HomeMy WebLinkAbout11-11734 CITY OF ZEPHYRHILLS �
5335 - 8TH STREET
(sis)�so-oozo 11734
BUILDING PERMIT
Permit Number: 11734 Address: 7204 LANDOVER DR
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: ALPHA VILLAGE
Est. Value: Parcel Number: 35-25-21-0050-00000-0580
Improv. Cost: 9,195.00
Date Issued: 4/05/2011 Name: HASSEL, JOHN & ANN
Total Fees: 85.00 Address: 7204 LANDOVER DR
Amount Paid: 85.00 ZEPHYRHILLS, FL. 33540
Date Paid: 4/05/2011 Phone: (813)788-8152
Work Desc: REROOF SHINGLE
I L I E I L 5. 0
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TAPE JOINTS ROO� INSP
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 � 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 fnancing, consult with your lender or an attorney
before recording your notice of commencement."
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CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
04/05/2011 10:50 3523656458 MICHAEL C NORVELL PA PAGE 01
H. I. S. of L�es b u r I n c.
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1410 Emerson Street
L�esburg, FL 34748
Phone 352-728�3329
�ax 3S2-3G5-64S8
bate: . �}f S 1/ 1
To: Gi�� � o�' ��,�a�i yr�r �/�s r 15��r'�c�ina � a� �'i�i�r�7Z'`"
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From: „L�Q, ��,� �
Fax: �/3 �=`7 �o � va a. /
Pages: (inciuding cover sheet)
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04/05/2911 10:50 3523656458 MICHAEL C NORVELL PA PAGE 02
t�mited Power o� Atto�rney
Date � "�'!
I k�ereby name an.d ap�Qiunt Kevin McDaniel of Hott�;e Impxovetx�ent Services to be my lawfu�
attorney xn fact, to act �or me and apply to � ' for a
�`-'" ��' ` n Pernut for work to be pErfe�med at a location dESCxxbed as;
S�ction. Towz�shi
Block � �e.� Lot
Subdxvision
�ddress of Job '7 a C� y o �
Own�r/Address ah � c.�s �l o� o..,, ,.. .`
A»d sign rr�y name to aIl tllings z�ecessary to this a�pointrr�ent.
Jaseph E. Rayl, tractor ��COS$227
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S�gnatur, e
Acknowledged:
Sworn to anid subscribed before zne th,is �_ �y o f _ � • r , 201 ],
bY � G. � I w�,o is .�
� P��11Y known to �ne ox �
produced as identification.
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Notaty Public, State of Flori -'- —��
My Comrz�ission expires: y-ii� ��/
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• �` My canMN.io
�aep°' �Plie�tl4l11/20iA
04I05/2611 10:50 3523656458 MICHAE� C NORVELL PA PAGE 03
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Pasco County Parcel: 35-25-21-0050-00000-0580 001 Page 1 of 2
Data Current as Of Weekly Archive - Saturday, April 02, 2011
Parcel ID 35-25-21-0050-00000-0580 (Card: 001 of 001)
Classification 01 - Single Family
Mailing Address Property Value
HASSEL JOHN W& ANN M Ag Land $0
7204 LANDOVER DR Land $18,990
ZEPHYRHILLS FL 33540-1016 Building $63,536
Physical Address Eutra Features
7204 LANDOVER DR $1,339
ZEPHYRHILLS FL 33540-1016 Market Value �83,865
Assessed (Save Our Homes) $77,25g
Le9al Descriqtion (First 4 Lines) Homestead 196.031 -$25,000
Non-School Additional Homestead Exemption -$25 000
See Plat for this Subdivision .•.- '
ALPHA VILIAGE ESTS PHASE 1 PB Non-School Taxable Value �27,25g
19 PG 69 LOT 58 School District Taxable Value $52,258
OR 4045 PG 1409 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)
Line Use Description Zoning Units Type Price Condition Value
1 0100 SFR OOR2 7,600.00 SF $2.49 1.00 $18,924
