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HomeMy WebLinkAbout08-7812 CITY OF ZEPHYRHILLS 5335 - 8TH STREIT (813)780-0020 BUILDING PERMIT 7812 Permit Number: 7812 Permit Type: ACCESSORY BLDG. Class of Work: 434-ADD/AL T RESIDENTIAL Proposed Use: SINGLE FAMILY RESIDENTIAL Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 5024 20 H ST ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 12-26-21-0100-0000-0020 29,400.00 4/30/2008 230.10 230.10 4/30/2008 GARAGE - 30' X 20' Name: THOMPSON, PATRICIA Address: 5024 20TH ST ZEPHYRHILLS, FL. 33542 Phone: 813 780-8559 - 14FT HT RADON 6.00 p~ DB ~/(~ SHEATHING 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." A~~ CONTRACTOR SIGNATUR PERMIT OFF I PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Owner's Address Fee Simple Titleholder Namel '7Drl 5+1 Owner's Name 1-;1.3-0 ~tf"r~ 502'1 Date Received WORK PROPOSED ADD/ALT REPAIR COMM FRAME 7?O-<g5~ 3' J 2-j03dJ I I I LOT# I I PARCELlD#I/2-2b- 2 ( -01 ~O -()OOOO-o6~O (OBTAINED FROM PROPERTY TAX NOTICE) D SIGN D MOVE 0 o o Fee Simple Titleholder Address I 502Lf ZO 1Jz 51, S ~Y"f/ YJ\U' J...;) /1 JOB ADDRESS SUBDIVISION D G1 o PROPOSED USE 0 TYPE OF CONSTRUCTION [0 DESCRIPTION OF WORK I g 4 t' cv;} e.. I 301 X 211 r SQFOOTAGEI bOO HEIGHT I Ilj I .-".11.....11.1111...'"'.......'....11....1111...11...111...11'....'.....1111....11.....,.....11...'.111.11..........111.....11111111.111'11111.11 1$ /6) {){Jo, -- 1$ 1$ 1$ D GAS 0 FINISHED FLOOR ELEVATIONS I NEW CONSTR INSTALL SFR BLOCK B D D DEMOLISH OTHER STEEL I D OTHER I BUILDING SIZE ROOFING I I I I D I AMP SERVICE D PROGRESS ENERGY D W.R.E.C [ZJ G6 BUILDING VALUATION OF TOTAL CONSTRUCTION ELECTRICAL MECHANICAL VALUATION OF MECHANICAL INSTALLA PLUMBING SPECIALTY 0 FLOOD ZONE AREA OTHER DYES DNO Ir...PII""III..'III'III....,.,III"'I'II'...IIIIIIII"..11"'.'111..""1111111"11111"11111"'..11111111Ilr.IIII'......'II...'II'......."..11 COMPANY f1~Me- () WI1.p~ REGISTERED I Y I N I FEE CURRENT License # I ;~:~~~~ Lit rrr-~! License # I ':~~~~RE I f~ ~ Address I EL~CTRICIAN I.. ./ jJ,-1.. /' I a t/d I~ A A~I SIGNATURE ~I t:U-~ (~g"n - - Y/N Y/N Address COMPANY REGISTERED PLUMBER SIGNATURE Y I N FEE CURRENT Y/N Address License # COMPANY REGISTERED MECHANICAL SIGNATURE YI N FEE CURRENT Y/N Address License # COMPANY REGISTERED OTHER SIGNATURE Y/N FEE CURRENT Y/N Address License # 1I11111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111I111111111I11111111111111111111111 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 subdivisionsllarge projects Attach (3) complete sets of Building Plans plus a Life Safety Page; (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 SIGN PERMIT Attach (2) sets of Engineered Plans. ... . ' ***.PROPERTY SURVEY required for all NEW construction.' . "''It~... 'i" --.,..;. .. ... ... 11I1111I1111I11111111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIJ 1111111) III L 11'111111111'1 i 11'1'1 fi i-I ;"1111111111111111111111111111 Directions: "\~~ly~,}., \\,'. ..'t"". ..