HomeMy WebLinkAbout05-4728
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4728
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
4728
SIGN
FREE STANDING SIGN
COMMERCIAL
Address: 5855 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
7/20/2005
87.50
87.50
7/20/2005 Phone:
GROUND SIGN AND LETTERS ON CANOPY
Name: DHIMANT SHAN
Address: 5855 GALL BLVD
ZEPHYRHILLS, FL. 33542
A & M ELECTRIC
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 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. II
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.
~ .~~
/2-
-
CONTRACTOR S NATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPAR'l'MBN'I' 5335 8TH st, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE BECEIVED
? /z9Io5~
PARCEL ID #
PROD CONTACT
Ga.Il Blvd Rea) [i~-f,,--+e../Tj,1c,
c/ c> l:> t,..,'t-''''' cu.+ .s"'~,~ h
5""855 Go-II BLd.,
l q-:.2. L/ BLOCK q
((-1-(.;. - ~ I -DDi t) ,- CO~OO -0 (Cf 0
!'OR PERYIftING 3cg~- 73tf- ~'3focf
OWNER'S NAME
PHONE
JOB ADD_IS
LEGAL DESCRIPTION: LOT(S)
SUBDIVISION
IOBTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: []NEW CONSTRUCTION
)(sIGN
[] ADDITION
[] ALT ERAT I ON
[] DEMOLISH
[] REPAIR
[] INSTALL
[] MOVE
PROPOSED USE: []SGL FAMILY DWELLING
)Z!cOMMERCIAL
[]MULTI-FAMILY
[] INDUSTRIAL
[]# OF UNITS
[] SWIMMING POOL
[] MOBILE HOME
o OTHER
DBSCRIPnON 01' 1fOIUt
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
~s+arl /D{,({ rp gYO~l1d S011 d' p~ (JYl ~1
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
~ BUILDING (~((;rM) $
~ELECTRICAL
[] PLUMBING
VALUATION OF TOTAL CONSTRUCTION
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
AMP SERVICE
W.R.E.C.
~t
VALUATION OF MECHANCIAL I NSTALLMi ON f1~~ ~~
[] OTHER f' ~ r Q j
o FRAME 0 STEEL
[] Progress Energy 0
[] MECHANICAL
$
[] GAS
[] ROOFING
o SPECIALTY
SIGNATURE
COMPANy-A- / u me -,., u m A u.S
41. . 7tfs ~ IAJT't.- >?wy BLVD. biE-LANtJ1FL 3;.27Nt
STATE CERT OR REGIST # C B e.- ~5 c; '83.;;1..
/
********************~****~~*************************************
~, ~;.;>v
-" ) ....t1. M ~ / _L '
, COMPANY 4- ec.--rr I C
IS
FLOOD ZONE AREA[] YES [] NO
TYPE OF CONSTRUCTION: [] BLOCK
FINISHED FLOOR ELEVATIONS
BUILDER
ELECTRICIAN
SIGNATURE
~ UJ ~~lrp
STATE CERT OR REGIST # ECl')C)O;;l. 8/!7
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
I&:CHARICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
OTHER.
COMPANY
SIGNATURE
STATE CERT OR REGIST #
CITY OF ZE~HYRHILLS PERMIT APPLrCATIO~
BUILDING DBPAR~ 5335 em St, Zephyxhilla, FL 33542
813-790-0020 rAX:913-7S0-0021
DATE RECEIVED
~k1/t;)
PHONE CON'l'AC'l' roa PElWIT'l'ING :3'?1~-73i- ;;;'S0l{
Ga./J Blvd Rea,,/ ~!:+(\...fe/::.j,1c'
OWNER'S NAME c/o ~L-t,.Wt w..+ ,S"/no. t, PHONE
JOB Al)l)U88 S-8sc:;- Go..l/ Bt vd '
LEGAL DESCRIPTION: LOT (S) l q -c2. L/ BLOCK q SUBDIVISION
PARCEL ID # tt-"2-(..-~I-DD{O-cc)crCO-C{<=?O (OBTATN FROM PROPF.RTY TAX NOTTeF.)
