HomeMy WebLinkAbout09-9915 CITY OF ZEPHYRHILLS
• 5335 - 8TH STREET
(813)780 -0020 9915
BUILDING PERMIT
Permit Number: 9915 Address: 3802 QUAKER RIDGE ST
Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: MAJESTIC OAKS
Est. Value: Parcel Number: 24- 26 -21- 0030 - 00000 -1200
Improv. Cost: 2,800.00"�
Date Issued: Na x3.
me: JAVON, ROBERT &CAROL
Total Fees: 67.50 Address: 3802 QUAKER RIDGE ST
Amount Paid: 67.50 ZEPHYRHILLS, FL. 33542
Date Paid: 12/21/2009 Phone: (937)418 -1958
Work Desc: ADDITION 10.6 X11.4 CEMENT PAD SHED /10.6 X 28.6 CEMENT PAD SCRN RM
�� " ^f'^� ' w�1. .. '' 1 a ? }'
HOM • WNE - B (DING F 67.50
J4u /
l
F�•TER 2ND - •U H PLUMB MI C INSULATI•N EILING
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE -METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE -SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to 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
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
im . - - to your property. If you intend to obtain financing, consult with your lender or an attorney
- fore reco g your notice of commencement."
111,
ar 4 1 /'
ONTRACT• R SIG/ATURE PERMIT OFFI 'R
PERMIT ' PIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
ALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
' ys,.v Vii. .
i
'ti
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: JQ lll/Y)
Date Received: / - l6 7
Site: 5 acme r idye JT
Permit Type: M-6 X go (teaner1 f/' d fr `s /'M
skod rco 1,nf .buili us ,o;(4q' -
Approved w /no comments: ❑ Approved w /the below comments: Denied w /the below comments: ❑
Ail ' - 7 E 13, < <iiP 6-e _' -'.J
This comment sheet shall be kept with the permit and/ • plans.
la-18 -07 1 / 4
Kalvin Switzer — Plans Examiner Date Contractor! 1. or Homeowner
(Require when comments are present)
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 9915
BUILDING PERMIT
`, g'1 :; : '
Ef
Permit Number: 9915 Address: 3802 QUAKER RIDGE ST
Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: MAJESTIC OAKS
Est. Value: Parcel Number: 24- 26 -21- 0030 - 00000 -1200
Improv. Cost: 2,800.00 °�.<<
Date Issued: Name: JAVON, ROBERT CAROL
Total Fees: 67.50 Address: 3802 QUAKER RIDGE ST
Amount Paid: ZEPHYRHILLS, FL. 33542
Date Paid: Phone: (937)418 -1958
Work Desc: ADDITION 10.6 X11.4 CEMENT PAD SHED /10.6 X 28.6 CEMENT PAD SCRN RM
P1
•M •WN - B I 101‘1 FEE 67.50
pace isign etore
kceSigar 1° '
o/f
• • ER 2N' - • U H PLUM: M IN LA EILIN
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE -METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE -SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to 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
"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."
CONTRACTOR SIGNATURE PERMIT OFFI FR
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 Fax- 813 -780 -0021
Building Department
Date Received Phone Contact for Permitting --
IIIIIIIIII I tII
Owner's Nathe ljG.: / % 4/ • — J A✓U:/ Owner Phone Number / /�- i
s
( 93� er
Owner's /Agfdress 3? 2 Q ti /9,,Cr, * De- 2 3 7 Owner Phone Number
j
r
Fee SimizIt: Titleholder Name Owner Phone Number
Fee Simple"Fitleholder Address
JOB ADDRESS ". Ft% 7. Ot ial KEIZ, 7/ DC- .7 LOT # /20
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD /ALT I 4...,,r SIGN I I MOVE I 1 DEMOLISH
INSTALL REPAIR
PROPOSED USE I I SFR I I COMM I I _ OTHER I I
TYPE OF CONSTRUCTION I I BLOCK I I FRAME I— 'I STEEL 11 OTHER I I
DESCRIPTION OF WORK 9 a /C .G .' X Ye) . 4.744 . A g 7 /714 4J fz Se Zr <' �aa,M £ 5Nc A - 'P'
BUILDING SIZE / 0 . G A /O SC1 FOOTAGE -/
V HEIGHT
n v ' l BUILDING $ ; ?G O ��' VALUATION OF TOTAL CONSTRUCTION
I I ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY 1 1 W.R.E.C.
