HomeMy WebLinkAbout08-8229
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
8229
Permit Number: 8229
Permit Type: FIRE PROTECTION MAINTENANC
Class of Work: FIRE-PROTECTION MAINTENAN E
Proposed Use: COMMERCIAL
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 5048 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0000-01400-0000
8/20/2008
25.00
25.00
8/20/2008 Phone:
FPM-SUPPRESSION SEMI ANNUAL-HOLE IN ONE DONUT
Name: CUMBERLAND FARMS (NAK MOM)
Address: 777 DEHAM ST
CANTON,MASS
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Chapter 633, Florida Statutes, authorizes the City to charge and collect user fees to pay for the costs of fire
prevention and protection related activities such as inspections, plan review, administrative fees, and other
costs related to the aforementioned.
Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written approval of
the Fire Department's Fire Marshal or required permits or opening up for commercial activity without an approved final
inspection shall be charged double permit fee per day of operation or a minimum of $100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT 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."
.....
P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
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CALL ~Lt.lD
lwners Address So 7/ R
:ee Simple Titleh0ider Name I TItleh0Ider Phone Number I II
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I I Lot#
I I Parcel # I
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>wners Name
ob Address
jub Division
Address I
:LECTRICIANj
,ignature I
Address I
'LUMBER I
,ignature .
Address I
~ECHANICALj
'lgnaWre I
Permit Application
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Bio-Hazard Waste Storage - ANNUAL
Comm Exhaust Kitchen HocxlIDuct
C0ntr0lIed Bum
Emergency Generator < 30 kw
Emergency Generator> 30 kw
Fire Protection MaintIIlnance - ANNUAL
'OIB!!!ll ~ ~ ~
OOOL-J
OOOOc=J
Doooc=J
~O av--O c=J
D FIl'8 Alarm Installation
B
D Fuel Tanks
D Other: I
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::Ontractor I
;ignature
Sprinkler
Fire Alarm
Hood Cleaning
Hood SuppressIon
Fire Pumps
FireWorks
Flammable Application- ANNUAL
II
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D
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Fumigation Tent
Hazardous Material (T1EIl" II or RQ Facility) ANNUAL
Hood hlAllatiol,
LPJNatI.I'aI Gas-lnstallation
LPINalI&'aI Gas-ANNUAL Sale
Places of AssembIy-ANNUAL
Recreational Bum
Spartders
Sprinkler System b Istallations
Standpipes (SprinIder Sys)
Torch RoofingITar Kettle
Waste Tn Storage ANNUAL
I Valuation of Project
I
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I
Address I I LIcense # I I
~THER I /e ~~~-VL I Company I S~,a/""" r::<?E' COl.>'Of""'-A.rr-
'Ignature . _ ..Y . v~ - .. Registered. cDN I Fee Cunent I Y I N _
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Fill out application ampIeteIy.
Owner & Contractor sign back of appIlcation, noIarized (Or. copy of signed contract With CMner)
If over S25OO, a Notice of Commencement is requinId (MechanIcal work over $50(0)
Supply two (2) sets of drawings With applicable documentation
Allow 1~14days for review aflersubmittal date. Parcel #- oblained from Property Tax Notice (htIp:l/appralser.pascogov.com)
Company
Registered
I Y/N I FeeCwrent I Y/N'
I
Ucense #
Company
Registered
License #
Y/N I FeeCUrrent I Y/N I
I
Company
Registered
Ucense #
Y/N I FeeCwrent I Y/N I
I
Y/N I Fee Current I Y/N I
Company
Registered
10000E OF'DEED RESTRICTIONS: The undersigned understands that this pennit may.be.subjectto."deed':':restrictions"
orhich may be more restrictive than County regulations. The undersigned assumes responsibility for !COmpliance' with any
Ipplicable deed restrictions.
JNLlCENSED CONTRACTORS AND CONTRACTOR RESPONSIBILI11ES: If.the owner has .hired':a~contractor or .