~'-' ..Il ~,~ Fill out application completely. \.., ..>\.., \ """';.t-. 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 lettet{rom ~~r autflorizing s~me OVER THE COUNTER PERMITTING (Front of Application Only) '- ')"~ Reroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage) COMMERCIAL '. 'h\\\ \.~ Driveways-Not over Counter if on public roadways..needs ROW 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 underta,ke 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 727-847- 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: The undersigned 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, 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-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 ~hat a s.eparate perm~t. may ?e requir~d for elect~ica.1 work, plumbing, signs, wells, pools, air conditioning, gas, or other Installatrons not speCifically 1n~luded. In 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. 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 th~ work is commenced: An extension may be requested, in writing, from the Building Official for a period not t~ exceed n1n~ty ~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 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) p CONTRACTOR Subscribed and sworn to (or affirmed) before me this by Who is/are personally known to me or has/have produced as identification. Notary Public Commission No. Name of Notary typed, printed or stamped ----~._~~.-_._. "..-........._-_.,---.-------,.~---~_._--_._~- .. City of Zephyr hills BUILDING PLAN REVIEW COMMENTS Qz':A<;~J~ .5/)~L/- cPtJ~~!it. ' )/... c9 1;'--0 ~ -~~.~ Contraclo~eown~ Date ReCeiVej Site: g , permit Type: Approved wino comments:D Approved withe below commenlll: "j1 Denied withe below comments: 0 f' .:2) Sn / . "FrDfVI " r (S ~' tJfen;~,',' .P ~(I( R kit - D{' ,'{\ condu J- I">{ purk d-eo/ rh~tJL 11(Pw '. e fh r~c1 , h V51-' //t Sf! Oc/I b~ {-6 - be -Qrkcl-e[ 111 This co ept with the permit and/or plans. 1- stY. ~{)5 ~~)~~~ Contractor "Bndl ' omeown ~wbcn~en-~~ent) Examiner Date 'DISCLOSURE' STATEMENTTFOR OWNER CITY OF .ZEPHYRHILLS ,:..... .BUILDING DEPARTMENT I, fa tri c~ }ham j:J5~Y\ provisions of this instrument. r Ihe undersigned states and affirms that he or she is desirous of constructing, renovating, atlding to or reroofing his or her own domicile, .that he or she. actually occupies, or will occupy by l r-e~ said domicile, and same is not for rent, lease or sale. That he or she shall comply' with the following conditions: have read and -fully understand and ,agree to the 1. ThaUhe owner and he or she alone shalLact as the builder-for all phases of construction. 2. Thatthe'owner will comply with all provisions of the City of Zephyrhills ordinances and codes pertinent to the building. 3. That in the event various phases of construction ate subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work. 4. 