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HomeMy WebLinkAbout06-5669 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT / 5669 Permit Number: 5669 Permit Type: RE-ROOF Class of Work: ROOF REPLACEMENT Proposed Use: NOT APPLICABLE Square Feet: Est. Value: Improv. Cost: 4,987.50 Date Issued: 4/11/2006 Total Fees: 55.00 Amount Paid: 55.00 Date Paid: 4/11/2006 Work Desc: FLAT RE-ROOF Address: 38734 NORTH AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 11-26-21-0010-04200-0170 Name: FERRIS, LOUIS RICHARD Address: 38734 NORTH AVE ZEPHYRHILLS, FL. 33542 Phone: 813715-1918 REINSPEcnON 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." NO OCCUPANCY BEFORE C.O. - /2tktCl<lr(;zuJ_-e1tku f~ ~ CONTRACTOR SIGNATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT Mcr 3lqq DATE RECEIVED PLANS REVIEW FEE OWNER'S NAME rcv-y\s Lou\S ~\chat<d , JOB ADDRESS 3"b 164- N.~c.\Iv1 A.\JC1Iue... ~ \"1 ~ LEGAL DESCRIPTION: LOT(S) .~ 1~ BLOCK Lt~ PARCEL ID It 1\-~.dl-ro\O. {)J.;tX)-()IIO PHONE 3131./ \ 5 -1918 SUBDIVISION CJ.-r~ oQ- L- ~d\s (OBTAIN FROM PROPERTY TAX NOTICEl WORK PROPSED: ONEW CONSTRUCTION o ADDITION o ALTERATI ON o REPAIR o INSTALL Os I GN o MOVE 0 DEMOLISH ~ USE: .~GL FAMILY o MOBILE PROPOSED DWELLING OMUL'fI-FAMILY Olt OF UNITS HOME o COMMERCIAL o INDUSTRIAL o SWIMMING POOL DOTHER CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK Bod- ?-e.l.<coC BUILDING SIZE SQUARE FOOTAGE ISoO 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. D BUILDING $ VALUATION OF TOTAL CONSTRUCTION '\:=Lf~oppm"~ : 1=-L~oa . \ PERMITS REQUESTED D ELECTRICAL AMP SERVICE D FLORIDA POWER D W.R.E.C. o PLUMBING D MECHANICAL $ o GAS ~ ROOFING TYPE OF CONSTRUCTION: 0 BLOCK o SPECIALTY VALUATION OF MECHANCIAL INSTALLATION ..~----- o OTHER("~.:2_~~~..'SO ') o FRAME 0 STEEL 0 OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES D NO BUILDER COMPANY STATE CERT OR REGIST It CITY PROCESSING It SIGNATURE ****************************************************************** ELECTRICIAN · COMPANY STATE CERT OR REGIST It CITY PROCESSING It SIGNATURE ****************************************************************** PLUMBER COMPANY STATE CERT OR REGIS'!' It CITY PROCESSING It SIGNATURE * * * * * **** **.* ***** **** * * ***** * * * * * *** * * ** * * * * ***** * **** *.* * * * ** * * * * * MECHANICAL COMPANY STATE CERT OR REGIST # CITY PROCESSING It SIGNATURE ***************************************************************** SIGNATURE ~ ~~/l COMPANY MILBAR CONsTRucrrON', INC. STATE CERT OR REGIST It CCC 051562 CITY PROCESSING # 218 OTHER ***************************************************************** CONDITIONS OI~' PElU4I'1' AE'E'IVAVIT 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, 813-788-6611. 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 pronlise 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 Ineet 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 Inust take to be in compliance. Such agencies include but are not limited to: *Departnlent 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 p~rmit 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 PROPER~Y. 