HomeMy WebLinkAbout10-10094 CITY OF ZEPHYRHILLS
, 5335-8TH STREET
' �sis��so-oozo 10094
BUILDING PERMIT
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Permit Number: 10094 Address: 5632 GALL BLVD
Permit Type: COMMERCIAL ZEPHYRHILLS, FL.
Class of Work: ADD/ALT COMMERCIAL Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-05700-0254
Improv. Cost: 60,000.00 �"m���x" ���°' r� " x
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Date Issued: 2/10/2010 ry Name:� BANK OF AMERICA
Total Fees: 470.00 Address: 6700 LAKEVIEW CTR DR
Amount Paid: 470.00 TAMPA, FL 33619
Date Paid: 2/10/2010 Phone:
Work Desc: INTERIOR RENVONATION /ADA MODIFICATIONS TO PARKING LOT
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AL D L IN I N 75.00 L RI AL 35.00�
COMMERCIAL MAINTENANCE SYS. PLUMBING FEE 35.00 FIRE PLAN REVIEW FEES 25.00
JERRY O GRIGG PLUMBING INC
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ER 2 U LUM MI I LA N EILIN
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 wiil 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 fl 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
before recording your notice of commencement."
ONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
� , ' Budding Department
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Date Received �� � (,� Phone Contact for Permittin �22 - ��'13 j 6 �D �
Owner's Nama f}�A/K �` �(( Owner Phone Number
�
Owner's Address Q� � � � T L �ner Phone Number
Fee Simple Tideholder Name Owner Phone Number
Fee Simple Tideholder Address
JOBADDRESS �(0�2 �wD Z Fi �3Sy2 LOT# �
SUBDIVISION PARCELID# I��ZG�N �00�0- 570� - '2,
,�.�/ (OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEW CONSTR I �I ADD/ALT � SIGN Q MOVE Q DEMOLISH
INSTALL LJ REPAIR
PROPOSED USE Q SFR �� COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q OTHER
DESCRIPTION OF WORK / Q�l/
BUILDINGSI2E SQFOOTAGE J`f`Z � HEIGHT I
BUILDING $ G/ / /��� VALUATION OF TOTAL CONSTRUCTION
"( (/
�� ELECTRICAL $ �OoO AMP SERVICE Q PROGRESS ENERGY Q W.R.E.0
dPLUMBING $ `��O� �_� J _w „// /V�
/ � ��(%L l[
Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �
Q GAS � ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES �NO
BUILDER r � � e COMPANY In
SIGNATURE �•� REGISTERED N FEE CURRENT N
Address ('J J� (�1fT�� �I�� • License# ���, //
J ��� � �
ELECTRICIAN �/ S' COMPANY7 L1'hr+���,4� lhr;��.+��c� r ��GjY
SIGNATURE ��✓ � REGISTERED Y/ N FEE CURRENT Y/N --
Addresa �,� L.i�S /'► 't. T K�"� !-! � License# � C.. V��! / �b •�'
PLUMBER �COMPANY �� 0 P um CI � ���� ��
SIGNATURE � REGISTERED Y/ FEE ENT Y/ �..�i°
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Addre �{ � �3 License# ���. e�(,s
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
Address License#
OTHER COMPANY �
SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
Address License#
RESIDENTIAL Attach(2)Plot Plans,(2)sets of Budding Plans;(1)set of Energy Forms;R-0-W Permit for new construction,
Mirnmum ten(10)working days after submittal date Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster;Site Work Pertnit for subdiwsions/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 construdion.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster Site Work Pertnit for all new pro�ects All commeraal reqwrements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans
""PROPERTY SURVEY reqwred for all NEW construct�on
Direcdons:
Fdl out application completely
Owner&Contractor sign back of application,notarized
If over f2500,a NoHce of Commencement is required. (A/C upgrades over 55000)
" Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authonzing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades A/C Fences(PIOUSurvey/Footage)
DrivewaysNot over Counter if on public roadways.needs ROW
' NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"resfictions"
which may be more resUictive than CouMy regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBIL171ES: if the owner has hired a corttrador or
contractors to undertake wo�ic,they may be required to be licensed in accordance with state and local regulations. if the
contractor is not ticensed as required by law, bath the owner and contractor may be cited for a misdemeanor viWation