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. 5. 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. 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 official notice to pay additional fees. 7. 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. .8. That the owner, shall comply with all the safety codes issued by the Florida Industrial Commission. ' 9. 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 $75,000. The building or residence 'mustbe for your own use or occupancy. It may not be built or substantially improved if for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your" contractor or to supervise, people working on your building. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide work~r's compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws,ordinances, building codes, and zoning regulations. , , ~~~Er;;; SI~~Jf~~_{j~~ } ?~TE 7'- ;?-tJ[ PHONE (~J) __~5_ ' WlTNESrfr:X:J<..:JO" -YIQ~ PERMIT r;V:L~ J , 7' ';;7tJ-tP y I/Mastcrforms/0wn=.A:fEidavitINov07 "S'~ > ~- / \ I I I ct , ' \ I 1 /-.f c, '0(;'-- .'--- , ;- , i ! i I I i i U T ! \ , '\ ^ , , /(~ J,I.. ~. ~ a; I <:) " ('(\1 ~i I v i I ~ I: j i 1 1 I I " ! ... ----L-.. : I , I" f, ., '_ :'; " r:i < ,,$ ',dJS I --....,. ._._----_.~----,- C, '0'(;' ,1"-- , > -1' I I ! i ~ ^ ':.$ ~ v 1, ~ \, I tL.. V' QJ c-- ~ '" ..-L {) J', \Il ~ U ~ .--A ,:{:. So ~ o o () C) -> S. --- (,;.- >< Cl ~ " -~:l, ~ -' ll\ ~ Yl I " -~"i r:'i';, ~ .- .J .- ~ <C' ~ ~ x.~~ C'b '5 <1:+ It\ ~ \V ~t I'....... II'i //( -;- ! {I ~"' I 'I ..-> ! / ; ! ! I I L . /, ! I I r- 1,,-1 ,:~ 61/i- - ~ "1:. "I X. I ti ,~I c1l I ! ./~jiJ -- ~----~ - -.,.,_.'. ... J.. ' ~ -::- ..... .\.. I '~ w- ~_ ~ rri-~~i\ ~tLl --t- - ~ \ -;-- ',))? -', ~ r. 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" " ~" - -p ~JI__..__ IN 5v..rr( i<vs ?P I ~ t:)O CJ Jo -r;lA5Se-~ . f?/!cJ, r f C-DX f~V) wODd. c..OVlC r e~e . ~lc....'fl C o~.,\ c rei e 'B \oc ks (}o._-fCt9 e bDbr /Dl1e 3'D DODr 4 HOtKe.,lAXA,\'e IOl1e tjx4 ~)( ,~ 141 fA.,YV\ " ~ Ov ~Y' ~ Cl "5~.J &.. f;z~s s1;'; :;:/~7e9)N>~ sh;~1IBS One I-+ect.d -e.-y$.. / ,:'1ot1l r...c~ft;" S+~tDv))/Y , HCL; I IS! tl--I f Y11 eft '1 - R ell fb../ I JX 11 ~/ 4l~/}1f5 T1f h f)41>'f /JaNe!...- 1~lJtnt. tJU!teC. , ISIJ/ft ) 1~1.i ~, tt.-A, SLJ't' A~ Id~'Y t.Jtt: (. c5::v,lcA ~- tJa~, I:;/J"y? ~ ~ J &~ CITY OF ZEPHYRHILLS BUILDING DEPARTHBNT 'Patr~ C/o.. -rlrCJrn;O"~11 . 2 0 #t. 5+' "7 L . . I ~ if F" L JCB LCCATICN fi () 2l-f ) L..er'~ r /Yf ~J PARCEL I .D.. # /2-2 b- D J 0 ti- tJOOO() - tJo 2() OWNER SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIHENSIONS & SETBACKS. ~Lfl ft1~ ~ C'f\ I ~.--- .l "- ?;J {. fi UTILITY BUILDINGS J MUST SHCW SIZE & FCUNDATION INFOR- MATICN. FRONT PROPERTY LINE II (NOTE EXAMPLES 1 & 2) STREET 1. SETBACKS FOR Rl, R2 ZONING 60' 10' P E- R X 0. I 10' P S 10' 0. T S I E N D G 20' 2. SETBACKS FOR R3 ZONING 60' 1 0' 10' 10' EXISTING 10' PRCPCSED 20'SGL FAM 30 'DUPLEX 1 0' FRONT PROPERTY LIRE FRONT PROPERTY LINE CITY OF ZEPHYRHILLS BUILDING DEPARTMENT -Patr~C/4. -r/rorn~7~n . 