:ontractors to undertake work, they may be required 10 be licensed in accordance with state and local'regulations. If the
:ontractor is not licensed as required by law, both the owner and contractor may be cited-ror a misdemeanor violation
Inder state laW. If the owner or intended. contractor are uncertain as to what licensing .requlrements may apply for the
ntended work. they are advised to contact the.Pasco County BuDding Inspection Division-Licensing Section .at 727-847-
K}()9. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
>ortions of the "contractor Block" of this application for which "they will be responsible. If you, as.the owner sign as the
:ontractor, that may be an indication that he is not properly licensed and is not entitled -to permitting privileges in Pasco
::;ounty .
:ONSTRUCTlON .WEN LAW (Chapter713, Florida Statutes,.as.amended): If valuation of work is $2.;500.00 or more, I
~ that I, the applicant. have been provided with a copy of the DRorida Construction Uen Law-Horneowner's
:;)rotection GuideD prepared by -the Aorida Department of Agriculture and Consumer Affairs. If the applicant is someone
lther than the "owner", I certify that I have o~ a copy of the above desaibed document and promise in good faith to
jeliver it to the "owner" prior to commencement.
CONTRACTOR'S/OWNER'S .AFFIDA VIT: 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.
If I am the AGENT FOR THE OWNER, I PfOITlise 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) consea.JtiYe days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A .NOTICE 'OF 'COMMENCEMENT MAY" RESULT IN .YOUR
PAYING lWICE FOR IMPROVEMENTS TO YOUR PROPERlY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOllCE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03)
CONTRACTOR
Subsai:Ied and sworn 10 (or aftinned) before me this
~
Who IsIare .....$Ot18lly known to me or haSihaYe produced
as idenIIfication.
OWNER OR AGENT
SUbsaibed and sworn 10 (or aftinned) before me ttis
~
Who Is/are personally knoWn to me or haSIhave produced
as idt:o ltifiGallon.
NoCary Public
Notary Public
Culamlssion No.
Commission No.
Name of Notary typed;1iinted or stamped
Name of NotaTy typed; printed or staJnped
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
8232
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:
8232
PARK MODEL
PARK MODEL SET-UP
NOT APPLICABLE
Address: 3442 AQUARMARINE WAY L T 21
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: EMERALD POINTE
Parcel Number: 24-26-21-0020-00000-0210
2,450.00
8/27/2008
175.00
175.00
8/27/2008 Phone:
PARK MODEL SET UP-TIF & WATER FEE PAID
CRANDAll, RICHARD PARK MODEL PLUMBING
BUTTERFIELD MOBilE HOME SERVICE
BAHR'S PROPANE GAS & A/C, INC.
PARK MODEL MECHANICAL
35.00
f{/lJ
qJ1 AJD
e~ M~ IV rN4-
PARK MODEL SET-UP
PARK MODEL ELECTRIC
PARK MODEL PLUMBING
PARK MODEL MECHANICAL
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."
~
~CONTRACT R SI~NATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED
PROTECT CARD FROM WEATHER
Pasco County Parcel: 24-26-21-0020-00000-0210 001
Page 1 of2
Search Again Show Map Generalized Building Schematic Estimate Taxes Frequently Asked Ouestions
