HomeMy WebLinkAbout08-8640 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 8640
FENCE PERMIT
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Permit Number: 8640 Address: 38817 10TH AVE
Permit Type: FENCE ZEPHYRHILLS, FL.
Class of Work: FENCE/NEW Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-07500-0120
Improv. Cost: 3,200.00
Date Issued: 12/12/2008 Name: JOHNSON, FAMILY LIVING TRUST
Total Fees: 40.00 Address: 13505 WOERNER RD
Amount Paid: 40.00 MANITOU BEACH MI 49253
Date Paid: 12/12/2008 Phone: (813)779-0235
Work Desc: INSTALLATION 247 FT CHAIN LINK-VINYL 4' ON FRNT/6' ON REAR
ACME UNLIMITED INC. (813)973-0826 FENCE 40.00
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FINAL
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c)when extra inspection
trips are necessary due to any one 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
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
CONTRACTOR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
13-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department p �t
ceived Phone Contact for Permitting --
ner's Name_______________________________________________rsU Owner Phone Number 13-77C_Cy2 S
Owner's Address 17 /0 V l Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address 2 Q�
JOB ADDRESS � LOT# ��
3 V
SUBDIVISION PARCEL ID# // 2 6-21-O0b0_0 LQ'2 o
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED EJ NEW CONSTR B ADD/ALT SIGN = MOVE = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR = COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL = OTHER
DESCRIPTION OF WORK FG ACe ` 7c1 Cl k .IL/ ' fin
�L / ,
4S I
BUILDING SIZE jW FOOTAGE 1 2..U7 HEIGHT I b
BUILDING $3 2 ov VALUATION OF TOTAL CONSTRUCTION
f
= ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C
= PLUMBING $
= MECHANICAL Is
VALUATION OF MECHANICAL INSTALLATIONLIII 1 x�
GAS = ROOFING = SPECIALTY = OTHER N(�
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES =NO
,11111111111111111111111111
BUILDER COMPANY C N C
SIGNATURE y t REGISTERED I Y/ N I FEE CURRENT Y/NN
Address �.� a l o /o License# O1/79S
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N
Address I License#
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N
Address I License#
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N
Address I License#
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N
Address I I License#
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 subdivisions/large projects
COMMERCIAL 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 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.
III
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C 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 A/C 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 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 that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS
AN ATTORNEY BEFORE TO YOUR
RECORDING YOU INTOEND TO FINANCING, CONSULT
COMMENCEMENT.
WITH YOUR LENDER OR
FLORIDA JURAT(F.S. 117.03) J
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed ands to(or affirmed)be ore me this
by by
Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced
as identification.
as Identification.
Notary Notary Public
Public
Commission No.
Commission No.
d Name of Notary typed,printed or
Name of Notary typed,printed or stampe stamped
Pasco County Parcel: 11-26-21-0010-07500-0120 001 Page 1 of 2
_ _ ___ _ A
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Other Agency Data: Tax Collector School Board Supervisor of Elections
Data Current as Of: Weekly Archive - Saturday, December 06, 2008
Parcel ID 11-26-21-0010-07500-0120 (Card: 001 of 001)
Classification II 01 - Single Family
Mailing Address Property Value
JOHNSON FAMILY LIVING TRUST Ag Land $0
JOHNSON E L&A J TRUSTEES Land $44,792
13505 WOERNER RD Building $81,556
MANITOU BEACH, MI 492539789
Extra Features $684
Physical Address
38817 10TH AVE Market Value $127,032
ZEPHYRHILLS, FL 33542-4467 Assessed (Save Our Homes) $0
Legal Description (First 4 Lines)
ZEPHYRHILLS CITY OF PB 1 PG 54 Taxable Value $127,032
LOTS 12 & 13 BLOCK 75
OR 7819 PG 443
Land Detail (Card: 001 of 001)
Line 1 Use IlDescriptionhl Zoning Units Type Price Condition Value*
1 0100 SFR 00R2 8 $44,184
22 0100 SFR 00R2 936.00 SF $0.65 1.00 $608
Additional Land Information
Acres 0.21 II Tax Area fl FEMA Code hi X liResidential Codell ZHLHLP2
Building Information - Use 01 - Single Family Residential (Card: 001 of 001)
Year Built 1975 Stories 1.0
Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 Carpet Flooring 2 None
Fuel Electric Heat Forced Air- Ducted
A/C Central Baths 1.5
Line Description Sq. Feet Repl. Cost New
1 FGR J 560 $15,714
2 BAS 1,260 $88,389
3 FOP 80 $1,403
Extra Features (Card: 001 of 001)
Line Description Year 1 Units Value
1 DCFENCE 1987 1 37 $14
2 DWSWC 1987 II458 $670
Sales History
Previous Owner WALLACE DELBERT P&RAMONA M
Year Month Book/Page Type Amount
2008 04 7819/0443 WD $108,000
2004 05 5836/ 1005 WD $0
2004 04 5824/ 1340 WD $93,500
Search Again Show Map Generalized Building Schematic Estimate Taxes Frequently Asked Questions
http://appraiser.pascogov.com/search/parcel.aspx?sec=11&twn=26&rng=21&sbb=0010&... 12/12/2008
PACKING LIST & SKETCH
EDWARD JOHNSON
38817 10 TH AVE
Zephyrhills, Florida 33541 II _Z 6-2) —00/0 0'750 -Oi 20
779-0225 (��`
QTY. PART # ITEM / L1 t C IGL'f L _1 k d-
157 056204 48" 11 1/2 GA. GALVANIZED (2 3/8" Mesh) CHAIN LINK FABRIC /Ft.
