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Home My WebLink About09-8975 CITY OF ZEPHYRHILLS 5335 - 8TH STREET • (813)780 -0020 8975 BUILDING PERMIT Permit Number: 8975 Address: 37924 M EDICAL ARTS CT Permit Type: SIGN ZEPHYRHILLS, FL. Class of Work: WALL SIGN Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 34- 25 -21- 0080 - 00000 -0023 Improv. Cost: 5,054.00 , "' _ Date Issued: 4/02/2009 Name: PEACEFUL SPRINGS LLC Total Fees: 90.00 Address: 37924 MEDICAL ARTS CT Amount Paid: 90.00 ZEPHYRHILLS, FL. 33541 Date Paid: 4/02/2009 Phone: (813)783 -6119 Work Desc: INSTALL WALL SIGN 27.92 SF FLAT CUT OUT ALUM. LETTERS INTERNATIONAL SIGN & DESIGN SIGN 90.00 fl °11/4.0 ,0 9 /3 a 1 B FOOTER ELECTRICAL ROUGH 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 "Warning to owner: Yo failure to record a notice of commencement may result in your paying twice for im s vements to your p • perty. If you intend to obtain financing, consult with your lender or an attorney • - recording your no 'ce of commencement." CONTRACTS - I i. u - E PERMIT OFFI 81 PERM ' EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER .11f3 ql 813 - 780• -0020 City of Zephyrhills Permit Application Fax -813- 780 4021 Building Department ^� bit/ Date Received r. , w� I -0 Phone Contact for Permitting 7 . - .53 , or y Owner's Nam, „4j ( L s/dj' /!✓6� <4e - .. r . 0 /✓ 7�3' //7 Owner Phone Number „ ram124 7 Owner's Address 37767 V ,t60/e/tz',QT,S GAT' Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address `. JOB ADDRESS ?7pi7 / //rL' / r 9 /Z-ATS l'T, T ' LOT # SUBDIVISION PARCEL ID# N-aS- 2/- l>OaJ %/ (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED ,'l= NEW CONSTR ADD /ALT n SIGN MOVE n DEMOLISH �� INSTALL REPAIR PROPOSED USE I 1 SFR I I COMM n OTHER I TYPE OF CONSTRUCTION 1 BLOCK I I FRAME 1 I STEEL n OTHER I DESCRIPTION OF WORK / r c '4- 516„lS 27 %7 5/' 17 4./7- 04/7/5tC ' Xr I BUILDING SIZE SQ FOOTAGE HEIGHT 4 - a BUILDING $ � VALUATION OF TOTAL CONSTRUCTIO ✓ l C,/,5 O d I ELECTRICAL $ AMP SERVICE I 1 PROGRESS ENERGY n W.R.E.C. I I PLUMBING $ I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION t� j J` /c� � I I GAS I I ROOFING I I SPECIALTY I OTHER // ( ` FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA T YES nNO A w` ` � / BUILDER 1 ' r ■ / I i t COMPANY I4 /72`x N 177eA //e s%G.,/f4 Ze/es/ O/2/' V SIGNATURE REGISTERED / N FEE CURRENT N A LIT Or Address VGt3/ �/)L�if ' / , $ 6 fi, ,7/7?? License # I Qc ckJc7 ELECTRICIAN L � COMPANY SIGNATURE ., j'..J REGISTERED 1 Y / N 1 FEE CURRENT I Y/ N I Address [ License # PLUMBER / ('/ ,� COMPANY SIGNATURE REGISTERED Y / N FEE CURRENT I I I Y / N I Address [ License # MECHANICAL �' / COMPANY SIGNATURE /- ^ REGISTERED I Y / N I FEE CURRENT I Y/ N I Address 1 License # • OTHER I A4 COMPANY SIGNATURE L REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I Address r License # I 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. tiliftEH titl ltlff ftl€f t€ Iff € lifil y J. mi.: ,: :•,1:17::1, Nt. 