2 0100 SFR OOR2 200.00 SF $0.33 1.00 $66
Addit' nd Information
Acres 0.18 Tax Area 3 ZH FEMA Code X Residential Code ALFALPI
Buildina Information - Use 01 - Single Family Residential (Card: 001 of 001)
Year Built 1982 Stories 1.0
Exterior Wall i Concrete Block Stucco Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall i Drywall Interior Wall 2 None
Flooring i Carpet Flooring 2 None
Fuel Electric Heat Forced Air - Ducted
A/C Central Baths 2.p
l.ine Description Sq. Feet Repl. Cost New
1 BAS 1,064 $62,404
Z F�P $0 $1,173
3 FGR 392 $9,208
4 FOA 48 $704
5 FSA 120 $2,463
6 FEA 144 $5,924
Extra Features (Card: 001 of 001)
Line Description Year Units Value
1 D W C 1982 350 $407
2 UDU-M 1987 1 $192
3 UDA 2006 1 $740
Sales History
Previous Owner DAVIDSON JAMES N& PATRICIA A
Year Month Book/Page Type Amount
1998 1 1 4045 / 1409 WD $77,900
1991 10 2062 / 1296 WD $62,000
— �
http://appraiser.pascogov.com/search/parcel.aspx?sec=35&twn=25&rn�=21 &sbb=0050&bl... 4/5/�(111
04/05/2011 10:36 3523656458 MICHAEL C NORVELL PA PAGE 01
H. I. S. of Leesbur Ir�c.
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STATE OF FI.ORIDA �
DEPARTMENT OF BUSTB�gg A1VD pRpFES3ZONAL R8dt7LATION
C�1�3TRVCTION T�ipVSTRY LTC�NS r�TG BOARD ($ 5 0) � g 7-13 9 5
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ACORb25(2007100} ' �`ACORDCORPpRA1'►ONt98g
s�saso-oo2o City of Zephyrhills Nermit Application Fax-lfl3-lSU-OU11
Building Departmen[
Date Received Phone Contact for Permittln —
Owners Name �'"�- V•.J - � SS� Owner Phone Number �( � � � ?l � �� ��
Owner's Address ��o I vV"� �J`� !E-> r Owner Phone Number
Fee Simple Titleholder Name � Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS L � 0�� O� �' (` Y� � � t 33s y a LOT # �
SUBDIVISION , PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e N TALLSTR �] REPA R T 0 SIGN Q Q DEMOLISH
u
PROPOSED USE SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK �.,`K(9V� Q� � �
BUILDING SIZE � 3Q FOOTAGE HEIGHT
QBUILDING $,� ) �� VALUATION OF TOTAL CONSTRUCTION
C
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING � . ��` _.
JI Y
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
QGAS Q ROOFING Q SPECIALN Q OTHER
����
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER y , n � � COMPANY �� � � � �
SIGNATURE /' ��W`-�/ REGISTERED Y/ N FEE CURRE� Y/ N
Address 7l� ��-� �' e� License # l� d��d � �
ELECTRICIAN � COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License # �
PLUMBER � COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N �
Address License # �
MECHANICAL �— COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address Ucense # � �
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License #
RESIDENTIAL Attach {2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-0-W Permit for new wnstruction,.
Minimum ten (10) working days after submittal date. Required onsite, ConstrucUon Plans, Stormwater Pians w/ Silt Fence installed,
Sanitary Facillties & 1 dumpster; Site Worlc Permit for subdlvisions/large arojects
COMMERCIAL Attach {3) complete sets of Bullding Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) wo►king days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facllities 8 1 dumpster. Site Work Permit for all new projects. Atl commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
""'PROPERTY SURVEY required for all NEW construcUon.
Directions:
Fill out application completely.