under state law If the owner or intended conVador are uncertain as to what licensing requirements may apply for the
intended work,they are advised to contact the Pasco County Building Inspedion Division—Licensing Secxion at 727-847-
8009 Furthertnore, if the owner has hired a t�ttractor or cor�tracxors, he is advised to have tfie contractor(s) sign
portions of the"corrtractor Block"ot this applicatfon fw which they will be responsible. If you,as the owner sign as the
co�tractor,that may be an indicatfo�that he is not properly licensed and is not entitled to pertnitting privileges in Pasco
County
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEE8: The undersigned urtderstands
that TransportaUon lmpact Fees and Recaurse Recavery Fees may apply to the construc�fon of n�.w buitdings,change of
use in existing buifdings,or expansion of existing buildirx,�s,as speafied 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 icferrtified at the time of
permitting. It is further urrcisrstood that Transpatation Impad Fees and Resource Recovery Fees must be paid prror to
reoeiving a"oertificate of ocxupancy"or final power releaae. Ii the projad does not involve a certificate of occupancy or
final power release,the fees must be paid prior to pertrdt issuan�. Furthertnore, 'rf Pasco Cowdy Water/��ieNre�Impact
fees are due,they must be paid prior to pertrrit issuance in accordance with appqqble Pasco Couaty ortiinances.
CON3TRUCTION LIEN LAW(Chapter 713,Florfda Statut�s,as amended): H waluation of work is$2,500.00 or more,I
certity.that I, the applicaM, have been provided with a copy of the "Florida Construction Lien Law—HOmeovmefs
Protection Guide"prepared by the Flwida Department of Agrlcutture and Consumer Aftairs. H the appticant is someone
other than the"omier",1 certily that 1 have obtained a copy of the above described document arxi promise in good faith to
deliver ft to the"owner"prior to carrnencement.
CONTRACTOR'3/OWNER'S AFFlOAVIT I ceAify that all the ir�formation in Uris application is aocxxate and that atl worlc
will be done in compliance wiTh a0 appliCffiNe Faws regulating construc�ion,zoning arxf land developmeM. Application is
herehy made to obtain a pemat to do wro�lc and insteBation as indicated. I certify that no vyork or i�taNation has
commenced prior to issuance of a pertnit and fhat all work will be perfomied to meet standartis of all laws regulating
construction, County and City codes, zoning regulatians, and land developrt�ent regulations in the jurisdidion. I also
certify Mat I understarx!that the regulations of othe�govemmerrt agencies may apply to the iMended work,ar�i that ft is
my responsibility to identify vvl�t adions f must take to be in compliarxe. Such agencies inGude but are not limited to:
- Departrnent of Erniroror�ental ProtecFion-Cypress Bayheads, Wetland Areas and Environmentatly Sen.sitive
Landa,WaterMtastewater Treatrt�ent.
- SoutFm�est Florida Water Managernent Distrid-Wells, Cypress Bayheads, W�etland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of HeaKh & Rehabilitative Services/ErnrirorxneMal Health Unit-Wetls, Wastewater Treatmerrt,
Septic Tanks.
- US Environrt�enfel Prutection Ap�,y-RSbestos abatemern.
- Federat Aviation Authorily-Runways.
I understand that the following restrictions apply to tFie use of fill:
- Use of fill is not atlwved in Flood Zone"V"unless expressy pertnitted.
- If the fill materiel is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"oompensatlng volume'wiN be submitted at time of permittirg which is prepared by a professional engineer
licensed by the State of Fbrida.
- If the flll material is to be used 'm Flood Zone"A"in connedion with a permitted buflding usirg stem wall
construdion,I certKy that fi11 witl be u4ed�y to ftll the area withhin the stem wa1l.
- lf fill material is to be used in arry area, 1 oeAify that use of such fill will not adversely affect adjac�ent
ProPe�. ff use of fill is found to adversely afFeG adlacertt Properifes.the owner may be ated tor violatfny
fhe conditi�ons of the 6udding pertrrt issued�the atfaMed pertnit appHcation,for lots iess than one(1)
acre which are elevated by flb,an engir�eered drainage plan is required.
