HomeMy WebLinkAbout06-6076
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
to
6076
Permit Number: 6076
Permit Type: ADDITION/ALTERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fe~s:
Amount Paid:
Date Paid:
Work Desc:
Address: 39212 PARK DR
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 12-26-21-0030-00400-0100
4,887.00
9/08/2006
82.50
82.50
9/08/2006 Phone:
REPLACE 2 ENTRY DOORS SIZE FOR SIZE
Name: WICOFF, DOROTHY
Address: 39212 PARK DR
ZEPHYRHILLS, FL. 33542
\O~
~(TC\\ ~
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."
NO OCCUPANCY BEFORE C.O.
.~. ~~
CONTRACTOR SIG ATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
UVr/U4ILUU4/MVN U4: U~ rM L.trl1r~.Jw.;, llUJLUJNl..
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CITY OF ZEPHynHILLS PERMIT APPLICATION
!lUIUlINlilOBP~'1HD1'l' 5335 Sn St, Zephyrhill., I'L 33542
S13-780-0020 VAX: 813-790-0021
DA'l'E RJ:CJ:IVa1l @ - O~ -0<0
PHOm: CON~ACT i'OR PJ:ItHU..r:rKQ '1/.3, - CJ;;' (p-99fo S-
fhC/IJ ;' elf
PHOm: $?13~Vf~ -, Z~ WCt:f5nN
. .. , . :
""m"ON ~t. f-11J.~bfs
{OeTAIN FRO~,TAX N~
[]ALTERATION 0 REPAIR X INSTALL
OO>>ER'S ~'('f~ UQr:clby
JOB ADDRESS ~ I D.Al~..
LEGAL DESCRI ~TION: LOT' (S) 10 . . BLOCK 4-
PARCEL 10 t \A'~lo,al-003 'OO.foO - Din 0
WORK PROPSED: []NEW coNSTRUCTION
[] SIGN
US~:'~GL FAMILY
[] COMMERCIAL
OADUITION
o MOVE
o DEMOLI SB
PROPOSED
DWELLING
[]WULTI-l7IMILY
[] INDUSTRIAL
D. OF UNITS
o SWIMMING POOL
o MOBILE HOME
[] OTHER
c:J RESTAURANT (, HEALTH Dl!:PARTMENT APpROVAL
DIISClUP'l'ION OF WORK ~ ;J., ~ doo r:s, .5 J 2P ~y .sJ':Le;
BUILDING SIZE SQUARE FOOTAGE HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS , (2) SETS or 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.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
~
,JOV
PBRMr!rS lUI:QUESTKD
o ELECTlUCAL
o PLUMBING
[] MECHANICAL
",
AMP SERVICE
o Pro9re~~ Energy 0
N.R.E.C.
VA- Ilt-e
~ Y-I <687 to!)
o BUILDING
$
VALUATION OF fOTAL CONSTRUCTION
$
VALUATION OF MltCliANCIAL INSTALLATION
o OTHER
o GAS 0 ROOFING 0 SPECIALTY
TYPE OF CONSTRUCTION: 0 BLOCK
FINISRID FLOOR ELEVATIONS
o FRAME
o STEEL
[] OTHER
IS PROJECT IN i'LOOD ZONE AREA[] YES
o NO
V1-l~d. w .A" (Y\Qn~,
.INc,
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BUn.DU
Q ') -~
~ ") COMPANY
6 IIf/SJ~TE CERT OR REGIST t. ~ Go \ d..5 3 ~
..........*.***.*.**.*..~**.*********....*..**..***...***
SIGNATU
IU.&C1'RICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST f
.**...*.*..*.*.****..**.**~*....***.****.**...**..*******...******
~
COMPANY'
SIGNATURE
v
BTATE CERT OR REGIBT f
WZCHAXICAL
..**.*..~*...*.........~~.**.....*.*..*..*.*.**********.*..*~....*
COMPANY
SIGNATURi:
BTATE CERT OR REGIST I
....*.*.........*.,.****.....*........*..**.*~~.~...~********.*.*.
0'!Jl%R
COMPANY
SIGNATURE
STATE CERT OR REG!ST I
I' I/U4ILUU4/MVN U4:U~ YM arnll!I1ILL;) l:lUILl!11'f-;
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A. NOTI~E OF DEED RESTRICTIONS
,Thll undersigned understancl.s th~t this permit may be subject to "deed restrictiom," which
may be ~ore restriotive than City regulations. The undersigned assumes responsfbility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
It the owner has hired a contractor or contraotors to undertake work, 'they may be required
to be licensed in accordance with state and local reQulations. If the contractor is not
lioensed as required by law, both the owner and oontractor may be cited for a misdemeanor
viol~tion under state law. If the'owner or intended contractor are uncertain 88 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 cOntraotor or contractors, he is advised to have the
contractor Is) sign po~tions of the "Contractor Seotions" of this application fo~ which they
will be responsible. If you, .a~ thQ owner siQ03 as the contr~otor, 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 indica~i6n that he is not properly licensed and is
not entitled to permitting privileges in the City or Zephyrhills.
