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Home My WebLink About10-10960 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 10960 BUILDING PERMIT Permit Number: 10960 Address: 6335 MAISIE RD #20 LOT 192 Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: TOWNHOMES Lot(s): Block: Section: Square Feet: Subdivision: EILAND PARK TOWNHOMES Est. Value: Parcel Number: 03- 26 -21- 0230 - 00000 -1920 Im rov. Cost: 43,660.00 ,° _ ° ,, Date Issued: 9/29/2010 Name: LENNAR HOMES INC. Total Fees: 430.00 Address: 600 N. WESTSHORE BLVD Amount Paid: 430.00 TAMPA, FL 33609 Date Paid: 9/29/2010 Phone: (813)769 -5277 Work Desc: REMODEL /REPAIR SEE SCOPE OF WORK `� Wit'' � •� ,` L 1 A' '• N BUILT 2:5. L - A 35.00 EDMONSON ELECTRIC INC PLUMBING FEE 35.00 MECHANICAL FEE 35.00 BAYONET PLUMBING HEATING & AIR C FIRE PLAN REVIEW FEES 25.00 FIRE INSPECTION FEES 15.00 BAYONET PLUMBING HEATING & AC IN ( (2r 4D •• - . - • H - L Y: MI IN I• 1 N 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 ilure to record a notice of commencement may result in your paying twice for improvements to your p �, -- you intend to obtain financing, consult with your lender or an attorney before recording yo • . t. - 1 N encement. 410*, 4 1 /t _ CONTRAC I PERMIT OFFI ■1 PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813.73U-UUlU f Lily UI L rc„int rnt.iN,,vu,... Building Depai;mont . /) Q ?� d 3 (.3 ate Received `1, 2 -, Phone Contact for Permittin• el �____ v� ■ iwner's Name med./rat- SRetoo1' Owner Phone Number '12') ,,c / 4 7 `� .. `2 (2 0 • iwner's Address 4114s /t!IAtJ1E - 4"910 / Z40 'o! A i Owner Phone Number 1 ee Simple Titleholder Namer • Owner Phone Number l ee Simple Titleholder Address [ OB ADDRESS 1 G 3 35 M4(6/e= , omO / 2 Ei ° yyt ,, W eJ , / 33510 LOT # l • 1 E „ „ ' , ry , c / 1 PARCEL ID#1 0 3 -. t - 21- 0. O - 00000 79. (OBTAINED FROM PROPERTY TAX NOTICE) VORK PROPOSED aril NEW CONSTR ADD /ALT I I SIGN 1 1 MOVE 1 1 DEMOLISH MI INSTALL REPAIR , ROPOSED USE ET SFR • 1 1 COMM 1 1 OTHER 1 1 YPE OF CONSTRUCTION 121 BLOCK 1 1 FRAME 1 STEEL 1 1 OTHER I )ESCRIPTION OF WORK 1 4EP4 fR- / RE Alo0 1 .J/Ne--Li FA al/ (-c/ /I2,4 _ Ty 3UILDING SIZE I /3 7/ l SQ FOOTAGE 1 1 HEIGHT a `57v, y 1 ■... BUILDING $ 3 i, 6 co VALUATION OF TOTAL CONSTRUCTION ELECTRICAL $ 3 ‘4/C) AMP SERVICE ® PROGRESS ENERGY 1 1 W,R.E.C PLUMBING $ Y32 MECHANICAL $ 1/.7 5(s VALUATION OF MECHANICAL INSTALLATION GAS 1 ROOFING 1 1 SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS F- OD ZONE AREA YES NO . c� ■. ■ •� COMPANY LENNA/2., y0.✓4 BUILDER t SIGNATURE REGISTERED 1 Y / N 1 FEE CURRENT 1 Y / N I Address / 550 La. F AC_±li2 /o C t* rMti FFLAWA License C.3c/ A S51.51 ELECTRICIAN • COMPANY No u �a N E G ECT,C /L z A/ C ELEC i � SIGNATURE REGISTERED Y / N FEE CURRENT Y / N Address ,A3 •5K 1 P" 7 Ar /s o/''VD,'T :9- f/g. rt37 6/3 License # eC 00 0.25 79 PLUMBER - r COMPANY BAYONET pGr/MeS /NG, h<es 94 C SIGNATURE Klir) ` REGISTERED Y / N FEE CURRENT I Y / N Address I P 0 : '1 5,30: '' _ yoNf7 PeiNf 3 n7y License # C FG 0 _dri2.9 9 MECHANICAL / � COMPANY 8�4Y0A/E /ZuM4 /�t//G, /-4 0,1C-- SIGNATUR REGISTERED 1 Y / N I FEE CURRENT 1 Y / N 1 Address A O r OOx 5o 8 3fyoA/67 - R), vr G4-•i - 791 License # , CAC O,$$ 0 60 2 OTHER j w' ' COMPANY Co JreieL/ A/6- &gni ry A2.00 , �uG, -Z Va. . SIGNATURE � ' ' � REGISTERED I Y/ N I FEE CURRENT I Y/ N I , Address 1 12 //. 