If I am the AGENT FOR THE dYYIlER,I pmmise in good faith to infarm the oMrt�er of the pe�mitting ca�dKior�set forth in
this atftdavit prior to commenchg oorMtn�etion. t underatand that a separate p�errrdt may be required for eleczrical worfc,
plumbing, signs,wells, pools,air conditionir►g,gas, or MAer inatallationa not specifically induded in the applicati�. A
permft issued shall be constn�eci to be a Ih�me to prooeed with the work and not as authority to vldate,canoel,alter,a
set aside any provisions of the tectnik�i codes.rror shaw issu8nce of a pertttit prevent the Buikiing Official from�r
�a�s a cortection of ertexs in pans,oo�truction or vlaaaions or eny oodes. Everr perrt�it isaued sn��become irnralid
unlesa the wotk eutho�d by a�ct►pemlit ia carrxner�ced wHhin six morrths of pertt�it issuanoe,�if work autt�oraed by
the pertnit is suspended or ebandoned far a period of six(6)rttonfhs after the Ume the work is Commenced. An exten.aim
may be requested,in writirg,fian the BuiMing Offidal fa a period not to e�cc�eed rrinetY(90)days and wiN dertronshate
justiNable cause for the extension. N work ceases fa�r�nety(90)cor�secutive days,the job is cans+dered abandoned.
WARNlNl3 TO OYYNER: YOUR FAIWRE TO RECORD A NOTICE OF COMMENCEMENT.�AAY REBULT IN YOUR
PAYING 71MICE FOR NMPROVBALNTS TO YOtlR PROPERTY. IF YOU INTEND TO OBTAIN flNANCINCi,CONSUIT
Y AM RE N Y O��
FLORtDA JtlHAT(F.
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�•o.tief� Expfrea 10/29/2013 '�����OF�OR�OP �����
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� City of Zephyrhills
� BUII.DING PLAN REV�W COMIVVIENTS
�ontractor omeowner: ( % �7 '� ^��"
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Date Received: ��� ~��
S
ite: ���02 �� C�.�i�E' -
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Permit Type:
Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑
�
This comment sheet shall be kept with the permit and/or plans.
��!� � a_��� ,
Bil�Burgess—Buildi.ng Official Date Contractor andlar Homeowner
(Required when comments are present)
PV008: PUBLIC VIEW CONTRACTOR INTERNET INQUIRY Page 1 of 1
,` �,..�4\
�-_�,� � Hernando County, Florida
�'�`� Public Inquiry System
CONTRACTOR INQUIRY TODAY'S DATE 01/21/2010
LICENSE# CFC0567560 PLUMBING CONTRACTOR-MASTER STATUS ACTIVE
CONTRACTORINFORMATION
NAME GRIGG JERRY O REG.# CFC0567560
SEARCH PA
SEND FEEC
BUSINESS INFORMATION FIND CONTR
NAME JERRY O GRIGG PLUMBING INC LOG OI
COUNTY 40 HERNANDO SUBMI
ADDRESS1 8588 OSTROM WAY REPOR
LIC GRANDFATHERED IN N
CITY BROOKSVILLE FL 34613
PHONE (352)596-3672 FAX NUMBER (000)000-0000
LICENSE INFORMATION
LIC EXPIRATION DATE N/A
BOND EXPIRATION DATE LIC APPROVAL DATE 03/07/94
STATE REG.EXP.DATE 08l31/10 LIC ISSUE/REGISTERED 03/10194
LIABILITY EXP.DATE 09/21/10 W/C EXEMIEXP DATE 06/11111
WORKERS COMP EXP.DATE N/A
APPLICATIONS/PERMITS
ACTIVE/OPEN
APP # DATE DESCRIPTION OWNER STATUS
1231693 03/13/2009 COMMERCIAL REMODELING PHARMACY ON MARINER BLVD ISSOED
1235108 06/29/2009 RES INTERIOR REMODELIN REIDY DONALD W ISSLIED
1236315 O8/09/2009 COMMERCIAL REMODELING MY PLACE LOONGE REMODEL ISSUED
123�253 09/09/2009 GARAGE WAGNER MIK ISSUED
1239186 11/12/2009 COMMERCIAL REMODELING DOCTORS OFFICE INTER REMO ISSUED
https://hclion.hernandocounty.us/BLDSYS/BIN/lionweb.dll/xmit 1/21/2010
LETTER OF AUTHORIZATION
Date: Januarv 21, 2010
TO� Buildinq Department
Citv of Zephvrhills
5335 8th Street
Zephyrhills, Florida 33540
RE: Bank of America
5632 Gall Blvd
Zephyrhills, Florida 33542
TO WHOM IT MAY CONCERN
Please be advised by this correspondence that Todd Stickler, and Ken Kneiss are
authorized to act as Agent on behalf of Jerry O Grigg, to register contractors license,
submit and pull permits under my Plumber Contractors License # CFC056756.