Owner 8 Confractor sign back of application, nota�lzed
If over s2500, a Notice of Commencement is required. (AIC upgrades over;7500)
*" Agent (for the contractor) or Power of Attomay (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (�ront of AppUcatlon Only)
Reroofs if shingles 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 compiiance�with ar�y
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, ff the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this appifcation 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 specffied 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 identi�ed at the time of
permitting. It is further understovd that Transpo�tation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"cert�cate 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 Co�nty 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 Agricultu�e and Consumer Affairs. If the appiicant 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 ail 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
ce�tify 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-Welis, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawatls, Docks, Navigable Waterways.
- Department of Health 8 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 fiil is not allowed in Flood Zone "V" unless expressiy 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 Fiorida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, 1 certify that fili will be used only to fill the area within the stem wail.
- If fill material is to be used in any area, I cerfify 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 unde� 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 electricai work,
plumbing, signs, welis, pools, air conditioning, gas, or other instaliations not specifically included in the application. A
permit issued shali 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 Officiai 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 ff 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 Officiai 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 TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE DING YOUR NOTIeE OF COMMENCEME
FLORIDA JURAT (F.S. 117.03) �
OWNER OR AGENT ' �"�!/ 6y'� CONTRACTOR �`� �
Subsc�ibe�d�a� bswom t r�afflrm_ ed) be�Or��� �,J Su sc��� and ti rr� tq (qr a�rmed, b� e me,th�s
Y „c 1 V h'1 � C� •�1/ �+f�
Who s/ar personally known to me or has/have produced Who is/are personal�y known to me or haslhave produced
�; � P/� as identlflcaBon. !�r C 4�`��- as identificatlon.
� � ` i „ ^� Notary Public
� ry Public
:' � r�er.,w;
CQUELI E B ES ' ;�� ''•, JAC LINE BOGES
mis ``,' � �n'M � t�.EEl4�.�2� ".--�---- ComrrVis`sion • •
c�res December 12, 2014 `� � Expires Dece►r►be�' 12, 2014
`�p��,• eonmann,noyr�
Name of Notary p, • T. Name of Notary e
� Home
1 m provement
Services of Leesburg, Inc.
1410 Emerson Street, Leesburg, FL 34748
Toll Free 888-728-8818 • 352-728-8818 • 352-728-3329 • Fax 352-365-6458
License # CCCO58227
SALES CONTRACT
HIS of Leesburg, Inc to furnish all materials and labor necessary to do the modernization work at the following address:
Name �if1,� �'1�'� /y 1�1 7�I � 5 5 f Phone �/����� g�SaPhone (w)
Address T � � n r,���i� � r Date
City �-� Ur �'1 1 ��S State ip �-� S 7�
In accord ce th specifications given below:
REROOF:
A. SHINGLE ROOF
1. REMOVE OLD ROOF TO WORKABLE SURFACE.
2. RENA�L ROOF DECK WITH RING SHANK NAILS.
3. REPLACE ANY ROTTED WOOD WITH STANDARD SHEATHING �$7.00 PER FOOT AND $90.00 PER SHEET OF PLYWOOD, IF ANY (Initial)
4. INSTALL IKO STORM GUARD SELF ADHESIVE MEM RA��R ENTIRE ROOF.
5. INSTALL FHANA EAVES DRIP COLOR w�� � _
6. INSTALL NEW VALLEY METAL AND FLASHINGS AS NECESSARY.
7 INSTAL� W BOOTS OVER VENT PIPES AND RESEAL VENTS
8. INSTALL� YEAR FIBERGLASS SHINGLES. COLOR 5 �L�'e r'
9. INSTALL FEET OF RIDGE VENT AT $6.00 PER F00T COLOR (,s ., .
10. CLEAN-UP JOB SITE OF ALL WORK DEBRIS AND HAUL AWAY ALL RELATED DEBRIS AND LEAVE JOB SITE CLEAN.
11 CONTRACTOR WILL COORDINATE REMOVAL AND REINSTALLATION OF ROOF RELATED PEflIPHERALS SUCH AS (BUT NOT LIMITED TO) SOLAR UNITS, SKYLIGHTS, N. DISN
AND AIR CONDITIONERS, ETC. REMOVE AND REINSTALL EXISTING SOFFIT AND FACIA �$4.25 PER F00T IN ADDITION TO CONTRACT PRICE, IF REQUIRED. THE COST FOR
SUCH WORK WILL BE IN AODITION TO CONTRACT PRICE AND HEREIN APPROVED BY HOMEOWNER.
