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Home My WebLink About10-11124 • CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 11124 BUILDING PERMIT Permit Number: 11124 Address: 37542 DALIHA TERR Bldg 21 #203 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 -2030 lmprov. Cost: 43,660.00 Date Issued: 11/10/2010 Name: US HOMES CORP - LENNAR Total Fees: 452.50 Address: 37542 DALIHA TERR Bldg 21 #203 Amount Paid: 452.50 ZEPHYRHILLS, FL. 33542 Date Paid: 11/10/2010 Phone: Work Desc: REPAIR /REMODEL SEE SCOPE OF WORK L 11.- ••v _ 1 111 • . - L 4.0, EDMONSON ELECTRIC INC PLUMBING FEE 40.00 MECHANICAL FEE 40.00 BAYONET PLUMBING HEATING & AIR C FIRE PLAN REVIEW FEES 25.00 FIRE INSPECTION FEES 15.00 BAYONET PLUMBING HEATING & AC IN l A ; (7,6 1,1 . -.•• 1, - . 1 1 = 11: . W. el 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 IL . perty. If you intend to obtain financing, consult with your lender or an attorney before recording your -- tice of commencement." j o. fi 4101110 4 t /„it• A CONT :f TURE PERMIT OFFI �R PE ' MIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER , 813- 78U -UUCU Lily ui L rcillill rlpNnvutiv. �� '� f Building Department `i' Pate Received- Phone Contact for Permittin• U / __ ti?� 1 -- 3 � 3 IIt111Ittt1Itti iv / .! /r� ` 17"7 'f Iwner's Name 1 <� Ir ,/ ! . n Yoko S�er-0 -- Owner P N umber (•! O) ' -- / r / 0 0 f_ _/II /0 a 3 G I Owner Phone Number 1 1 Iwner's Address j 341 N ��. �- 41 y � N y ee Simple Titleholder Name Owner Phone Number ee Simple Titleholder Address 1 ,3 75 -. DA LE H4 774- 76 ,9/14.1, �L 535 1 ,0 1 �� LOT # 2 ;UBDIVISION I E/G� OB ADDRESS o �' 2 E 6 7 4 • 4 7 / t / 0 / ° / 9 x . , , 1 PARCEL ID #1 0 3-26 _21` 0"23 0 00000 ` 2 030 (OBTAINED FROM PROPERTY TAX NOTICE) VORK PROPOSED I �_:•'A NEW CONSTR ADD /ALT I SIGN I I MOVE 1 DEMOLISH MN INSTALL .,>•C REPAIR PROPOSED USE = SFR 1 1 COMM 1 OTHER YPE OF CONSTRUCTION BLOCK 1 1 FRAME ( STEEL [ 1 OTHER I I )ESCRIPTION OF WORK 1 /C. / Root 1 ..Tht./G- tf " F/rit'/ /Gy 042,E Areve f r/1,/ l 3UILDING SIZE I 1 SQ FOOTAGE /53 / 1 HEIGHT 1 a s7-be& 1 B $ 31 65".9 VALUATION OF TOTAL CONSTRUCTION / ELECTRICAL $ .3 T yv AMP SERVICE PROGRESS ENERGY 1 I W.R.E.0 PLUMBING $ i4 3.Z MECHANICAL $ 41.2 9c VALUATION OF MECHANICAL INSTALLATION GAS 1 1 ROOFING ( 1 SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES 1 INO i tlr.:rcaur BUILDER /� - `' LE/V/1/4/2., COMPAN LELE/V/1/4/2., /,�0 /1/A�e iI SIGNATURE , REGISTERED 1 Y / N 1 FEE CURRENT 1 Y /-N Address /5 L16 1 At. 101 /0 C LOP w/tTrILAFL MA License # C 43C / A 5 5-'7.5 / b COMPANY C�h 50 WSJ EC ECT /(,. .ZN C • ELECTRICIAN �� SIGNATURE REGISTERED L Y/ N 1 FEE CURRENT 1 Y/ N Address , *-341/ .SK• /f p ' 4'12,1P7704 'r"LA 33 6/3 License# I C 00 0,25' 79 PLUMBER X . COMPANY 8/9 YoNET pcLi/kt6/ t #O. 94C SIGNATURE _. REGISTERED Y / N FEE CURRENT Y / N Address I i -'09( 5 Oi["' " yoNEf Awir l Z 3 fVb License # C FG o_�"Z 9 9 8 MECHANICAL ' p COMPANY 8q O/✓�guMO /�f/G, /4-,9774/6-,1 /1 G SIGNATURE > , ` REGISTERED 1 Y / N I FEE CURRENT I Y / N I Address / ? 0. 8oX S30g 84yaNFT G[- JY67r71 License # C4 a 0 s8 0 6 2 OTHER //� COMPANY Co NS /iV(,- ( vq[ /Ty /POOF - c' SIGNATURE / "/. REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N I Address ,y2 //. 