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HomeMy WebLinkAbout12-12986 CITY OF ZEPHYRHILLS � ' S335-8TH STREET (si3)�so-oozo 12986 BUILDING PERMIT Permit Number: 12986 Address: 6634 FOXMOOR DR Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 03-26-21-0120-00000-0610 Improv. Cost: 2,600.00 Date Issued: 4/24/2012 Name: MACKIN KAREN CLARK Total Fees: 62.50 Address: 6634 FOXMOOR DR Amount Paid: 62.50 ZEPHYRHILLS, FL. 33542 Date Paid: 4/24/2012 Phone: (813)782-8682 Work Desc: REPLACE SIX WINDOW SIZE/SIZE L �� � � �� n1 � �f/� r I`�` �� � 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 wmply 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 inspecfion 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. "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." Complete Plans, Specifications Must Accompany Application. All work shall be pertormed in accordance with Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O. - � � �e� � � CONTRACTOR SI NATU E PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER `'�L��Uit�s�.r`� �i�" �-- a City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: _ l�'��,t�S ��`�l e �'��— Date Received: `�—� �--� Z Site: /�,�� �XVyId�Q►� �)--- �� Permit Type: R'�p �Q�e � �.��� �Le �S'i Z� Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑ � ���� �� �� This comment sheet s�ll be kept with th rmit and/or plans. , �, �� � ���� � Kalvin witzer—Pl xaminer Date � Contractor and/or Homeowner (Required when comments are present) nninlmum ten(10)workin�iiays after subm;ttal date,uRequired onsite CjonstrucUonPlansC Stormwater Plans w/Silt Fence Instatled, Sanitary Facflitles 8 1 dumpster Slte Wo�Permit for a�l new projects.All commerclal requirements must meet cnmpliance SIGN PERMIT Attach(2)sets of Engineered Plans. ""'PROPERTY SURVEY required for all NEW�nstruction. Dlrections: FIII nut appllcation completefy. � Owner&Contractor stgn back of application,notarized If over a2500,a Notice ot Commencement Is required. (q/C upgrades over a5000) " Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing sam� OVER THE COUNTER PERMITTING� (Front of Application Only) Reroofs Sewers ;iervice U pgrades A/C Fences(PIoUSurvey/Footage) Drivoways•Not over Counter If on publ(c roadways..needs ROW � NOTICE OF DEED ReS TRi gT�haN County r gulatlons. The unclersign d aissumes esp nsibllf�ty for compl a'ncestwith any which may be mo applicable deed re;�trictions. UNLICENS�D CONTRACTORS AND CONTRACTOR RESP()NSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be ticensced in accordance with state and local regulations. If t�e cont�actor is not lic:ensed as required by law, both the owner and contractor may be cited for � misdemeanor violation under state law. Ifi the owner or intended contractor are unceMain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division—Licen�cing Section at 727-847- 8009. Furthermore, ff the owner has hired a contractor or contractors, he is advised to hawa the contractor(s) sign portions of the "contractor Block" of this appiicatfon fvr 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 IMPACTIUTILITIES IMPACT AND RESOIIRCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees rnay apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinsance number 89-07 and 90-07, as amended. The undersigned also underskands, that s�.