B. LOW SLOPE ROOF SYSTEM
1 REMOVE OLD ROOF TO WORKABLE SURFACE ,
2. RENAIL ROOF DECK WITH RI SHANK N .
3. REPLACE ANY ROiTED WOOD TH ST ARD SNEATHING �$7.00 PER FOOT AND $90.00 PER SHEET OF PLYWOOD, IF ANY. (Initial)
4. INSTALL IKO STORM GUARD SEL ESIVE MEMBRANE OVER ENTIRE ROOF. �
5. INSTALL NEW LEAD BOOTS. qq
6. INSTALL FHANA EAVES DRIP, OLOR • COf1tt'8Ct PI'IC@ $______! _! �____
7. INSTALL 1 PlY ROOF SYST . COLOR .
8. CLEAN-UP JOB SITE OF ALL WORK DEBRIS AND HAUL AWAY ALL RELATED DEBRIS AND LEAVE JOB SITE CLEAN.
1 Contract Documents. This contract consists ot this document, extra work/wood authorizations, if any, and if paymenis
hereunder are to be financed, all financing documents. No promises other than thase specifically set forth m the contract , 200.00
documents shall be recognized by either party. The entire understanding and agreement of the parties is contained in the Permit $----------------
contract documents.
2. It is understood and agreed that this coniract shall not become binding upon HIS of Leesburg, Inc. until it is duly approved,
accepted, signed and witnessed by an officer or officers of the Seller. -(f(�
3. Work on the job described in th r ments wili commence on approximately �� and be Total $___I_l_ �v ��
completed on approximately ���. The recited dates are approximations and are subject to scheduling ---------
difficulties of Seller, labor and/or material shortages, acts of God and other events not foreseen by Selier. Seller reserves
the right to employ any sub-contractor for the compietion of the work described in the contract documents. / v �1(/
4. HIS of Leesburg, Inc. reserves the right to substitute materials of equal or greater value and kind. My required materials `�'� �`� ` �'� JO ^^ �
such as fire retardant plywood, tongue and groove board, etc. will be billed on a time and material basis. All other changes 1/3 Deposit $___� ___�
required by New Jurisdictional Code Enforcement Laws may result in additional charges. -
5. Interest at the rate of eighteen (18%) per cent per annum will be charged on all balances not paid as per the terms specfied
above. Reasonable attomey's fces will be charged to the Purchaser'rf ft is necessary to place this contract in the hands of an D!�
attorney for collection, and this charge becomes a part of the contract and obligation of the Purchaser to pay. __� / q� �
6. Parties agree that this agreement shall be construed according to the laws o( the State of Flaida and any action brought Subtotal • $_ < <
thereon may be brought in the State of Florida. Venue is hereby agreed to be in Lake County Florida. -- ---------
7. BUYERS RIGHT TO CANCEL (SOLICITED SALES ONLY) If you do not want the goods or services, you may cancel
this agreement by providing written rrotice to the seller in person, by telegram, a 6y mail. This notice must Indicate that you �^ /
do not want ihe goods or services and must be delroered or postmarked before midnight of the thirci business day after you ���
sign this agreement. BALANCE DUE $
8. Both worker's compensation and public liability insurance are carried by the Seller and they are applicable to the work to be (plus Total from Item No. 3 above)
performed. UPON COMPLETION
9. It is understood and agreed that the buyer hold harmless, HIS of Leesburg, Inc., for any damages that may occur to the
buyer's driveway(s) during delivery of materials and/or removal of the work related debris that may be required to perform
this home improvement contract. Furthermore, the buyer herein gives permission for typical delivery vehicles and typical
waste removal vehicles to enter said driveway(s) fa the purpose of expedfting this sales contract.