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 NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGN~~AG~ R. ABU S"G'~C~~R' ABIA STATE OF FLORIDA COUNTY OF The foregoing instrument was acknn~"leclged Before me this 11- day of A:pet-I , ~~~ by DAVID R. ABLA (name of person acknowledged) ~who is personally known to me, or PASCO STATE OF FLORIDA COUNTY OF The fo::cgoing instrwnent was acknowledged Before me this Ii day of ~(( ,~~ by DAVID R:-AI3LA (name of person acknowledged) ~ho is personally known to me, or PASCO Owho has produced (type of identification) and WhW~ke an oath. . Signature of person taking acknowledgement Owho has produced (type of identification) and who ~id not take an oath Signature '-E Name typ" t 51 ~ 51 ~ ~ ~~;C'G i~ lSWTOFI EXP:~4~L~rt;g:J,?~8 i',:~ f"r:~i;-~ rw INS.iJr;':~NC: CCMtANY i"vrr'~;"..~_"'':.~~,""~t 'Y~~lI',y..I.m__J APR-11:2006 09:06A FROM: TO: 7800021 P.4 C;5';'.<-"~ U.s. Intee Certified Platinum Inetaller "5204 ~ 'm 1 ---- Pa~e N~J.___m.o.f .. ._J_.h__n~~_Q~~ = 1F'rnpllsa - ---~'-~:=i.:::=21. . . . State Certified MIIBar Construction Inc. Roofer'CCC051562 Roollng . Concrele . Commerciel . ReSident., State Reglatered Roofer'RC0055215 15911 US Hwy.301 North. Dade City, Florida 33523 <::> RCI Reglatered 352/567-6047 · 800/562-2393 · FAX: 352/567-4454 Roof Conaultent .0149 f 1-=:: -.- .- Member of the Florida Roofing and Sheet Metal Aaaoelatlon PHON~I -7 JS'-l'll DATE JOB NAME NUE JOB LOCATION ZEPHYR I LS FL 335 ARCHITECT DATe OF PLANS JOB PHONE --.........---... .-- -.-.-.....-----.-.....-.-,-. -'-'--- -..-... We her8bY-iubrri~-sp8CiflC8llons and estimates Ior:-----.- ---....-.-.- ....?;P_HVR.ti.J L L~.._.fJ...____.,.._,...___._.___., .,........ .___.___...~..-.,_ ......_ ".' _',. .,-._-______0... .. ... ---1 PIaU a-ROO!' ..l...__.J:ear. .atf.and...dispaseo,f the o.ld .ane.....,laye.r.: fla.t roo.fing sys.tem. clean up work area daily. 2. Provide and mechanically fasten a 1/2" recovery board insulation and a Firestone I'IB .."....,,,._.-t.1.b.r.gJ.-H&--.b.6&-&h88toV8.r theplywood.,d8Ck p.rio.... to the.i.nstallatlon of the Firestone roofing membrane as per the manufacturer's requirements. 3. Provide and install a new Firestone APP-1B0 white granule-surface roofing membrane ... ,....-whJ.-ctl."J..6-...-tor-ch-..p~lled.full.Y-Bdher8d modified. bi tumeo .roof system that i. he.a.tm welded at the seams to form one sheet; and offers Firestone's 12-year "Modified .".,a.1tumer:l.,IIJ.m~ar:l. Li.ml-t8d.~roduct WarraFl-ty". 4_.-_....All metal.and.,conc.r-e.te su.r.f.acas. will be pr imed-wi.th an asphalt base prime.r p,rio r to installation of the Firestone roofing membrane. S. Provide and install new 2 1/2" 26 gauge galvanized metal eavedrip around the .-pe.,.-ime-tel" o-f.the, ,.oaf as ne-eded. 6.AA.y.-ro.tten..or,~..maged, woad deck.. fascia. trim.. framing. etc.replace.-ment or re.- nailing of the existing roof deck will be completed on a cost-plus basis above and ._.........--beyond1:he'--conera~pde8" .. :r-.,., ..Own&~,-.t(). .p.r--ov!de- aoeess for delivery tr-uoks for loading/unloading for entire roof area. 8. Mi18ar Construction. Inc. to provide General Liability and Worker's Compensation -::::::;::::-.=.__-I-ASta':aEIee ($? ~l imi-t:'l-AAd:::..~.fi1e~~p.eemk..-_.:c__,;.. .:::::~.:::c::..:--:~:.;..... _ .... :::.:=:..;:=::==_~C:. I r ~! 'tapas! hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: I dollars ($ ~ . ~E17 _li~ ). DUE UPON CONPLETION. Invoiced amounts no! paid in accordance wtth the peymenllerms shall be considered deln- Authorized quenlend beer Interest .tthe rale of one end one-hall percenl per month. Owner agreeB to Signature ~ay all COBtll incurred, sucl1 all allorney lees, COllector fess, court costs. etC., for collecllon 01 dellnquentlnvolc88 Including Inter881. OWoor to carry fire, tornado ond other neeesaary Nole: Thls proposal mar. be Insurance. Our workers are fully cowred by Workman's Compen88f1on Insurance. withdrawn by us if not accepted within ~ -~..... .