5#o,44 Lai f 5s v,o SP4ING,41/u `63/60 License # C— CO S 99 1' 1 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. II►lillil11 IIIIIIIIilillililllililiiiiiillilliiiiililli 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 (PIoUSurvey /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 REC 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 Protectibn- 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 fn material is will be used submitted at time of drainage permitting which Is prepared edby agprofessio addressing alengi eer "compensating volume" 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 o ad affect adjacent properties, il owner may r be i cited for violating properties. If use of fill is found to Y the conditions of the building permit issued under the attached permit application, for lots less than one ( ) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise iunde�stand faith that inform sepahate permit the ay be l equ g ired for conditions electrcal work, this affidavit prior to commencing condttuctiog, g as, or other installations not specifically included in the application. A P y p plumbing, ed shall wells, on air be aiocing, g permit as id a aany rois io construed ns of the technical be a hnical c e es e nor shall issuance ce of a permit prevent the Building Officio fficial from thereafter set aside ny provisions tco requiring a correction of errors In plans, construction or violations of any codes. Every p ermit Issued shall become invalid unless the work authorized by such permit is commenced within si after the time permit issuance, c , o r If work Ut extensio months the permit is suspended or abandoned for a period of six (6) m 90 days and will demonstrate may a e requested, au o In h ea te n from the work Official a period not cea es forninety (90)cosecutive days, the c onsidered abandoned. Justifiable cause for the extension. If w TO OWNER: YOUR FAILURE TO RECORD A NOTICE INTEND ENT FINANCING, E U IONSULR WARNING T TO YOUR PROPERTY. IF • �i OBTAIN E _ T WITH y TWICE FOR IMPROVEM T O. WITH YOU' LE ! 9 - O' . N T., :_,._ :EFORE RECORDING OU- N FLORIDA JURAT (F.S. 117.03) � / L / .� CONTRACTOR : this .7u G OWNER OR AGENT T ��,, ,,, .. ate iv Subscribed and sworn � Y t� /vote �bscr(bed and sworn to (or a � g 2v/ R by 0 � N 2p1 o by ✓'' 0,4,,, Wh•1� . re personally known to a or has/have as Identification. produced Who { dare personally know to m an r /hay oproduced �� Notary Public // Notary Public AIPP DD 77 O 23 Comm i pion No. _b 775 Z3 Commiss!on No. "•"' • 3 e - type printed or stamp ' * , , '4 ° Commission 00 77402 Name of Notary 2012 dt " 6, Name of Notary typed, Pri ;.R;P Expires j on DD 77402i3 '"a ��.� Expires TIN June P 003BS7Ot9 1,, . June 6, 2012 P , a v •4; Expires Ju 5.7019 ' , " ,, eanra.m rnru Troy nun Inman** WO 3e City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: 4 tf) ✓1 g r Date Received: q-21-10 Site: 6033 /ii/:5 ie /(4) 4/ I #zo 761/2-- Permit Type: /(eekii e17/0de ( lir See Approved w /no comments: Approved w /the below comments: ❑ Denied w /the below comments: ❑ This comment she: sha 1 . - - it with - permit and/or plans. // f Kaivin Swit y. — Plans :��'. iner Date Contractor and /or Homeowner / (Required when comments are present) ZEPddYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Fire Chief Keith Williams Bus (813)780 -0041 Fax (813)780 -0044 FIRE SERVICE USER FEES Occupancy No.: � Plan No.: h — / /2_ Contractor: y�/2 /r /97 Business Name: , Li /&,- /(, - I Z— " e..9 Billing