10. Contractor will coordi removal and reinstallation of roof relaied Peripherals such as (but not limited to) solar units, skylights,
T.V, dishes and a' onditioners, etc. The cost for such work wiil be in addition to contract price and approved by homeowner.
11 HIS of Leesb , Inc. shall not be held responsible for damage to electrical lines, water lines, refrigerant lines or other
mechanic components that have been improperly installed near roof decking and may be damaged while performing
installat' of roofing materials. HIS of Leesburg, Inc. shall not be responsible for any additional costs due to roof decking
that m have old materials adhered in such a way that requires redecking of structure.
12. Cons ction Industries Recovery Fund payment may be available from the CIRF H you lose money on a project performed
und contract, where the loss resuRs hom specified vidations of Florida law by a state-licensed contractoc For .
infor ation about the recovery tund and filing a claim, contact the Florida Construction Indusiry Licensing Board at the
foll ing telephone number and address: 7960 Arlington Expressway, Suite 300, Jacksonville, FL 32211-7467 or call (904)
72 -6530.
13. Chapter 558, Florida Statutes contains important requirements you must follow before you may bring any legal
action for an alieged construction defect in your home. Sixty days before you bring any legal action, you must
deliver to the other party to ihis contract a written notice refercing to chapter 558 of any alleged consLvction defects
and to consider making an offer to repair or pay for the alleged construction defects. You are not obligated to accept
any offer which may be made. There are strict deadlines under this Florida Law which must be met and followed to
protect your interests.
�ecuted in triplicate, one copy of whi h was delivered to, and receipt is hereby acknowledged by Buyer, this
day of �ri I , 20�.
Approved and Accepted:
NOTICE TO OWNER
a. Do not sign this home improvement contract in btank.
b. You are entitled to a copy of the contract at the time you sign. Kee it t rotect yo r right .
(Seal) (X) (Sealj
(Dealer-Seller) (Purchaser Si n Here)
BY ( (Seal)
(Title) (Purchaser Sign Here)
�1 f /'� j�'1ci V�t7�O17
C A 1 CCM A A1 rno� ooeca ���r oan_vnv_ea�n
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2031050860
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!'eroili No. . "1'sx P'olio No.gK 25-21-o050-OAx0-oSYO
�Sec'l'wp Rt�g
PqULfi 5 0'NEIL,Ph D PRSCO CLERK i COMPTROLIEF
s'1'n'I'f3or rlori�U 04/0S/ii 10:1 a i of 1
CqUN'fYOF — 0.5G0 OR BK 85� PG 26�
'I'l ll; UNUCRSICiNl7.l) Iwrchy infoi n�s all cnncerned Ihnl iuipro�nwenls will I�e �neJe lo cetlabi renl properly, ond (b necorJxnce wf4b
seclinn 713 13 oFlhe Plorida Slalules, lha fi�llowing julbrmoliou is slaled in lhis NO'I'ICG O�CUMMENI:EMGN'I'.
