HomeMy WebLinkAbout07-6414
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6414
Permit Number: 6414
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 Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 6011 HARRI L T
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: PINE CREST M.H.P.
Parcel Number: 03-26-21-0210-00000-0500
6,800.00
2/01/2007 Name: WRIGHT, DWIGHT N
97.50 Address: 6011 HARRIET ST L T #50
97.50 ZEPHYRHILLS, FL. 33542
2/01/2007 Phone: 813783-1912
ENCLOSE WIWOOD FRAME FOR SHED INSTALL 18 VINYL WINDOWS
CfJ:(\
vA)
11.1
I I
FOOTER DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC,
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.
C{~~':~ ~ ~ ~.
GNA ~':n-.h.-/~ PERMIT OFFI
FOR INSPECTION - 8 HOUR NOnCE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6414
Permit Number: 6414
Permit Type: ADDITION/AL TERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 6011 HAR lET ST L T# 50
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: PINE CREST M.H.P.
Parcel Number: 03-26-21-0210-00000-0500
6,800.00
Name: WRIGHT, DWIGHT N
Address: 6011 HARRIET ST L T #50
ZEPHYRHILLS, FL. 33542
Phone: 813783-1912
ENCLOSE WIWOOD FRAME FOR SHED INSTALL 18 VINYL WINDOWS
97.50
IJO~ ~
FOOTER DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
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 SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 .
City ot Lepnyrnllls ~erml( f-\jJjJllvi:1l1UII
Building Department
Date Received
Owner's Name U/,i t;: ? /V,. 4/ r (}C /'. / Owner Phone Number ~ t;J
1./ .// /1' _1 LJD.i_ r C'T 2ifr/Yh/'r,e..J Owner Phone Number I ~(.J -7!";J '-/"7/'L
Owner's Address tJ O~, r/ n r~' ao.., ..cL .
I ,.\,_..../.r.,L/' > A/ '_fL1/~.d-7 Owner Phone Number I tj-O' -?rJ -/'7/2-
Fee Simple Titleholder Name &/ 'V' ,,"':&7 /' ;' l" .- --- ;'~ rr '
Fee Simple Titleholder Address I t>ct 1', 8A".e,e t'E?.rr 2 F/# rK'd rC.C--f,. ,c ~ J )' .J7i"L
JOB ADDRESS I ~dl'r I-fA/PR/rr.> r
SUBDIVISION ~/"v.cc"e.J7 Pfll'ee..r /fiT",,;" )fA-
PARCELID#la.l 26 .:2. / 0.2../0 t::U:~oc;-(/ e;.F,.,.t;,I
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN D MOVE CJ
LOT #
I .> e;;'
DEMOliSH
WORK PROPOSED
B
CJ
CJ
PROPOSED USE
TYPE OF CONSTRUCTION
NEW CONSTR
INSTALL
SFR
BLOCK
OTHER
STEEL
WOO,
DESCRIPTION OF WORK I/V'$TALL v~~,rvJ Co':
BUILDING SIZE I 1/'" X V'" /' ISQ FOOTAGE I I HEIGHT I I
I . I . I I . I . ~ I .' I I I . , . I . . I . I . I I I . : . . . I I . I . , , I . I I . . . . . I I , . I I . , I . . . . I I I . . . . I . . I I . I . I I . I . . . I . I I I . . I , I I . I I I I I I I I . . . . . I I I . I I . . . . I . . t . . I . . . . . I . I . . . I I I . . . I I .
[}?J BUILDING 1$ I VALUATiON OF TOTAL CONSTRUCTION ~ , Qr.\r<.
