HomeMy WebLinkAbout07-6472
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6472
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:
6472
ADDITION/ALTERATION
SHED INSTALLATION
NOT APPLICABLE
Address: 5731 CRAN ROOKE ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: TREE LANE VILLAGE
Parcel Number: 10-26-21-0000-00100-0000
3,336.50
122.50
122.50
2/15/2007
SHED & ACRYLIC ROOM
POYN ER, DENNIS & JACQUELIN
5731 CRANBROOKE ST
ZEPHYRHILLS, FL. 33542
Phone: 813779-8740
IL
PLUMBING FEE
~U~/
UM 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.
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.
0~ N41tu;Z ~.
CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
i ~~b ~v't/ 1 eq tf
City of Zephyr hills
BUILDING PLAN REVIEW COMMENDS
Contractor/Homeowner:
fAs~ ~UrI,f-
2-(3-07
573/ C,r~r1j;rookeSl.
~~&d 1l Aery I,L 1M
Date Received:
Site:
Permit Type:
r t -2{ I t3/61
12- e;lJ;fY1'
~
-',
'-...,
-------- - -.
This comment sheet shall be kept with the permit and/or plans.
<>7
Contractor and/or Homeowner
(Required when comments are present)
813-780-0020
City of Zephyrhills Permit Application
Building Department
Date Received . L. - f 3 r 0
Owner's Name ()eA.-II if I'a nler fI. ,-I lOR.
Owner's Address I g13 I Cr-anhrooke 5t. 33SlfJ...-
Fee Simple Titleholder Namel
Owner Phone Number 8/ - 1
Owner Phone Number I
Owner Phone Number I
Fee Simple Titleholder Address I
1~1BI CrtLnb({)oke .sf-
lIre e La,nt: V i I ttije.
JOB ADDRESS
I
rn NEW CONSTR D
D INSTALL D
PROPOSED USE EJ SFR D
TYPE OF CONSTRUCTION D BLOCK [I]
DESCRIPTION OF WORK l:5h evf -t A try he-. R.oo YY1
BUILDING SIZE I Y' X ,]61. ~' ISQFOOTAGEI /q<l t:p HEIGHT I
1111..111.111............,.,..'.11.111..........,..'....'.111..11.....'..............11111'.1111.11...111...111....'...........II..III.III.II.p...
ctn BUILDING 1$ a, 000, Q!L
I
D ELECTRICAL 1$
D PLUMBING 1$
D MECHANICAL 1$
D GAS D
FINISHED FLOOR ELEVATIONS I
Address 15131 Uttn broof.:e- .:5t. Lo +- 33~LfL- I License #
ELECTR~N ~ It-Jw i -.4-f4-/- ~5ri~PANY
SIG~~ REGISTERED Y/N FEE CURRENT
Ad ess LIcense #
PLUIIBE"l\; j ~ ~1tv0 - Aj<?-A)- 5S,,"~"
I COMPANY Y/N FEE CURRENT
SIGNA~ REGISTERED
I
Address LIcense #
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/N FEE CURRENT
Address LIcense #
OTHER COMPANY
SIGNATURE REGISTERED YI N FEE CURRENT
Address LIcense #
SUBDIVISION
WORK PROPOSED
I
I
I
I
D
I
ROOFING
BUILDER
SIGNATURE
~gp~
LOT # I
PARCEL 10#1
/~-d.(O -;1. /-OO~O - 00/00 -0000
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN D MOVE D
ADD/ALT
REPAIR
COMM
FRAME
D
D
D
OTHER I Q/1/ I>t 1/1 uP
DEMOLISH
I
m
OTHER
STEEL
VALUATION OF TOTAL CONSTRUCTION
1~~RV-:;: D PROGRESS ENERGY
D
W.R.E.C.
VALUATION OF MECHANICAL INSTALLATION
~c&
SPECIALTY D
FLOOD ZONE AREA
OTHER
DYES
DNO
Y/N
Y/N
Y/N
Y/N
111111111111111 111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111
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 onslte, Construction Plans, Stormwater Plans wI Slit Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsions/large 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 onsite, Construction Plans, Stormwater Plans wI Sill 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.
