HomeMy WebLinkAbout06-5550
.7
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
5550
rmlt #: 5550
armit Type: ALUMINUM
~Iass of Work: ALUMINUM PACKAGE
Proposed Use: NOT APPLICABLE
Sq. Feet: Est. Value:
Cost: 19,386.58 Total Fees:
Amount Paid:
Address: 7712 KAY MARIE AVE LOT 235
ZEPHYRHILLS, FL.
Township: Range:
Lot{s): 235 Block: Section:
Book: Page:
Subdivision: GRAND HORIZONS
Parcel Number: 34-25-21-0170-00000-2350
Name: B & H CONSTRUCTION OF C
Addr: 11494 SEDATE ST.
BROOKSVILLE, FL. 34614
Phone: 813782-1064 Lic: Phone:
Work Desc: 12x12 SCREEN RM, 8x12 SHED, 12x35 CARPORT
Name: GRAND HORIZON
Address: 7712 KAY MARIE AVE LOT235
ZEPHYRHILLS, FL. 33542
I (\1 Dl1
y' ~X f"'
FRAME
ELECTRICAL ROUGH
1ST ROUGH PLUMB
FINAL
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection
trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections 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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
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."
=~:tORS~UREG r~M~
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
L:J. 'l' oX Obi ~l!iJ:ltU:RH.lLLS J:lJ!iRMl'J.', AJ:l J:l L,LGA,'J.' .lQ~
BUILDING DEPAR'l'WZ~T. 5335 e~", Street; Zephyrhilh, I'L; 33542
813-780-0020 i'~1'813..780-0021
DA'rZ RECEIVED 3 !~/()fL7
PLANS REVIEW FEE
, \L" rn~ .
1'CtJ-1 '
OWN<R'S NA~~~~Lj ~~~\T\~
JOB ADDRESS_ \L ~ '\j~ ~~_
LEGAL DESCRI PTION: LOT (S) BLOCK. SUBDIVISI~~ \-br \-Z::J)
PARCEL ID #5-\ ~~'")\ ~\a-c:::i0~ -M~~ (OBTAIN FROM PROPF.RTY TAX NOTTCF:I
PHON~\3 ~~ - ~'J
WORK PROPSED: ~ONSTRUCTION
@...A-r;1)fT ION
OALTERATION
(J REPAI R
~ALL
o SIGN 0 MOVE 0 DEMOLISH
,.
PROPOSED USE: ~ FAMILY DWELLING OMULTI~FAMILY Olt OF UNITS 0 MOBI LE HOME
,/'"'~ COMMERCIAL 0 INDUSTR~~L . ;'r 0 SWIMMING POOL (:\\~~c\~
'\~ D RESTAURANT & ~EPA'TMENT APPRO~
DESCRI PTION OF WORK ~)~\~ \s'r\:S~ ~\, \~\l~~ P -\-
BUILDING SIZE SQUARE FOOTAGE ~~ HEIGHT
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS &, (2) SETS OF BUILDING PLANS & (1) SET ENERGY fORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
NoC..,/
~
~LDING
~EICAL
PERMITS.RmQumSTED
s \Q 31\\s::::, ~~ VALUATION ,O~";~;~~' ~ONSTRUCTION
,
(
AMP SERVICE
o
FLORI DA POWER . {J. }i., R, E. C . \
~.....)\, Y- ~~.\.
o PLUMBING
o MSCHANICAL
s
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE Of CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
I S PROJECT' IN FLOOD ZONE AREA 0 YES 0 NO
\C, (),' j
ElAN
STATE CERT OR REG 1ST It
CITY PROCESSING *~~
, '.0'"
'J
* * * * **** * ** * ******* * * *** ** * *** * * *********** **** *~* ~.** * ~ * * ~* ~ * *
ELECTRIC~ / " ',~OM~ANA\ ~\l_J ~\W--{ \ ",--
S IGNATUR< ~~ il iJjJ ~;~~< P;~~~S~~N~E~I\~I
~",j
****************************************************~*************
'.
PLUMBER
COMPANY
STATE CERT OR REGIST *
CITY PROCESSING *.
SIGNATURE
******************************************************************
MECHAN I CJ>.L
COMPANY
STATE CERT OR REGIST *
CITY 'PROCESSING *
S I GI~ATURE
.***..*******.*.***.********.**.**.~.**.****.**********.**********
OTHER
COMPANY
STATE CERT OR REGIST *
CITY PROCESSING It
SIGNATURE
*~*.*************************************************.****.*****~
'J."":: .
