Description of Property: Parcel No.
2. General Description of Improvement
3.
In.::>-\o \ \ \-03 \~ t"Il ') 1'16 ( C"YtC v.P-1-e .~ '\ \~ 'rsyC"C'J wi ~
(IXl.v;,? e6)
O\mc~r Information: Name ~Yrl d..sl'nlf /5,4/f.l7I'f..F
f\ddressS5.,2 9 .f7/1oY;Lt1 C~ City ?~.( )'ILA.,/A
In t e re st in P rope r t y : In ~-tn II, Yl5 (}oncf-P-+e.:sJA ')/mm, ns 'jJno I w 1.5fb.-
Name of Fee Simple Titleholder:
(If other th~n owner)
State 533f""Yl
City
Stuts
F-\ddress
R." 4.
,.'
Cont.ractor: N.:lme 4~/ X ~JJ(,J
^Jdre~3~?;2{)/:~~~ ~Ao, City k~
/
1'1 ' J
( f\o be r-+ ~ '
C>CSSCJ
State~ ~(,:J~
':l. Surety: t'L:llne
City
State
Address
Rcpl: 875185
OS: 0.00
04/18/05
Rec: 10.00
IT: 0.00
Dpt.y Clerk
l\mount of Bond: S
6.
Leode r; Uame
Address
City
State
7.
Persons '~Jithin the State of Florida
notices or other documents may be
7!.3. ~ J ( 1) (a) (7), Florida Statutes;
designated
served as
by OHner
provided
upon ,,,,hem
by Section
~~91~~~~MAri: ~C:;O fOUNToYf C1ERt<
OR Bt< 6325 PG 1486
tiicmc
City
Slo.te
f\\1ci r f:':' S S
8. In addition to himself, O..",oer designates
() t
Lienor's Notice as provided 1n Sect10n
to receive a copy of c~e
713,13(1)(b), Florida Sta.tut:es.
'I. ~"xpi:-n1 ,L'.fl dt'lte o[ ?i0t.lce oE Conl1nencemeot. (the explrat,i":,d1 d.":te l~i 1 ~'ed:
ir':lm the c":iJ.tc uf recording unless a different date is specified_)
Slg"a~'JreOfowner:l7_ A ~ /1 isz -77/-f/7--7tt)-f1
S'-;orn to and sub~f'!b"'cd before me this ~ day of 4/ft./L Z~tJ..!
20.n.S .
NoLll:)' Publ },C;
PC93053048/A
IJ\io!!""'-
I~ \ NoIary Pubic. State of Florida
\~ . i My Commlsslon Expires Jill 5. 2009
~':'~Ilji~'" CommissIon. DD3840t4
'1,,,,"~,it'- Bonded NlIllonaI No Aan.
~-
COUNTY OF PASCO
rHlS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COpy OF THE DOCUMENT ON FILE
OR OF PUBLIC RECORD iN THIS OFFICE.,.JVLTNESS MY
HAND AND OFFICIAL SEAL THIS~ DAY OF
~,€ 2~
JED PI AN, LERK OF CIRC IT COURT
BY , DEPUTY CLERK
1'-'1':i C_~;;11;1.~ ss,ic)n Ex