5 # O A L L/uE C 3 c . v o c 5 P a d N G / Y ' / t . G ` 663si6o License # C Z ' Co S 99 / 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/ Sill 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 (PlotSurvey /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 t "contractor an Block" indicat indication this that application he is not properly licensed will a d is not entitled responsible. ed toyou, permitting privileges gn Pasco contractor, that y County. TRANSPORTATION IMPACT /UTILITIES IMPACT AND RESOURCE RECO 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 Court.ty 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. 1 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. 1 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 t area, affect adjacent fill mayr affect d for adjacent lating - properties. If use of fill is found to adversely the conditions of the building permit issued nder the attached pe application, for lots less than one ( ) acre which are elevated by fill, an engineered drainage plan is ons set forth in If i am the AGENT FOR THE OWNER, i promise In faith d that a permit ma Pbe r for cal work, this affidavit prior to commencing construction. I.un derstan sins, wells, pools, air conditioning, gas, or other installations not specifically included in the application. plumbing, 9 se issued shall construed to be a license , nor shall 1 suance a permit preventatheh Official from t ereafter q set t aside any provisions of the technical code e requiring e ng a correction of errors in plans, construction or violations of any codes. Every permit Issued shall become invalid n unless the work dud authorized such permit is commen ced within six months of permit issuance, or if work authorized by days and will .demonstrate the permit is suspepe nded or r abandoned ed for a peri Offclal fos period not to exc menced. An extension of six () months after the may requested, in a te fr the Building justifiable le cause for the extension. extension. if work ceases for ninety (90) consecutive days, the is considered abandoned. IF YOU IC MMENCE � , IN FINANCING, CONSULT G TO OWNER: YOU' FAILURE TO RECORD A NOTICE OF CO ENT MAY RESULT IN YOUR WARNIN - TS TO YOUR PROPERTY WIT TWICE FOR IMPR �, ._ ' � FLORIDA JURAT (F.S. 11 = Eu WIT YOUR LE'!ERO- :L•'�.��. , - BEFORE RECORDING YOU ; 7 - I TOR ��• '� CONTRAC . -"ore me this 7u,v e OWNER OR AGENT 5111111 _ Subscribed and sworn to (or a yf - d Lwe`r Subscribed and sworn to (-�• "�• "" •e 1 e me this ENE ��R by .../ A i g I i o by ,mo /./N L r✓F� y wh.� -re personally known to me or haslhave d s Identification. Who are personally known to rroduced as iden Notary Public N otary Public z3 .mmisslon No. DD 77 023 Com sslon No. 77� • • . Troy Hon Immo e .. Name of Notary typed, printed or stampe R.` ", *, Commission 00 774023 - • : _ .. Expires June 6 2012 Name of Notary typed, pri = *.af ; ; :mmission OD 774021 as•�ore �,' � June 6, 2 012 " F o ,,1, doodad ITN 100 :: y !�; Expires Ju 9-70,9 � � F 61000.0 T11N Troy Pilo 10Iwrano ®0038 Jacqueline Boges From: Jacqueline Boges Sent: Wednesday, February 16, 2011 1:38 PM To: Kerry Barnett Subject: FINAL INSPECTIONS Hey Kerry, Have you done your final inspection at 37554 Daliha Terr Bldg 21 #209 and 37542 Daliha Terr Bldg 21 #203? We did our final on yesterday the 15` Jackie Boges Code Support Specialist ext. 35 1 . . - , — -,— _ —.....,. -.....