WORK PROPSED: DNEW CONSTRUCTION
~IGN
PROPOSED USE: DSGL FAMILY DWELLING
)d.cOMMERCIAL
D ADDITION
D MOVE
D ALTERAT ION
D DEMOLISH
D REPAIR
D INSTALL
DMULTI-FAMILY
DINDUSTRIAL
D# OF UNITS
D SWIMMING POOL
D MOBILE HOME
D OTHER
C:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
D..auFnoat or WOJUt ~$+af I cQ Ir. ~.E:=;r VIAlYL t \ 5 U).}c.'JCO Ie I e*rJ 011 (1011"
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
~ BUILDING (~(rIJ)
Et.ECTRI CAt
REs I PEN'l'IAL: 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. - MlV (_ J
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTIO~) rr ff! 1 J (jt/ffV" ~
PERMITS REQUESTED f;U-,. cL vi
VALUATION OF TOTAL CONSTRUCTION !P~ 1 " .' n L
) 7 r (~p
AMP SERVICE D Progress Energy D W.R.E.C ~.
$_ 560.06
o PLUMBING
[JGAS
D ROOFING
D SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
D OTHER
o MECHANICAL
$
TYPE OF CONSTRUCTION: D BLOCK
D FRAME
D STEEL ,;::'( OTHER
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
FINISHED FLOOR ELEVATIONS
.,:::f
, "';' _~~~~,.QIi
COMPANY.-t}I U W!{ >7t.l WI Pius
7tfS e I""'/... SPw'l BLIIO. DE-t-ANtJ,Ft.. 3:J.74
STATE CERT OR REGI ST # C B e. (() 5 ~ '83;)"
m ,;".:". .....~... ....'f{f':,
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. .' '. ,", " -..' .;.,: : ,(t.~~,;.:..'. """,,:(''''.~.';'(I~;'''''-'
BtnLDD
SIGNATURE
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******************************************************************
&t.KC'1'JlICIM
COMPANY----
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUIlmBR
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MKCHNfICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
0THEa
COMPANY
SIGNATURE
STATE CERT OR REGIST #
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The 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 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 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 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 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.
Application 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 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 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 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 DQ NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
~ItcTOR
STATE OF FLORIDA I J I A
COUNTY OF V C) uS I
The foregoing ins~ument was acknowledged
Before m~, this../..Z!;. day of JUvE , 2005"
by MI G-tfl4~ O;;~ A?I/A.J
(name of person acknowledged)
~WhO is personally known to me, or
o who has produced
(type of identification)
and whoOdid Odid not take an oath.
ng acknowledgement
Name typed, printed or stamped
MICHAEL L. SAXTON
Notary Public. State of Florid,.
My Comm. EXPlrel March 31. 2(Jo)9
No. 00413670
SIGNATURE:
I/O/USI A
STATE OF FLORIDA
COUNTY OF
The foregoing ins~r~ent wa~~cknowledged
Before me this ~day ~ . J u,uc:: , 20 ~
by R _ S. ~ll(
~ (name of person acknowledged)
~U~ is personally known to me, or
o who has produced
(type of identification)
~id not take an oath
and who Odid
printed or stamped
MICHAEL L. SAXTON
Notary Public. State of Floridk
My Comm. Expires March 31. 20,19
No. 00413670
A. NOTICE OF DEED RESTRICTIONS
The under~igned 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 applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owne'r has hired a contractor or contractors to undertake work, they may be required
to'be l~censed 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.
Furthecmore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(~) ~ign portion~ of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner ~igns 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 licen~ed 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 ~fairs. 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 "owneru 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 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 re9ulations, 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 agencie~ 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 AIeas,
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.", 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 thereafte~ 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 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 ~ ~ ~EED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
~~.
