HomeMy WebLinkAbout11-11383 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 11383
BUILDING PERMIT
Permit Number: 11383 Address: 6134 16TH ST
Permit Type: RE -ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: PARK HILL
Est. Value: Parcel Number: 02- 26 -21- 0180 - 00000 -0750
Improv. Cost: 8,900.00
Date Issued: 1/07/2011 Name: DUNGELMAN, FRANK SR
Total Fees: 80.00 Address: 6134 16TH ST
Amount Paid: 80.00 ZEPHYRHILLS, FL. 33542
Date Paid: 1/07/2011 Phone: (813)788 -4375
Work Desc: REROOF SHINGLE
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TAPE JOINTS ROOF INSP
FINAL 1-- 1 Lt--1
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
befor -/ ecording your notice of commencement."
CONT' - ORS N 'URE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
Pasco County Parcel: 02- 26 -21- 0180 - 00000 -0750 001 Page 1 of 1
I Data Current as Of: Weekly Archive - Saturday, January 01, 2011
I Parcel ID U 02- 26 -21- 0180 - 00000 -0750 (Card: 001 of 001)
I Classification 11 01 - Single Family I
Mailing Address Property Value
DUNGELMAN FRANK J SR Ag Land $
6134 16TH ST Land $17,710
ZEPHYRHILLS FL 33542 -2654 Building $62,875
Physical Address Extra Features $9
6134 16TH ST
ZEPHYRHILLS FL 33542 -2654 Market Value $81,554
Assessed (Save Our Homes) $81,554
Legal Description (First 4 Lines) Homestead 196.031 $25,000
Non - School Additional Homestead Exemption - $25,000
See Plat for this Subdivision 1"
PARK HILL SUB UNIT 1 PB 14 PG Non - School Taxable Value $31,054
70 LOT 75 School District Taxable Value $56,054
OR 6212 PG 1986 Warning: A significant taxable value increase may occur when sold.
Click here for details and info. regarding the posting of exemptions.
Land Detail (Card: 001 of 001) I
Line II Use IlDescriptionll Zoning II Units II Type II Price 0 Condition II Value
1 II 0100 II SFR 11 00R2 11 7,700.00 11 SF 11 $2.30 11 1.00 11 $17,710
Additional Land Information
Acres 11 0.18 II Tax Area Il 30ZH II FEMA Code II X llResidential Codell PAHILP1
Building Information - Use 01 - Single Family Residential (Card: 001 of 001)
Year Built 1978 Stories 1.0
Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 Carpet Flooring 2 None
Fuel Electric Heat Forced Air - Ducted
A/C Central Baths 2.0
Line II Description 11 Sq. Feet II Repl. Cost New
1 II BAS 1 1 1,993 II $74,498
2 II FOP I l 174 1 $1,645
3 11 FGR II 348 1 $5,196
Extra Features (Card: 001 of 001)
Line II Description II Year II Units 11 Value
1 I DWSWC 1 1978 II 444 II $450 $212
2 II CLFENCE 1989 II
3 11 CON PTO 11 1993 1 I 195 $307
Sales History
Previous Owner 1 FARRELL MAY E
Year I Month I Book /Page I Type II Amount
2005 I 01 11 6212 / 1986 1 WD 11 $0
1989 09 11 1841 / 0544 11 W 11 557,000
1978
II 10 11 0968 / 1539 1 1 $36,000
http: // appraiser. pascogov. com / search /parcel.aspx ?sec= 02 &twn= 26 &rng =21 &sbb= 0180 &bl... 1/7/2011
813- 780 -0020 City of Zephyrhills Permit Application FaX 813-780-0021
Building Department �'
f►3
Date Received'
Phone Contact for Permittln
Owner's Name Fra V S btAY-r31 I y►-)t 1 n >l Owner Phone Number TS 3 4 . 75
Owner's Address W l JH 1 (o —� S Qom .- Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS Sc■ O LOT #
SUBDIVISION PARCEL ID# oc.0 CU SO cCCM — 01
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR n ADD /ALT 1 1 SIGN 1 1 1 1 DEMOLISH
INSTALL I I REPAIR R , Q
PROPOSED USE 120 SFR I COMM 1 1 OTHER 1
TYPE OF CONSTRUCTION I -1 BLOCK El FRAME I 1 STEEL n I
DESCRIPTION OF WORK O' ' re --( C)C1 U.l si') "1 f f Q--S
BUILDING SIZE SQ FOOTAGE c( 515 HEIGHT
1 (BUILDING $ c3 CA 00 • CY VALUATION OF TOTAL CONSTRUCTION
v
1 'ELECTRICAL $ AMP SERVICE 1 PROGRESS ENERGY ni W.R.E.C.