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" w'cic:
may be more restrictive than City regulations. The undersigned assumes responsibillty tor
compliance with any applicable deed restrictions.
8, UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be requlred
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 intende~ work, they are advised to contact the
City of Zephyrhills BuildinQ Department, 813-788-6611.
Furthermore, if the owner has hired a contractor or contractors, h, is advised to have the
contractor(s) sign portions of the "Contractor SectionsH of this application for which the
will be responsible. If you, as the owner signs as the contractor, you are indicating thai
you, rather than the contractor, are responsible for the work. If the contractor wlshes
you to sign as contractor that may be an indication that he is not properly licensed and 1
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 ConstructlOI!
lien Law _ Homeowner's Protection GuideH prepared by the Florida Department of Agrlculture
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 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,
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 law8 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 (
the intended work, and that it is my responsibility to identify what actions I must cake
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitlve
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
*v,s, Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "AH or "A, etc.", lt is
understood that a drainage plan addressing a "compensating volume" will be submitted whi
is prepared by a professional enQineer registered in the State of Florida prior to perml
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 ~equiring a
correction of errors in plans, construction, or violations of any code. Every perrrut
issued shall become invalid unle.s the work authorized by such permit is commenced withi
six months of issuance, or if work authorized by the permit is suspended or abandoned fc
period of six months after the time the work is oommenced. One 90 day extension of timE
may be allowed for the permit with tee charge ot $15.00. The extension shall be request
in writing to the Building otticial. An approved inspection must be logged during each
month period, or the project will be considered ~bandoned.
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, CON
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE or COMMENCEMENT. JOBS UND
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENTH.
acknowledged)
known to me, or
.ArJ" ~,~ '
SIGNATUR. CONTRACTOR
STATE OF FLORI~ ~~
COUNTY OF ~ K:S
The foregoing i ument ~~~le~
Befo m th ay 0 '
by
~na of person acknowledged)
~ is personally known to me, or
o . <rf;~
SIGNAT~: OWNER OR AGENT
STATE OF FLORI D~ ~ CJ
COUNTY OF ~
The fo.regoing i trument was a~.dge~ .
Be~ t s day o~ ' 2~
by
Owho has produced
(t
Owho has produced
(
Odid
Slgnature of person taking acknowledgement
of person taking acknowledgr
Ndlll
Notary P.mIIc State 01 Florida
6~am ed
I~
FREE ESTIMA YES
B &: H CONSTRUCTION OF CENt1tAL FL, INC. r.
401S MORRIS BRIDGE ROAD
ZEPBYRIULLS, FL 33543
-.
.........
1-800--214-1 %06
""....
-UCENSro · BONDED · INSURED · SKIRTING · SlEPS .. R.OOM ADDITIONS · ALUMINUM" CONCRETE..
Loc: It:~, Subdivisio.a: 771.2 LILLy BEA
lap Siding Cob':
Hum", SailtJ 1#:
Home ModrJ II;
ilk- Color:
All aI~ ftlC6.iDriwle: ..... 'l'rba1,. ~. Dcowa
ISDOuts.. ~ xJ PcKIs.. ... FIlIIIaiIllt..
U hns III f1. ~
.,., f"aas -.E-.. Ft. lAIc
.-.- _lit. Lotts
p~ _ ,.... LMg
Vlll_,.'n'.... ,.......... .......
GIdIa IllII HcaJe.,.. ...,..., ...."
gealn Wort;
2x4 SM B.3"*-__ __. _ ___....... .". H
~ SM Sca.tIl..., '. n' '. .....n...
2,;<7 SM &c:.I...... .............., .-:..
1xS ~a-.. ...............,.
b.9 SM~. .....'....n ........
hlO SM ac.m,................._ _
~WJl'OI' o.Me 1>7..... ......... _
SUtEEN ROOM WAILS
l.: ,,"""- u
~ ., 'I"~
('. ..N 3 - ~1f,1' -a ~
....!?2.. Sq.. 'F1. x J.71 - 435
~ Sq. PI..~ 3.71- 4.JS
~Sq, k x 3.77 -..~
~~f.'t. x 3.77.435
iii l/f x $.1.11
~ l/F J( $5.."
-
1:151.96
$t.09
S5.'1
16m
IU9
SI,J3
SU1
ll. $101.00
1..,. 1(1' ~ .. ..!:.... t ~_ t _ '" ~ UF x
~ I)oQr Includes;
c~~~",.........
Oabk FlU Oflt Side.. ............