C. TRANSPORTATION IMPACT FiES AND UTILITY CONNECTION FEES
D. CONSTROCTUION LIEN LI\W (CWU>'rl!:R 713, FLORIDA STATUTES, AS !'\HENDED)
I certify that I, the applioant, haye been provided with a copy 'of "Florida'. Construction
lien Law - Homeowner's ,Protection Guide" prepared by the Florida Department of Aqriculture
and Consumer Affairs. If the applicant is somaone other that the ~owner", I,cerify that I
have obtained a copy of the above desaribed document and promise in qood faith to deliver
it to the "owner" prior to cOll1l1lenCelllent.
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 regulatinQ construction, zoninQ, and land
development.
Appliqation is hereby made to obtain a permit to do work and installation as indic~ted. I
certify that no work or instellation has oommenced prior to issuahce of a permit and that
all work will be pGrfo~ed to meet standards of all laws regUlating construction, City
oodes, zoninq requlations, and land development regulations in the jurisdiction. I also
oertify that I understand that the regulations ot other governmental aQencies ~y apply to
the intended work, and that it is my responsibility to identity what aotions I must take to
be in oompliance. Such agencies include but are not limited to: *Oepartment of
Environmental Regulation-Cypr~$s Bayheads, Wetland Areas and EnVironmentally Sensitive
Lands, Water/Wastewater Treatment
.Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
AlterinQ Watercourses
*Arny Corps of Engineers-Seawalls, DOCKS, NaviQable Waterways
*Department or 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 ~oompensating volume" will be submitted which
is prepared by a protQssional engineer registered in the State of rlorida prior to permit
issuance.
A permit iss~ed shall,be construed to be a license to proceed with the work and not as
authority to violate, cancel, ~lter, or set aside any provisions of the technical oodes,
nor shall issuanoe of a permit prevent the BuildinQ Offioial from thereafter requiring a
correction of errors in plans, construction, or. violations of any code. Every permit
iSSUQd shall become invalid unless the work author1zed by such permit is commenced within
six months of issuance, or if work authorized by the permit i8 suspended or abandoned forla
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
1n writing to 'the Building Offioial. An approved inspection must be lOOQed during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: 'fOOR !"AILOM TO RECORO A NOTICE OF COMMENCEMENT MAY RESULT ni YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOOR PROPERTy. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOSS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE i OWNiR OR AGENT
SIGNATURE I CONTRACTOR
STATE OF FLORIDA
COONTY OF
The foregoing instrument was acknowledged
Before me this _ day of. ., .2L
by
(name' of person acknOwledged)
o who ill personally known to roe, or
o who has prodUCed
(type of identification)
and whoO did Ddid not tah an oath.
STATE or FLORIDA
COUNT\, 01'
The foregOing instrument was acknowledged
Before me this ----..Pay of, 20_
by
(name of person aoknowledged)
C1ho 1s personally known to me, or
Owho has produoed
(type of identification)
and who Ddid [J:iid not take an oath
Signeture of person taking acknowledgeMent
Signature of person taking aoknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
~. .~ Job #
Slaars Hoine Improvement Products, Inc.
License No, CB C039161 l8S Location:
P.O. Box' 522290 . Lort9'Naod. FL 32762-2290 - __ Phone #
' Doors
Name, '\>,..,R " '\l\"." AI \A.)', ~.0<;: -~, "_~ 3,,&"4-1 i. 4<i
. ?n ...,.\~ '~a..\~~."." City~.e.f "'/R\\.'\~-S St.: A Zip: '33'SY-z.
Address. Q::! .... _.f", c.o.. -.-- -_. --- I _
I/We, the owner of the premises described below, here inaner referred to as "Purchaser" offer to contra~ with Sears Home Improvement P~Od-
ucts, Inc. heretnaner referred to as "Contractor". to furnish, deliver, a~range for installation of all matenals necessary to improve the premises
located at: (C~ty) e. (State) (Zip)
(Street) 7-
Entry Door 1 Loc. __~ Entry D~~r 2 Loc_ Loc. Loc.