1 (PLUMBING $
1 $ VALUATION OF MECHANICAL INSTALLATION
nGAS ROOFING El SPECIALTY 1 1 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IVES NO
BUILDER COMPANY
SIGNATURE REGISTERED 1 Y/ N 1 FEE CURREN 1 Y/ N 1
Address License # I
ELECTRICIAN COMPANY
SIGNATURE REGISTERED 1 Y/ N 1 FEE CURREN 1 Y/ N 1
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED 1 Y/ N 1 FEE CURREN 1 Y/ N 1
Address I License # 1
MECHANICAL COMPANY
SIGNATURE REGISTERED 1 Y/ N I FEE CURREN 1 Y/ N 1
Address I License #
()THEN � COMPANY Rl n R Cx9c` V �-
SIGNATU - , `�„� A ,r- REGISTERED E `Y / N FEE CURREN / N 1
r !
Address j�c.* ��j rj -1 2 h ►-L1 t IIS 1 License # 1 C
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 wl 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 $7500)
** 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 if shingles Sewers Service Upgrades A/C Fences (Plot/Survey /Footage)
Driveways -Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division — Licensing Section at 727 -847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT /UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89 -07 and
90 -07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water /Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law — Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner ", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to commencement.
CONTRACTOR'S /OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection - Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers - Seawalls, Docks, Navigable Waterways.
Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency- Asbestos abatement.
Federal Aviation Authority- Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone "V" unless expressly permitted.
- If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TW E j• R IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WIT _ YOUR E T� ER OR AN ATTO - EY BEFORE RECORDIN 0 - NOTICE OF COM NCEMENT.
FLO ` _ . 117.03) /
,' / � CON
• •� z Y1I '��I � � �
Subscribed a `lrr.m to (or affi -d b- ore M' S u b s c r i b ' n r ' d sworn to (or a; ul d) before �� :
by by
Who is /are personally known to me or has/have produced Who is /are personally known to me or has/have produced
as identification. as identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped
•
4.. 0" ASPHALT SHINGLES 2007 FBC PRODUCT APPROVALS
MANUFACTURER PRODUCT TESTS PASSED MIAMI -DADE FL #
LESS THAN 110 MPH 110 MPH ANO HIGHER
ASTM ASTM TAS ASTM ASTM TAS
01161 0"7158 107 0 3181 0 7158 107
CLASS 0 CLASS G CLASS•F CLASS G
CERTAINTEED CLASSIC HORIZEN_ X • • 5444.1
CARRIAGE HOUSE X 5444.1
CENTENNIAL SLATE X 5444.1
GRANO MANOR X 5444.1
LANDMARK X 5444.1
LANDMARK PLUS X 5444.1
LANDMARK PREMIUM X 5444.1
LANDMARK TL X 5444.1
PRESIDENTIAL SHAKE X 5444.1
• PRESIDENTIAL SHAKE TL X 5444.1
-HATTERAS _ X 5444.1
PATRIOT X 5444.1
GAF -ELK ROYAL SOVEREIGN X • - 10124.1
CAMELOT ' X 10124.1 • CAPSTONE X 10124.1 •
COUNTRY MANSION • X 10124.1
• GRANO CANYON X 10124.1
GRANO SEQUOIA X 10124.1
GRAND SLATE X 10124.1
GRAND TIMBERLINE X 10124.1
. TIMBERUNE ARMORSHIELD II • X 10124.1
TIMBERUNE PRESTIQUE GRANDE X 10124.1
TIMBERLINE PRESTIQUE 30 _ X . 10124.1
TIMBERUNE 30 X 10124.1
TIMBERUNE PRESTIQUE 40 X 10124.1
TIMBERLINE 40 X 10124.1
TIMBERLINE LIFETIME " X 10124.1
TIMBERUNE ULTRA X • 10124.1
SLATELINE X 10124.1
OWENS CORNING OAKRIDGE PRO 30 X 10874.1
OAKRIDGE PRO 30 AR X 10874.1
OAKRIOQE PRO 40 X 10874.1 .
OAKRIDGE PRO 40 AR • X 10674.1
O. KRIDE PRO 50 X 10674.1
OAKRIDGE PRO 50 AR X 10674.1
DURATION X 10674.1 .