157 00521 1 3/8" SWEDGE END .047 TUBE TOP RAIL /Ft.
7 P00526072 2 3/8" X 6' .047 TUBE TERMINAL POST /Ea.
12 P00524066 1 5/8" X 5'6" .047 TUBE LINE POST /Ea.
20 03559 2 3/8" REGULAR BRACE BAND /Ea.
30 03519 2 3/8" REGULAR TENSION BAND /Ea.
10 03736 1 3/8" DIE-CAST ALUMINUM RAIL-END /Ea.
10 03813 46" 3/16" X 3/4" TENSION BAR /Ea.
12 03666 1 5/8" X 1 3/8" DIE-CAST ALUMINUM EYE-TOP /Ea.
7 03614 2 3/8" DIE-CAST ALUMINUM DOME CAP /Ea.
114 03928 6 1/2" 11 GA. E-Z ALUMINUM TIE WIRE /Ea.
50 03881 5/16" X 1 1/4" CARRIAGE BOLT /Ea.
159 03945 14 GA. 2 STRAND TWISTED TENSION WIRE /Ft.
78 03904 9 GA. ALUMINUM HOG RING /Ea.
.23 11059 HAND MIXED CONCRETE /Cu. Yard
1 FABRICATED 48" X 8' 1 3/8" .065 TUBE SINGLE SWING GATE (Gate Only) /Ea.
1 04259 1 3/8" X 2 3/8" REGULAR GATE FORK LATCH /Ea.
2 04024 2 3/8" REGULAR POST HINGE /Ea.
2 04006 1 3/8" REGULAR GATE FRAME HINGE /Ea.
2 03891 3/8" X 3" CARRIAGE BOLT /Ea.
2 03888 3/8" X 2" CARRIAGE BOLT /Ea.
64'
3 8'
6'
° 14'
12'
HOUSE
66'
7'
10'
7, CHAIN LINK
38' ---------------- VINYL N
WE
5
ACME UNLIMITED, INC. 11/22/2008
PASCO COUNTY BUSINEs5 TAX RECEIPT 2008-09
Issued pursuant and subject to Florida Statutes and Pasco County Ordinances. Issuance does not certify compliance with
zoning or other laws. This license must be posted conspicuously in place of business. Expires September 30.
Mike Olson
ACCOUNT NO: 011795 TAX COLLECTOR TYPE OF BUSINESS:
SIC CODE: 1799.05 PASCO COUNTY FLORIDA FENCE INSTALLATION
•,••OE•{NE STgT'••, LOCATION ADDRESS:
F° 5610 6TH STREET
ACME FENCE ? � P ZEPHYRHILLS
ACME UNLIMITED INC
5701 MARIE DR .
ZEPHYRHILLS FL 33541-1971 ^�oow,E,a�y` DATE RECEIPT AMOUNT
12/09/08 561239 16.50
III",I.IInI,fun$i,jIiu{lhi{nlniluilllluuull.IiI,I
12/15/2008 12:11 PM FROM: Fax Commercial Specialty Insurance TO: 7800021 PAGE: 002 OF 002
DATE(MM/DONYYY)
ACQRD- ' CERTIFICATE OF LIABILITY INSURANCE 12/.15/2008
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
COMMERCIAL SPECIALTY INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
9422 Balm Riverview Rd HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Riverview, FL 33569
(813) 671-5400 INSURERS AFFORDING COVERAGE NAIC#
INSURED ACITI unLimited J.flC INSURER ABankers Insurance roup
INSURER B:
5610 6th St INSURER C
Zephyrhills, FL 33542 INSURER D.