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 (PIot/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 irk, 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 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 sgmeone 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 rewlating 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 tjhat 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 addrelasing 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 stizilm 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 Tots less than ,pne (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 demglnstrate 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 IMPROVEMEN • TO YOUR PROPERTY. IF YOU INTEND TO O3T IN FINANCING, COINSULT WITH YOUR LENDER OR AN ATT . ' Y BEFORE RECORDING YOU NOTICE OF, CO ENCEMENT. FLORIDA JURAT (F.S. � ) I i OWNER CONTRACTOR _ M -\. /('-.-- Subscribe.. . sworn 1 or a irme., be re m: is ` Subscribed and sworn to (or affirmed) bp r e this . ^C1�by 7_1 , _ L m f CS g -il * by1ct Z2_ i _ r af�A ISO is /are p- rsonall k awn to me or has /have pr.duced W ho i /a . •ersonall ..... • • e or :s /have produced \- .s iden -tion. as identification. Notary Public Notary Public Commission No.__ mmission No. "" "a GARY HICKS f ....... $ ; .— MY- COMMISSION) DD 609574 — '" —GARY-HICKS- - Name of Notary typed, printed: t. • : . me of Notary typed printed or s t - .� , * ' EXPIRES: January 1 0, 2011 f : :*= MY COMMISSION # DD 609574 !. BondedTYvu Notary Public Underwriters '''? 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D. 1 T.______________B.D. :..... ,, _,-----"--- EXIS11NG WALL ( ) / /; 1 ALUMINUM CUT OUT LETTERS, ' AV, if FINISH TO BE DETERMINED SPACERS- 0 , 3 o , -- 0 a . 1 /8" ALUMINUM STUDS WELD I - 3 0' ° 0 TO BACKS OF Lt 1 1 ERS ADHESIVE IN ALL HOLES "/ ' :/`• ..v a \ LETTER SECTION ',..\--_,-- SCALE: NOT TO SCALE w .Pasco County Parcel: 34- 25 -21- 0080 - 00000 -0023 001 Page 1 of 1 Search Again Show Map Generalized Building Schematic Frequent) 'LAskedQuestions Estimate Taxes Other Parcel Cards: 1 l 2 Other Agency Data: Tax Collector School Board Supervisor of Elections Data Current as Of: 11 Weekly Archive - Saturday, March 21, 2009 I Parcel ID II 34- 25 -21- 0080 - 00000 - (Card: 001 of 002) Classification II 19 - Professional Service Building I Mailing Address Property Value PEACEFUL SPRINGS LLC Ag Land $ 37924 MEDICAL ARTS CT Land $39,274 ZEPHYRHILLS, FL 335414323 Building $131,768 Physical Address Extra Features $1,167 37924 MEDICAL ARTS CT ZEPHYRHILLS, FL 33541 -4323 Market Value $172,209 Legal Description (First 4 Lines) Assessed (Save Our Homes) $ TOWNVIEW MEDICAL ARTS CENTER Taxable Value $172,209 PB 29 PG 68 EAST 31.17 FT OF LOT 2;SUBJECT TO & TOGETHER WITH EASEMENT AS DESC IN OR Land Detail (Card: 001 of 002) I Line II Use IlDescriptionll Zoning I Units 11 Type II Price II Condition II Value I 1 11 1700 II1STORY OFFII 00C2 II 4,909.28 I SF II $8.00 II 1.00 11 $39,274 1 Additional Land Information I I Acres II 0.11 11 Tax Area I 30ZH II FEMA Code II X IICommerical Code' PTVM2AA Building Information - Use 19 - Offices Professional or Medical (Card: 001 of 002) Year Built 1991 Stories 1.0 Exterior Wall 1 Common