11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 i 1111111111111111I111111111
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 Fences (PloUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "dE;led" 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 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 727-84.7-
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 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, 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, vVetlandAreas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
Southwest Florida Water Management District-Wells, Cypress Bayheadsj Wetland Areas, Altering
Watercourses.
Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
Department of Health & Rehabilitative Services/Environmental Heaith 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 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 "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 s.eparate perm~t. may ?e requir~d for elect~ica.1 work,
plumbing, signs, wells, pools, air conditioning, gas, or other ~nstallatlons not specifically 1n~luded.1n the application. A
permit issued shall be construed to be a license to proceed With the work a~d not as authorl~y !o vlol~t~, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the B~II,dlng Official from the~eaft~r
requiring a correction of errors in plans, construction or violat!o~s o! any codes. Every ~ermlt Issued. shall become, Invall~
unless the work authorized by such permit is commen~ed Within SIX months o.f permltlssu~nce, or If work authorized. by
the permit is suspended or abandoned for a period of SIX (6) months after the time th~ work IS commenced.. An extension
may be requested, in writing, from the Building Official for a period not t~ exceed mnety ~90) da~s 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 Y<?UR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN TTO EY BEFORE RECORDING YOUR NOTICE OF CO ENCEMEHT.
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT
Subscribed and sworp,to (or affirmed) '# re this
rJ-~-07 by ue~A/S PO,,/) r
Who Is/are'personally known to maor haSlhave produced
Vt.. as Identification.
CONTRACTOR
Subscribed and sworn to (or affirmed) efo m,e this
02 -Or-en by LUA/lir 'p~}f'r
Who is/are personally known to me or ha ave produced
tJt.. as Identification.
~oC-- f/uvL-
Notary Public
~~~
Notary Public
Commission No.
Commission No.
Name of Notary typed. printed or stamp Commission # DD510984
Expires: OCT. 16, 2009
Bonded Thru Atlantic Bonding (;:0., Inc.
813-780-0020
vllY UI "'-..:;,..,.1"11111.... ............ "..-r-"-
Building Department
Date Received
fI. (,./I/lf.
33SW2-
Owner Phone Number 81 - 7
Owner Phone Number I
Owner Phone Number I
Fee Simple Titleholder Addrees I
15'13/ Cra-nb({){)ke. 5t-
I Tre e L~Y\e. V i 11~e... I
rn NEW CONSTR B
g INSTALL
PROPOSED USE ~ SFR 0
TYPE OF CONSTRUCTION 0 BLOCK IT]
DESCRIPTION OF WORK l:5h e.vf T It efy I ic.. RtJo YY1
BUILDING SIZE I 9" X il.J. ~ ' ISQ FOOTAGE I / q g tp HEIGHT I
.................................... ..................... ........... ................................................................1..........
1$3,000,0L
,
1$
1$
1$
o GAS 0
FINISHED FLOOR ELEVATIONS I
LOT# I
JOB ADDRESS
SUBDIVISION
PARCEL 10#1
/()-;lfo -;1, /-0000- 00/00 -0000
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN 0 MOVE 0
WORK PROPOSED
ADD/AL T
REPAIR
COMM
FRAME
o
o
o
DEMOLISH