Style: ~____ Style: _.....,!:fa:2 SIDELITES: STORM DOORS:
"81 Full Jamb D L Frarne [J Double )'!:l Full Jamb U L Frame 0 Double Model Number: Model Number:
Dee Stainable1ii:)CC Smooth CJLMT Smooth Dee Stai.nable ~C Smooth DLMT Smooth DCCStainable DCCSM DOne DTwo [] Deluxe
S......l ~"L Exterior Colors ~~. Exterior Colors Exterior COlors Color
~~M- Interior COlors <ta...l,\&",c. InteriQr Colors Interior Colors D Non Self-Storing Model
D Intemal Muntins 0 Brass Muntins [] Internal Muntins CJ Brass Muntins 0 Internal Muntins D Brass Muntins [J Tinted Glass U Bronze U Gray [J Gr
D Internal Blinds D Obscure Glass D Internal Blinds CI Obscure Glass 0 Internal Blinds 0 Obscure Glass [J Aluminum Screen Wire
Grid/Blind Color ~J1.. Grid/Blind Color
1"l Glass Style c.~ - -:L c::,.. Glass Sty leu c:...\.-~ - ~ ~ --- GridIBlind Color [] Storm Door Standard Hardware
")<f Hardware Finish 0 BB ~B =, NS )Q Hardware Finish [1 BB "!8AB [J NS [] Glass Style [J Black 0 White
'!9 Standard Hardware PKG ~ Standarcj Hardware PKG [] Brass Threshold Specialty Hardware
o Decorative Trim Handle CI Oecomtive Trim Handle [] 3Y.. 0 2Y.. Colonial Casing
D Magazine Slot U MagaZine Slot CJ 2Y.z Modern Casing Color: _
D Door Knocker and View [J Door Knock.er and View [] Jamb Color
D Door Knocker [J Door Knocker [] Standard D Extended Jamb
o Kick Plate [J Kick Plille Additional Options
Additional Options Addltiona Options TRANSOMS:
POS07SS'"
--
( (1....r."
~13 - 3~jH
Y"'l-~l>
Bus.:
[] OuraGuard
[] Hardware Fin [] Be [] AS 11 NS
Inawlng I O~utal
L.tt Har\. d I~I Hand Ltfh Hanel t
:::l!...........::: : -J'--..~.: ,:::Jr--' . ~ ..'
lna.ln., ':" ho"!UI In. of hQ.....
Model Number:
[] CC Stainable [] CC SM
Exterior Colors
Interior Colors
o Intemal Muntins 0 Brass Muntins
Grid
[] Diamond
[] 3Y.. 0 2Y.. Colonial CaSing
[] 2Y.. Modern Casing Color: _
CI Jamb Color
["] Standard 0 Extended Jamb
Additional Options
SECURITY DOOR:
Model Number:
[J Single Door Double Door
CJ Sldelltes 0 One 0 Two
Color
rl Standard Hardware (Bright Brass)
Hardware Options
[J Brass Threshold
[] 3Y.z D 2\.iz Colonial Casing
Q2l1t Modem Casing COlor;~L
D Door Cutdown
Jamb Cladding COIO,.c:;.......~~"'...
Standard Jamb CI Ex1ended Jamb
Patio Door Screen Color ___
U Briles Threshold
[J 3~2 '., 2.Y2 Colonial Casing
~2h Modern CaSing COlor:<3.M~'~
[] Door Cutdown
Jamb Cladding COlor~~..
)Cb Standaro Jamb C) Extended Jamb
Patio Door Screen Color ___
CI Magazine Slot
D Self Storing Glass
Do Not Do: I {}....",..'\~A.i~""-
Speciallnstructlo~~_.__
~~~~._--~_'S\3t&\5-'
Contractor is not _liable for condition or operat,.~.':l of rehung storm doors.
Clean up job related debriS and provide neeess'iiry permits and insurance.
Allow approximately 3 - 6 weeks for installation. Warranty will be mailed upon satisfactory completion.
NOTE: THE WARRANTY PROVISIONS AS STATED ON THE REVERSE HAVE BEEN EXPLAINED J'ND IIWE UNDERSTAND THEM
ADDITIONAL PROVISIONS AND WARRANTIES ARE STATED ON THE REVERSE SIDE AND ARE A PART OF THIS CONTRACT.
Please read t e 0 wIng 0 type and nitl correspon ng ne.
Verbal understandings and agreements with representative shall not be binding. All understandings and agr_menta must
be .et forth In writing In this Contract. Due to cllmstlc conditIons, In".lo. conden_tlon may ocour. Purcha.er Inltl
IcIng on storm doors may occur,
Terms: Credit:E'" (SUbject to the approval of the Credit Department)
Cash 0 (Final Payment payable to Installer upon completion)
Total Items
......