DURATION PREMIUM X 10674.1
CLASSIC X 10874.1
CLASSIC AR X 10674.1
SUPREME X 10674.1
SUPREME AR X 10874.1
PROMINENCE " X 10674.1
PROMINENCE AR X 10674.1
BERKSHIRE X 10674.1
WEATHER GUARO HP X 10874.1
r •
TAMKO GLASS SEAL AR X 1958.2
EUTE GLASS SEAL AR X 1956.1
HERITAGE 30 X 1956.3
HERITAGE XL - X _ 1956.5
HERITAGE 50 X 1956.4
•
HERITAGE VINTAGE AR X 7154.1
•
M1
� VISA
/-*--.' fr X' ;E:'• . flige.
:i
40,411,_.„....7.:._ A Division of Ryman Construction, Inc. Proposal # 0461
INC. 36413 SR 54 • Zephyrhills, Florida 33541 Estimate # c> ".
Phone: 813 - 782 -6094 • Fax: 813 - 788 -6773
License # CCC 1325505 Job # t 1 el 03
1 -800- iOO -AOQF Also, Serving the Central and East Coast of Florida
(7663)
Customer: C c k i �..•, \n, c,:- Date: 1 / iri / 61 t
Address: 6, 1 L 164N-, 5 v, City: ti / r ■ t' 1 IS Zip: 335 ),
Home #:.9) ') _ - 7:! , )'-- LI 3 ). c Cell #: Business #:
E -mail Address:
1J/Complete tear off of existing .5 ; .., cj it;z_ j Additional Items: `-, c.\ 'Adz j , ' 40 (3 )
ecure all loose roof decking as needed according _S1,. :'k-� c 1 l jl-t -C ` 1 , \T (N)
t Florida Building Codes !
oof dried in with 1,.., ■ 4 ,'e A{ 'r _ 5 . A, 1a iO
rfnstall new valley metal with galvanized metal
&install all new 6 " drip edge color: (,�)., ,' I-
&install all new lead boots
il'install all new 30 year fungus - resistant shingles
hingle brand/color: 6,4 /.7-_-_. l k i .-. L. ...5 / -- G,,.., i,, Warranty Package.
UYAl1 roof related debris removed from job site c r 00
ll materials, labor and permits furnished Total bid price $ -g, jG L
rA
Extra'
ad plywood replaced at a cost of $ , 3. per sq. ft. m the roof field. All other wood work/additional labor, such as, but not
limited to, valley rebuilding, rafter replacement, etc. will be a rate of $ _S-s. pc) per man hour plus the cost of materials.
THIS BECOMES A BINDING CONTRACT UPON ACCEPTANCE OF PROPOSAL. PURCHASER ACKNOWLEDGES RECEIPT OF A COPY OF THIS CONTRACT.
1. All material is guaranteed to be as specified and completed in a substantial workmanlike manner.
2. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, hurricane and other necessary insurance upon above work.
3. Labor warranty does not cover damage to roofs caused by lightning, hurricane, tornado, hailstorm, impact of foreign objects or other violent storm or casualty damage to roofs due to
settlement, distortion failure or cracking of roof deck, walls or foundation of a building.
4. Workman's compensation and public liability insurance on above work to be taken out by RYMAN ROOFING, INC., a Division of Ryman Construction, Inc., or it's subcontractors.
5. RYMAN ROOFING, INC., a Division of Hyman Construction, Inc. is not responsible to provide any materials or to perform any work other than what is described above. Replacement
of deteriorated decking or fascia boards, is not included and will be charged as an extra unless otherwise stated herein.
6. This contract is subject to final approval by RYMAN ROOFING, INC., a Division of Ryman Construction, Inc. and is the entire agreement of the parties and no other written or other
forms will recognized.
7. A charge of 1.5% will be.made on all unpaid balances after 30 days, plus charges incurred for non - payment procedures, plus attorney's fees.
8. A 4% processing fee will be added to all credit card orders.
Ryrnan Roofing, Inc., a Division of Rynran Construction, Inc. will not be responsible for any damage to septic tanks, sod, shrubbery, paint, satellite signal loss, sprinklers,
concrete drives or any underground piping. �
Payment Schedule: XS 4 /(90- 3 U PCO U t -‘ I. /-, 4;) I 1 Payment Method: C— LAr.. \k- 7J
Acceptance of Proposal
STATUTORY • • 1 0 lk _ ■ 1 ■ ■ . • ACCORDING TO FLORIDA'S
CONSTRUCTION LIEN LAW (SECTIONS 713.001 - 71337, FLORIDA STATUTES), THOSE WHO WORK
ON YOUR PROPERTY OR PROVIDE MATERIALS AND SERVICES AND ARE NOT PAID IN FULL
HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. THIS
CLAIM IS KNOWN AS A CONSTRUCTION LIEN. IF YOUR CONTRACTOR OR A SUBCONTRACTOR
FAILS TO PAY SUBCONTRACTORS, SUB - SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THOSE
PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU
HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR,
YOUR CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS
FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS,
OR OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO
PAY. TO PROTECT YOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY
PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN
RELEASE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A "NOTICE
TO OWNER ". FLORIDA'S CONSTRUCTION LIEN LAW IS COMPLEX AND IT IS RECOMMENDED
THAT YOU CONSULT AN ATTORNEY.