SIGNATURE: .~~GENT
STATE OF FLORIDA · J I A
COUNTY OF V () v.s I
The foregoing ins~ument was acknowledged
Before m~, this ~ day of -::ruJ.Ji?" ,2~
by t:J..1 e-tfl1 PL- ~E/I A711,v
(name of person acknowledged)
jE(WhO is personally known to me, or
[J who has produced
(type of identification)
and whoe did [Jdid not take an oath.
MICHAEL L. SAXTON
Notary Pubflc. State of FIorIdii
My Comm. Expires March 31, 20,)9
No. 00413670
~OR
VO(USI A
SIGNATURE:
STATE OF FLORIDA
COUNTY OF
The foregoing instr~ent was~cknowledged
Before me this f!if-,day il- I u~E? ,20 ('J.t;
by R S. 0./)(
~ (name of person acknowledged)
~u._ is personally known to me, or
D who has produced
(type of identification)
~id not take an oath
and who D did
owledgment
MICHAEL L. SAXTON
Notary Public, State of Florid"
My Comm. Expires March 31, 20,)9
No, D0413670
Aluminum Plus
748 E International Speedway Boulevard
DeLand, FL 32724
(386) 734-2864 Fax: (386) 736-7096
State Certif'ted
CBC056832
PERMIT AUTHORIZATION
I, R. Scott Pollitt hereby authorize Michael Seaman to obtain a Building
and/or a Sign permit in my behalf under my License # CBC056832 for
the job described below:
DESCRIPTION:
Owner:
GALL BLVD. REAL ESTATE
Site Address: 5855 GALL BLVD.
ZEPHYRHILLS, FL
Parcel #: 11-26-21-0010-00900-0190
~
(Li~nse Holder Signature)
Date: ~ -/3-0S-
State of Florida County of V olusia
Affirmed and subscribed before me this 131H day of June, 2005
By R. Scott Pollitt, who is personally known to me.
~Q&~
Date:
&, -/.3 -6 s;-
Notary Public
State of Florida
MICHAEL L. SAXTON
Notary Public. State of Aorldit
My Comm. Expires March 31, 20,j9
No.DD413670
A & M Electric
1147 E Heartwood Drive
DeLand, FL 32720
(386) 734-4864 Fax: (386) 736-7096
State Certified
ECOOO2815
PERMIT AUTHORIZATION
I, John W. Matthews hereby authorize Michael Seaman to obtain an
Electrical permit in my behalf under my License # EC0002815 for the
job described below:
DESCRIPTION:
Owner:
GALL BLVD REAL ESTATE, INC.
Site Address: 5855 GALL BLVD
ZEPHYRHILLS, FL
Parcel # 11- 26- 21-0010-00900-0190
~~~~
( License Holder Signature)
Date: c- Z 7- O~
State of Florida County of V olusia.
Affirmed and subscribed before me this 27th day of June, 2005
By John W. Matthews, Jr., who is personally known to me.
~Publie Date: h-l.7-0S
State of Florida
MICHAEL L. SAXTON
Notary PubNc, State of Florida
My Corrim. Expires March 31, 20.)9
No.bD413670
LETTER OF AUTHORIZATION
DATE: 06/13/05
OWNER: GALL BLVD. REAL ESTATE, INC
C/O DIDMANT SHAH
168 OAK GROVE CIRCLE
LAKE MARY, FL 32746-9274
JOB ADDRESS: 5855 GALL BLVD
ZEPHYRHILLS,FL
IIWE HEREBY AUTHORIZE ALUMINUM PLUS TO PULL PERMITS,
INSTALL SIGNS, AND PERFORM ANY OTHER WORK THAT IS
REQUIRED AT THE ABOVE LOCATION. ONCE PERMITS ARE
APPROVED, ALUMINUM PLUS IS AUTHORIZED TO PICK UP ALL
NECESSARY PERMITS.