Address: l'3" S75 f2 ve ,� Business Address: ��3 5 4 , rie K- elUA- 5 "Z 3J Business Phone No.: Billing Phone No.: Business Fax No.: Billing Fax No.: Contact: Contact: PLAN REVIEW FEES INSPECTION FEES — PERMIT FEE _ FALSE ALARM FEE Site Plan N/C ^ Annual N/C Sprinkler $50 1st Alarm t ii N/C Multi - Family /Commerci. !. sf 1st Re- inspection N/C Standpipes $50 2nd Alarm (Minimum Chan $25 00. _ ~ 0 Plan Revisions DBL 2nd Re- inspection $100 Fire Pum — N/C P $50 3rd Alarm N/C _ 3rd Re- inspection $250 r Hoods $50 r 4th Alarm 4th Re- Inspection $500 Fire Alarm $100 $50 5th Alarm $150 SPRINKLER SYSTEMS (Business closed until ..... Gas $50 6th Alarm — $ 0 - 25 Heads $50 violations corrected) Natural Gas $50 _ NON COMPLIANCE $150 26 plus Heads $100 SPRINKLER SYSTEMS ^ Fuel Tanks per tank $50 STANDPIPE SYSTEM _ Hydro Undergrounds $45 Sparklers $100 Per Riser $50 _ Hydrostatic Test $65 per system _ Fire Works $500 FIRE PUMP _ Acceptance Test $45 per system Camp Fire $25 0 Per Pump $100 _ Hydrant Flow $75 _ Controlled Burn $100 FIRE ALARM SYSTEM Hood /Duct $50 _ 0 - 25 Devices $50 _ FIRE ALARM SYSTEM — Place of Assembly 550 Annual 26 plus Devices $100 — System Acceptance $50 ^ Fire Protection $25 SUPPRESSION SYSTEMS — Recall Acceptance $50 — Flammable Application $50 Annual _ Wet 550 OTHER _ ^ e 9 Waste Tire storage 550 Annual Dry $50 Fire Wall /Smoke Wall per wall _ Generator < KW $100 CO2 $50 LP Gas per tank Generator >30 KW 150 Other $50 Natural Gas 525 per system _^ Bio-Hazard Waste $100 Annual KITCHEN EXHAUST _ Fumigation Tenting $50 0 Hood /Ducts 550 r Tent 10)10' or greater $15 per tent _ Torch Pot/Applied $50 OTHER _ Fire Pump 545 Haz. Materials $100 Annual _ LP Installation per tank $50 _ Fire Suppression $30 Fuel Tank Installation 550 _ System Acceptance (Per Tank) $50 _ Exhaust Hood /Duct $30 0 Natural Gas Installation $50 .__. Re- inspection DBL (Per System) (other than annual) 0 Spray Booth 550 0 Inspection scheduled DBL and cancelled less than 24 hours Construction Insp. N/C Emergency Vehicle Acs $o FALSE ALARM PLANS TOTAL INSPECTION TOTAL! / _ PERMIT TOTAL TOTAL GRAND TOTAL Clif:r=i Comments: 7/20/7; 7 Date: Insglctor: �' ' /me) I SCOPE OF WORK Original Permit # 7100 . Home Address 6335 Maisie Road, Zephyrhills, FL 33542 Construction Value: $26,587.00 Pre - Demolition • Disconnect electric panel from home • Keep one (1) GFI outlet in garage only for irrigation, pool (if needed) and power for repairing home • Turn off gas line in home (if needed) • Remove existing outlets and switches from electrical boxes Demolition 10 • Remove selected drywall ^ �� t G� • Remove insulation (except foam insulation against block wall) i ,S • Remove/Repair any damage to existing studs �lS; ��` � • Remove cabinets, countertops and fixtures as nec �' - +10,4 �., - -' °`'� • Remove tubs, commodes, sinks and hot wa1� I ii p7 • Remove all appliances as necessary gel / . • Remove all duct work and air handler, refrigt .. 