�ch fees, as may be due, wili be identified at the time of permitting. It Is further understood that Transportakion Impact F'ees and Resource Recovery Fe�ss must be paid prior to receiving a "certiflcate of occupancy" or final power release. If i:he project does not involve a certificate of occupancy or flnal power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco Couh�ty WaterlSewer Impact fees a�e due, they must be paid prior to permit issuance in accor��ance with applicabie f?asco County ordinances. CONSTRUCTION LIEN LAW(Chapter 713, Flortda Statutes, �is amended): If valuatfon of worlc 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 appiicant is som�one other than the"owner", I certify that I have obtained a copy of thi� above described document and promise in good faith fo deliver it to the°owner" prior to commencement. CONTRACTOR'SIOWNER'S AFFIDAVIT: I certffy that all the information in this application is ac;curate and that ail work will be done in compliance wlth all applicable laws regulating cc►nstruction, zoning and land deveslopment. 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 4o issuance of a permit and that all work will be performed to meet standarcis of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify tiiat I understand that the regulations of other governmerit agencies may apply to the intended work, and that ii is my responsibility ta identify what actions I must take to be in com�pllance. Such agencies include t�ut are not limited to: - Department of Environmental Protecfifon-Cypress E�ayheads, Wetland Areas and Environmentaily Sensitive Lands, Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Aitering ' Watercourses. - Army Corps of Engineers-Se�walls, Docks, Navigable Watenrvays. - Department of Health � Rehabilitative Services/Environmental Nealth Unit-Wells, Wastewater Treatment, Septic Tanks. . - US Environmental Protection Agency-Asbestos abatement. Feder�l Aviation Authority-Runways. I understand that the following restrfctio�s appiy to the use of fili: Use of flll Is not allowed in Flood Zone"V" unless ex��ressly permitted. If the flll material is to be used in Fiood Zone ",4", it is understood that � drairiage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a,professional enginE�er IicensE►d tiy the State of Flor(da. If the flll material is to be used in Flood Zone "A" in connection with a perrriitted building using stEm wall construct(on, I certify that fill wil) be used only to fill ti�e area within the stem walE. If fill rnaterial is to be used in any area, I certify that use of such fill will not adversely affect adJac�nt properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for vlolating the conditions of the building permit issued under ihe attached permit application, for lat5 less khan one (1) acre which are elevated by fill, an engineered draina.ge plan is required. If I am the AGENT'FOR THE OWNER, 1 promise in good faith t�� 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, piumbing, stgns, welis, pools, air conditioning, gas, or other installations not specificaliy inciud�sd in the application. A permit issued shall be construed to be a license to proceed witti the work and not as authc�rity tc� violate, cancel, aiter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a eorrection of errors in plans, c i{�s�C°t�°mencediwithin s xa onths of perm Pssr alnce, or�if wo'rk authorized�by unless the work authorized by such perm the permit is susp�nded or abandoned for a period of six(6) months after the time the work is �`��s andewfll demonstrate may be requested, in writ(ng, from the Bufidi�g Officiai for a pe�riod not to exceed ninety (9U) y justiffabie cause for the