M4-/i'A
o RS SIGNA
fiSH/sA 1< A-PA-bn4
OWNER (pRINT)
NOTARY ACKNOWLEDGEMENT
STATE OF FLORroA
COUNTY OF V 0' v.s I A
THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME TIllS
I P DAYOF JVNE .2005,BY ASf/rs/f f:::4/A-iJ/14. WHO
IS PERSONALLY KNOWN TO ME OR HAS PRODUCED
f<tuOWA) (TYPE OF I.D.) AS IDENTIFICATION.
QWf~
NOTARY PUBLIC
STATE OF FLORIDA
DATE: 0-/7-()~
MICHAEL L. SAXTON
M~ PUb,"?, State of Florid;,
mm. exPIres March 31 20')9
No. 00413670 '
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1111I1111111111111111111111111111111111111 11111111111111 II1I
2005146769
TO BE COMPLETED WHEN CONSTRUCTION VALUE EXCEEDS 52,500.00
NOTICEOFCOMMffiNCE~NT
PARCEIJ# 11-26-21-0010-00900-0190 STATE OFFWRlDA COUNTY OF PASCO
THE UNDERSIGNED HEREBY GIVES NOTICE mAT IMPROVEMENT WILL BE MADE TO CERTAIN REAL
PROPERTY, AND IN ACCORDANCE WITH CHAPTER 713, FLORIDA STATUTES, mE FOLWWING
INFORMATION IS PROVIDED IN Tms NOTICE OF COMMENCEMENT.
LEGAL DESCRIPTION OF PROPERTY: 5855 GALL BLVD.! CITY OF ZEPHYRHILLS PB 1 PG 54 LOTS 19
THRU 24 INCLUSIVE BLOCK 9 LYING WEST OF US HWY 301 R/W
GENERAL DESCRIPTION OF IMPROVEMENT: INSTALL SIGNS
Rcpl: 904928
DS: 0.00
07/20/05 _~_-
JED PITTMAN PASCO COUNTY CLERK
07/20/05 1 i : 01am 1 of 1
OR BK 6483 PG 1485
Rec: 10.00
IT: 0.00
opty Clerk
OWNER: GALL BLVD. REAL ESTATE, INC.
ADDRESS: 168 OAK GROVE CIRCLE
LAKE MARY, FL 32746-9274
PIIONE#:
INTEREST IN PROPERTY: OWNER
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER(IF OTHER THAN OWNER): N/A
R
CONTRACTOR: ALUMINUM PLUS
ADDRESS: 748 E INTERNATIONAL SPEEDWAY BOULEV ARDDELAND, FL 32724
PHONE: 386-734-2864 FAX: 386-736-7096
SURETY COMPANY(IF ANY): N/A
ADDRESS:
PHONE#: FAX:
BOND AMOUNT:
LENDERlMORTGAGE COMPANY: N/A
ADDRESS:
PHONE#: FAX:
PERSONS WITHIN THE STATE OF FWRlDA DESIGNATED BY OWNER UPON WHOM NOTICES OR
OTHER DOCUMENTS MAY BE SERVED AS PROVIDED BY SECTION 713. 13(1)(A).,FWRlDA
STATUTES:
NAME: N/A
ADDRESS:
PHONE #:
FAX:
IN ADDmON TO HlMSELFIHERSELF. OWNER DESIGNATES ALUMINUM PLUS OF 748 E
INTERNATIONAL SPEEDWAY BLVD. DELAND, FL 32724 TO RECEIVE A COPY OF 1HE UENOR'S
NOTICE AS PROVIDED IN SECTION 713(1)(B). FWRlDA STATUTES,
PHONE#: 386-734-2864' FAX: 386-736-7096
:71.1 Iv
,
2005, BY:
PERSONALLY KNOWN
PRODUCED
./
MICHAEL L. SAXTON
Notary Public, Slate of Aorld"
My Comm. Expires March 31. 20')9
No. 00413670