. ..>00. Cr <:> ."1l<V~v
o ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY
o PLUMBING 1$ I
o MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
D GAS D ROOFING D SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ~o
;~~;;~~",'''; 'i"""'" ~'" "'1'"''''';''''''''''''''' ","" '~;I ~;;;~~:"'''''' ~: ~""""'"'''' i
Address
License #
Y/N FEE CURRENT
License #
YI N FEE CURRENT
License #
YI N FEE CURRENT
License #
Y/N FEE CURRENT
License #
ELECTRICIAN
SIGN.ATURE
COMPANY
REGISTERED
Address
PLUMBER
SIGNATURE
COMPANY
REGISTERED
Address
MECHANICAL
SIGNATURE
COMPANY
REGISTERED
Address
OTHER
SIGNATURE
COMPANY
REGISTERED
Address
OTHER I
D
~O~~
W.R.E.C,
Y/N
Y/N
Y/N
Y/N
~11111'1"II"IIIIII'IIIIIIIIIIII'II'IIIIIIIII'I'111111111111111111'11111111'111111111111'1111'111111111111111111111111111111111111111111111
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit tor new construction,
Minimum tell (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlslonsllarge projects
COMMERCIAL 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 onslte, 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
SIGN PERMIT Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW construction.
I1I111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I i III i 1I1111111I111I11111111
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 Attomey (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 AlC Fences (PloUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEEO RESTRICTIONS: The undersigned understands thatlhis permit may be subjecl to "deed" resbiclions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance With any
applicable deed restrictions. , , ' ' . .
UNLlCENSEO CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a conlractor or
contractOfs to undertake work, Ihey may be required to be licensed in accordance With stale 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 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 appllcetion for which they will be responsible. If you, as Ihe ow~er 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 ofexisling buildings, as specified In Pasco Counly Ordinance humber 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, Ii Pasco Counly 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 LalJll-Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If t~e 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 alllJllork
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a p'ermitto 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 Bayheiads, 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. '
US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Hunways.
I understand that the following restrictions apply to the use of fill:
Use offill 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 "N in connection with a permitted building using stem wail
construction, I certify that fill will be used only to fill the area within the stem Wall.
!f fill material is to be used in any area, I certify that use of such fill wili 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 hot 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 Buildihg 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 reqllested, 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 considel1ed 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)
OWNER OR AGENT
Subscribed and sworn to (or affirmed) before me this
by
Who Is/are personally known to me or has/have produced
as Identiflcallon.
'. CONTRACTOR
Subscribed and sworn to (or affirmed) before me this
by
Who Is/are personally known to me or has/have produced
as Idenllfication.
Notary Public
Notary Public
Commission No.
Commission No.
r
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
.I
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
511# M.. Wr.qW (N'\ '-1.9-c1
;'1/ ltt;LOL~b~-fa
(.AJ c. ill &oJL(fJ
Contractor/Homeowner:
:Dwf /))oqil-
J 7
1- ..~ 1...30....0
h all 1-k1'f"/f'1- sf. (IP""" FtfAt.,&
Z&<s'itt!J t}J v tl'~4r<J~ Jt '{,r/s~ {'tt-''jJ,,-f-
Approved withe below comments: 0 Denied withe below comments: if
Date Received:
Site:
Permit Type:
Approved wino comments: 0
CD ~("" NP'W...I N,," FDIl.. '5-rlWGr~V'-l'~ ~WlI,.( b 0rt.. 8.l(b<,..:iY/E..
I S ~0\ \1.:i1J:
~ ~~~~S 6~-J,~ti%- .,\/
/ .. . tl::a~;;'r ._~ 1<.Lc. ~a~ \lIP \
~-p..UsI pc;w "51~ "WI,-,Ie:. D I'> rf1f'ic.E. ~l\I! ~? ""S~ F--IQ,."~~
-r; J\l};:l{;J~'2t,.,.( ~ t '51'.(}, IS r44 \.H~~ .
This comment sheet shall be kept with the permit and/or plans.
-t
'lding Official
Contra or and/or Homeo er .
, '"J
(Required when comments are present)
B'
To: Pinecrest Board of Directors
Wednesday, January 17, 2007
I respectfully request permission to enclose my carport.
I intend to use vinyl sliding windows with screens, on the front side,
with a door and at least one window at each end.
I would like to move the existing shed from the front, middle of the
carport to the rear, facing Geiger Rd., but atill within the carport.
Once approval is received, a permit will be applied for at the City Hall.