Brick Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Min Roof(Corr. or Sh M) Interior Wall 1 Drywall Interior Wall 2 None Flooring 1 Asphalt Tile Flooring 2 Carpet Fuel Electric Heat Forced Air - Ducted A/C Central Baths 4.0 Line ' Description I Sq. Feet II Repl. Cost New I 1 II BAS I 1,920 I $1,214 $179,290 I 2 II CAN II 42 Extra Features (Card: 001 of 002) Line II Description I Year II Units II Value 1 11 SWC I 1991 II 312 1 $351 2 II PAV ASP 1 1991 1 1 2,418 1 $816 Sales History Previous Owner 1 MARLA SU LLP I Year I Month I Book /Page II Type II Amount 1 2008 1 05 I 7841 / 0858 1 WD II $0 1 2004 (1 08 5989 L15 11 WP- 11 $ I 1 1991 1 05 1 _ 2039 ... L.1417 I WD 1 $0 Search Again Show Ma.p Generalized Build ing Schematic Frequentlk _ Asked ..._ Questions . Estimate Taxes Other Parcel Cards: 1 1 2 Other Agency Data: Tax Collector School Board Supervisor of Elections • - - -- ..,9,.o,. —a it R.twn= 75Rr.rn g =21 &sbb= 0080 &b... 3/24/2009 .:ounty Property Appraiser - Map Page 1 of 1 • Pasco County, Florida Section 34, Township 25, Range 21, 2. mi les NNW of Zephyrhills Prepared by the Office of Mike Wells, Pasco Coun P rope rty A ppraiser. Map Created on 3/24/2009 at 11:36:41 AM. 4 ''•" s � � 1 x 1 r P x F AVN�t "AC B P �' � 4 � x n xi-' .� ` � 5 " '021 X022 —%'44"1• � . . _ ° I : - i b r l y g 4r fi ' g N b" t ... : �. , : '_• - ... wri ye _, a ., �t -..< t _ , a - ._ 1120 '1110. 1100 109A r s s/6,,/ 4 c. http: / /maps.p / print. asp? img=/ mapdata /43261236752097.jpg &id =U2Vj d... 3/24/2009 PI ' Zephyrh DATE: TO WHOM IT MAY CONCERN: This letter authorizes INTERNATIONAL SIGN AND DESIGN CORPORATION to manufacture and install signs and /or awnings at the following location: It also grants authorization for William H Griffin; President and qualifier for International Sign and Design Corp.to sign the permit application on behalf of the owner. PROPERTY ADDRESS: 37924 Medical Arts Ct., Zephyrhills, FL 33541 INTERNATIONAL SIGN AND DESIGN CORPORATION or subcontractor is authorized to secure permits and variances by the local governing body. NAME: ( '.. - C C indy McM lari TITLE: _Assistant Vice President Notary Public: /44_ h 2 County of: Wig e,,0 _. State of: � ; inn � .�� D °� l_ - rua 2 II, 2011 (407)398: " My Commission Expires: 0 • .� k f ,2011 t y`s r<ec Adventist Health System 7050 Gall Boulevard • Zephyrhills, Florida 33541 -1399 • (813) 783 -6119 • Fax (813) 783 -6196 TDD — Telecommunication Device for the Deaf (813) 783 -1242 - IISITERNATIONAL 1 -1-131:1 SIGN & DESIGN 7'.."(i'it pates. 3( n of' 190 *1. Esixace3..4.a. CONTRACT, matte ani en4end th* TA , P...*Vite Ivy bw inIentatorai Slop anti DasOk Cowadivn, Lama, RI:gide, helping/el ralbed Setael! Heieioater coded Buryeg. FLORIDA HOStiriAL np+mootas 1 GAL"- BLVD. ZEPKYR,11115,5:1 33541 Ateh: Jan Baskin VtitilMESSETH: cDr.stiettz povenwts aflid Vecrents. ilx;reinarltri coAattied pen o te a accort.tame to terms ard s co REVERSE s.tde kereol ,03 a e evevetymcorpoomed arid made a pW12.4 ts ;:cetract. Sataw agre-es tra furmst,r1 as per aproyed &mins the tolowng desated SierNe: Pro*.t Locatotr P4.411ress: 37924 g!e.c.rtf....r. ks Court 22 Pi4is MANUFACTURE: One 0) Sit FCVS mounted to wall Main. ) $ 732.00 One 11) set of PCOPsyln mounted ne to90 IAGTB INTERNAL MEDICINE „ . INS ABOVE SAID SIGNS. ' $ 1,6810.00 Total Investment: $ 5 054 00 Plus pennitslengineennsOaturals, taxes added to final Invoice It agyp TERMS: Ul% DUE WI SIGNED CONTPACNBALANCE DUE UPON COMPLETION. 