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Si ur .
Jerry O Griqq Plumbinq, Inc. DBA Earlv Bird Plumber
Company
5205 South Lois Avenue
Address
Tampa Florida 33611
City State Zip
STATE OF FLORIDA)
COUNTY OF HILLSBOROUGH)
Sworn to and subscribed before me this o�.� day of Gt.�-�. AD, 2010
�-�1��,�, -���,�
(SEAL) Notary Public, State of Florida
;�:�yr:�; MARYANNTURNER rnr�, .Q-,�M �v2u-��--
i�r .: MY COMMISSION k DD 871361
��;�;�;�:0. BondedTh�uNota�PubAcUO�ndervrtiters Print, Type of Stamp Name of Notary Public
Personally Known _�
Type of Identification Produced
My commission expires:
CBRE
C8 RICHARD EIUS
Work Authorization
Master Contract No. LSPCALDEV20100581.00
CBRE Real Estate Services, Inc.hereby authorizes the Work and/or Services described hereunder pursuant and in accordance
with the terms and condifions of the Master Services Agreement/Contract referenced above
""•""*"TNIS FORM 1S NOT VALID WtTHOUT A WORK AUTHORIZATION NUMBER"`•""'•'
Project Name: Zephyrhills ADA CBREWark Authorization#: FL.O'l40.09-004-ADA09043
issue Date. 1/5/2010 CBRE P�oject Number: FL.0140.09
Supplier Name: Cal Development, Inc. CBRE Project Manager: Albert Anderson
Supplier Contact: Patrick Keane PjM Manage�Tel&Fax: a�a-s�2-sa33 813-812-8249
CW Job Number: ADA09043 Sr.Managem�t.Contact: Faye Darden
Estimated Due Date: BAC Facility Location Name:
ProJect Type: R=Retaii , Address: 5632 Gall Bivd.
Project Architect: CitylStatelZip: Zephyrhilis!FL/33539
.Scope of Work: Costs include interior partitions,fixtuFes,flooring,new ADA parking(to include paving,survey,
testing),and markings.
.Exhibits or Pfease tlst all drawing(s),pians,specifrcations,addettda w other documenfs appl'�cable fo this Work Authorization•
ile Attachments:
.Instructiona: in accordance with your contract for the Project listed above:
a.Please provide Consulting Services based an the Hourly Rates Exhibit,not to ${Coat of Serviceati.
— exceed:
_ b Please prepare a Budget Proposal Form(BPF)or Schedule of Values(SOV)for the above Scope of Work
_X_ c.Please begin execution of the Scope of Wo�C for the ProJect Asted above(BPF/SOV/Proposal attached)
.PriCfng: SuppRer warrants and covenants to provide the Work and Services tor the Prtce Nsted below:
�SP : $78,383.89
CBRE Projed Manager: Thts form must be physicaily signed by both Contractor and the CBRE personnel having the approp�iate signing authority
.CBRE t � `'�
utho�ization: M:� � • � P
�
Name Date Title
.Supplier �-s +
cceptance: ,� - ""''�-� C--'A-'�-'�- ' ��0 p �r'eS,�ciQitC-�
Name Oate Titte
I hereby acknowiedge recoipt and accept the commtssion of the Services andtor Work as stated herein for lhe Price Iisted
above. The signatory represents they are a duly authorized representative of the Coniractor with contractual authority to
bind Contractor with res ct to ihe Services and the Work descxibed herein.