. P ,_2-{, . of,
/ , , I /0 ~
O^'" ~ (__rte
'in~ ~ }nee
\\eI\~..... St.~
LM3 Hatn~
~ytbi\\s FL 33
Sincerely,
: \rc&~~,
Dwight~~ ~right
Lot 50
6011 Harriett St.
\'OCS: ,\ t yu,uN;L Vd)<,:'~nbeVV
;no.t:".H'.niCl to tnsoH JP.91:::>f.H1t"'! 01
tl()(116;:"; ym eaobn9 oj nc,,:;.::irmsq tc9upc~1 yllUlt09Q291 I
,fC,bl~ tnOlT9rU no ..8n99103 ritlw ewobniw Rmbil.~ Ivn!v szu of bnetnl I
bfl9 rbB~' 16 wobniw {~ilO tassl ts bnSloob s rttiw
8rl1lo elnblil i in(f1l 9rH 1Tl00t bsrla t?nitaix9 ant evom 01 a)fii bluow I
JtOQ1G:::;,'lOt nirltiw Ihte jud bS1 lagi9v gniosl ,lsen ertt 01 hOQlf,;:1
Ilf.,H VtlJ arB ts lot b~!lqqE 9d Ihw timlsq s ,bavi90~:'n ai Isv01qqs 90nO
,Vi;31S:Jf HZ
li1gil\f\J 1.-1 tnr;::wO
oa '0 j
t3 tt9111SH t f' Ob
CITY OFZEPHYRHILLS BUILDING DEPARTMENT
OWNER .??'-t// c.4T ~ Wt?/~//~
JOB LOCATION GO// //A~/(/aT .,J"T
PARCEL I. D.' # c>3 ..z...,-,z / P::2/c/ Clt?ooO
.z E/'//Y/Cp /L~~',.L~ ~.7S7.e- $ 2. ?,J
e;lSC7(J
Cv -<./~ ~/"",.rc,?.c.>T /'ft:4f/LF/~v.>?tC /19/Bf:
SHOW ALL EXISTING & PROPOSED STRUC"I"URES GIVING DIHENSIONS & SETBACKS.
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UTILI'l~Y BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
(f:E/~E~ Ro
1. SETBACKS FOR Rl, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E
R X
0 I
10' P S 10'
0. T 1 0'
S I
E N
D G
20'
FRONT PROPERTY LINE
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
DISCLOSURE STATEMENT FOR owmm
CJ:.TY OF .zEPRYRB:ILLS BUILDJ:NG DEPARTMENT
:I, Ptvr t::H r /Y: tvRrt:::# 7' have read and fulJ.y understand and
agree to theprovi'sions of thi;s' instrument.
The undersigned states and affirms that he or she is desirous of constructing,
renov.ating, adding to or reroofing his or her own domicile~, that he or she
actually occupies, o;;I..I., ..~~l. ,",,",aUllY :by ,'said dom:i.ci~e, and same is. not for
rent, ~ease or sa~e. That he or she sha1.1 comply with the :following conditions.:
~. That the owner and.he or she alone shall act as the builder 'for all phas~s of
construction.
2. That the owner will comply with all provilS!ions of the City of Zephyrhills
ordinances and codes pertinent to 'the building.
3,. That in the event various phases of constructi~ are subcontracted, he wil~
engage o~y properly licensed subcontractors and will personally supervise
such work..
4. That 'in the event the Building Inspector shall requ:i.re corrections to be made,
the owner wil~ assume fuJ.l,respo:c.sibi~ity to insure the.y are ,made, . and upon
completion wi11 call for a reinspection before proceeding with the building.
,5. That the oWner shall assume ful.1 responsibiJ.ity for the construction and will
not expect supervision of his Work from. the City of ZephyrhillsBuilding
Department.
6. That prior to final inspection any additional fees, including reinspection
fees, must be paid in full_ A written request from. this office shall
. constitute' an officia~ notice. to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws'in: regard to
social securi ty ~ workman's compensation, lien laws, etc., where applicable.
8. That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission. .
9. State lawrequ:i.res construction to be don~ by licensed contractors. You have
applied for a pe:cait under an exemption to that law. The exemption allows
you, as the own,er of your property, to act as your own contractor with certain
restrictions even though you do not have a license. YOi1; must provide direct
onsite supervision of the construction yourself. You mci.y build or improve .a
one-family or two-family residence or a farm outbuilding. You may also"build
or improve a commercial building, provided your costs do not exceed $25,000.