20 -tit ),f, 7 L ,- /.-}} F~L JOB LOCATION _'i () 2 Lf ) L. ~'W;; r /}1 ~I PARCEL I.D.' # /2-2b- D J OIJ- tJOOOO- t>62() OWNER SIIOW ALL EXISTIt1G & PROPOSED STRUCTURES GIVING DIHENSIONS & SETBACKS. ..... ~ ~ 0v ~'-II ft1~ 33 Ii/ ~ C'f) I ------ -.- - .l " t( I {i UTILITY BUILDINGS I MUST SHOW SIZE & FOUNDATION INFOR- MATION. FRONT PROPER'ry LINE I (NOTE EXAMPLES 1 & 2) STREET 1. SETBACKS FOR Rl, R2 ZONING 60' 10' P E- R X 0 I 10' P S 10' 0 T S I E N D G 20' 2. SETBACKS FOR R3 ZONING 60' 1 0' 10' 10' EXISTING 10' PROPOSED 20'SGL FAM 30'DUPLEX 1 0' FRONT PROPERTY LINE FRONT PROPERTY LINE BOUNDARY SURVEY Client: JOHN BULOVA & PATRICIA THOMPSON Work order number: 12611-ZH Date of Survey: AUGUST 9, 1999 _ Ms. Patricia Thompson 5024 201h St , Zephyrbills, FL 33542 C. Fred Deuel and Asse 5151 Gall Blv Zephyrhills. Floride Phone: (813) 782 Fax: (813) 782- _I~.:= __ -~::=' '-.;..... NORTH LINE OF SUMMER HILL SUBDIVISION~ _ _ _ _ _ LOT 1 NORTHWEST CORNER OF LOT 5 "'I LOT 2 III 9 u.. o '" Z -------::l :i ~ ot ,\ ~ ~. ,<:l <,,'}. .:!> w LOT LOT :3 WEST 2/3 (BY AREA) VACA~'T 9701.6 S.F.:l: SOUTHWEST CORNER OF LOT 5 ---------.1 , LOT 6 LOT 4 --4-~--- ./ -- ~. ...../ C... -~. /~ ~. ~~. Cv' q. NORTHEAST CORNER 12.3. 7<;1';: LOT 5 J ~. ~M) ~~. ::E 35:62;--........ <=d ~ U I 0 ! 50.00_ v<?- .~" ~ !~ i ~~l'V ~ \~ \ - /' ~,\"'~ ~LO~N~ 8 '\0 ~ " . '~ : A:,~~> '\ --::> -....\ \ :- -:- .>,....- r-........... - o ./~f ',- ,_, :'::Ci"t.' ---- ~ SOUTHEAST CORNER "I: \ 170::~~&~'= /'j' ~~~, ,~. t>'- ,. ~r,; . :::l: <". '" i NORTHWEST CORNER , <=d' Or LOT 7 I Vl ~ <1, 1~~1 ~ ~U"J' _>- W -I "<: CD- ~3= I 3O.oO'~1 " ~oo:: : !Q 3=1 ~ en ~bl Q::; ~ ~' CD ~I c g 0Cl r--. ~ ::: r'J1 ~ I ~~ LEG; 38. Corr the nort line or L and w i:o LC) r-- , , , 1 LOTI HILL SUBDIVISION ! " I --------------! SOUTH A VENUE I I <( . v'iO' 9<( ~"V I SOUTH LINE OF SUMMER NOTICE OF-COMMENCEMENT 1111111111I1111111111111111 II1I1 I1111 1111111111 11111 1111111I 2008050733 PennitN~., ' '^~~ 25Vv1r\~~\ lISlAh.JTv,/?lo7 3' /l\ 38'+3u9- , Property~~onNo. L., f~5 5 L<,........h~) \ $tJJ:y. e\~ 31, fl .Ji', ' ' , l~~~ v-rr I'Z.. 26'" 21-t!!:>J'!)t) ....tJ~"{)().,.. t;i:J2~OW:P7J.71IZ-"1.6-21~OI.?'''_~~o _ ,tHE UNbERSIGNED hereby give' informs you that the IIDprovement will be m, fa" certain real property, and nf accordarice With ~ Section 713.13 of the Florida Statutes, the following information is provided in . NOTICE OF COMMENCEMENT. 0 SO I.Description of pr?perty (1iG1H, :!9,~ cripJio,1IjJ , 71i ~ a) Street Address: ~ 2 ~ ,~()tfl,f ~~r;"; Jf j~f': :'5 :3 ~ '17- 2.General description of improvements: " ' , F/" 3 .OwIier Information ' ' ) ,--L " , A' ~_ .' a) Name and address: ' . c::t:Tr~ <:-i, 1"1 0 Y'l"\. , b) Name and address of fee simpll(. titl,holder{ifotherthan own ) , c) Interest in properly , (" e.:s I a-~ ct -e... ' ,4.Contractor Inform, ation, <" ' . ',',', a) Name and address: J~ ~~' (!