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HomeMy WebLinkAbout12-13215 CITY OF ZEPHYRHILLS 5335-8TH STREET . �si3)�so-oo20 13215 BUILDING PERMIT Permit Number: 13215 Address: 39040 CARDINAL AVE 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: EASY ACRES Est. Value: Parcel Number: 13-26-21-0100-00000-0190 Improv. Cost: 4,300.00 Date Issued: 6/28/2012 Name: DOUGLAS, ROBERT JR Total Fees: 202.50 Address: 39040 CARDINAL AVE Amount Paid: 202.50 ZEPHYRHILLS, FL. 33542 Date Paid: 6/28/2012 Phone: (813)679-9796 Work Desc: CONVERT CARPORT INTO BEDROOM 192 SQ FT HOMEOWNER MECHANICAL FEE 60.00 HOMEOWNER � � / !'`" - �� LJ//� � � � FOOTER BOND DUCTS INSULATED SEWER MISC._ ROUGH ELECTRIC LINTEL MISC MISC._ 1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC._ DUCTS INSTALLED WATER MISC DRIVEWAY PRE-SLAB SHEATHING MISC. MISC._ CONSTRUCTION POLE FRAME MISC. MISC._ REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c)when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b)condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d)work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. "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 Ac:company Application.All work shall be pertormed in accordance with Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O. / �� �. CONTRAC IGNATURE PERMIT OFFI R PE IT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF / / / / BUILDIN� 2EPHYRHILL3 DEPARTMENT OF ADDITION OR CORRECTION � • • - • ADDRE55 DATE PERMIT�, 3Z/ S' THIS JOB HAS NOT B PLETED. The following additions or corrections shall be nnade before the job ' I be accepted. , U � � � , , 7 .�- �G tt is unlawtul tor any Carpenter,Contractor,Builder,or other persons,to AFTER CORRECTIONS ARE MADE CALL cover or cause to be cavered,any part of the work with flooring,lath,earth 780-0020 FOR RE-INSPECTION or other material,until the proper inspector has had ample time to approve the installation. /J OFFICE HOURS 7:30 AM-5 PM MON.-FRI INSPECTOR ��� - 1`: FORMS � � FLORIDA BUILDING CODE,ENERGY CONSERVATION � FORM 402-2010 Residential Building Thermal Enveiope Approach ALL CLIMATE ZONES Scope:Compliance wfth Sectlon 402 oi the flo�ida Building Code,EnergyConseruatlon shall be demonstrated by the use of form 402 for s(nple-and multiple-family residences of three stories or less in height,additions to existlng residerrtfal bulldings,renovations ta exist�ng residential buildings,new heating cooling and water heating systems in exisUng butldings as applicable.To comply,a buitding must.meet or exceed all of the energy efflciency requirements on Table 402A and ail applipble mandatory requirements summarized in Ta61e 4028 o{this form.If a building does not comply w�th this method or Alternate Form 402,it may still comply under Section 405 of the florida 8uilding Code,EnergyConservatJon. PROJECT NAME: �OL1.0 (�d.(✓�p� �VQ� BUILDER: AND ADDRESS: �e.piny r In�'�5��(�, OFF CE:ING � L �. Q 2'l� S OWNER: �p�-4- �aU la PERMIT NO.: I3 �� JURISDICTION NO.: � General Instructinns: 1.New constructlon whfch incorporates any of the foliow(ng features cannot comply usinp this method:glass areas in excess of 20 peaent of conditioned floor area,eiectric resistance heat and air handlers located in attics.Addltions 5 60D sq.ft.,renovatlons and equfpment changeouts may comply by this method with exceptions given. 2.Fill in ail the applicable spaces of the'To Be Installed°column on Table 402A with the information requested.All"Ta Be Instalied"values must be equal to or more e�cient than the required Ievels. 3.Complete page 1 based on the"To Be Instalied"column fnfortnatfon. 4.Read the requirements of Table 4026 and check each box to(ndicata your fntent to comply with all applicable items. 5.Read,sign and date the"Prepared By"certification statement at the bottom of paqe 1.The owner or owners agent must also sign and date the form. Piease Print CK 1. New construction,addition,or existing building 1. 2. Single-family detached or multiple-family attached � 2.