's . d C gulls • Remove flooring -tile, carpet, hardwood, etc. weeded • Remove all interior doors and trim, mirrors and shower doors as needed • Remove /repair any copper damaged by drywall • Remove all switches and outlet plates • Note: during demolition we will bring home back to rough -in mechanical, electrical and plumbing stage. No structural changes will be made in home. Mechanical Scope of Work • Re- install all new trunk lines and duct work per what is in existing home including bath fans REVIEW DATE. q - 3 -d • Replace interior compressor unit CITY OF ZERHYRH Plumbing Scope of Work PLANS '�'��` • Repair and replace any damaged copper • Install new copper after removal as necessary • Install new tubs and fixtures as necessary • Repair and replace any damaged copper • Install new copper after removal as necessary z � , . ` , Fr s Page 1 of 2 F , 15550 Lightwave Drive, Suite 210 Clearwater, FL 33760 • Phone: 727 -479 -1700 • Fax: 727 -479 -1707 Cr LENNAR.COM Plumbing Scope of Work (Continued) • Install new tubs and fixtures as necessary • Install new commodes and fixtures (at finish) as necessary • Check for any damage after demolition and repair as needed • Install new hot water heater Electrical Scopes • Repair damaged ground wire in switch, outlet, and light boxes • Keep existing recessed cans as necessary • Keep all light fixtures and ceiling fans, reinstall at finish • Install all new outlets, switches and trim plates • Install all new recess trims • Install all new light bulbs throughout homes Insulation Scopes • Install new insulation to match or better from whatever was removed during demolition • Check and install any fire stopping as needed Inspections (rough in) • Mechanical • Plumbing • Electrical • Insulation Inspections (final) • Mechanical • Plumbing • Electrical • Insulation • Final C/O Page 2 of 2 15550 Lightwave Drive, Suite 210 Clearwater, FL 33760 • Phone: 727 -479 -1700 • Fax: 727 -479 -1707 LENNAR.COM :R September 16, 2010 City of Zephyrhills 5335 8 Street Zephyrhills, FL.33542 To Whom It May Concern, Lennar Homes, Inc. is submitting the following Chinese Drywall permit request. The original Permit number was 7100 and the address is 6335 Maisie Road. Parcel ID# is 03-26-21-0230-00000-1920 located in Eiland Park Townhomes. Thank You. Sincer-� issa Holleran Permit Coordinator Lennar Homes Central Florida Division 727 - 479 -1740 15550 Lightwave Drive, Suite 210 Clearwater, FL 33760 • Phone: 727 -479 -1700 • Fax: 727 -479 -1707 LENNAR.COM g.M. arramuxm September 16, 2010 City of Zephyrhills 5335 8 Street Zephyrhills, FL.33542 To Whom It May Concern, Lennar Homes, Inc. is submitting the following Chinese Drywall permit request. The original Permit number was 7100 and the address is 6335 Maisie Road. Parcel ID# is 03- 26 -21- 0230 - 00000 -1920 located in Eiland Park Townhomes. Thank You. Sincer lissa Holleran Permit Coordinator Lennar Homes Central Florida Division 727 - 479 -1740 15550 Lightwave Drive, Suite 210 Clearwater, FL 33760 • Phone: 727 -479 -1700 • Fax: 727 - 479 -1707 Cr LENNAR.COM PAM Zephyrhills Fire Rescue 6907 Dairy Road, Zephyrhills. Fl, 33542 Fire Marshal Bus (813) 780 -0041 Kerry Barnett Fax (81 3) 780 -0044 F, mail: kharnett iaire.zephyrhills.fl.us Plan Review #: 10 -112 Project: Townhome Renovation (Chinese Drywall) Number of Pages: Scope of Work Packet September 23, 2010 I have received and reviewed the scope of work to remove the Chinese drywall in the unit located on 6335 Maisie Drive and will allow the project to move forward. Please note that this review does not eliminate any further requirements as the project continues moving forward. By receiving permit, contractor acknowledges to comply with the items listed below. Should anyone have any questions, please do not hesitate to contact the Fire Marshal's office. 