HomeMy WebLinkAbout06-6286
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6286
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:
6286
SIGN
FREE STANDING SIGN
COMMERCIAL
Address: 40509 CHANCEY RD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 18-26-22-0010-06800-0000
11,550.00
Name: TENBRINK, BRUCE L
110.00 Address: 40509 CHANCEY RD
110.00 ZEPHYRHILLS, FL. 33542
12/29/2006 Phone: 813 788-0184
INSTALL MONUMENTAL SIGN, BACKLIGHT & FOOTERS
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tJj)(/;/
ELECTRICAL ROUGH
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."
NO OCCUPANCY BEFORE C.O.
~('"~W ~~
CONTRA TOR S URE PERMIT OFFI
~OR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6286
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:
6286
SIGN
FREE STANDING SIGN
COMMERCIAL
Address: 40509 CHANCEY D
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 18-26-22-0010-06800-0000
11,550.00
Name: TENBRINK, BRUCE L
110.00 Address: 40509 CHANCEY RD
ZEPHYRHILLS, FL. 33542
Phone: 813788-0184
INSTALL MONUMENTAL SIGN, BACKLIGHT & FOOTERS
Jf
b~eP lll-j
~ f'\~tJ //
REINSPECTlON 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 SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NonCE REQUIRED -
PROTECT CARD FROM WEATHER
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Date Received:
R:yrs C }?o /l dl.ytJ-
(2-I-O/;
f;t 0 ~ C/'~cz-:';
Permit Type: ~ -_.11- /J-1f>1tl ',/J4eHyA-J i:Jmfi,(S
Approved wino comments: ~ Approved withe below comments: 0 Denied withe below comments: 0
Contractor/Homeowner:
Site:
This comment sheet shall be kept with the permit and/or plans.
Bill Burgess - Building Official
Date
Contractor and/or Homeowner
(Required when comments are present)
813-780-0020
City of Zephyrhills Permit Application
Building Department
JOB ADDRESS
Date Received
Owner's Name
o~one Number <?lo - 1\ ~ - D I K. '
""no< pn.;!tumbe' I 'b \ "J, - ] 9. b - '6 4.~ 7.. - '-'~.,>>
Owner Phone Number L I ~
Owner's Address
C~
DESCRIPTION OF WORK
Mo
I
I
B
D
D
SUBDIVISION
WORK PROPOSED
NEW CONSTR
INSTALL
SFR
BLOCK
ADD/ALT
REPAIR
COMM
FRAME
!&1
SIGN
D
DEMOLISH
B
PROPOSED USE D
TYPE OF CONSTRUCTION D
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ISi 5\-, .
lit S5D,~ I
?
D ELECTRICAL 1$ I
D PLUMBING 1$ I
D 1$ ,. .I~___CP-~
MECHANICAL . VALUATION OF MECHANICAL INSTALLATION ~ /Jot, -
(. ~ \iU-"-~
D GAS D ROOFING D SPECIALTY D OTHER 0 ~"r"---
FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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~~o
BUILDER ( n . ..Ai J r .. COM~ANY I R ptrs. S:?", G,.-p I
SIGNATURE CXtA "" It 'f4 REGISTERED Y I N I FEE Cl1RRENT I Y I N I
License # I f"SOOoo q.t7
OTHER I
BUILDING SIZE
,,'
BUILDING
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
D
PROGRESS ENERGY
D
W.R.E.C,
Address
ELECTRICIAN
SIGNATURE
I ~o~~r~
S~h U~~
I T FEE CURRENT I Y I N I
License # I ~ S Or> VoL/I?
Address
PLUMBER
SIGNATURE
COMPANY
REGISTERED
Y/N
FEE CURRENT
Y/N
Address
MECHANICAL I
SIGNATURE .
Address I
OTHER I
SIGNATURE
I
License #
COMPANY
REGISTERED
Y I N
FEE CURRENT
Y/N
License #
COMPANY
REGISTERED
Y/N
FEE CURRENT
Y/N
Address License #
1111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsionsllarge projects
Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
Attach (2) sets of Engineered Plans.