Initial Visit DIscount
State Sales Tax (_'Yo)
(If applicable)
Total Contract Price
Deposit
Balance Due
10% Pnofarradeu.tomer DIscount (PCD)_ardedfor any future Sears Home Im~ Proctucta ~ Current prtcIng available for one (1))'Mr.
If this Is a credit transaction, the agreement for credit is contained .n a separate document which Is incorporated herein by reference and made a part hereof. IN>Ie the
undersigned are hereby authorizing Sears Home Improv. ement PrOducts, Inc,.to verify and r,view my/our credit record with an independent c. n.dit reporting agency
and rel.a.... them Irom all liability incurred from .n..dvttr1ttnt oml....lons or errors. 2?f=.'f ~ rl:=
IN WITNESS WHEREOF Purchaser(s) have hereu",:> signed their name(s) thiS '--'- day of ft' . 2.00(. and acknowledge
receipt of a true copy of thiS Contract and unless othorwisa specified, Ills understood that the owner Is ready fo Ork to begin.
YOU 1he Pu~S) may cancel this transaction any time prior to midnight of the third day after the date of this transaction, See
accompanying notice of cancellation form for an explanation of this right,
~ .~.- .....--- - -. - -.,., - --- '-
~ - --.....--
D/ tato
ey, S..r. Hom. I~. P">duct-~'";;;~''' - - .-----~~
Funded by Bank__
City
Phone #
State
Acct #
X
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PROJECT NAME
Wl~
.~~ L4kDr-.
ft;0;30.1S$' A-
PROJECT ADDRESS
SEARS PROJE STATE OF FL
APPROVAL
PRODUCT MANUFACTURER NUMBER
CATEGORY SUB CATEGORY Pro ~ t~j'bY\. 911\:}{u PLla.t5
If' JLtev i' dY Doo r~ .5w I WA-L.: hi
TU ' a
,
CT#
PLEASE NOTE:
ALL WINDOWS HAVE AAMA APPROVAL WITH DESIGN PRESSURE ON THE WINDOW
Florida Building Code Online
:-)11 t N/\''fi( iAT ION
PIlOnlJCT J\PPROVAt PlOdl/ct Type Detail
r
, r- '~ r .,
Overview Product Search Organization Product
Search Application
User: Public User - Not Associated with Organization _
Application #:
Date Submitted:
Code Version:
Need Help?
FL1215-Rl
07/27/2005
2004
Product Manufacturer:
Address/Phone/email:
Precision Entry
2150 SR 39
Sugarcreek, OH 44681
(330) 852-4711
Category:
Exterior Doors
Subcategory :
Swinging
Evaluation Method:
Certification Mark or Listing
Referenced Standards from the Florida Building Code: Sedron Standard Xgr
ASTM E330 1997
ASTM E330 1997
Certification Agency:
Keystone Certifications, Inc.
Quality Assurance Entity:
Validation Entity:
Authorized Signature:
Chris Nolt
cnolt@precisionentry.com
EvaluationlTest Reports Uploaded:
Installation Documents Uploaded:
PTID 1215 I 2020NCCDIS,pdf
PTID 1215 I 20
20NCCDOS,pdf
PTID 1215 I 20
20NC.cDPTO, pdf
PTID 1215 I 2020RPCDIS.pdf
PTID 1215 I 2220NCTDIS,pdf
PTID 1215 I 22
http://www.floridabuilding.orglpr/pr _detl.asp?IPT= 1215&RV=1&fm=ROSrch
page 1 ot 'l.
I
~jl
-
..
.
.
1/23/2006
,!'Jonda HuHdmg Code UnlIne
Page 2 01"2
20NCTDOS,pdf
Product Approval Method:
Method I Option A
Application Status:
Date Validated:
Date Approved:
Date Certified to the 2004 Code:
Approved
08/0812005
08/24/2005
Page: Page 1/1
IGo/
pp/Seq Product Model # or Model Limits of Use
# Name Descri ion
20 ga. New FBC Dp.. +/- 47 pst Not
o NCCDPTO 3-Ute or use in HVHZ Test
1215.1 PD / Wood Frame (OXO) onstruction idth.. 106.2" Test height
'nging Patio 79.5"
FBC DP .. +29 / -32 psf
1215.2 NCTDIS lED / Wood ot for use in HVHZ Test
rame / S-Utes / Trans .dth.. 67.75" Test height
100.7"
FBC DP .. +/- 25 pst Not
1215.3 2 NCTDOS OSED w/ or use in HVHZ Test
R &amp;amp; SL idth .. 68" Test height ..