— ,e,...41.1., -- r _ City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: Date Received: 0 /6/270 Site: 3 7 5-ef 2 AlYtet leo-- bds--- D Permit Type: kb fi 1 de / Approved wino comments: E Approved w/the below comments: Denied w/the below comments: 0 1 i .,', "t 1 , ii,- , ,)- (,, ( ( .1 4.) V ,,,, ) This comment sheet shall be kept with the permit and/or plans. 1 i l - 7 / "" i f Kal v ' Switzer / -4:1;'‘ns Examiner Date Contractor as s sr omeowner , (Required when comments are present) Zephyrhills Fire Rescue 6907 Dairy Road. Zephyrhills, FL 33542 Fire Marshal Bus (813) 780 -0041 Kerry Barnett Fax (813) 780 -0044 E- mail: kbarnett (a)tire.zephyrhills.fl.us Plan Review #: 10 -130 Project: Renovation /Drywall Replacement Number of Pages: Packet November 5, 2010 1 have received and reviewed the packet for the renovation for Chinese drywall located at 37542 Dahlia Terrace 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. Firewalis 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 `�%!l� KERR '�A , IRE 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. ZEPHYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 l= ire Chief Keith Williams Bus (813)780 -0041 Fax (813)780 -0044 FIRE SERVICE USER FEES Occupancy No.: / Plan No.: r ^ L-30 Contractor: I/3Gf/� �ffi°�i Business Name: Billing Address: ` • - 4 ' .. v.40-4:: "r2/4 Business Address: ; 9/ 'jt' 474 ,/ " 37 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 $50 1st Alarm N/C ulti -Famiy /Commercial .06 sf _ 1st Re inspection N/C _Standpipes _ 2nd Alarm N/C Minimum Char 25. 00., _ 2nd Re- inspection $100 _ Fire Pump $50 3rd Alarm N/C Plan Revisions DBL 3rd Re- inspection $250 _Hoods $50 _ 4th Alarm $100 4th Re- Inspection $500 Fire Alarm $50 5th Alarm $150 — SPRINKLER SYSTEMS (Business closed until LP Gas $50 6th Alarm $200 ^ 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 Ei 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 $50 Annual 26 plus Devices $100 — System Acceptance $50 ` Fire Protection $25 SUPPRESSION SYSTEMS _ Recall Acceptance $50 — Flammable Application $50 Annual — Wet $50 OTHER Waste Tire Storage $50 Annual ,_ Dry $50 Fire WaII /Smoke Wall wall Generator < KW $100 — CO2 $50 _ LP Gas 525 per tank _^ Generator >30 KW 150 Other $50 _ Natural Gas $25 per system — Bio -Hazard Waste $100 Annual KITCHEN EXHAUST _ _ Fumigation Tenting $50 0 Hood /Ducts $50 — Tent 10'x10' or greater $15 per ten Torch Pot/Applied $50 OTHER — Fire Pump $45 — Haz. Materials $100 Annual LP Installation per tank $50 ` Fire Suppression $30 Fuel Tank Installation $50 System Acceptance (Per Tank) $50 _. Exhaust Hood /Duct $30 El Natural Gas Installation $50 — Re- inspection DBL (Per System) (other than annual) LI Spray Booth $50 0 Inspection scheduled DBL — and cancelled less than _ 24 hours Construction Insp. N/C — Emergency Vehicle Acs $50 FALSE ALARM PLANS TOTAL Z — INSPECTION TOTAL 1 � PERMIT TOTAL i 1 TOTAL GRAND TOTAL `/ Comments: Date:// 7 Insg /7 `� ',"t� SCOPE OF WORK Original Permit # 6009 Home Address 37542 Daliha Terr, Zephyrhills, FL 33542 Construction Value: $30,478.00 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 :r1 v �. IC- • Remove selected drywall � -�_ � � � , /, t • Remove insulation (except foam insulation against blo' ?ny 0._ • Remove/Repair any damage to existing studs SJ 0 �`1 • Remove cabinets, countertops and