I L)escrlptlun nf p ope r4y Qegel desoriplion afpro �erly and sireel address if avnilable):
_ 72o y Lan �oVBh DY` Zep`1yN �/S
ALPNR l�1LCl�ri� EST , P PG 69 LOJ58 OR P�_lyo9 __
2 �Ueneral llescriplion of improvemeuL �
Reroof
3 Uwllel• fnl'ol'nlui on , •
a. Ni�meaudAdJress, s ��n �r Ann 4.558 i 7�0�1 Lan c�aver�h Zeph,�_rb�Jls, FL 33540
b. 1'hnne N�.unber Inieresl in pru��erly „�.�nNrs _
c. Nnnte HuJ nJdress oF fee simple tiileholder (if olher thau owncr) . _
� Coiilrnct��l': — ^
n. Nniva and AJc6ess I fum luipi'oveme Se�vices IA ID Eiuerson 56ee1 Leesbu�'g, FL 94746
b, f'honc Nulnber 352-726-3329 —
c. I'ex nwnber (c�pliannl, IFservlFe by fox is ficce�itnble) 952-3G5-(458
5 Surely
n. Nnme nml AJJiess ---
b, Ainuunl uf bonJ U
c. Phune Niuuber
d, 1 miuil�er (opkloiial IPSef��ce Ily PnX IS Accepirllie _ —
G I..ender
n, Nnme nnd AJdress — --
b. 1'hane NGUnbet —
c. Fnx uuu�hr.�� (nplloual, lf service by fFlx is nccepinlde) ._
'j {'crsuns wllhln Ihe Slale of I'lorida designaled by Owuer upon whciio nolices u� i�lher docuinenls mny ha served es pI oviJed 'In
seclic>n 713.IJ(I)(a)7, I'loridu Stolules
n. Nnm� nnd Address �_ _ , ----
b. E'lione Nutnl>cr _ _ ; — : —
o. Pnx nuhil�er (opl1�ntnl, IFservice hy fnx Is nrcepinble) -
R In nd�Jille�n Ic� Idn�self, Owner desigmiles lhe followiug pers<m(s) lo recelve a enpy uf the l..ieuur's Nulice as provlded ln Se�liun
713, I J( I)(I�), I�luride 5lnlules
a. Nume pnd Ad��ress ------
6. 1'Iroue Ntuuber ` -- --
c. f�nx wunher (u��liunnl, IPservlce hy fnx Is qcceple6le) — --- ------ �� . .--- - - ---.._.
q E�x�>h �llai d:de of nnllce of cununencemeul (Ihe expiralicm dNe is I year Gum 16e dale of recurding u�iless a di ffereid dida is �
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CUMMIi :INU WOItK OR R' RD1Nc7 YUUR NU'1"ICC <)I' COMM�NC[:MFiN1'
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uo ure nf Owner or Owne 's /�idho�'iznd Ofiice�'/4�I�'ector/I'nUner/ M�u�ger Sigunluty's'1'ille/U(Ilce
'I'I�e furaguing brsh'u�ncrll was ack�towledged beRire mc lhis _,^ dny of , 2U ^, l ie of null�ol'il ,. a. . officer, U'uslea,
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Was execllled).
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NOTARY PUBLIC
STATE OF FLORIDA
, Camm# DD967497 ,
EzW►os 9J95�2014 '
51gi��(uie el y Publlc — Slaie of Clotide ��� :
���.__.5� 3�__Y.Z _ -o
I'el:snnalylCl�uwli_---_-orl'nxluceJlUeuli�cntiun __ �' --.
verificelion p�lrsunnl ln Secliun 95.525, Ploridn Slnlucs. UnJer penallies of peijiu'Y, I declnre thnt i have renJ tlie fin•egoiug nnd Ilml
lha li�cla slnle4 lu II pi'e lrue lu Iha best of my kiiqwleJge rtnd befief.
� '
�_ ,_ --
nuhira nf Naturet Pei�son Slgi {ng Abova
�'GA1'E 4F FLORIDA, COUNTY OF PASCO
TH�•IS TG CERTiFY THAT i HE FOREGOING IS A
'� TRUE AND CORRECT COPY OF THE DOCUMENT
ON.FILE OR OF PUBLIC REC RD IN THIS OFFICE
WITNESS MY HAND AND 0 ICIAL SEAL THIS
. . �_ DAY OF � 2 Q//
PAULA . O'NEIL, CLE C TROLLER
g�r EPUTY CLERK