extension. If work ceases for ninety(90!consecutive days, th�job is considered abandoned. WARNING TO OWNER: YOUR FAlLURE OUR PROPERTOTIF YOU IN�END TO O TA N FANANCSNG C'ONSULT PAYING TWICE FOR IMPROVEMENTS TO WITH YOUfR LE"'^eD OR AN ATTORNEY BEFORE RECORC�IN('YOUR NOT{CE OF COM��N�'+EMENT. �..,.... FLORIDA JURAT(F:S.117•03) OWNER OR A(3ENT_ GONTRACTOR Subscribed and swom to(or affirmed)before me this Subscrit�ed and swom to(or affim►ed)before me thls � by bY— Who Is/��re personaily known to me or haslhave produced Who is/are pe�sonally known to me or has/have produced as identfficaUon. asidentlflcatlon. Notary Public Notary Publ(c "--^ Commission No. ' ------- Commission No. Name of Notary typed,printed or stamped Name of Notary iyped,Prfnted or stamped � . • eoto290191 a�2o11,RR Dom�elby.Alf riQMS resetved,•0221 • � .. v; n• T. • ws•. �. r.' r �RL'.�cr rx '�:ii� �'� '.-✓ w' ""`.+! , .s'F^' i�� t. < ^�.3 bt:i5�C5 �'r � "• s � ��� 7.:�:.$�+,�� �f.�..- .>, .�n ,.r.� .j�, .�''.�;�:.. ,�.. � • � H .s� a . "n's. ,r 'r r • �.�.. �y� �- ` 't� '..�" �• 'aZR'C .�'�',�' . .Y =.3�e ! J , +,[�;... � �. 4 'Y 9 iC:#'�� : ,-it:.. ' ',hN�� w��% .i'• ' �1,'��� �c:,:.;-* :�iw � . A•.os � pi ,�1 G,�„¢�� 7; .` ,.; V:• � •� ,;�•'^J .�' i 1 (+ ���i ;�� ,I' :N�, r� 'G.i , . ',�,.':L: . � . 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'to . �oF1RT).�wes,end�¢}�s�h-:. •r•..`�' L�{�A11�A,MO ° Ii�ry.:Lcwes and�,Cu$komer'i�`r�pnH�p�,to. a�'FAt�t'HFA�N�G::i�.ipt:�., itraklor ' �p ;.:,., �, '�1b1�P� ��,L!lGICt��7H1it�!1'�EI�ES�A��U�ABkE i1J�GOf�37 Arb(ftafof"eaeision's are as e�prt�ab�a as"'isy ee'tir!"o'r'de''r anc �ann����"e��.�'o,'YERY.`�III�IT�d� &NI:EiT� O�RT. �S`R MORE. i . F.,e�:i.i�i�clzoN..dtuupicAn N foii� in DET�11L9:.�Rgv�erv:�,e'se..caon ciuea�x�errw►�4�i�tc�MEr��•W/UVER C71�;JEIR1 #1�1Y1�,iBk�tD•.WIV V�R;q � . , : . i• . . . �d 1't�g.Tet�m's�nd Conditi0n6 of�hls Cont�il:��� . • . , ��. � .� . . � ,. �, �;C.jh.'�7t. " � � ' • ' � �`hi')1- . . Jr..�d;..:`6e•1;.:'�t� � � .�.� �- _...-� �~--�� - _ r, � � � �. � � r� � jl � ,�� i � ��r I �� �LL�o � �"1 �-Sf f.q�j, I �,� pR�VAILING C0� C��MP�,y WTT � � �ODE N,qT10NAL ELEC�RIDq g�D�G � CITYOFZEPHyRHILLS p�COD�'AND � RDINANCES �� i __ ; — 1 � � ._...J ' '`'.�,';rV�,� ..} I I . .�. � 2�5T`- �-�/-�`3 � ,. , r, _ _ _l{ '>•- `�' ?���?a!-. ' } �,'s�,�' _ �y/��l�t �� � � -���!',,,���.� -- r ; i _�S � i - I -_ �.� �� ' s-7a��..� / � s� ��� � ��, 7�, � £ d L 6�h805 6;)��/sa 1�S su I 800 - ._...�£8-£68 (�586) ��•S� �A_L„ _ — ------a ,..,.... ........., Yage 1 ot 3 � Prod�PCt Approval . usert:wan�u:e. . � FlODUCf AODfO_yJ�Menq>produCt orAaali�ation Search>Aqnptatlon Llsl>AppUestbn Dets!l FL# FL14671-R2 Applrca[ion Type Affirmation Code Version 2010 Applicafion Sfatus Approved Comments Archived Product Manufacturer Pella Corporation Address/Phone/Email 102 Main St. Pella,IA 50219 (641)621-6096 pellaproductapproval @pella.com Authorized Signature Joe Hayden Sandi Robinson pella productapprova!@pella.com TechnrcalRepresentative Joseph Hayden Add�ess/Phone/Email 102 Main Street Pella,IA 50219 (641)621-6096 jahayden@pella.com Quality Assurance Representative Ali Zarghami Address/Phone/Emai! 102 Main Sf Pella,IA 50219 (641)621-1000 zarghamia @pella.com Category Windows Subcategory Double Hung Compliance Method Certi�cation Mark or Listing Certificatlon Agency Window and Door Manufacfure�s Association Validated 8y Rene J.Quiroga,PE Valydation Checklist-Hardcopy Received Referenced Standard and Year(of Standard) tand rd AAMA 101/I.S.2 NAFS-02 Year