OTHER I
STEEL rn
OTHER I Q/!, I>t //1 vP
r;m
I
I
I
I
o
I
BUILDING
VALUATION OF TOTAL CONSTRUCTION
D
o
W.R.E.C,
PROGRESS ENERGV
ELECTRICAL
AMP SERVICE
o
o
o
PLUMBING
~((LJ
MECHANICAL
VALUATION OF MECHANICAL INSTALLATION
SPECIALlY 0
FLOOD ZONE AREA
ROOFING
OTHER
DVES
DNO
I~ gCJ I COMPANY
BUILDER .f~
SIGNATURE REGISTERED
Address 15131 &ttnbroo~.:5+-. Lot 3854-1- I License # I
ELECTRICIAN I I COMPANY I
SIGNATURE REGISTERED YI N FEE CURRENT LY.!..!U
Address I License # I
PLUMBER j COMPANY I
SIGNATURE REGISTERED VIN FEE CURRENT LY.!..!U
Address I License # I
MECHANICAL I COMPANY I
SIGNATURE REGISTERED YIN FEE CURRENT LY.!..!U
Address I License # I
OTHER I COMPANY I
SIGNATURE REGISTERED VI N FEE CURRENT LY.!..!U
Address I License # I
11111111111111111 J I J III11IIII J II J 11111 J 1111111111 J I J I J II J II J 11111111111 J 11111 J 1111111111111111111111111111111111 1111111111111111111111111111111111
RESIDENTIAL Attach (2) Plot Plans; (2) sets o( Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) workIng days after submittal date. Required onslte, ConstrucUon Plans, Stormwater Plans wi Silt Fence Installed,
Sanitary Facilities & 1 dumpster; Site Work PermIt for subdlvlslonsnarge projects
COMMERCIAL Attach (3) sets of Building Plans; (1) set o( Energy Forms. R-Q-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwaler Plans wi SIlt Fence Installed,
Sanitary Facilities & 1 dumpster. Site Work Permit (or all new projects. All commercial requirements must meet1Xlll1pllance
SIGN PERMIT Attach (2) sets of Engineered Plans.
....PROPERlY SURVEV required for all NEW construction,
1111I1111I111111111111111111111111111111111111111111111111111I11111I11111111111111111I111111111111111111111111I1111111I i 11111111111111111111111111
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 AlC Fences (PIoVSurveylFootage)
Driveways-Not over Counter If on public roadways.,needs ROW
:J+.~wJ
TRANSACTION REPORT P.Ol/Ol
FEB/13/2007/TUE 02:37 PM
RECEIVER
918668247894
TYPE/NOTE
OK
. City of zephyrhills i
BUlL DING PLA:N" REVIEW COMMEN'ffi
f -JJttb~ 14 ~ ~ ~q if
riMeD .I-fftnl:';' ·
2-{ 3-01
S73/ CrtLl1J;rbiJKeUb'
:i~ d c(, fk..-y lie. .b1 .
. .
~
Confractor/Homeowner:. .
Date Received:
Site:
Permit Type:
Approved wIno comments:D
.t\pproved w/the.below .comments': 0 Denied withe below comments:
CD ~ ~n"~ LSI~&=f> ~~ ~ ,,~ ~
~~P-D ~<6.~ Pro 'gfP. Wlrij <Z..~~r-florr~' OvL' O~J~
~ \\'I\ ---!:\i~~~ t.... ~~I,.( 10;.5 f.."r-- Ft:ouI 71),w.
.~-1ff-\!-- ~~~ /'trp{fJtL ~t~
This comment sheet ~ be kept with the pemrlt and/or pianS.
~~~~.. ..
B.o. Bmgess-'B.. . g 9fficial.
j Ifj/~7 .
f D
.... . ate
Contractor aDaIor,Homeowner
(R.~ wheJi'Commmts are Present)
,.
NOTICE OF COMMENCEMENT
~ 0-/ Z-J/<//r
State of Slor id tt-
County of P a. 5 CO
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. IO-;}.~ - :11- DODO - O/OOD -OODO Lot-"
tV) broo/ce..- Sf. l i!l t=i 35
(Legal description 0 th prope y and street address if available)
2. General Description of Improvement Shed t Aery (Ie f( eJO YY)
/11111111111 1111I1111111111 11111 111/11111111111 1111111111111
2007026228
3. Owner Information: Name .f2a~L'u ,/Jot; de"
J ~
Address 113/ Cra.nb(oo~S+. trl- City 2eph\fY'hiUs
(
. State fL 3354-2-
Interest in Property:
Rcpt : 1073530 Rec: 10. 00
DS: 0.00 IT: 0.00
02/13/07 Dpty Clerk
Name of Fee Simple Titleholder:
(If other than owner)
Address
4. Contractor: Name Owner--
Address 5:tm e... a. <; CLh D >Ie.....