813-973-0826 INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
, W Bt POLICY EFFECTIVE POLICY EXPIRATION
LTR NERD TYPE OF INSURANCE POLICY NUMBER DATE MM/DDNY DATEIMMIDO/YYI LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 'guy juy
COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurence $
CLAIMSMADE OCCUR MED EXP(Any one person) $
'guy
B 09-0005338661000 7/14/08 7/14/09 PERSONAL&ADV INJURY $
GENERAL AGGREGATE $ 2,00u,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMROPAGG $
POLICY JECT LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
ANYAUTO (Ea acadent)
ALLOWNEDAUTOS
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Peracadent)
PROPERTY DAMAGE $
(Peracadent)
GARAGE LIABILITY AUTO ONLY-EAACCIDENT $
ANYAUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESSAJMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CI CLAIMSMADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
A I WORKERS COMPENSATION AND TORSTATUS I ER
EMPLOYERS'LIABILITY 1000339 1/17/08 1/17/09
E.L.EACH ACCIDENT $
A ANY PPCe RIETORIPARTNER/EXECUTIVE
0FFICERMIEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $
Ifyes.describe under 500 000
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMB $
OTHER
DESCRIPTION OF OPERATIONS/LOCAT IONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
City Of Zephyrhills SHOI II D ANY OF THF AROVF IIFSCRIRFt)PO1 IC:IFS AF C,ANCFI I Fl)RFFl)SF THF FXPRATION
5335 8th Street DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 33- DAYS WRITTEN
Zephyrhills FL 33542 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR
813-780-0021_______:�'Z"XO;U"
ACORD25(2001108) ®ACORD CORPORATION 1988
NOTICE OF'CONIlVIENCEMENT
Permit No. g• '/ G !!IIIII VIII II
III VIII VIII VIII Lull LIIII VIII IIII IIII
I VIII
Property Identification No. 2009011304
THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property,and in accordance with
Section 713.13 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of property(legal descr' Lion: 112 b' - / "O7 C0 G1 O
a)Street Address: / /O11' 4c'C 1
\ O4-
2 General description of improvements: ` a C 2�tc _ - b v, rlvacy
3.Owner Information I
a)Name and address: Gvgrc l ''ak+t on
b)Name and address of fee simple titleholder(if other than owner) 7_/0 0 e . /, `• ft�
c)Interest in property-
4.Contractor Information �1
a)Name and address: r trl✓1 C (� tnn�TCd_ �1 C: 4 Z K i l t L 3 3 f 2
b)Telephone No.: /13_-_'79g_r7'79S' Fax No.(Opt.) 8' ¶7 '-Y53
Surety Information
a)Name and address: Rcpt: 1223485 Rec: 10.00
DS: 0.00 IT: 0.00
b)Amount ofBond: 01/27/09 Dpty Clerk
c)Telephone No.: Fax No.(Opt.)
6.Lender — PRULR S. O'NEIL, PRSCO CLERK & COMPTROLLER
01/27/09 1'J
a)Name and address: OR SK 1 PIS
Phone No. i
7.Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: -
a)Name and address:
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(1)(b),Florida Statutes:
a)Name and address:
-b)Telephone No.: Fax No.(Opt.)
9.Expiration date of Notice of Commencement(the expiration date is one year from the date of recording.unless a different date is
specified):WARNING TO OWNER: ANY'PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION-OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,.
FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,C9NSULT YOURIfER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE-OF,cOM1EN9r .
STATE OF FLORIDA
COUNTY OF PASCO ( 7i
Signature of Owner or wner's Authorized Officer/Director/Partner/Manager
Print Name . /
The fore oing instrument was acknowledged before e i day of
l- �� � (type of authority,e.g.officer,trustee,attorney
name o party on behalf of m instrument w d).
Known OR Produced Identification ✓ Notary Signature ft(J \LQL1OClIT)
type f entification Produced (�� _ . Name(print) Q
�,i� CCJz�+ _
' e'I4m n pursuant to Section 92.525,Florida Statutes.Under penaltie f perju� dec are thatread the foregoing and that
1� ted in i dbelief v v .q�Y P� , f WNWV A.DAVIS
5SION#DD 45M30 -
3:July 14,2009
pi:;°? wctary Public Underwriters u Signature ofNat el erso Signing e
FaRMSl�t1OC, 007 -
STATE OF FLORIDA,COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COPY OF THE DOCUMENT
ON FILE OR OF PUBLIC RECORD IN THIS OFFICE
WITNESS MY HAND AND OFFICIAL SEAL THIS
:Q tL DAY OF (1AAf 2OO '
PAULA S. O'NEIL, CLERK&COMPTROLLER
BY AQf� DEPUTY CLERK