1. Firewalls will be required to be looked at prior to any drywall being reinstalled to verify no additional penetrations have been made and if so sealed in accordance to the code to maintain the fire rating. Inspections Required: 1. Firewall 2. Final PA, � IJ KERRY 'O � "- T, FIRE MARSHAL ** *Please be advised this review of plans submitted is a cursory review to assist the contractor in compliance with applicable fire safety codes. This review is not intended to be a final approval of the submitted plans. It is the contractor's sole responsibility to ensure that the plans are in complete compliance with all applicable NFPA codes and local ordinances. In the event that further examination or site inspection reveals areas of non - compliance, it shall be the contractor's sole responsibility, at their sole expense to bring those areas in compliance. The City assumes no responsibility for the contractor's failure to be in compliance with all applicable NFPA codes and local ordinances. US HOME CORPORATION CENTRAL FLORIDA / MANAGERS ACCOUNT 7386 US HOME CORPORATION CENTRAL FLORIDA / MANAGERS ACCOUNT 7386 5.49 (3/10) • John Lively To Elissa Holleran <Elissa.Holleran@a lennar.com> ofet <jlively713 @yahoo.com> cc 09/28/2010 08:46 AM bcc Subject Fw: PERMITS Hello John, I have the permits for Building 11 ready for you to pi up tomorrow . The permit for the one remodel is ready also and the cost for that pe it is $430.00 . Thanks Jackie Boges 0 11101101101111101011101111101IIIII11011011IIIIIIII 2010139628 Rept:1328237 Rec: 10.00 DS: 0.00 IT: 0.00 09/29/10 S. Shultz, Dpty Clerk NOTICE OF COMMENCEMENT PAULA S.O'NEIL,Ph D.PASCO CLERK & COMPTROLLER Permit No. 09/29/10 12:5 mm 1 of 1 OR BK 8q, 9 PC 1843 Property Identification No. 03- 26 -21- 0230 - 00000 - 1920 '7 THE UNDERSIGNED hereby gives notice that improvements 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 :) Lot 192 EILAND PARK TOWNHOMES PB 60 PG102 a) Street Address: 6335 MAISIE RD ZEPHYRHILLS FL 33542 2. General description of improvements: Repair / Remodel Single Family Residence 3. Owner Information a) Name and address: SHELDON, MICHELLE L 6335 MAISIE RD ZEPHYRHILLS FL 33539 b) Name and address of fee simple titleholder (if other than owner) c) Interest in property 4. Contractor Information a) Name and address: LENNAR - 15550 Lightwave Drive Ste 210 Clearwater, FL 33760 b) Telephone No.: (727) 479 — 1700 Fax No. (Opt.) 5. Surety Information a) Name and address: N / A b) Amount of Bond: N / A c) Telephone No.: Fax No. (Opt.) 6. Lender a) Name and address: N / A Phone No. 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: N / A 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: N / A 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 NOTICE OF COMMENCEMENT. STATE OF FLORIDA }!1 ,,c COUNTY OF PASCO x / P/ {��{ .��Y' LJ 1J Signature of Owner or Owner's Authorized Officer/Director /Partner/Manager SHELDON, MICHELLE L Print Name The foregoing instrument was acknowledged before me this POI day of Jt/ M en- , 20 /V , by / ' g ' -5 as Owner (type of authority, e.g. officer, trustee, attorney in fact) for (name of party on behalf of whom i : ent was executed). Personally Known OR Produced Identification X Notary Signature ELI SA M. HOLLERAN Type of ldentificatio /� Name (prin a '' ? ° $ ` ELISSA License # f f V V J "3 73 ` 5 . ' Expires June 6, 2012 Oundad Thru Troy Fain Insurance 800 -386 -7010 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. /� �r b' it C/ kdtL &t --Ct. „ ' Signature of Natural Person Signing Above FORMS /NOC,rvsd2007