.Dates: Piease define the Canmencement Date,Date of Substantiai Comptetion and Date of Final Completion:
Commencemem Date: Datc of Substantisl Complction: Date of Final Completion:
tl512010 3/18/2010 4/15l2010
Zephyrhills Fire Rescue
6907 Dairy Road, Zephyrhills, FL 33542
Fire Marshal Bus(813) 780-0041
Kerry Barnett Fax(813) 780-0044
E-mail: kbarnett@fire.zephyrhills.fl.us
Plan Review#: 10-008
Project: ADA Renovation
Number of Pages: 9
February 4,2010
I have received and reviewed the plans for the ADA renovation located at 5632 Gall Blvd
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 o�ce. ,
1. Install emergency lights in each restroom.
Inspections Required:
1. Final
KE TT, 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.
.��?!-OY6�&itLLS �ER�:D�PAR�'M�IV�
69D7 Dairy Road, Zephyrhilis, FL 33542
Fire Chief Keith Wiiliams Bus (813)780-DD41 Fax (813)780-0044
FIRE SERVICE�USER FEES
Occupancy No.:
Plan No.: -�' Contractor:
Business Name: Billing Address: "'
Business Address: ,3�t,I(��
Husiness Phone No.: Bilfing Phone No.:
Business Fax No.: Billing Fax No.:
Contact: Contact:
PLAN REVIEW FSES INSPECTION FEES PERMIT FEE FALSE ALARM FEE
5ite Plan N/C Annual N/C Sprinkler $50 7 st Alarm N/C
Mu '-Family/Commeroial .06 sf 1 st Re-inspection N/C Standpipes $50 2nd Atarm N/C
Minimum Charge _� 2nd R�inspection $100 Fire Pump $50 3rd Alarm N/C
� Plan evi -DBL 3rd Re-inspection $250 Hoods � 4th Afarm $10D
4th Re-Inspection $500 Fire Alarm $50 5th Alarm $150
SPRINKLER SYSTEMS (Business closed until LP Gas $50 6th Alartn $200
D-25 Heads $5D V1012tI0I1S COlfECYE(�) N8h1(21 G3S $50 NON COMPLIANCE $�SO
26 plus Heads $100 SPRINKLER SYSTEMS Fuel Tanks- Permnk $5D
STAN�PIPE SYSTEM Hydro Undergrounds $45 Sparlders $100
�Per Riser $50 Hydrostatic Test $65 �r�m Fire Works $50D
FIRE PUMP Acceptance Test $45 Persystam Camp Fire $25
� Per Pump $10D Hydrant Flow $75 Confi�olled Bum $100
FIRE ALARM SYSTEM Hood/Duct $50
8 0-25 DeVices $50 FIRE ALARM SYSTEM Place of Assembly $50 Annual
26 plus Devices $10D 8 System Acceptance $50 Fire Protection $25
SUPPRESSION SYSTEMS Reqll Acceptance $50 Flammable Application $5D qnnual
Wet $50 OTHER Waste Tlre Storage $50 nnnual
Dry $50 Fire wa111smoke wau $15 �r�n Generator<KW $100
CO2 $50 LP Gas $25 pertank Generator>30 KW 150
Other $50 Natural Gas $25 Persys�em Bio-Hazarcl Waste $100 Annual
KITCHEN EXHAUST Fumigation Tenting $50
� Hood/Ducts $50 Tent 1D'x10'or greater $15 Pertent Toroh PoUApplied $50
OTHER FI2 Pump , $45 HaZ.Materials $100 pnnual
BLP Installation pertank $50 Fife SuppreSSion $30
Fuel Tank Installation $50 System Acceptance
(Per Tank) $50 Exhaust Hood/Duct $30
�Natural Gas Installation $50 Re-InspeCfton DBL
(Per System) (otherthan annual)
� Spray Booth $50 � Inspection scheduled DBL 8
and cancelled less than
24 hours
Construction Insp. N/C
Emergency Vehicle AG Ti50 FALSE AlARM
PLANS TOTAL� INSPECTION TOTAL� PERMIT TOTAL� TOTAL�
GRAND TOTAL �
Comments:
Date:� �
Ins��cto . "—�ti'��..