fixtures as necess a / • Remove tubs, commodes, sinks and hot water heater 01 • Remove all appliances as necessary • Remove all duct work and air handler, refrigerant lines and HVAC grills • Remove flooring -tile, carpet, hardwood, etc. as needed • 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 • Replace interior compressor unit Plumbing Scope of Work • 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 t Page 1 of 2 Lightwave Drive, Suite 210 Clearwater, FL 33760 • Phone: 727 - 479 -1700 • Fax: 727 - 479 -1707 LENNIAR.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 CIO Page 2 of 2 15550 Lightwave Drive, Suite 210 Clearwater, FL 33760 • Phone: 727 -479 -1700 • Fax: 727 -479 -1707 LENNAR.COM STATE OF FLORIDA, COUNTY OF PASCO IIIIIIIIIIII111111IIIIIIIIIIII111111IIIIII11III11IIIIIII1III THIS IS TO CERTIFY THAT THE FOREGOING IS A t I ( 1 2010165520 TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE OR OF PUBLIC RECORD IN THIS OFFICE WIT SRv1Y HAND AND OFFICIAL SEAL THIS Rcpt :1336457 Rec: 10. / D AY OF h ( d / d DS: 0.00 IT: 0.00 PXULA S. O'NEIL, CLERK & COMPTROLLER 11/17/10 L. Korb, Dpty Clerk BY ,e----1A--t---- (1 j DEPUTY CLERK NOTICE OF COMMENCEMENT PAULA S.O'NEIL,Ph.D.PRSCO CLERK & COMPTROLLER 11/17/10 12:18 pm 1 of 1 Permit No. OR BK 8468 PG 675 Property Identification No. 03-a 6`3 t - 6 - 31,-oo000 - 3 030 /\r'''''.--- THE UNDERSIGNED hereby give informs you that the improvement will be trade 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:) L a 03 C t, ,A iaeKTnws,),.o ,,es Pe e 46 ?G iOa a) Street Address: 3'1SY 5� a al -11..4. Ter. ZGp1.yy r1 -41 \s l rt. 33 S4a 2.General description of improvements: REPS /•e. / yeeAf pD e L s /N6LE <4nsv4 t/ tees /DE/VCE 3.Owner Information a) Name and address: % /KroV �sp€r - 3=11 W• 4 s ' \ & New s '\& NY 1oo3h - 140 1 9 b) Name and address of fee simple titleholder (if other than owner) c) Interest in property 4.Contractor Information a) Name and address: LEA/ /ABC — / Lt 6/1TCa4LF Z - C1;.11f / rrji(ff J3 74 o b) Telephone No.: (777 ; 4 -1 ?0 0 Fax No. (Opt.) 5.Surety Information a) Name and address: / b) Amount of Bond: /tVA c) Telephone No: Fax No. (Opt.) 6. Lender a) Name and address: /t/ /t9 • • 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: // 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: /V/4 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, CON LT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF r a MENCEMENT. p STATE OF 410 W# nJ + y t2 COUNTY OF.ESS60 - j\I X /V 1 Signature of 0 4 or Owner's Authorize. Offcer/Dir ' for er/M agar , � Print Name Ni- 1 O The foregoing instrument was acknowledged before me this _ _ day of 20J , by 6 p /.l .c 0 E,,, a-,-c-4 k 0 kc �'d pt l as 2 � /i/42 (type of auth/<g. o trustee, attodney e ›.. in fact) for (name of party on behalf of whom ins..:. • w• xe . e. ■ 3 3 = ' - W 8 ' n Personally Known OR Produced Identification 4/ Notary Signa % / /I _ , Q $? as y OT Ai? J y a� rn ='a Type of Identification Produced /)r /^/GCS -a Name (print) ,G /ld 2 f 4 , -frcl l /.) o v w < < LIG4 1-az Verification pursuant to Section 92.525, Florida Statutes. Under penalties o erjury, I declare that I h e ead foregoing and that r, is the facts stated in it are true to the best of my knowledge and belief. Signat c of tor e j i r p---- s\ gning e FORAISINGC.rved2007