.---PROPERTY SURVEY required for all NEW construction.
11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000)
Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades NC
COMMERCIAL
SIGN PERMIT
Fences (PloUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
....,.
T~A\"'8 1:.'Ci" Y,)W ; ".;; _:.... t
6llil'."~ In !lI..k:lOl;;,..') 'tl6Jl"'" ,';";/, ,...~''.' t,',
Otot ,8' I'I.L ~d il~i',i'j;'ViK'~ ~M~ '~'4 :,1 ~
"~f>Il'lf ~;(i , ,.~.;u"r, ,;,.){:.... ~_ J,
MeA '(\6ki\<, ',.(I,ct,,:., v~: V9>b~iOH ".,
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NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit 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.
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 violatioh
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 Pasco County Building Inspection Division-Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the oWner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: Theundersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation 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 permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
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, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's
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.
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, County and City 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 what actions I must take to be in compliance. Such agencies include but are not limited to:
Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, WaterlWastewater 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.
US 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 permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building 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 properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated 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 permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in thE! application. 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 codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is 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.
FLORIDA JURAT (F.S. 117.03)
~~
Notary Public
PASCO COUNTY BUILDING PERMIT APPLICATION
CENTRAL PERMITrING 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 O' Lakes Boulevard (U .S. 41). Land 0' Lakes
OCCUPANCY:
SEQ#:
NO. OF UNITS:
Fire District:
Permlt#:
THIS APPLICATION MUST BE TYPED OR PRINTED IN INK
AND IS VOID IF NOT PERMITTED WITHIN SIX MONTHS
Type of Construction:
"
III
IV V VI
Date Received:
By:
Is this Application the Result of a Stop Work Order or Notice of Violation? Y
o Owner's Name:
W Job Location:
N ParceIID#: S T
E
R Owner's Present Address:
N
Project #
Phone # ( )
Subdivision:
T AZ Lot Size
State: __ Zip:
R
Sub
Blk
Lot
City:
x
Fee Simple Titleholder's Name (If Other than Owner):
Address (If Applicable):
City:
State:
Zip:
D Description of Work:
E
S
C
R
I
P
T
I
o
N
Living Area:
# of Bedrooms:
Patio:
# of Bathrooms:
Garage: Entry:
Type of Construction: 0 Block
o Frame
Total Under Roof:
o Other:
Fill: Yes No
If Mobile HomefRV, Make:
Work Code
Model Name:
Year:
Size:
FEES BLOCK
Plans Fe'e: $
Prepaid Plans Fees: $
Plans on File? 0 No 0 Yes
Valuation $
Receipt #
Building:
$
o Bonding Company:
T Address:
H Architect/Engineer:
E Address:
R
Mortgage Lender:
Address: City: State: _ Zip:
Contractor: ~ S'9^ C""'rJ Print Name: gb~~ /{,;tev S.
Signature: ~' Phone # ( J
Address: /0/ e" LL'm=" A-<-. c: City: &Jx-(Ih:,tate: FL Zip: 3;/60/
State License # (if applicable) E-x::>ooc;:d/f 7 Pasco to. Computer 100
Electrical Contractor: / ~7'''''' s S'7^ Co'f/Print' Name: ~.b-
Signature:~ Phone # ( )
Address: 70/ 5 Lc'#'VIC>Y'\ /lc..---e City: hi'u/kState: rc.. Zip:.5S'6c/
State License # (If Applicable) ~ .5c;:>ocx::>Lf f 7 Pasco Co. Computer 10#
Power Co.: Sawpole: AMPS:
City:
State: _ Zip:
City:
State: _ Zip:
eo7'~"'S
,
Electrical
Fee: $
C
o
N
T
R
A
C
T
o
R
Mechanical Contractor:
Print Name:
Mechanical
Fee: $
Signature:
Address:
State License # (If Applicable)
o New 0 Alteration Valuation: $
Phone # (
City: State: _ Zip:
Pasco Co. Computer 10#
(Required)
Plumbing Contractor:
Signature:
Address:
State License # (If Applicable)
# of Fixtures: _ Septic Per. #:
Print Name:
Plumbing
Fee: $
Phone # (
City: State: _ Zip:
Pasco Co. Computer 10#
Sewer: _ Water: Well:
Other Contractor.