ITMIIIId I(i~ ~,.....,....._
Fin Ream (1lOl _ired)............ I
~.;
U11LffY ROOM WALLS
Walls ,,+......... 12 -... LIF "
lA4SNdsWOC - -
SbcdDoonnd I Window....,.. I'
SinBIe Wi~ (F...)........,., I
8cqJ Sjajdd,.............. .......... -
DuublccS&-IOoor,.", .',',.... _
Oo/Iww.._ +_ + __ + _ = 0
V)'NYl.ROQMWAU....
V'JJI)'1 Will.......,................... _
ID5ick Mk P18&c........ '......... _
Lap Top !aside Bd Out........ '. _
...Iorica~.., ............ .......
1nJulcc Top lIn4 BuQuaL.,.,... _
~ irlclude (2) 2 T~ U"nl1l/.
II~Jd IIft4 CI'*'"............ EA )(
IBaH wiD DGl be ~'fI'bIe b ..;;- '-b
in VINYL ROOMS X
Ut-'x
L/F x
tIf ll.
LIF x
IJF 'lC
LJF 1(
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UFx
L/Fx
R'\ x
EA II
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UF x
EA I
f.)F)(
lIf'l
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l./f J{
LIP X
L$Jo.
$lo.n
$97.96
Sl'~
",9Z
U6.50
SJ6..0lI
Sl~.70
1.51.00
SS.2Z
$42.16
J5l.J.4
$S.93
$15.40
SlO.l1
15,49
$141.61
~ HORIZON
Date; ,0 I /26106
.to 0\
SD.1lIJ
SllOll
SQ.OO
$n~,H'
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$ll,Oli
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$11.909.67
$7. 126,Ql
S350.00
$0.00
$19,386..51
AD -.n. <1.1 ~ ..... --- .......JW...... ..._,..-. AI'INAftCI ~ Of!1~....-...... ~~_.....,... _;", U'l"_
~"AI. ~AGJ: -ntJtU"lGo,. .....~....... anMAnr.AM""'f' ??oo POIIta 1I-A"Va
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GLASS R.OOM'IIAUS
W:db; -+-..... = (, l.If )(
R~~- -x-"'-;-Sq.J'I.
O'o--...'.'..m....-:=...-=- = FA
~Raili.,......................... _ LIF
Sf.cp k.iJina. ....,....... .. .. . .... .. . .. . E1\.
~~Dow.."",.... _)1_ _ eA x
$Z.ecn.. o.r..: Door' tWdn- _x _ _ EA l(
39.01: ~DoorOpella' _ ~ _ _ EA ~
so.oo Mise:
S29U2
szn.u
~,..,_ ETEANONlCK WQIU(
s~.J,PlMioS1ab.............. .....!!...x~ -...!.!!.. Sq. Fr. Il $J,06
to,lJlJ"'ioS~.............. :n" lJ =.zD Sq. Fl. l\: S3.06
S3'Ul f'IIio 5bb.............. =)( = '" -;- Sq..Ft..!( Sl06
_.OC PUos...,.........._ _x_ ~ ~ S4-Ft. II ~.06
so.GIlI Sick"'................ ,)( ~ .. ~ 5<1, J'l. ~ $3.(1)
$IUlO Oriv~............... ,. ll. It '.' _ Sq.. FL ~ S),U6
- Dri_., n1ir.....m. --:- x ,.. = -;- Sq.. f\,,, J4.~
JltiIItcI Ullliry........... 1 112" I ... x SJ4.60
_~.lt Ibdacd hlio /) Co 11 X ~ .. 1M Sq. Fr. x $9..36
b5cd hIio 6 c- lC ~ Il Sq. fL x S9.3t)
SI9S.9.1 0.... '1* a,...- -;- }l7..-;;;" I.:f' " $2,%
m.aa FOCCler..UReinfofted........=- " VF " SS..l1
to.OII Foa(cr 12x'Z~~........... ...!L LIf' II S7.J.W
....50 ~Foo&ct....................... ~ L/f x SI.I}
JO..OO I Tft'ad ~....................., _ F.A J( 110937
2 Trea:I Srep.................... " _ EA x SZJI.74
$J~UO J TJYad 5tq)...................... J EJ\ x 1321.11
~3foop.......................,. _ EA x Sl'1~.S:l
~I~~,1O BricIIc Slirti"C M.x , KIp
"'a.0lI ~ Rridt Air - lJf @ eo..nc. x
SQ,0lI StItis 8dck SoiW --;; 1A @-;- 0Nrses ]I:
SOJlo FIJI Dirt....................'........n . l.4eds x
10..00 ~.... ................ .... ....,...., '............,...