'itilERNATIONat SIGN DESIGN CORP IS VC/M ACCEPTING MCARSASAMEX Acteptedfcr Sart: Accepteo ty Borg: ItAtiraialtegtai S eaul Des*itt Coopeitattsm m" Mg EL DOOS-SALES EXECUTIVE eirtrmi O. VAUGNISVP Of SALES (1. I 131:PRVII: 3 1i /4 j it/ » 47 btlecteekrgatli S rend Dtsism Coopon41400 SS14:_ U4 4 Am ()vett ',heti Date Appeuect tits Date L r 77; / At LARGO R. Cuomo* Offictiftwegsactutv lattetongtit-Oftbstlatatotbetecifts, Catt4 Street 2$74 ttittestdat Put Da. Law, FL 33177 kkgriapvittr. M. NA* Pboote: g727)5411-55t3 vothceit.inittigor.mit Flom: 0457545c Fax: trin $447745 SM. ESatSlift1J01614-SIERVICE Fair $254$15.3447 Pasco County Parcel: 34- 25 -21- 0080 - 00000 -0023 001 Page 1 of 2 Search Again Show Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes Other Parcel Cards: 1 1 2 Other Agency Data: Tax Collector School Board Supervisor of Elections I Data Current as Of: I Weekly Archive - Saturday, March 21, 2009 Parcel ID I 34- 25 -21- 0080 - 00000 -0023 (Card: 001 of 002) Classification I 19 - Professional Service Building Mailing Address Property Value PEACEFUL SPRINGS LLC Ag Land $0 37924 MEDICAL ARTS CT Land $39,274 ZEPHYRHILLS, FL 335414323 Building $131,768 Physical Address Extra Features $1,167 37924 MEDICAL ARTS CT ZEPHYRHILLS, FL 33541 -4323 Market Value $172,209 Legal Description (First 4 Lines) Assessed (Save Our Homes) $0 TOWNVIEW MEDICAL ARTS CENTER PB 29 PG 68 EAST 31.17 FT Taxable Value $172,209 OF LOT 2;SUBJECT TO & TOGETHER WITH EASEMENT AS DESC IN OR I Land Detail (Card: 001 of 002) Line 11 Use IlDescriptionl) Zoning II Units I) Type II Price II Condition (I Value 1 1 II 1700 IIISTORY OFFII 00C2 II 4,909.28 II SF II $8.00 11 1.00 II $39,274 Additional Land Information I Acres U 0.11 11 Tax Area II 30ZH 0 FEMA Code II X (Commerical Code(I PTVM2AA I Building Information - Use 19 - Offices Professional or Medical (Card: 001 of 002) Year Built 1991 Stories 1.0 Exterior Wall 1 Common Brick Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Min Roof(Corr. or Sh M) Interior Wall 1 Drywall Interior Wall 2 None Flooring 1 Asphalt Tile Flooring 2 Carpet Fuel Electric Heat Forced Air - Ducted A/C Central Baths 4.0 Line II Description I Sq. Feet 11 Repl. Cost New 1 I II 1,920 0 $179,290 2 ( I CAN II 42 0 $1,214 Extra Features (Card: 001 of 002) Line II Description I Year II Units II Value 1 0 SWC 1 1991 Q 312 Q $351 2 11 PAV ASP 1 1991 11 2,418 II $816 Sales History Previous Owner 1 MARLA SU LLP Year II Month I Book /Page II Type U Amount 2008 05 1 7841 / 0858 II wD 11 $0 2004 II 08 1 5989 / 1561 11 WD 11 $0 1991 II 05 1 2039 / 1417 11 WD 11 $0 Search Again Show Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes Other Parcel Cards: 1 1 2 http: / /appraiser.pascogov. com/search/parcel. aspx ?sec= 34 &twn= 25 &rng =21 &sbb= 