The building .or residence, must be f,or your own use or occupancy. It may not
be built or. substantially improved for sale: or lease.' rf you seJ..J..;or' lease' a
bui~ding you. have buil torsubstantially improved your~eifwi th1ri: 1 year' after
the const:tl1ction is cc:implet~, th'e law will presWne .thiLt you built or ,
substantially improved if for sa~e or lease, which is a, violation of this
exemption. You may not hire an unliceIJ.S'ed person to act as your contractor or
to supervise people working on your building. It is your responsibility to
make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You may not. delegate the
responsibility for superv:tsing work to a. licensed contractor who is not
lic~ed to ~erfo:cn the Work being done. Any person working on your building
who J..S not lJ..censed must work under your direct supervi.sion and must be
employed.by you, which means that you must 'deduct F.J:.C.A. and wi.thholcling tax
and provJ..de wo::kers' compensati,on for that emp~oyee, all as prescr:i.bedby iaw.
Your construct~on must comply with all applicable laws, ordinances, building
codes, and zoning r7~latio~s;. q 1 \. W \ . / /
OWNER'S S GNATURE '..-tr \.. I' I ~ / /) :} .r
ADDRESS Qr~ 'I ~ +-
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NOTICE OF COMMENCEMENT
State of ~Lt;1/?l'd,4
,
County of
~.5'cc)
,
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,
and in accordance with Chapter 713, Florida Statutes, the following information is provided in
this Notice of Commencement:
1. Description of Property: Parcel No. 03 :2 b ::z..."". 02 /C,} 00000 o,J'"l:Jo
f///Yc C~tC.$?' plg,t~~ ~ // Qmc j?A,e/r Lo/ S?;;
c;' o-oj? Q!e. 't'??7 f7~ /170 v:- oR. Yr:!/' j1~ ( ('..z.. 60// H,4R/C/F? .>7 ..2E///"$I'/~L....5
(Legal description of the property and street address if available) /CC
2. General Description of Improvement %/YcCo-$t:F eXI'Jr//Y ~ CA,R,P'C7,e7'
1111I1111111 1111I1111I11111 11111 11111 11111 111I1 11111 IIIl 1111
2007018695
R 3. Owner Information: Name LJ4//~/// ~ it//?/t:;:'#?
Address tb'o// //A~/f'rET jl?
City -ZEP'//Y:e///LLJ ' State ,.c- c
Interest in Property: OCV/VE/L
Name of Fee Simple Titleholder:
(If other than owner)
Address
Rcpl : 1070108 Rec: 10.00
os: 0.00 IT: 0.00
02/01/07 Dpty Clerk
City
State
4. Contractor: Name
Address
5. Surety: Name,
Address
Amount of Bond: $
6. Lender: Name
Address
City
State
City
State
JEO PITTMAN, PASCO COUNTY CLERK
02/01/07 12: 05pm 1 of11S29
OR BK 7369 PG
City
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 ,rr'l,4,rtr=;4,RE?- A - tJ'e-/VJ A/J1/#
Address.>7p.2 r ~- ...>7 City ...2F,?A" y,/?U/-,L'C..J State"c- e-
8. In addition to himself, Owner designates P1,4Rd::rJ".eE/ A. I.qe/V::TA,nr/y
of '>/0< 7k' .$"7 .z..~#y"e//rLCJ....rC. to receive a copy of the Lienor's Notice as
provided in Section 713.13 (1) (b), Florida Statutes.
9. Expiration date of Notice of Commencement (the expiration date is 1 year from the date
of recording unless a different date is specified.)
L ;CE# :2008
Signature ofOwner: l'u~ 11, w ~#
Swonl to and subscribed before me this 3"/ day of ..:::r u- Yl u ,A tL-\../
,
Notary Public: 'is -r; e A ~ 'to
j& I tl<J: tJ
, 20 0 rJ .
My Commission Expires:
PC93053048/ A
LOUIS ....COlANDRIA JR. :
CInIIlIt aDClIOJ'" i
~ ~ ......1Iru (IOO)4Uo4254i
~"'J'ff.rJt; ....... NaI8rv Aan., Inc :
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