AAMA 101/I.S.2-97 2002 AAMA/WDMA/CSA 101/I.S.2/A440-OS 1997 2005 Equivalence of Product Sfandards Certified By 1 af�rm fhat there are no changes in the new Florida Building Code which affect my p�oduct(s)and my product(s)are in compllance with the new Florida Building Code. Documentation irom approved Evaluation or Validation Entity Ye5 No N/A PL14671 R2 C�� 2010fB affirmation Nola9n aa n FL14671 412-n�n�,,,�f Product Approval Method Me[hod 1 Option A Date Submitted 01/18/Z012 Date Validafed 01/18/2011 Date Pending FBC Approval Dafe Approved 01/30/2012 http://www.floridabui lding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqsw8Z VNfe8A7... 4/12/2012 rage � or .s �Summary of Products ----_--- - FL� �_ Model,Number or Name 14671 1 Descr! tion . High Performance Pella Viny!350 Series . Size 40"x 63" Double Hung(non-impact) [!mlts of use App�oved for use ln HVHZ:No Certlfleatlon ADency Certlfltate Approved for use outside NVHZ: Yes FL14671 R2 C CA[ rr� r.,.pella 6-Q-11 411 H 125a�.�r Impact Reslstant:No Qual!!y Assurance Contract Explratlon Date Deslyn Pressure:+60/-60 02/10/1015 Other:1)Configurations of glass sha!l conform to current ASTM E1300;2) PL14671`R2 IISPELL0006 _ERIEs�sn.asnH n ar Frame types shall be 3.25"Pocket fln,4,5"B1ock,or Flange fL14671 R2 II_pfLL0007 SFRI sosn_a�snN n.,ac Ve�ified By:Robert J.Amoruso 49752 Created by Independent Third Pa�ty: Yes Evaluation Reports fL14¢Z1. R2,AE._P€3N91.�Q,�..��.(1�S__,35Q-0FJ Rg_v„9:Bd� ' Crea[ed b inde endent Third Pa� : Yes 14671.2 High Performance Pepa Vrnyl 350 Serles Size. 54"x 78";Pocket Frame Double Hun non-im act) L1mlts of Use Approved for use!n HVMZ;No CertJfleaHon Ayency Certlflcate Approved fo�use outslde HVHZ; Yes FL24671 R2 C CAC CCL for Pella -11 11 411 H 1266 odl Impact Reslstant:No Quallty Assuranee Contract ExplratJon Date Deslyn Pressure: +40/-40 01/31/2015 Oiher:1)Configurations of g/ass shaJl conform to cu�rent ASTM E1300 FL14671/R2 IISPELL0007 SERIES?sn_��cnu 0 vdf Verified By•Rvbe�t).Amoruso q9752 Created by Independent Third Party• Yes Eva/uallon Reports FL14671 R2 AE PERNo1805 Se�ies 350-DH RevO odf - Created by Independent Third Party: Yes 14671 3 High Performance Pella Vinyl 350 Series Size:54"x 78", frn Frame Unit � Double Nung(non-impact) Limlts of Use Approved for use!n HVHZ:No Cert/flcat/on Ayency Certlf)eate Approved for use outsJds HVHZ: Yes FL14671 R2 C CAC CCL for Pella 6-9-11 411-H-1256 adf Impact Reslstant:No Quallty Assurance Contract Explratlon Date Desiyn Pressure:+40/-40 02/03/2015 Other:1)Configurations of glass sha!!conform to cur�ent ASTM E1300;2) FL14671,R2 IISPELL00 6 SERIES350 45DN 0 odf Frame types shall be Fin,4 5"B/ock,or F/ange Verified 8y. Robe�t 1.Amoruso 49752 Created by Independent Third Party, Yes Evaluallon Reports FL14671 R2 AE PERNo__IgpS �erles350-DH RevO.pdf ____ Created by Inde endent Third Party: Yes 146�1 4 Standard Performance Pe!!a Vinyl 350 Series Size. 40"x 63" Double Nung(non-im act) timlts of Use Approved for use in HVH7_;No Certlfication Aqency CertlAeate Approved for use ou[slde HVHZ: yes FLI4671 R2 C CAC CCL for Pe//a - -1 411-H-12 9, df Impact Resistant:No Qua/fty Assuranee Contraet Explratlon Date Deslyn Pressure: +40/-40 02/10/2015 Other;1)Configurations of g/ass sha!l conform to current ASTM E1300;2) FL14671`R2 IISPELL0006 SERIES3sn Frame types shall be 3.25"Pockel,Fin,4.5"8/ock,or Flange FL14671 R2 II PELL0007 SERIES350-32�H0�df j Verified By. Robert J.Amoruso 49752 Creafed by Independent Third Party• Yes Evaluatlon Reports _ FL14671 R2 AE PERNo1805 Series 350�OH RevO.vdf 14671 5 Created by lndependent Third Party: Yes Sfandard Performance Pella Viny!350 Series Size. 54"x 78" Double Hun (non-impact) Limits of Use Approved for use!n HVH2;No CertlfleatTon Ayency Certiffeate Approved for use outsido HVHZ: Yes fL14671 R2 C CA� CCL for Pe!la 6-12 11 411 H__. 