I ACCEPT THIS PROP•'AL 1H I BY CERT THAT I HAVE READ AND FULLY UNDERSTAND THE PROVISIONS OF THIS CONTRACT.
Purchaser: p , '` G1 � ' . �'r Date: 'Ile • C r! -.11111110W- /
Purchaser: Estimator.
11111111111111111111111111111111111110111111111111111111111
2011003254
•
Rcpt:1344546 Ree: 10.00
DS: 0.00 IT: 0.00
01/07/11 A. Giard, Dpty Clerk
PAULA S.0'NEIL,Ph.D.PASCO CLERK & COMPTROLLER
01/07/11 11:23am 1 of 1
OR BK 8499 PG 3745
NOTICE OF COMIVIENCEMENT
Permit No.
Properly Identification No. 2 I -- OL_ OCCOO — 01
THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real ro e rty, and in accordance with
Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
p p
t 1\ b I 1 NCI MENT.
1.Dessc p t ti o n ofp (l escrt t ` j P � fit-( P6"
a) Street Address: 3 t� G S. � � S �a a P G- IQ ��
2.General scription f it provements: t (� Ft-- 3 �_�
3.Owne Inforrnation
a) Name and address: Fro, _
•• ,. - . i3y 1bah SF Z ' fit0S 3 a ■
b) Name and address of fee simple titlehold- "if other than owner)
c) Interest in property
ii. k .
actor Information
a) Name and address: R C)Ol-
b) Telephone No.: kJ, S Ft_ ��� 1 ma, 5.Surety Information • "'� • v! Fax No. (Opt.)
a) Name and address;
b) Amount of Bond:
c) Telephone No.:
6.Lender Fax No. (Opt.)
a) Name and address:
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other
a) Name and address: documents may be served:
b) Telephone No.:
B..In addition to himself, owner designates the following person to receive a copy of the Lieuor'
713.13(1)(b), Florida Statutes: s Notice as provided in Section
a) Naine and address:
b) Telephone No.: ------- __.._.
9.Expitation date of Notice of Commencement (the expiration date is one year ax from the date ) of recording unless a different
specified):
date is
WARNING TO OWNER: ANY PAYMENTS MADE BY TIIE
COMME COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS OWNER AFTER THE EXPIRATION OF THE
STATUTES N UNDER CHAPTER SECTION OF
AND CAN RESULT IN YOUR PAYING TWICE FOR ME PART I, SOURION 71
A NOTICE OF CONIIVII;+ COMMENCEMENT MUST BE RECORDED POSTED FOR IMPROVEMENTS TO YOUR TROPE
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CO YO
I NSULT ON THE JOB SITE , R`1 Y
BEFORE ORE THE BEFORE
OIi COMME LENDER OR AN ATTORNEY B BEFORE
2OIM MENCING WORD OR RECORDING YOUR NO
NCEMENT.
;TATE OF FLORIDA
OIJNTY OF PASCO / r'
y Notary Public State of Florida Christian Ryman S n Si t re . `
Owner a Owner's . th
: iz de Officer /Director /Partner /Manager
44 , ft r E pC 01,72szDD751610 4 4 �/ ft Y e LLL Ai
Print ilanie
rhe foregoing instrument was acknowledged before me this
day o 2011__, by r r r2�„ z
as
n fact) for o
(name of party on behalf of (type of authority, e.:. officer, trustee, attorney
� � whom ins g - , as executed .
'ersonally Known _ 6C��It Produced Identification ��
Notary Signahu t'
'ype of Identification Produced
Name (print) C` _, S \-6
v
1
'erification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the fo regoing and that
to facts stated in it are true to the best of my knowledge and belief
iRMS /NOC,rvsd2o07 -d i �,- � ��� �
Sigua ure of Natu a ' erson Signtn: • bove
•
• .
STATE OF FLORIDA, COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COPY OF THE DOCUMENT
ON WIT Y
FILE OR
M HAND AN OFFICIAL SEA I L THIS
DAY OF Ate" 2L_
PAULA' O'NEIL, CL.4 0 PTR
BY
P . RK