M~
SO.OlIILot ~.............h........n _
$0.00 NOtE: AClClG&"dlae 10 tbe fL B\JiWiCl& Code
so.oe . crack is .neIla ~ probkIh IIDIiJ it
:'.:-~~'
- -. CON<:.1tlOl'(;
SIGN; ALUMINUM
fQ.0Il DATE: , - '3 0 - 0 ~ PUR.M1'f
FA."X TO: al~71~ TAX
FOR.~ TOTAl..
:>: SJ.20
ll, ~57.00
x m.1l
x $92,85
ALUMINUM TOTAl..
$1.29
$2,52
$137.70
SIOC),OO
x ~S1.oo
v.oti:i
~V'LS' II ~-~-l
LEONARD G. "GEOFF" WOOD, P.E.
4034 THE FENWAY
MULBERRY, FL 33860
(863)646-5517
Date:
02/01/06
B&H Construction
Zephyr hills, FL
Re:
Address:
2006 Jacobsen
7712 Lilly Bea
Zephyrhill, Fl.
Mod, #: CH 3 4463 B
Lot #: 235
Dear Sirs,
This letter is to certify that I have reviewed the above referenced
structure to determine the structural adequacy of the existing structure
to receive the attached structure, The proposed structure is roughly a
12x12 Raised Screen Room, a 8x12 Shed and a 12x35 Carport.
The existing mobile home, has been considered and is adequate
as a host structure, with the blocking and anchoring at 5'4", Based upon
review and acceptance of other structure to home per manufacturers
requirements.
As always, should you have any questions, please feel free to call
me at any time,
SLw
Leonard Q, Wood
4034 The Fenway
Mulberry, FL 33860
BUILDING SHALL COMPLY '~TH
ALL APPLICABLE BUlLDIN~
ELECTRICAL, PLUMBING . .
MECHANICAL CODES. \ . \t>
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ALL APPLICABLE BUILDING,
ELECTRICAL, PLUMBING AND
MECHANICAL CODES,
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FOR: B.t:H CON~T Of CEN fL INC
4025 MQRRIS BRIDGE ROAD
__ ZEPHYRHILLs. FLORIDA 33543
8~224-1~~J..!..~' 813-715-6585
T'HESB ST ANDI'UW5 AND J'tANS MEET
l'HE 2004 FLORIDA BtlU.DINO CODE
BlJU.DlNG SEC'TJON 1609
<< ';10.
· ;1 _:;;t~7tJ'141i~
lEoNARD G. "GEOFPWobo
ENGINEER
LEONARD G. WOOD, P.E, '47377
4034 THE FENW A Y
MVlBERRY. F1.OR.lDA 33860
TELEPHONE/FAX (863) 646-5517
; MOBILE (863\ 287-7073
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EDGE BEAMS AND CENTER BEAMS
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gradient, load intensity and erosion characteristics of slope
material.
1805.4 Footings. Footings shall be designed and constructed in
accordance with Sections 1805.4, I through 1805.4.6.
1805.4.1 Design, Footings shall be so designed that the.
allowable bearing capacity of the soil is not exceeded. and
that differential settlement is minimized. The minimum
width of footings shall be 12 inches (305 mm).
Footings in areas with expansive soils shall be designed
in accordance with the provisions of Section 1805.8.
1805.4.1.1 Design loads. Footings shall be designed for
the most unfavorable effects due to the combinations of
loads specified in Section 1605,3. The dead load shall in-
clude the weight of foundations, footings and overlying
fill. Reduced live loads, as specified in Section 1607,9.
are pennitted to be used in designing footings,
1805.4,1.2 Vibratory loads. Where machinery opera-
tions or other vibrations are transmitted through the
foundation, consideration shall be given in the footing
design to prevent detrimental disturbances of the soil.
1805.4.2 Concrete footings, The design. materials and con-
struction of concrete footings shall comply with Sections
1805.4,2, I through 1805.4,2.6 and the provisions of Chap-
ter 19.
Exception: Where a specific design is not provided. con-
crete footings supporting walls of light-frame construc-
tion are pennitted to be designed in accordance with
Table 1805.4,2,
1805.4.2.1 Concrete strength. Concrete in footings
shall have a specified compressive strength if I c) of not
less than 2,500 pounds per square inch (psi) (17237 kPa)
at 28 days,
1805.4.2.2 Reserved.
SOILS AND FOUNDATIONS
1805,4,2,3 Plain concrete footings. The edge thickness
of plain concrete footings supporting walls of other than
light-frllJTle construction shall not be less than is Inches
(203 mrn) where placed on soil.