Other Agency Data: Tax Collector School Board Supervisor of Elections
Data Current as Of: Weekly Archive - Saturday, August 09, 2008
ParcellD 24-26-21-0020-00000-0210 (Card: 001 of 001)
Classification 02 - Mobile Homes
Mailing Address Property Value
SALISBURY HAROLD] & Ag Land $0
SALISBURY CAROL A land $26,503
3437 PERIDOT lN Building $13,748
ZEPHYRHIlLS, Fl335407425
Physical Address Extra Features $3,184
3442 AQUAMARINE WAY Market Value $43,435
ZEPHYRHIlLS, Fl33540-7410 Assessed (Save Our Homes) $0
Legal Description (First 4 lines) Taxable Value $43,435
THE EMERALD POINTE RV RESORT
PHASE ONE
PB 34 PGS 87-90
lOT 21
Land Detail (Card: 001 of 001)
I Line I Use Description Zoning .~ Type Pri ndition Value*
I 1 I 0200 MBl HM 00C2 2,5;:;;:;.;:;;:; SF $10.55 1.00 $26,375
SUB
2 0200 MBl HM 00C2 229.00 S.E $0.50 1.00 $115
SUB
3 0200 ~r 00C2 I 1,250.00 /I SF II $0.01 " 1.00 I $13
Additional Land Information
Acres II 0.09 II Tax Area II 30ZH II FEMA Code 1u:=JIResidential COde11 EMPTlP1
Building Information - Use 02 - Mobile Home (Card: 001 of 001)
Year Built 1995 Stories 1.0
Exterior Wall 1 Pre-Finished Metal Exterior Wall 2 None
Roof Structure Flat Roof Cover Min Roof(Corr. or Sh M)
Interior Wall 1 Plywood Panel Interior Wall 2 None
Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet
Fuel Gas Heat Forced Air - Not Ducted
A/C None Baths 1.0
I Line II Description II Sq. Feet I Repl. Cost New
1 I BAS 280 $18,833
Extra Features (Card: 001 of 001)
Line Description Year Units Value
1 DWC 1998 1,450 $1,994
2 UDU-M 1998 1 $1,190
Sales History
Previous Owner DAWSON MURRAY & VICKI
Year Month Book/Page II Type II Amount I
2006 04 6965 / 1794 I WD $50,000
2005 03 I 6288 ; 0181 I WD $42,500
1997 10 WD $12,000
3833 / 0999
http://appraiser.pascogov . com! searchlparce1.aspx?sec=24&twn=26&mg=21 &sbb=0020&b... 8/15/2008
City, of Zephyrhills
BUILDING PLAN REVIEW, coMMENTS,
Contractor/Homeowner:
, ~~dcJ
Site:
, t:I-16-D~
34tf2. ~U'~l'~e Li)~
, --r~k:.- (VLod~1 ' ~-f- <4.fl
Date Received:
Permit Type:
Approved wino comments: 0
Approved w/1he below =ents:~ Denied withe below =ents: 0
-0 /l-jj . S4:&c ts
~L6e f/Uof
d-
This comment:sheet shall be kept with the permit aridlorplaris.',
L/(~
Kalvin Switzer - Examiner
.e-/~6~L~
Date .. . Contraclor.- d/;'" Homeowner
(Required when comments are present) ,
Fee Simple Titleholder Name
\..IllY VI Lv}JI 1]1 I 1111";' I '-'11111" I 'fJt-'II--"'-"
Building Department
tl"l j- (VV-vv.<:v
Date Received
Owner's Name
Owner's Address
JOB ADDRESS
Fee Simple Titleholder Address I
IJ4'fl AqlAaman/J~
ILme/a ld Poil)1e- I
WORK PROPOSED
NEW CONSTR
INSTAll
SFR
BLOCK
W Qj . I LOT # I 2 /
PARCELlD#12L{-2Cp-2!- {)6 20 -00666" 6Z{C>
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN D MOVE 0
SUBDIVISION
PROPOSED USE
TYPE OF CONSTRUCTION
B
D
D
DESCRIPTION OF WORK l~_lJ\I'od. e... \ S e... -t ~
BUilDING SIZE I /L{ 1-3 Z SQ FOOTAGE ILf'-f ~
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ADD/Al T
REPAIR
COMM
FRAME
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DEMOLISH
OTHER I 'Pa/ J:-Mod L I
STEEL D OTHER If'I1d:J/1L
HEIGHT I
D BUILDING 1$ ('2>0.00 I VALUATION OF TOTAL CONSTRUCTION
D ELECTRICAL 1$ 2S0. Ot> I AMP SERVICE D PROGRESS ENERGY D W.R.E.C.