>t.Q~ ' b) TeleJ?hone No.:' ,(8J "7 8(' - ~ ,~ ' 5.Surety Information ' , " . a) Name and address: b) Amount of Bond: c) Telephone No.: 6.Lender a)Name and address: df1 ' Fax No. (Opt.) 19 a::a . ". cnn .........'U 19 .... ".~.. .......19.... ~cg~ N 19 co .... !IIK Fax No. (Opt.) Phone No. 7. rdentityof person within the State of Florida designated by own,er upon whom notices or other documents maybe served: a) Name and addfess: b) Telephone No.: Fax No. (Opt.) , 8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in: Section 713.13 (l)(b), Florida Statutes: a) Name and address: 'b) Telephone No.: .FaxNo. (Opt.) _ 9.Expiration date ofN otice of Commencement (the expiration date is one year from the date of recording. unless a different date is specified): "', 'JED PITTMAN, PASCO COUNTY CLERK _ " 04/04/08 11: 29am 1 .r~ ~ ' WARNING TO 0WJ>lER, ANY PAYMENTS MADE BY THE OWNER ~Knd w..ri;Ndt~lOTlCE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDERCHAPTER 713, PART I, SECTION 713.13, . FLORIDA STA TOTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTEl) ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOuR LENDER OR AN ATTORNEY BEFO~, COMMENCING WORK OR RECORDING YOuR NOTICE OF COMMENCEMENT. ' " :::u ..... -fn 019 .... ". 19 ...19. '< 19 19 o 19 .- II ., ... { ~=~~=~ ~c,~Y.~~~ JANa:LClAAK ~,f~ "a~',~ * ~ * MY COMMISSION' DO 50094~ Signat\! OfnC~or ~cr's Auth izcd 0771' ircc, torJPartncrlManagcr ' "}.;.., ' EXPIRES: Aprlf 15, 2010 r I A ~ ,-1~OFf\.~'" BondedThruBlId!)etHotaI'fS~"1 ~ I c.:.-i 4 'i v ,~~ 1\ , , PrintName " , , ~', The foregoing instrument was acknowl~dged before me this 4d day of4JN ' / . 200: t! . by /~Ir; c. ; ~--;J;111,f>>>> as " , , '(type of authority, e.g. officer, trustee, attorney m fuct) to. . .. (name of'""".~ 7-ofWhom ~ot wa.o oxecnt ). . Personally Known L OR Produced IdentificatIOn ---,- Notary SI ture '~, ~ ~ T)'pe ofIdentification Produced Name (print) Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, r declare that r have read the foregomg and that the facts stated in it are true to the best of my lmowledge and belief. FORMSINOC,rvsd2007 Signature of Natural Person Signing Above I II , SQ. FEET PRICE l ! , \ i MAIN OR LIVING 600 $49.00 ; t ~ OTHER AREA UNDER ROOF: - $94.00 , 1 , OTHER - $-1 ; i , ! ! f --- -.......... ' ; VALUATI/DN $29,400.00 ..) ... . ! FEE SHEET $180.00 i l ADDRESS , f DRIVEWA'( BUILDING $183.60 V ELECTRICAL. ~0.50 --=> V PLUMBING MECHANICAL SUB-TOTAL $224.10 RADON r' :66.UU -- TOTAL "- --S230.10 SEWER $- WATER $- IRRIGATION $- TOTAL $- I WATER METE~ IRRIGATION METE ~ I FIRE DEPARTMENT FEES PLANS TOTAL INSPECTION TOTAL PERMIT TOTAL TOTAL $- PUBLIC SAFETY IMPACT FEES POLICE $- FIRE $- 5% $- TOTAL $- ~ ~ SUB-TOTAL $230.10 I $- I PARK IMPACT FEES~ SIF'S $- 100.0'* $- 1.0% $- TOTAL $- I I T1F~ $- I $- $- TOTAL: $230.10 I