^/Pl
I I PLUMBING $
MA (9 1-_ - 61'‘ i 9)(z) '
I 1 MECHANICAL $ A / / 4 VALUATION OF MECHANICAL INSTALLATION e fir /
I I GAS I I ROOFING 1 1 SPECIALTY I I OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES T4NO
/� i / 7/ i
BUILDER 4 /04. G (4.,i, c� g
/Z-. ` COMPANY' �I • ./// —
SIGNATURE � 1 V I J l 1 REGISTERED 1 Y/ N I , E CURRENT 1 Y/ N 1
Address License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address License #
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address License #
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N . 1 FEE CURRENT I Y/ N 1
Address License # F
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.
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 1, 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 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 OTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.-49� g )1
// °, J J ) y
�''
te r " " i. -c`Y� CONTRACTOR J � i✓
OWNER OR AGENT / ubSpribed and sworn to (or affirmed)/before me this
Subscribed and swor� ,to or affirmed) befor� a
me this / 2 ib C c7 by �o i3�/2 ' /'� ✓
( - /f� 79 by a 013 dr /11 Yore
Who is/ r‘personally known to me or has /have produced Who is /ar ? personally known to me or has /have produced
as Identification. . CGS as identification.
_ �._ Notary Public
C, e r q1 1 - Notary Public J
JACOU 6 BOGES
` ° DD 621833 Commission No ,
Comrftj lon ...
Cd. •.. o` Expires eGT " ta') ��" Com ELI BOGES
— —
' "� fires Decemb E BO
` BondedThruTra/FamInst ance Notary t
:,a.. ? * ' p , �D 621 ti33
Name of Notary ty ed, printed or stamped Name of Nota ic
"1 RM ++ Th", T, F,;n n ber 12, 2010
Qn `�' 8M-385.701)
DISCLOSURE STATEMENT. FOR OWNER
CITY OF .ZEPHYRHILLS BUILDING DEPARTMENT
(/ 1 A/ have read and fully understand and
agre to the provisions 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.
2. That the 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 are 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.
B. 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 $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 mu o ly with all applicable laws, ordinances, building
codes, and zoning ,a`egula " ns. Cry
OWNER'S SIGNATURE � /v+r -LY`� DATE /3 �C Q /
ADDRESS 3b > ,i fli'e'Z 7r ' / _5 (1_
PHONE I 3 7 y/ ' / ( j S j /
WITNESS 7 7 Q PERMIT # ���
___„,....
,--- -
ALL WORK SHALL COMPLY WITH .'
P" VAILING CODES, FLORIDA HE
I , NATIONAL ELECTRIC CODE AN
. ;7/1 / d c a . OF ZEPHYRHILLS ORDINANCES
'
-,. — — ir - ------- 1
1 ,
/
\,..... J N..,. .
. i
.... )
■,. c). -...
D__ a . r ■1
‘,
.%.. vsi OP1/4
, \-, REN1E, ,01,1410-S Ni (4
r . ) ; ZEPV PC_---i ( 'A
t ‘,3 crrY - opott siek.„---t- !
x
pLols
. ,
: i.„
\5 ,
\-•.. VI
I ;
,
;
i■ ,,. -)-•-,c, 1 (<1 L \i
- 1 14 .....,,,
1
Q,
c\<-
........, . .
, `i 1
- 4
I
- ■.1 ;
\■6 — 7-1,,,N,
0 1 \
' \ 1
k...)
()
,
1
_I il ''-) .
, 1 0
1 I
i .;;;)
,,...-,
Tzr -) ) 7 ' - 7 1>7 7 4 / 4 1 .712 ( . 17 1 )
7")
Pasco County Parcel: 24- 26 -21- 0030 - 00000 -1200 001 Page 1 of 2
Search Again Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes
Other Agency Data: Tax Collector School Board Supervisor of Elections
Data Current as Of: II Weekly Archive - Friday, December 18, 2009
Parcel ID II 24- 26 -21- 0030 - 00000 -1200 (Card: 001 of 001)
I Classification II 02 - Mobile Homes
Mailing Address Property Value
JAVON ROBERT M & CAROL C Ag Land $0
3802 QUAKER RIDGE ST Land $9,814
ZEPHYRHILLS, FL 335428422 Building $19,651
Physical Address Extra Features $1,017
3802 QUAKER RIDGE ST
ZEPHYRHILLS, FL 33542 -8422 Market Value $30,482
Legal Description (First 4 Lines) Assessed (Save Our Homes) $p
See Plat for this Subdivision s' Taxable Value $30,482
MAJESTIC OAKS COMMUNITY -
PHASE ONE
PB 35 PGS 107 -112
LOT 120
I Land Detail (Card: 001 of 001)
Line II Use IlDescriptionlI Zoning II Units II Type �I