Signature:
Address:
State License # (If Applicable)
Type of Contractor:
Print Name:
Other Bldg.
Fee: $
Phone # (
City: State: Zip:
Pasco Co. Computer lOr-
Valuation: $
Other Fee Type:
Amount: $
Receipt #:
Radon Fee: $
JOBS UNDER $2,500.00 IN VALUE DO NOT NEED TO
RECORD AND POST A "NOTICE OF COMMENCEMENT." TOTAL BUilDING PERMIT FEE
$
-* NOTICE **-
BOTH THE OWNER AND CONTRACTOR OF RECORD (LICENSE HOLDER)
MUST READ AND SIGN THE REVERSE SIDE OF THIS APPLICATION
EDITIONS OF THIS FORM RELEASED BEFORE 03105 AR6.-0BSOLETE
A. NOTICE OF DEED RESTRICTIONS
The undersigned understand that this permit may be subject to "deed restrictions" w~ich may be more restrictive than County 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. he may be required to be licensed In accor?ance with S~te and local
regulations. It the contractor Is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor VI?latio~ 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, Ucensing Section, at (727) 847-8009.
Furthermore, If the owner has hired a contractor or contractors, he Is advised to have the contractors sign po~ion.s of the "Contractor Block" of
this application for which he will be responsible. If you as the owner sign as the contractor, you are Indl.ca~lng, that you, r~ther 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 entiUed to permitting privileges in Pasco County.
C. IMPACT FEES/UTILlT!ES 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 exlsUng buildings. The undersigned also understands that such fees as may be due will be Identified at
the Ume of permlttln'g. It Is further understood that Impact Fees and Resource Recovery Fees must be paid prior to receiving a "Certificate ?f
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 permit Issuance. Furthermore, 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 -
Homeowner's 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-clescribed 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, County codes, zoning
regulations, and land development regulations In the jurisdiction. I also certify that I understand that the regulations of other govemment
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 bayheads, weUand areas, and altering watercourses.
. Army Corps of Engineers: Sea walls, docks, and navigable waterways.
. Florida Department of Children and 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 permitted.
If fill material Is to be used In Flood Zone "A," it Is understood that a drainage plan addressing a "compensating volume" will be
submitted at the time of permitting which Is prepared by a professional engineer licensed by the State of Frorida.
If fill material is to be used In Flood Zone "A" in connection with a permitted building 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 ~rop'ertles, the owner may be cited for violating the conditions Of the Building Permit issued under the
attached permit application. For lots less than one (1) acre which are elevared 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 permitting conditions set forth in this affidavit prior to
commencing construction.
.
.
.
.
I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not
specifically Included In the application.
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. construcUon, or
violations of any codes. Every permit Issued shall become Invalid unless the work authorized by such permit Is commenced within six months of permit
issuance, or If work authorized by the permit 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 exceed ninety (90) days and will demonstrate justifiable cause for the
extension. If work ceases for ninety (90) consecutive days, the job Is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN 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.
The foregoing Instrument was acknowledged before me this
200 by
, (name of person acknowledging), who is personally known to me or who
has produced
SIGNATURE: /-?~
CONTRACTOR
STATE OF FLORIDA COUNTY PASCO
The foregoing instrument w~ flcknq~le~~ before me this Dc) U
;2~ 20fbby t</~~ ~t'P'>
(name of person acknowledging). who's personally known to IDe or who
has produced ,-
(type of
SIGNATURE:
OWNER OR AGENT
STATE OF FLORIDA COUNTY PASCO
(type of
identification) as IdentificaUon.