City
State
City
State
5. Surety: Name
Address
Amount of Bond: $
6. Lender: Name
Address
City
State
JED PITTMAN, PASCO COUNTY CLERK
02/13/07 11: 32am 1 of 1
OR BK 7385 PG 480
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
Address
City
State
8. In addition to himself, Owner designates
of to receive a copy of the Lienor's Notice as
provided in Section 713.13 (1) (b), Florida Statutes.
9. Expiration date of Notice of Commencement (the expiration date is 1 year from the date
of recording unless a different date is specified.)
~ . J
~~,~ /~
Sworn to and subscribed before me this 1'1'fJ- day of ~ tu:J
~~
Signature of Owner:
,20~.
Notary Public:
My Commission Expires:
PC93053048/ A
NOTARY PUBLIC-STATE OF FLORIDA
~ Stacie Cross
Commission # DD510984
Expires: OCT. 16, 2009
Bonded Thru Atlantic Bonding ,"0., Inc.
~VIV7]E Ai
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DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
I, be.nni<;; :Po~n+er have read and fully understand and
agree to the pro isions of this instrument.
The undersigned states and affirms that he or she is desirous of constructing,
renovating, adding to or reroofing his or her own domicile, that he or she
actually occupies, or will occupy by said domicile, and same is not for
rent, lease or sale. That he or she shall comply with the following conditions:
1.
That the owner and he or she alone shall act as the builder for all phases of
construction.
That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.
That in the event the Building Inspector shall require corrections to be made,
the owner will assume full responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from the City of Zephyrhills Building
Department.
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 official notice to pay additional fees.
That the owner shall comply with all City, State and Federal laws in regard to
social security, workman's compensation, lien laws, etc., where applicable.
That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
State law requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owner of your property, to act as your own contractor with certain
restrictions even though you do not have a license. You must provide direct
onsite supervision of the construction yourself. You may 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 for your own use or occupancy. It may not
be built or substantially improved for sale or lease. If you sell or lease a
_building you have built or substantially improved yourself within 1 year after
the construction is complete, the law will presume that you built or
substantially improved if for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed 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 supervising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on your building
who is not licensed must work under your direct supervision and must be
employed by you, which means that you must deduct F.I.C.A. and withholding tax
and provide workers' compensation for that employee, all as prescribed by law.
Your construction must comply with all applicable laws, ordinances, building
codes, and zoning regulations.
OWNER'S SIGNATURE ~~L~ #hIM]
ADDRESS 513) Cr~.., brO k.e.... 5+ LO+
:::SS~~~
2.
3.
4.
5.
6.
7.
8.
9.
-A~..L~;' DATE ol-r--u}
1 '<Ph'f r h',(ls, FL.- 33542-
PERMIT #
/Jry/Jkr
513/ Crt1nbrDokSf-. Lof-
Address
ZepAyr-hi 1[>; "FL -33S42-
To Whom It May Concern,
Please be advised that:
Stacie Cross, & Debbie Dokendorf of Pasco
Permit Service have my permission until further written
notice to act as my agent to sign and pick up permits.
Sincerely,
/5k^j<:~
signature
,2- S--07
date
NOTARY
STATE OF FLORIDA, COUNTY OF PASCO
The foregoing instrument was sworn to and
subscribed before me this S.;.~ day of rei;n.<e:t-r:; ,;;z..oo 7
Personally known
NOTARY PUBLIC-STATE OF FLORIDA
"~"~,oIl"~"~, Suzanne Bahr
{W kommission # DD601 110
~.~,~ Expires: NOY. 15,2010
',,,,,- THRU ATL.' me BONDING co., 111:e.
BONDED .~
or Produced identification ......---
J1~~;
~
Commissioned Stamp
and Expiration Date
Page 1
TREE LANE VILLAGE
5729 Dayton Street
Zephyrhills, FL 33542
(813) 782-2717
February 14, 2007
Mr. And Mrs, Dennis Poynter
5731 Cranbrook street
Has permission from the park manager to renovate inside of existing screen room encloser,
and also to extend it to the end of their trailer on one side
p.rHnan~~~~
Bruce Lasdin
DATE ~c~/cJr