12F�Zf Impact Reslstant:No Quallty Assurance Contract Explratlon Date Deslyn Pressure: +30/-3U 01/31/2015 Other:1)Configurations ot g/ass sha//conform to carrent ASTM E1300;2) fL14671 jR2 IISPE��n�nna cco. Frame types shall be 3.25"Pocket,Fin,4.5"Block, or Flan e ����45DH 0 od� 9 FL14671 R2 17 PELL0007 SERIES350-325DH O.ndf Verified By•Robert J Amoruso 49752 Created 6y lndependent Third Party: Yes EvafuaHon Reports FL14671 R2 AE PERNo1805 Series 350-OH RevO,pdf 14671.6 �- Created by Inde endent Third Party; Yes Standard Performance Pella Viny!350 Se�ies Size: 146"x 78", 3-Wide;Fin Frame Double Hung 2-Wlde or 3-Wlde(non-Im act) LlmJts of(/se APproved fo�use In HVHZ:No Certlflcatlon Ayency Certlflcate Approved for use outslde HVHZ:Yes FL146� �qC CCL f9r Peda 6 10 �1 411 H ��» .�r Impaet Reslstant:No Qua/!ty Assu�ance Contract Explratlon Date Deslyn Pressure:+25/-25 �Z/z2/2015 Olher:1)Configurations of glass shal!conform to current ASTM E1300;2) fL1q671 jR2 IISPECL�,nn� SFRIFCZCn w Widths not to exceed 54"for each individual double hung;3)Fiame types Venfied By Robert J.Amoruso 49752 5�`� 0 odf shall be Fin,4,S"8/ock,o�Flanqe Created by Independenf Third Party• Yes Evalua[1on Reports FLI4671 R2 AE PERIVQ��_Series�Q_ON RevO;�df http://www,floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqsw8Z VNfe8A7... 4/12/2012 ra�C J UI J Created by lndependent Third Party: Yes 14671.7 Standard Performance Pella Vlnyl 350 Series Size:146"x 78";3-Wide;Pocket Frame Double Hun 2-Wide or 3-Wide(non-lmpact Llmlts of Use Approved for use!n NVHZ:No Certlt7eatlon Apeney Certli/eate Approved for use outsfde HVHZ: Yes FL14671 R2 C �AC C�L for Pe!la 6 10 11 411 H 1326 odf Zmpaet Reslstant:No Q�a1�tY Assurance Contraet Expiratlon Date Deslyn Pressure:+25/•25 �2/21/Z015 Other:1)Configurations of glass shall conform to current ASTM E1300;2) FL14671�R2 IISPELL0�007 SERIE5350-3250H 0. df Wrdths not to exceed 54"for each individual double hung Verified By•Robert J.Amoruso 49752 Created by Independen[Thlyd Party. 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'���� TJH 0&15/11 ,�����Rn�u�+'��� �i` aeue.N.T.S. oa�w.,PELL0008 n.aaainoemxwa..0 ae�areuur �WmvOOD,iOiO\YA1 4 IIW. PEV: SNEET: E�wo��.� - 8 OF B A� DEfiCNiM1N OwtE BY CITY OF BUILDINO ZEPHYRNILLS , , , I DEPARTMENT OF ADDITION OR CORRECTION � • • - • ADDRE55 �, DA E PERMIT f (�b 7��-{' ,. v��c�- i� -Z ��l� THIS JOB HAS NOT BEEN COMPLETED. The foliowing additions or corrections shall be made before the job will be accepted. ��� �tti�J�c. Tfi� w1 It is unlawFul tor any Carpenter,Contractor,Builder,or other persons,to AFTER CORRECTIONS ARE MADE CALL "cover or cause to be covered,any part of the woric with flooring,lath,earth or other material,until the proper inspector has had ample time to approve 780-0020 FOR RE-INSPECTION the installation. �OFFICE HOURS 7.30AM-4 30 PM MON-FRI INSPECTOR'__��'LZ+�-.L`�2.5� � i iiiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiii iiii 2012077125 Rcpt:1433527 Rec: 10.00 vQ�CE OF CO�VIMENCEMENT �s: 0.00 IT: 0.0e 05/07/12 E. Munguia, Dpty Clerk }BIITllt NO. �����' PRULR S 0'NE I L,Ph D PRSCO CLERK & COMPTROLLEF I'ax�oiio No. 05/07/12 02:17 m 1 of 1 (,�� ._�6 �2-/-�/�O ':C�t'�bd� - ��/� OR BK ���� P� 3525 THE LJNDERSIC�NED hereby gzves nonce that the improvements will be made to"real properiy,and.in accordance with Section 713.13 of the Florida Sffitutes,the following information is provided in this NOTICE OF COMI��NCEMENT. 