ype Price Q Condition II Value
1 0200 MBL HM OPUD 2,880.00 SF
SUB $3.33 1.00 $9,590
2 0200 MBL HM OPUD 560.00 SF
SUB $0.40 1.00 $224
I Additional Land Information
I Acres II 0.08 II Tax Area II 30ZH I FEMA Code I -- I Residential Code I MJOKLP1 I
I Building Information - Use 02 - Mobile Home (Card: 001 of 001)
Year Built 1998 Stories 1.0
Exterior Wall 1 Above Average Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall 1 Plywood Panel Interior Wall 2 None
Flooring 1 Sheet Vinyl Flooring 2 Carpet
Fuel Electric Heat Forced Air - Ducted
A/C None Baths 1.0
Line I Description II Sq. Feet I Repl. Cost New 1 1 AS II 490 I 2 $1,275 1 1 1 FST p 96 0 $14,524
I 3 II FCB II 364 II
II $9,722
I Extra Features (Card: 001 of 001)
I Line
a II Des II 1998 II 11 Units 288 II Value
I j II $529
I 2 I I CAC -II 1998 II 1 $308
I 3 II CON PTO II 1999 II 96 II $180
I Sales History
Previous Owner II FITZGERALD JAMES E & LOUISE T
Year I Month lI Book /Page II Type 11 Amount
2009 II 11 I I 8226 / 0584 II WD Il $60,000
I 1998 II 04 II 3916 / 1184 11 WD II $14,900
http: // appraiser. pascogov.com / search /parcel.aspx ?sec= 24 &twn= 26 &rng=21 &sbb= 0030 &... 12/18/2009
Majestic Oaks
carefree
ry resorts
12/16/09
To whom it may concern,
Attached you will find a drawing for adding an addition
to 3802 Quaker Ridge in Majestic Oaks RV Resort.
Additions include a 10.6 X 11.4 cement pad and shed
plus a 10.6 x 28.6 cement pad plus screen room addition.
These additions have been approved by management at
Majestic Oaks.
If you have any questions, please contact me,
Pa icia Briggs, Manager
2
cz n
3751 Laurel Valley Blvd. * Zephryhills, FL 33542
Telephone (813) 783 -7518 * Facsimile (813) 782 -3559
111111111111111111111111111111111111111111111111111111111111
2009182185
Rcpt:1279148 Rec: 10.00
DS: 0.00 IT : 0.00
• 12/21/09 Dpty Clerk
NOTICE OF COMMENCEMENT
PAULA S. O'NEIL, PASCO CLERK & COMPTROLLER
12/21/09 0 0 of 1
Permit No. V 1 .3 OR BK 8Z ' 1 PG 1246
Property Identification No. 2 t / lv 2 / U 1 0 0o 000 / a U b
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 description: Hik J S 7/ G 4:5/1: A' 5 CG m rH 4 A/ , y P14 /t S Z- D '4/
a) StreetAddress: P& PC _s /U //X AP /.26) c/ F,1.26 P 5S
2.General description of improvements: S C 1? t r N r 1) Po u /.i / f) ` X A 7 ' ` S - 11 --. / d ' X / 9 '
3.Owner Information
a) Name and address: &8 / , _
,? T J v0 J 2'4 Q coy h' c: ,2 �, 0 c - r .35 2L/�Ny IR l� //s f7 33 s y Z
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property
614)/v t "
4. ontractor Information I /�
a) Name and address: 15e / SAo
'v., / ?Eva Cie /1 / «Z .i ' T 06: f , / 3 ‘--/' ‘--/' Z 4 0/4)//2 , S
b) Telephone No.: 9 ?7 - yte / 9 .-- r Fax No. (Opt.)
5.Surety Information
a) Name and address: ,
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6.Lender
a) Name and address:
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents maybe served: / //
a) Name and address: CO .7 va ;./ 3fr).2 Qu„ /,ez 'o6-� Si . z'/� °y z,4 f/ 3 3- y�
b) Telephone No.: 9 3 7 - 3 3 ti - ., ,-; k• 2_ 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 JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTIC s • t ' NC ME
STATE OF FLORIDA / / /
Si:. of Owner or Owner / u orized Officer/Director/Fertner/Manager
. �D aZR7. / y4 . .Ti-IYciA
/ Print Name
The foregoing instrument was acknowledged before me this / ( day of en"bei. , 206 / q
, by
as (type of authority, e.g. officer, trustee, attorney
in fact) for (name of party on behalf o i . m instrument was exec
Personally Known OR Produced Identification Notary Signature �` /` / DO�Q ( 5 c.,_ .. .
_ ' 0. t
Type of Identification Produced �t C Name (print) (AC .. 1 ^ l r GA 0
' "" s , O
�
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
Signature of Natural Person Signing Above
FORMSINOC,nad2007