NOTARY
s. MULl
MY COMMISS N # D0418873
EXPIRES: July 22, 2009
FI. NotaJy DisCOWlt Assoc, Co,
Aaartistic Armadillo
Estimate
4841 Allen Road
Zepbyrbills, FL 3354]
813-780-8462
Date
Estimate #
6/2712006
81
Name I Address
Ten Brinks Underground Inc.
Project
Description Qty Rate Total
Monument style sign, base price per square foot, includes 110 105.00 11,55O.00T
installation, Footer & Credit for recycled faces, this sign will be -
stucco fini!dled, backlit, 11' tall x 10 wide
Engineered Drawings 1 225.00 225.00T
Permitting Fees, for staff time permit application & fees, plus 1 250.00 250.00
permit at cost
Sales Tax 7.00% 824.25
.
Thank you for the opportunity to quote your job! Total
$12,849.25
Customer Signature ~44G< Z, ~
;r /'
Letter of Authorization
Re: Parcel 10 # 5'IiC 1/?--rty/!.rJ(; 5, /<!vb, ;<,;1 E
-
=--
Address:
'105'09 Ch'H/VC~Y /Lo
ZeDhvrhills. FL. 3 5Jj;l
To Whom It May Concern:
This letter shall serve as authorization for Roger's Sign Co., 101 Daniel Ave., Brooksville, FL,
34601.
To apply for all necessary permitting and provide installation of monumental sign per approved
art on our property as listed above.
ljt.j/ b ,gOV6# i2tJ
Property Owners Address
/JA/L~ '~ v&AL~/
A5roperty Owner StQnature
T6Jv BE-Ink. tJ..
IV
U i--' 0 fi-d. CPI'lt;' () 'I ftl <-
~/l.--
Corp. Namel Position Of Signatory
i3rUc.~ Ie n. ef I~ k
Property Owner Name
2fjfIf7t/fI{{s rL 335'il
Property Owner City, St, Zip
81"3 781/ o/f?7'
Property Owner Telephone Number
Sworn to & subscribed before me this I C1 day of -cx iv he f
,~
Notary Public it l Y.(a (ldlLu-'J!, l},MJL I a-v;,
Print Notary Name IJ~.l-'f-Q V\ eM' i ~ N' W \ \ \ ~ CA rv0
,
2: ALEXANDRIA N. WIWAMS
:.!J .. NOTARY PUBLIC - STATE OF FLORIDA
. .
: : COMMISSION # 00487434
~')o,"'~.: EXPIRES 111212009
.,... BONDED THRU HIS8-NOTARY1
== ~
- -
--
-
-
-
-
--
-
-
-
-
~ ....
Rogers' Sign CarR.
SALES · SERVICE. INSTALLATION
701 S. LEMON AVENUE · OPDOKSVILLE, FL 34601
PHONE (J52) 799-192J · FAX (J52) 799-6994
LETTER OF PERMISSION
Date: November 27, 2006
To whom it may concern:
I Robert F. Rogers give my permission for Vallery Hilliary to act as my agent to
update my contractor license ES0000417 and apply for and pick up sign permit.
Ten Brink
40509 Chancey Rd
Zephyrhills, FL
Si~
~rt rZogers
State of Florida
County of Hernando \ \ 1\
The foregoing instrument was acknowledges before me this 'J-,7 day of ~
Robert Rogers whorais 'personally known to me or has produced
- as identification
. t.
~"'vP~t;. RUSSELL S. MULl
~ MY COMMISSION N 00418873
"i;""",;,R EXPIRES: Jill)' 22. 2009
1-800-J-NOTARY '1. NIIWYDI!~I-' Co.
R
Prepared By and After Recording Return To:
Stephanie Rooney
FL9-1 00-0 1-06
. Bank of America, N.A.