�3. If multipfe-family-No.of units covered by this submission 3. �-- 4. Is thts a worst case?(yes/no) � 4. 5. Conditfoned floor area(sq.ft.) 6. Glass type and area: 5' a.U-factor b.SHGC �a• ' S m . c.Glass area sb• ��r1 • 6c. sq.ft. 7. Percentage of gtass to floor area 7.�_a 8. Floor type,area or perimeter,and insulation: �° a Slab-on-grade(R-value) �q^ b.Wood,raised(R-value) $a•R°� < <+ lin.ft. c.Wood,common(R-value) 8b•R= _sq.ft. d.Concrete,raised(R-value) 8C•R= _sq.ft. e.Concret�,common(R-value) $d•R= _sq.ft. Se.R= _sq.ft. 9. Wall type,area and insulatton: a Exterior: 1. Masonry(Insulation R-value) 2. Wood franie(Insulation R-value) 9a-1. R= � ��� sq,ft. 9a-2. R= t` � sq.ft. b.Adjacent: I. Masonry(Insulation R-value) 2. Woodframe(InsulafionR-value) 9b"1• R=� �sq.ft. 9b-2. R- 10. Ceiling type,area and insulation: - sq.ft. a.Under atdc(Insulation R-value) �� b.Single assembly(Insuladon R-value) 10a.R=�o _sq.ft. 11. Air distribution system:Duct insulation,location,Qn 10b.R= _sq,ft a.Duct location,insulation 11 a. R= �j . � �_[,� b.AHLT]ocation 11 b .�}�[� c.Qn,Test report aztached(<0.03;yes/no) 11 c.Test report attached? Yes � 12. Cooling system: �'�° 12a.Type: b.Efficicncy 12b.SEER/EER• - 13. Heating system: - ��,p� 13a.Type: 3 a� b.Efficiency 13b.HSPF/COP/AFUE: 14. HVAC stzing calculation:attached 15. Hot water system: 14. Yes � a.Type 15a.Type: N�At' b.Efficiency i5b.EF• - I hereby cartify thffi the plans and spec(flcatlons covered hy the calculaHan are in compltance wfth the Rorida Review of plans and spedfications covered by this cakulatlon indicates comp0ance wftli the Flarida Enerpy Code. Ener Code.Before const L �1' r4CNon is complete thi buildinp wip be tnspected for complfance in PREPARED BV: � � ,�A G��'�j 'Z accordance with Sectlan 5 D8 DAiE: ! �'.� I heraby certiry th thi d is In co e the jlodda Eneryy Code: / j� CODE OFFICIAL � OWNERAGENT, ! DATE:�0/�+ /� DAT• � C.4 2010 FLORIDA BUILDING CODE-ENERGY CONSERVATION 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received —?p � �Z�" I Phone Contact for Permittin — � � P� _ �..�5 _ �. 7� Owner's Name ° �Ct Owner Phone Number Owner's Address J �p� r •� . Owner Phone Number � —� Fee Simpie Titleholder Name � � Owner Phone Number C Fee Simple Titleholder Address JOB ADDRESS � C� C , � Z 1 I LOT# � SUBDIVISION �— _� PARCEL ID# � �j ' ��' � ��. Lj/[�Q— (��j�Qpp — Q I�-!O (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROP03ED e NEW CoNSTR 8 ADD/ALT � SIGN [� �] DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM Q OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q � DESCRIPTION OF WORK G�C�S��1 C :' S i ^o c,� ` 2' • �''f� BUILDING SIZE SQ FOOTAGE I -1 � HEIGHT g� ] QBUILDING �� L �� �''� VALUATION OF TOTAL CONSTRUCTION J QELECTRICAL $ � �,�C, �t�„� AMP SERVICE 0 PROGRESS ENERGY [� W.R.E.C. OPLUMBING $ � � /,� - "� ��___L1�L f�� OMECHANICAL $ 1 U� 0� VALUATION OF MECHANICAL INSTALLATION � .7 QGAS Q ROOFING Q SPECIALTY 0 OTHER � ��� FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER P' _ � ��.� COMPANY �p —� SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# C � ELECTRICIAN ' � ��. � COMPANY S e ! � SIGNATURE ` � REGISTERED Y/ N FEE CURRE� Y/N Address License# C � PLUMBER n' COMPANY J� � � SIGNATURE ��( REGISTERED Y/ N FEE CURRE� Y/N Address License# C MECHANICAL `° "' � I _� ; � COMPANY � C� � � SIGNATURE �E� REGISTERED Y/ N FEE CURRE� Y/N Address License# C —� OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address license# 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 w/Silt Fence installed, Sanitary Facflities&1 dumpster,Site Work Permit for subdivisionsAarge projects COMMERCIAL Attach(3)compiete 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 consVuction. Directions: Fill out application completely. Owner&Contracto�sign back of application,notarized If over:2500,a Notice of Commencement is required. (A/C upgrades over 57500) "" Agent(for the contractor)or Power of Attomey(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(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 