--....--.-"'-':'.. .. . .. ........:---.---'== ..:.;;;::.;:;:.=--=,:=:-=-=-.,...,..:;=:.="_:.:;;=::-:.,..:,,:;-~,--,;.. ".;'..::::-:.::=-:-::-:::..::< // ~tt.eptant.e of JropOSal-Theeboveprices.sp8Clflcalions ~ /).. II (;\f~.:r-~ I' and conditions are satisfactory and hereby accepted. You are authorized SignalureK~ ..h ~~ I::-~Jf.lM >J)~ I. to do the work as specified. paY7m nl wIll be made as outlined above. , ~ . ~~ r I Date 01 Acceptance: IYJ 1'lA~ :l 7 ~ orJ {t:I SIgnature . ~--;;=:==:.:;:.=::;:----_. 30 days. ._.___~_.._ ,... ____. _......_._n.~ __ ..'"" ._______ "'_'__'__.~_.'_" _____. '_'__._"'_ '.__'n TO: 7800021 APR-11~2006 09:07A FROM: P.5 NOTICE OF COMMENCEMENT MCJ# 31~q Pennit No. ParcellO/Folio rI~~-dl- Cf)IO' ()l-teCO.O,+10 State of Florida County of 'P~ The UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with Chapter 713, Floridn Stntues, the following informntion is provided in this notice of commencement. 1. Description ofproperty(/egul description ofprop!f!1l and address ifavailabJe) 3&?~ ~attenu.e Section I' , Township ~ , Range 0Lf 71""p~~ '11~~e-' AJ~M.b4! '" 1)- '1.1..,-2..' - 1)01 /)-IJ 'f LbO - tJ 171J 8364'J- General description of improvements _______.___._.____ 2. 3. Owner Information a) Name and address.l tJ "L' S" R...J=e.,. Y"' S" 3 f 73 ~ /tJt).... # IJve kp~ y~hi /h) fl 3 g r 't z, b) Interest in property 0l11ner '" c) Name and address offee simple titleholder (if other than owner) 4. Contractor (name and address) MilBar Construction. Inc. 1 L:s.vid. /2. AbIeS. 15911 US 301 Dade City. FL 33523 5. Surety a) Name and address b) AmotlOt of bond Lender (name and address) 6. 7. Person within the State of Florida designated by owner upon who notices or other documents may served as provided by Section 713.13 (1 )(a)(7), Florida Statues. 8. In addition to him or herself, owner designates of to receive n copy of the Lienor's Notice as provided in Section 713. 13( 1 }(b), Florida Statues. 9. Expiration date otnotice of commencement (the expiration date is one year from the date of recording unless a different date is specified). STATE OF FLORIDA OWNER'S SIGNATURE~~~ COUNTY OF tt9>&i) PRINTED NAME & TITLE L 0 "t.i sR. ~-e.r,.".s I O~ The fOllOWing. instrument was .cknowledged before me this 4" a d.y of '!/;.(Jlt~ i?/PP! ~ ' Lou 1..9]. FGIf e /$ who IS personally known to me or who produced _'/t J)~ ~ as identification. t:r~,-.s:t~-76-/?/- 0 After recording, return to: Notary Signature~ ~ c.;.. . Name: MilBar Construction. Inc. Name(Print} ~ce t? It 's Address: 15911 US 301 Title or Rank: ,4/d'!A72/ City: Dade City. FL 33523 Serial number, if any: ~ BE1TIE C. JOHNSON MY COMMISSION' D0332616 EXPIRES: Scptllllbcr 16. 200& ,.... .Mn'IUlV P1.Nooooya.-,_ea. APR-l1-2006 09:05A FROM: TO: 7800021 P.l ~ ~ MilBar Construction, Inc. 15911 u.s. 301 · Dade City, Florida 33523 <::> 352/567-6047. 800/562-2393. FAX: 352/567-4454 3~ to ~. (':or~p e~- Ul " .__, \ I - e'Jlp , _._---:----_.....-. . .....P DATE: a.run, t \ ~~ ~hLUS?:'\dj.~ . ,,^.\\\:i)~ ~ Ci~rJ'.,(:-(~-t~ C~e.023L21 '-J ~01.~ '.'. . .~ - 3 (...-os- . ~ C1tJ-t Cer4 . 4 LO'~ -- FAX FAX: ~\51~- tea\ . Pn '. ~\2>\ 1 ~ \) . ('tS::J TO: FROM: c.ne.l~ edo\ MilBar Construction FAX: 352/567-4454 PH: 3521567-6047 RE: ~ APPLICATION FOR: -~~ . 