P.O. Box 40329
Jacksonville, FL 32203-0329
11111111111111111111111111I11I11 1111111111111111111111111111
2006079945
4727199/265
Rcpt:990268
DS: 0.00
04/20/06
Rec: 10.00
IT: 0.00
Opty Clerk
JED PITTMAN, PASCO COUNTY CLERK
04/20/06 09: 02am 1 ~f 1-
OR BK 6945 PG /1/
SATISFACTION OF MORTGAGE
KNOW ALL MEN BY THESE PRESENTS: That BANK OF AMERICA, N,A" the owner
and holder of that certain MORTGAGE, executed by Bruce L. Ten Brink, a married man" to
Bank of America, N,A" dated the 15th day of April, 2005, recorded in Official Records Book
6333, Page 156, said mortgage was re-recorded in Official Records Book 6537, Page 507, in the
Public Records of Pasco County, State of Florida, securing the note or notes described therein in
the principal sum of One Hundred Forty Thousand AND 00/100 ($140,000,00) DOLLARS,
and certain promises and obligations set forth in said instrument, upon the property situated and
lying in said State and County as more particularly described therein, hereby acknowledges full
payment and satisfaction of said Note and Mortgage, and surrenders the same as cancelled, and
hereby directs the Clerk of the Circuit Court to cancel the same of record.
IN WITNESS WHEREOF the undersigned has caused this instrument to be executed this j 8HL
day of A-D ( I I , 2006. -
I
Signed, sealed and delivered
in the pr~e .
BANK " AMERICA, N.~ n.J I , I A ,
By~ ~ ~.h~'Y'
~V?________.
Witness: Beverly F. Bousquet
Evelyn Davis Myers, Asst. Vice President
State of Florida
,...---..- ~ p ~
PAN FORMED ---,
FACE
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1111111111111111I1111111111111111111I111111111I1111111111111
2006240940 .
State of Flo V" ,J"
NonCE OF COMMENCEMENT
County of p~ LO
Rcpl: 1054712 Rec: 10.00
OS: 0.00 IT: 0.00
12/05/06 Dpty Clerk
THE UNDERSIGNED hereby gives notice that Improvement wiD be made to certain real property, and in accordance with
Chapter 713, Rorida Statutes, the foJlowing infomtatioo is provided in this Notice of Commencement
..
1. Des~ption of Property: Pal'ce1 No. SEe I ~ -T W 1>.. J..~ S 1< IV ~ 22. E
(lega' description of the property and street address if available}
General Description of Improvement A U
2.
~"\ \~
~\.\j~ "RJ.
"" 'Tt ~ B r ; '" k
Ze..p~yr""',lIs
City
m()~u.Wlttl'lftJ ~~j Ie. Sj h .
JEO PITTMAN~ PASCO COUNTY CLERK
12/0!5/06 1... : 00am 1 of 1
OR BK 7294 PG 1798
3.
Owner Information: Name Bv- Llc..'"
Address
Fl
State
Interest in Property: Ow .,e~1/
N/ft.
(If othel than owner)
Name of Fee Simple Titleholder:
Address
State
City
A~
Contractor. Name ~ L r.., S l'j ... Co rp
70 \ 5 ~ .......11"" Ilvt.
Address
B..-oolc.s "ale
City
F! L. 31...\'(00 \
State
5,
Surety: Name,
^J}A-
l
Address
State
City
Amount of Bond: $
6,
Lender: Name
1J/4
t
State
Address
CIty
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:
^//4
./
Name
8.
Address
In addition to himself, Owner designates tJ /It
of
Notice as provided in Section 713. 13(1}(b), Florida Statutes.
City
State
to receive a copy of the Lienor's
9. Expiration date of Notice of Commencement is one year from the date of recording unless a different date is
specified.
o,~;).Lijfo~ ~ ~SJ J/~kj)
STATE OF FLORIDA 0 11
COUNTY OF ___
w1odQedbefo",methe-1.eomw ~ DLP
Seal:
'11II\' WIoN IIUlIIIIN At IIIIIUIlI
Nt80SI aa I lIIlI"IlllUlO:)
O~~ '8~ ....1IIIdIlJ ~
lIIl!'OI~ 10 IIIIS . :JICIIld __
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