CITY OF ZEPHYRHILLS PB 1 PG 54 COM NE COR BLOCK 58 TH N63DG ,
28 ' 30"E TO INTERSECTION...OF ELY R/W LN US 301 & SLY R/W
LN 12TH AVE 60 . 00 FT FOR POB TH CONT ALG SLY R/W 12TH AVE
' ' � N63DG 28 ' 30"E 200 . 00 FT TO WLY R/W LN 7TH ST TH ALG WLY
R/W LN 7TH ST S26DG 25 ' 00"E 225 . 00 FT TH S63DG 28 ' 30"W
200 . 00 FT TO ELY R/W US 301 TH ALG ELY R/W LN US 301
N26DG 25 ' 00"W 225 . 00 FT TO POB
OR 1251 PG 320
I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII I'll
Key No. Permit No. 2010014667
NOTICE OF COMMENCEMENT Rcpt:1286005 Rec: 10.00
THE UNDERSICaNED hereby gives notice that improvement will be made ; D$: 0.00 j T; 0.00
to certain real property,and in accordance with Chapter 713,Florida State: 02/02/10 Dpty C lerk
Stat�tes,the fotlowing informahon is provided in this Notice of ;
Comme�cement: : PAULA S O�NEIL, PASCO CLERK & COMPTROLLER
:...................................... .�2/02/10 0 4
OR BK �� "�j 1 0 1
1 pescription of Property: Parcel No. 1_� � _� �_O2�` ` PG ��
�1 SF� �b��
, `�3�'[J� (Legel description of fhe property and street address if availaWe)
J1
2. General scription of Improvement � _
3. Owner Infortn ion� N�ne
Address ip
IMerest in rape •
Name of Fee Simpie er o r an owne :
Address p
�t. Contrador: m ,
.� Address: i a e ip
Phone No. ax o.
5. Sur�ty: Name
Address a e ip
Amount o one o. ax
6. Lender: Name
Address a �p
Phone No. ax o.
7 Persons within the State of Florida desigrta6ed by Ownerupon whmm�otices orother documents m8y be served as provided by Seclion
713.13(1}(a)(7),Fiorida Stetutes:
Name Adciress City State
Phone o. Fax No.
8. In addition to himseif or herself,f)wner designffies ot
to receive a copy oi the Lienor's Notice as provid �n on . , on a a es.
Phone No.of person or entiry designated by owner
9. Expiration date of Notice of Comment�rtient(the expiration date is 1 year from the date of recording uMess a different date is speafied.)
WqARNINt3 TQ 11VNER:ANY PAl'M�NT$FMDE 9Y THE OyVNER AF7ER THE EXPIRATION�OF THE NQTICE OF COMkIENCFJNENT ARE CONSIDERED IMPROPER
A NOMECES UtC�M ENC��EN7T�IU�UST BE�lE�OROED AN�D P�OS�"fED O�SE'JOB&TE BEKORE�TFIE FIRS71N3RECT�IOPl.I�OU 1N Nb TO�k N�FII�W4NCft��(`,�
CbN TH YOUR LEND OR AN A NEY 9EFORE GOMMENCING W�RK OR RECORDING YOUR NOTICE OF CAMMEPlCEMEhtT.
igna o neror ' ne s o cer or a anage� n� o s ce
"'3ignatule Re9uhsd by below by`X'mark"' .
S7ATE OF COUNTY OF Y"Li��S �w�.ir��
�—
The foregoing fnstrumerrt was adcrawledged befare me this�day _�e+�.vc,�ry,r-,20�,by T�.vhrh i �� s_�J 1 .
as � '� for a,ti� �i�,.r.� .� •��.
(TYPQ ��b e. e,trustee,aNaney in fact) �PertY ort alf �irxitrument was exodrt�
igna e o Print,Type or amp ame o o ary � �Y Public State W Fiorida
/ . ��rY R Weieer
Personally KnoWn�OR Produ�ed Id�9ntification My Commissbn DD936822
Type of identiftcadon uced: � n� �xP�ros 10/29/2013
Verificati pu r�to Seqion 92.528, lorida&tatutes:under penalties of pe�ury,I dedare lhat 1 hava read the foregoing and thffi tl�e sta i d r
true beat�my kn ge�nd b Mf,
�
i9 re o a erson x�g ove
STATE OF FL(?RIDA,�COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING iS A
TRUE AND CORRECT COPY OF THE DOCUMENT
ON FILE OR OF PUBLIC RECORD IN THIS OFFICE
xoc-rrs.wrn��uro�� WITNESS MY HAND FFICIAL SEALTHIS
4!24l07 tsg
� DAY OF
P ULA O' , ERK&COM ROLLER
EPUTY CLERK