38164 ~~ "l--e.f'ht'\.( ~ US, tcc...... NOTES/COMMENTS: .. Please process the following Roof Permit Application for the above referencCd IQcation. Call me at 352/567-6047 with the permit number. Maib\h~ pamit.aa:4___iyt l,,: MilBat Construction J5911 US 301 Dade City, FL 33523 ... vJt wW pi ~ I {i~r~ . . ,~.1 . If you should have any questions or require any additional information, please call me at 352/567-6047. ' . ., Thank your ~ o Total number of poges faxed. .. .'; State Certified nll;I,I,., nrnr.o"", State CI!1ln~ nnolr" nr.r.r.Olimn, Stale Reglelered n"oln. Hrroor,r",r, Rei RegIlt... n"", ('",nAl ,lInnl .01411 -_.~~~ ~ C:,o=.-" u.s. Intec Certified Platinum Installer #5204 -T=CL.. ....~.~. - Jrorosal. - :3~'~~E~:~'i MIIBar Construction Inc. Roofer#CCC051562 Roofing. Concrete. Commercial. Residenlial State Registered Roofer #RC0055215 RCI Registered Roof Consultant #0149 ~ c'''-;c' r( II II II Ii I' I PROPOSAL SUBMITTED TO I - Member of the Florida Roofing and Sheet Metal Association 15911 US Hwy. 301 North' Dade City, Florida 33523 <::::>c 352/567-6047 · 800/562-2393 · FAX: 352/567-4454 FERRIS STREET LOUIS RICH RD PHON~I -7/5-1'11 DATE JOB NAME 38734 NORTH AVENUE CITY, STATE and ZIP CODE JOB LOCATION ZEPHYRHILLS FL 33542 ARCHITECT We hereby submit specifications and estimates for: c___~_~~_~~~.,. _ ZEPHYRHILLSL FL__p_ i I I II FLAT RB-ROOI' 1. Tea.r off and di.spose of the oldone,....layer flat roofing sys.tem; clean up work area daily. 2. Provide and mechanically fasten a 1/2" recovery board insulation and a Firestone MB fi-berglassbaseshe~tov~r the plywood deck prior to the installation of the Firestone roofing membrane as per the manufacturer's requirements. 3. Provide and install a new Firestone APP-180 white granule-surface roofing membrane whichlsatorch-ap.plied.fully-adhered modified bitumen roof system that is heat..... welded at the seams to form one sheet; and offers Firestone's 12-year "Modified 8.itumen Membrane Limited Product Warranty" . 4. All metal and concrete surfaces will be primed with an asphalt base primer prior to installation of the Firestone roofing membrane. 5. Provide and install new 2 1/2" 26 gauge galvanized metal eavedrip around the perimeter of the roof as needed. 6. Any rotten or- dama.ged wood deck, fascia, trim, framing, etc. replace.....ment or re- nailing of the existing roof deck will be completed on a cost-plus basis above and beyond the contract price 7. L."_ Owner to provide access for delivery trucks for loading/unloading for entire roof area. MilBar Construction, Inc. to provide General Liability and Worker's Compensation Incurance ($2 ,000,000 limit) and re roofing permit. -C-====~=n ~t Jropost hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: P~~~~~to IeW~a~;ft~~ow~;rNE HUNDRED EIGHTY SE'/EN t.ND 60/100 dollars ($ '1. 9S7. a@ ). DUE UPON COMPLETION. Invoiced amounts not paid in accordance with the payment terms shall be considered delin- Authorized quent and bear interest at the rate of one and one-half percent per month. Owner agrees to Signature pay all costs incurred, such as attorney fees, collector fees, court costs, etc., for collection of delinquent invoices including interest. Owner to carry fire, tornado and other necessary Note: This proposal may be insurance. Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within ~ ,,"-----------~----- ------....---------.- -----.-..---- a~~~~~;': ,~t!:,.