D PLUMBING 1$ 2- 00 . 00 I
D MECHANICAL 1$ '5"00.0-' I VALUATION OF MECHANICAL INSTALLATION
D GAS 0 ROOFING D SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
I I I I , , I I I , I I , , I I I I I I , f , I I I , , I I I I I I I I I I I I I I I ~ r 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 , 1 , 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 If' , I I I I ,
BUilDER
SIGNATURE
PLUMBER
SIGNATURE
COMPANY
REGISTERED
IBi~~~~UR~~5 IO/N I
License # II HO O()6 ~ ~ 0
Ell-cffi~
I Y / N I
License # Ie ROo/29/0
IB~~f~f~~C~E~j I Y/N I
License # IIH..10000cP<:J
1/3a.hrJ pr7;)~r)f2 a.4 A / C
I Y / N I FEE CURRENT I Y / N I
License # I G4 c (:) </3 '1 (j;g
CrarJd a.J I
I Y / N I
FEE CURRENT
COMPANY
REGISTERED
Address
MECHANICAL
SIGNATURE
Address
OTHER
SIGNATURE
COMPANY
REGISTERED
Y/N
FEE CURRENT
Y/N
Address License #
11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111 J 11111111111111
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 w/ Silt Fence Installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 w/ 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.
111111111111111111111I1111111111111111111111111111111 " I " 111111 " 1111111 " 1111111111I11111111111111111 " I11I1 " II " 1111 " I i It 11111111111 111111111
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A1C 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 (Plot/Survey/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 "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 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 bf
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordihance 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 bccupancy 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 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 Bliilding 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. 117.0
CONTRACTO
su)SCr~ed...and sworn to (o~ a
?' /'1 (;i~ by r1
Who Is/are personally known to me or has/have produced
~ as identification.
-=ran0 ~
Notary Public
~,~
/ ~. Notary Public
Commission No.
Commission No.
Name of Nota~~0 printed~~
*...~ * MY COMMISSION' DO 616391
"'~.. J;XPIRES: November 20, 2010
~'Ii OF f\.O~'" Bonded Thru Budget Notary Services
Name of~~d, prin~d
*. * MY COMMISSION. DO 616391
<l}: .. EXPIRES: November 20, 2010
'1'1i OF f\.r:f>'" Bonded Thru Budget Notary SeIVIces
NOTICE OF COMMENCEMENT
State of f- / 61"'1 'C/O( County of ()a:5J 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: ParceINo".-rhe. ErYltRAl.-n PO/lilT Rv Re.)(jt.{- pl1a~"( ClI'1'
0i3iPG5l{7-')6 Lcrl 2) 6t'fbq{~ PG r79'-/
(Legal description of the property and street address W available) '~L '42 ;.1 a a/l,,- ~ i . /
'). '1- 2 (p - 2/ . ()C) Z 0 '. 6 ()cIOO . () 2 10 6 I ",t.. U t( r /(,t.-1v1 ':" !IV a rl
2. General Description of Improvement 2ep~y 11, Ill'f / -::f"2, <:;;L./
-\)0-..- Ie. IV)Cldt t So( t- l.t P
3.
Owner Information: Name l-Ia./oJd "
:1'-137 Pf'ollof LrJ
Address
('cve.> I Sa /J!.h4Cj
~phJiliJ IJ
f ) ?SSL/6
State
Interest in Property:
Name of Fee Simple Titleholder:
(II other than O'Mler)
R'
Address
Contractor: Name~1 f1.LjY\ e
LjD3'-1 Gal} Blvd
Address
Ctty
13u -rte-rff' Jei
~fh'Jv h,'\b
City
Slate
F I 3:S5i./ Z
State
5.
Surety: Name
Address
Ctty
State
Amount of Bond: $
6. lender: Name
Address
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
Ctty
State
8. In addition to himself, .Owner designates
of
Notice as provided in Section 713.13(1)(b), Aorida Statutes.
. 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.
<;? 1'2 /6_'i:i
Date
~~ e-~ L0~
Signature of Owner -j
STATE OF FLORIDA:}/l \.
COUNTY OF '("'Vc.... ( 0
.The fOregO~umentwas aC~ledgd. before me.the
-----rev, -, \.J.. (-f e--v . .l .
known tome or who has produced
<gih O{ A~''''I.ST 200'i'?(date),by
(name of pe n acknowledging), who ~~.>
(type of ic!.enf ion) as identification.
Seal:
dv/pc053048
~\)"'~~~.~~0 TONI SCHMIDT
*.. . * MY COMMISSION # DO 616391
EXPIRES: November 20, 2010
"'~~~ OF FI.r:P"''' Bonded lbru Budget Hota1y Services
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