100"
FBC DP .. +/- 60 pst Not
1215.4 o Ga. Steel lED / Wood or use in HVHZ Test
rame / S-Utes / Trans idth" 67.87" Test height
88.75"
FBC DP .. +/- 45 pst Not
1215.5 o Ga. Steel OED / Wood or use in HVHZ Test
rame / S-Ute / Trans idth.. 68" Test height..
8"
FBC DP .. +/- 50 pst Not
1215.6 o Ga. Steel Pepl. lED or use in HVHZ Test
'dth .. 38.5" Test height
85.25"
Next
Copyright and Disclaimer; @2000 The State of
Florida. All rights reserved.
..n~-
http://www.floridabuilding.org/pr/pr _detl.asp?IPT=1215&RV= l&fm=ROSrch
1/23/2006
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PERMITS R
17128 DOWNS
ODESSA, FL
813-926-9965
813-926-8536
US
DRIVE
33556
(PHONE)
(FAX)
FACSIMILE TRANSMITTAL SHEET
TO, ~ (.2J'ft ith N J
COMPANY:
FROM:
Monica Watson
DATE: ?; ~:50- () b
FAX NUMBER:
TOTAL NO. OF PA6ES INa.UDIN6 COVER:
PHONE NUMBER:
SENDER'S REFERENCE NUMBER:
RE:
"
YOUR REFERENCE NUMBER:
o URGENT 0 FOR REVIEW 0 PLEASE COMMENT 0 PLEASE REPLY 0 PLEASE RECYCLE
i\r0d
{~tZ
PA(2.fc. elR- / P/~A~,
(UAcJ; Af2- f-- ~ '
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THANK YOU,
MONICA WATSON
;;-
~
1 his Instrument l'repare<1oy:
Na~e: SEARS HOME IMPROVEMENT PRODUCTS, INC,
p,O, BOX 522290
LONGWOOD, FL 32752-2290
1-407-551-5376
11111111111111111111111111111111111111I111 I1111 11111111111I1
2006178027
NOTICE OF COMMENCEMENT
Rcpt: 1028857
DS: 0" 00
08/30/06
Rec: 10.00
IT: 0 , 00
-"---- Opty Clerk
State: FLORIDA
County:
.Qu...-Sc.~
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 ~is notice ~f C<?mmencement, . Db 0 "'" _ 0 I 00
hl:iCLl LD# 1 ~-.1(.,-~1-()b30- 4- v
I, Description of property: (legal description of
property, and street address if available)
2t1~l ~ P CtA.k en,
Z~hL~. FL. 33S4-~
~$
JED PITTMAN PASCO COUNTY CLERK
08/30/06 02:5~m 1 of 1
OR BK 715~ PG 300
2,
General description of improvements:
3,
Owner information
a, Name and address:
1'n~\\!i K
f)u.J -e. R.
t )j ~ c..o\-~
3 q~ I ~ PCVI.k. l>t,
2r~ Ft...33S'to
)
b, Interest in property:
c, Name and address of fee simple titleholder (if other than owner):
ti9
Contractor: (name and address)
5, Surety
a, Name and address: NA
SEARS HOME IMPROVEMENT PRODUCTS; INC,
1024 Florida Central Parkway, Longwood, FL 32750 1-800-222-5030
b,
Amount of bond
$
6, Lender: (name & address) NA
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(I)(a)7, Florida Statutues: (name and address)
M/k
f
8, In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as
provided in Section 713, 13 (I){b), Florida Statutes: (name and address)
ABOVE NAMED CONTRACTOR
9, Expiration date of Notice of Commencement (the expiration date is 1 year from the date of recording unless
a diffe ent date is specified)
Owner's Address:
'-
All information must be typed or printed legibly to comply with recording requirements,
STATE OF FLORIDA
COUNTY OF
by ~(''''"~ <<r oM. c.u b.Q'-
L~ as identification and who did (did not) take an
(Signature of person taking acknow4;:dgement)
(Name of officer taking acknowledgement - typed, printed or stamped)
"\"~~~"" L. Keith McWhorter .
." o<.t?', . . ,~(/." ""'DD"7/",tl\ I
:':i;~ .~":. COniltllSSfOR jj' Ii, .V'1IV'
=.;:, \{;,:;~ Expires: Dec 21, 2007
~/;;.; OF ~o~~ ,....'" Bonded ,1luu
'1IIl\\\' AtlanticBQl\dms.Co" Inc.
M9 - Rev, 08/06
I