1.Description ofproperty(legal description}: �� ILf�R Q ��G S P�/��� � �aT6i O2���a /�5'/3z �2 S 7�} P� ;�o y a)Street(job)Address:��`3�_�X mooP 02 Z�Py�2ti�/�S %-C. 33s`YL 2. General description of improvements: c.�s.JrJ�cJ fZ�-P�/}c.z.�n�.1T 3.Owner Information a)Name and a.ddress: ��l'!� �(��+4—�� . �n,a�t��� FL �i 5��. b)NauYe and address of fee simple titiehoIder(if other than owner) -�- _ c}.�nterest in propeity Owner �ontractor Information �- NamE and address: Lowes Hame Centers Inc. P.O.Bo��81993 Orlauda FL 32878. b}Telepko�e No:���7'-S�`.?,2�-�� �'''�' Fax No: Q.� � 5. Sui�ty Information � - a)1�iame arid address: NA b)Amount of Bond: NA ' c)Telephone No:_NA 6.Leitder a)��e�nnd address: NA b},'I`el��hone No: NA Fax No: NA _ �:�,:Id�fti�'<if'�son.within the State of�ioi�icia_desig�ia#�b}�.owner upou whor�,riotic.�s;or.otFieF documents ma�be served � ,. -..,- a��e�arid�dchess. NA " _ ' . ��'Felephone No:_NA Fax No., ._NA. - 8•Tn�.��'dif�ciit to hiinself,owner designates the•fo�lowi�ig pierson to rec�ive a.capy offhe Lienor's Natice as pro�rided in Sectio�l'1..�3<I3(-1��}; Plbri�c��t�t�ites; - a}Nam,e:and address: NA • b)Telephone No. NA Fax No. : N:4�_ - 9•Expiration date ofNotice of Commencement{the eiepi�ation dafe is one year from the date of recor.ding u�less a differenf date is specified): - . � , , _ .Al�i,ti�IG�0 OWNER:A�tY PAYMENTS.MAI7�'S!�T,_:�.�VVNERAF'.['�R;'�:;.��......`. �'�Ol�Q�:THI3_�If�'ICL OE . �1��.��MENT.�CONSID�R� ` , <.�.. f= s.>, � ,� ��"i�► -Cr�!i RLSULT. ����,�' *n� -��L�_�P'I'�R�; �`��,�1tT 1,SFCTI�3.N•��3.�� FI�QRII3�: � ,���, I��QIJR PA,�'�:��?P�I.�M �.�t�*�`��b����PE � � � .��0�` : >a. .-,:,<:,� ��'.�.�`�-����-�;;...- '_�..._. � _ RT'ir.,e��NEE�I�'�E'Q��b ..,,�.� _ 1:D ANIT�`O�TLlar�`Z' ! s�:.:�:..,,,.-:�_ _ -- ��°r .-� :$�: - �:.'�'`��'��,.`�� �.e� ���rOV ` . , .. .. ;...�`T Y�ITIt LEIVDEIt'OR�!P!T AT"TQ��'B�. - - �.:.::;:...:�:` ' _ INTE�tII� .. C*, ,[,V <: . .: �RL:�1�1�IE1�TG;'�1VG W'. C�;�. ,_ . �D�i�T�1''�GIN'. :,,.. - .. `�•--'TE�' _ GC�M���sEMEN'T. . ,,- 4��:0`R:It��O1�DING'f'O�R:N�TI�CE OF State of Flbrida, Co�nty Of • KEITH B AHLHEIM . I���" �o -.ki L„� =o�►?�Y h.g� S�g7lature of Owna or OwQer's AuthoriiEd Offiar/Direc r/PartnedMsnaqa MY COMMISSION�EE737457 kA R =�r � � EXPIRES:OCT 12,2015 Pnnt Name � � �RC Kt� � °F^� Bonded throuph 1 st State Insurance �t fOr re me this��day of��'Ch _20�,6y �ti� �� ��� or . � � (type of suthority,e.g.officer,trustee,attomey in fact} ame of parcy on behalf of whom inst�ument was executed). 'ersonally Kc:�wn OR Prbduced Identificarion Notary Signature - 'ype of idenrification Prpduced /''���- Name(Print) rerification pursuanY to Section 92.525,Florida Statutes.Unde penalties of perjnry,I declare that I have read the foregoing and that the facts stated in it are true to the best of �y knowTedge and betief. STORE# ��'� � A r � , 1 X��. C_ea►,�. �����_kti��., � �igna of Nstura!Person Signing(in line 10) bove ^�'�ti ✓��r:�, . t}y sT�T��oF ����o�,�,�out�r�r o� ��sc�� ,_ THIS IS TG CERTIFY�ri�,a i H�rOf-�c��i_1!i�l�: l::.r�r? TRUE AND GORR�CT�PY QF THE Or1�f3Uf���l i ; ON FiLE C>R OF PUBLIC R�CORD ihf T'-i "�O��IGr� � WITN�SS MY HAND AN Ff=#CIALb�1i_�'MkS �- -�_-�—_,�n.YaF � ` � 1�r;a-_ PA L�-8` �EIL �L�, COMFTRi���R C�� �- BY i�F �,,, ,=�2r �