~:~C :~=~~::,~;:;;~:~. s;goal"ref2~Q%~~ .to do the work as specified. PaYr1]fnt will be made as outlined above. Date of Acceptance: IYl ~ ::L 7 ~'"' ~ orJ fa Signature ~-------==--:====:===-----_._~--- 30 days. ! ---------_---:,-~" " Ii II II II . ..d.. ~ 3~ ~1~~=1~D:~~F~~~~~~n, Inc. tJtlulD~r 352/567-6047. 800/562-2393. FAX: 352/567-4454 FAX DATE: G.pluD, Il ~~ Z-hiLl$ 6\dj.~ . FAX: <6.\3l~<6D- ~l . Pn '. ~\3\ '1 ~ b . Ct€f:) TO: FROM: L'ne1~e~ MilBar Construction FAX: 352/567-4454 PH: 352/567-6047 RE: ROOF PERMIT APPLICATION FOR: }--cri\.S B~~ 38154- "ttw4-h ~ "Z--€.{J\rv\.{ hi.US\ H...... NOTES/COMMENTS: Please process the following Roof Permit Application for the above referenced location. Call me at 352/567-6047 with the permit number. MailJftjIQ~ ......,~..wjpt tv: MilBar Construction 15911 US 301 Dade City, FL 33523 . ~~ WiU f/~ ktLL~ r (l{ . If you should have any questions or require any additional information, please call me at 352/567-6047. Thank. you! CNl/.ULL o Total number of pages faxed. Slale Certified Ill/ildrr HrnrO:>1ryry1 Slale Certified nnnfr>r Hr.r.r.O~ 1 ~r,? Slale Registered Rnnff'r HnrOO~~?1~ Rei Registered Rnnf r.nn~II"rtnt #014!l 1111I111111111I11111111111111I111111111111111111111111111111 2006073279 NOTICE OF COMMENCEMENT MCI# .:3-)CJq Permit No. Parcel IDlFolio rr'~~dl- tf)IQ. ('l4Q(..--x). 0170 Rcpt: 987647 DS: 0.00 04/11/06 Rec: 10.00 IT: 0.00 ---- Dpty Clerk State of Florida County of 'P~ JED PITTMAN~ PASCO COUNTY CLERK 04/11/06 0~:15pm 1 of 1 OR BK 6931 PG 1050 The UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with Chapter 7I3, Florida Statues, the following information is provided in this notice of commencement. 1. Des~ription of property(legal. description of property and address if available) 3<6 ?.3-fNOJCJhauenu.e Section II , Township ~ , Range 52-1 2.eph'''P.{tA::lls. ~ P4...c:.e/ AJ....M.b\?\r IJ-2G,-'21-001f.J,-lJlfLIJO-O 170 339VJ- General description of improvements ') 3. Owner Information , a) Name and address-Lol.L\ S' R ~e\'"r-\ S b) Interest in property Oll1nt'f c) Name and address of fee simple titleholder (if other than owner) ~ i 73 Lf ttJoY' thlfv.e :ref), vyhills) A 3 ~ S" it z. , ;/ H Contractor (name and address) MiIBar Construction. Inc. / L:::avid (2, R-bla 15911 US 301 Dade City. FL 33523 5. Surety a) Name and address b) Amount of bond Lender (name and address) 6. 7. 8. Person within the State of Florida designated by owner upon who notices or other documents may served as provided by Section 713.13 (1)(a)(7), Florida Statues. In addition to him or herself, owner designates of to receive a copy of the Lienor's Notice as provided in Section 713 .13(1 )(b), Florida Statues. Expiration date of notice of commencement (the expiration date is one year from the date of recording unless a different date is specified). 9. STATE OF FLORIDA _ OWNER'S SIGNATUREf~~~ COUNTY OF (Ii;> &iJ PRINTED NAME & TITLE L () 0.1-15 (\. ~..:..(,f'15 I O\.O'(1('f ;;t.. The following instrument was acknowledged before me this .;?t; day of llkhef, #t1f.. by ? LOti is -,. ':':(jf'( e /S who is personally known to me or who prod,!ced ?.;, lJ/z;.",,"c<-~ .f~ce"""'-c.-/ as identification. /-C;':<t?~5")'? -7S-.l7/- D J /) Notary Signature4./~'::~ L-'~ )o/i::.~. . Name(Print) ;5: r:: 77:' /:. f ("7. (J~Jl,tu' Sc:.-./ Title or Rank: /V,"'-7/vz I Serial number, if any: After recording, ret;jrn to: Name: MiIBar Copstruction. Inc. Address: 15911 US 301 City: Dad_~ City, FL 33523