0080 &bl... 4/1/2009 ‘ c ' 11 It � f " 1 / i City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: ,,,kir-ri entr-f V Date Received: 3 2‘ -6 Site: J 7 9 C Wed d 44' Permit Type: 6,/,,e, S ,j» Approved wino comments Approved w /the below comments: ❑ Denied w /the below comments: ❑ This comment sheet shall be kept with the permit and/or plans. Kalvin Switzer - Plans Examiner Date Contractor and/or Homeowner (Required when comments are present) 111111111111111111111111111111111111111111111111111111111111 2009043645 Rcpt:1235025 Rec: 10.00 D$• 0. IT : 0. 00 This Instrument Prepared By: 0 Dpty Clerk Name Address Permit No. Tax Folio No. J"/. 0Z.s - a / (J (/1-15- 000dd --oUa 3 ad / NOTICE OF COMMENCEMENT PRULR 5. O'NEIL, PR5C0 CLERK A COMPTROLLER C OON OF FLORIDA, 03 0��.• am 1 PG c l COUNTY OF V Q 1 1 �8 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 prope (legal description of property, and street address if available) / c / file ca! 4r7 C'7 2e lcyyr4, l /, / f • 33sy /- -re e_.3/ rw »;sj Pit A/ 2. General description of improvement: LA/ttL J r'- / 6',,/S- 3. Owner information a. Name and address: P *Vito - frrl SPr .tq5, / ! C. i'TQ U her-141164 At . ( , - b. Interest in property: /dp % c. Name and address of fee simple titleholder (if other than owner): R 4. Contractor: a. Name and address: INTERNATIONAL SIGN & DESIGN CORP. - 10831 Canal Street Largo , FL 33777 b. Phone number: 727 -541 -5573 5. Surety 4 4 a. Name and address: b. Amount of bond $ . c. Phone number: 6. Lender K i} a. Name and address: b. Phone number: 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(1Xa )7., Florida Statutes: a. Name and address: pen (S'2r A4j: LLC IT? Ito A-rbor gav 1r, - 6567p2 %z 3697 b. Phone number: g G -g,5- 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes: 1. r� a. Name and address: u kh i n , /)'r b 1'l o/ Ito /7rbor /0,144 b r n p , tom. 33Gw7 b. Phone number: 5 Expiration date of notice of commencement (the expiration date is 1 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK Or RECORDING YOUR NOTICE OF COMMENCEMENT. Signature of { \ \ • g 4 r ner's Authorized Officer I hector Partner/Manager Signatory's Title /Office Ci( N r The IL KII foregoing instrument was acknowledged before me this N day of °lard-- (year) by i,1 L ll in (name of person) as 0 i, (type of authority, ...e.g. office , trustee, attomey in fact) for ',ho '1 " n115, ir� (name of party on behalf o whom instrument was executed). 11 1 ° ' 4 Signature of Nota ' Public - tate of Florida Print, Type, or St . p Comm ssioned Name of Notary Public Notary Public State of Notts Commission Number e Cindy 0 McMillan Personally Known) or Produced Identification My Commission DD611721 ‘ 0, Expires 11/05/2010 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. 14 It si C Signature of at al P talon Signing love (Signature of Owner or Owner's Authorized Officer /Director Partner/Manager) STATE OF FLORIDA, COUNTY OF PASCO THIS IS CORRECT COPY OF FREGOING IS Ps DOCUMENT AND ND CORRECT FILE OR OF PUBLIC R EFF O IC A !AL O \N at SMYHAN 2� OF PAULA - O )DAY NEIL, LERK & COMP BY --__ DEPUTE" CLERK