Exception: For plain concrete footings supporting
Group R-3 occupancies. the edge thickness is permit-
ted to be 6 inches (152 mm), provided that the footing
does not extend beyond a distance greater than the
thickness of the footing on either side of the supported
wall.
1805,4,2,4 Placement of concrete. Concrete footings
shall nC!,t be placed through water unless a tremie or otber
method approved by the building official is used. Where
placed under or in the presence of water, the concrete
shall be deposited by approved means to ensure mini-
mum segregation of the mix and negligible turbulence of
the water,
1805,4,2,5 Protection of concrete. Concrete footings
shall be protected from freezing during depositing and for
a period of not less than five days thereafter. Water shall
not be allowed to flow through the deposited concrete.
1805.4,2,6~orming of concrete. Concrete footings are
perffiitted to be cast against the earth where, in the opin-
iOD of the building official. soil conditions do not require
forming. Where forming is required, it shall be in accor-
dance with Chapter 6 ofACI 318.
1805,4,3 Masonry-unit footings. The design, materials
and construction of masonry-unit footings shall comply
with Sections 1805.4.3.1 and 1805.4.3,2, and the provisions
of Chapter 21,
Exception: Where a specific design is not provided, mo,
sonry-unit footings supporting walls of light-frame con-
struction are permitted to be designed in accordance with
Table 1805.4.2,
1805,4,3,1 Dimensions, Masonry-unit footings shall be
.Iaid in Type M or S mortar complying with Section
II
TABLE 1805.4.2
FOOTINGS SUPPORTING WALLS OF WGHT.FRAME CONSTRUCTION-' b. c, d
.. WIDTH 011. ,. I
THICKNESS OF
NUMBER OF FLOORS FOOTING FOOTING
SUPPORTED BY THE FOOTING' (Inoh..) (Inch..)
I 12 6
2 15 6
3 18 gf
i
II
For SI: I inch = 25.4 mm, I foot = 304.8 mm.
u. Depth of footings shall be in accordance with Section 1805,2,
b. The ground under the floor is permitted to be excavated to the elevation of the top of the footing,
c. Interior-stud-bearing walls are permitted to be supported by isolated footings, The footing width and length shall be twice the width shown in this lable. and fool-
ings shall be spaced not more than 6 feel on center,
II d. For thickness of foundation walls, see Section 1805.5,
e. Footings are permitted to support aroofin addition to the stipulated number of floors, Footingssupporting roof only shall be as required for supporting one !loor
r. Plain concrete foolings for Group R-3 occupancies are permitted to be 6 incites thick,
FLORIDA BUILDING CODE - BUILDING
18.5
State6~
NOTICE OF COMMENCEMENT
County o~ C) .
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,
and in accordance with Chapter 713, Florida Statutes, the following information is provided in
this Notice of Commencement:
1. DescriptionofProperqr: ParceINo.\\\~ ~-...j ~j ~~c0~
. \
3'--\-~~\ -c:cJa-~D -<::)&)~,
(Legal description of the property and street address if available)
2. General Description of Improvements ~ . f..J\\ ~~\Lc\::' \'., {\=DC .-\
1111I111111111111111111111111111111111111111111111111111111I
2006048216
3. Owner Information: Nam~l~\'\c-\ \-~('l~\'{)\-\Q
Addres;l~Lb\ ~~~\~D{ , Ci~\)~~~\s St~~, ?D)'--\ \
Interest in Property:
Name of Fee Simple Titleholder:
(If other than owner)
Address City State
A contractor:Nam~~\~'t~-y ~'\-1.c-Ww,+1.
Addres\-\~~ If\Cj ( Sh ,~({-\cit7v0'~ \'\\\ \~ Sta~\ '?:?)~~ 3
5. Surety: Name
Rc:pt: 971251
os: 0.00
03/10/06
Rec: : 10.00
IT: 0. 00
Dpty Clerk
Address
City
State
Amount of Bond: $
JEO~PITTMAN~ PASCO COUNTY CLERK
03/10/06' 00: 53am 1 of 1
OR BK 6878 PG 1722
6. Lender: Name
Address
..~>
cny:~
State
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
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. Rxpiratio? date of Notice of Commencement (the expiration date is 1 year from the date
of rec5rdmg unless a different date is specified.) .
Signature of Owner:
Sworn to and subscribed bef~re me this ~ ~~,
Notary pU~~~~'::lQ ;t--
My Commission Expires:
PC93053048/ A
I r:~ _~._u,~ I
"".i ==--
Of Po" Expwes 0811812009