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'SIOWNER'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 aiso certify that I understand that the regutations 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-Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services/Environmental Heaith Unit-Welis, 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 Fiood Zone�V"unless expressly permitted. If the fill material is to be used in Flood Zone "A", it is understood that a drainage ofessionalren I neer "compensa ting volume" will be submitted at time of permitting which is prepared by a p 9 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�t�ction!S I Iunde�stand thatna�separat permit may be�requ9 ed for lelectr cal work, this affidavit prior to commencing plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. permit issued shall be construed to beal codesenor shall i sualncehof a pe mitprevent thehBu ding Officeal from therteafter set aside any provisions of the technic � requiring a correction of errors in plans, mI{Ssrcommenced within si amonths of perm pss a'nce,uo aif wolrk authorized by unless the work authorized by such per the permit is suspended or abandoned Build ner'Offi ial fosa per ohd not to exc'edtn netyr(90) days and will demonstrate may be requested, in writing, from the 9 the job is considered abandone . justifiable cause for the extension. If work ceases for ninety(90)consecutive days, \ WARNING TO OWNER: YOUR FAILURO YOUR PROPERT1f.TIF YOU INTEND TO BTAIN F NANC NG C'O SULT PAYING TWICE FOR IMPROVEMENTS T WITH YOUR LENDE OR AN ATTORN BEFORE RECORDING YOU NOTICE OF CO ENCEMENT. FLORIDA JURAT(F.S.117, ) � �, �+' '� �' � � CONTRACTOR -���-�"��- OWNER OR AGENT� Subscrlbed and swom to(or afflrmed}, e me this S bscrlbed and swom to or aftirmed)befor e is �_�,�y by e � •ZO��Y Who Is/areperso� n�known to me or ha have produced Who islare personally knovm to me or haslhave produced � as identification. �,r CL°�LY� as IdendficaUon. ��� Notary Public ublic ,,,,y."�, JAC LINE EE�20 � Com on N '� Co sion •• � r�is� �'` Commission#EE 040520 �" _w� 'R� r,,,3f���80p„'185�7019 •� . ,� �'-r�ey,�. �T��� T�o F�^ � t i Name of Nota aooae�a�:� �• Name of Notary °"�" - ---__._._ �•. . `�<� � City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: �b�� �--��� I GL�S' �YZ- Date Received: (� � �— ��- Site: ��b�O �.#$-r d r�aX 7�"t''� Permit Type: � � 2" 61f,• `� �"�b�� �tC�d� u� ( c��.�2 s��e� Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑ ( � p � `� L �� f I �`�� �'f�� ! �t � C -S-T�'��;�( f�(��f`f,�`1� .��rt (�_(��' �-t �C'���t ��' S1 �rl`!� , ('{c' e /f' } !d' r % � � > � G � t � '� rr'�J � „ /' / �, � � � � ��f l � �( � � � � �� fF�l't� /� �-"�� �(t�� 1 �;)��� r (�,,�;�,= C!l Y" ���,(7 (�'C�f�'�fl�`I �,(�� ,:�f . � fj fr£.�i � �'�.�"Y �� �i%� LC` , � '' �� �,�` This comment sheet shall be kept with the permit andlor plans. � � � � �� � � ' ��� � Kalvin witze��=� lans Examiner Date Contractor o omeowner ;' � (Required when comments are present) � Pasco County Parcel: 13-26-21-0100-00000-0190 001 Page 1 of 1 Data Current as Of: Weekly Archive - Saturday, March 31, 2 _ � , Parcel ��- --� --- 13-26-21-0100-00000-0190 C d: 001_qf Q ) Classification "'�--- • •------�--� __.. - e a m tty Mailing Address Property Value DOUGLAS ROBERT E)R Ag Land $0 39040 CARDINALAVE Land ZEPHYRIiILLS FL 33542-2207 $16,880 Physical Address Building $40,108 39040 CARDINAL AVE Extra Features $589 ZEPHYRHILLS FL 33542-2207 7ust Value �57,577 Assessed (Save Our Homes) $57,577 Leaai Descri�tion (First 4 �ines) Homestead 196.031 - $25,000 See Plat for this Subdivision �' Non-School Additional Homestead Exemption - �7 577 , EASY ACRES PB 10 PG 100 Non-School Taxable Value �25,000 LOT 19 School District Taxable Value �32,577 OR 6387 PG 1583 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 Zoniny Units Type Price CondRion Value 1 0100 SFR OOR3 8,000.00 SF $2.11 1.00 $16,880 Additional Land Information Acres 0.18 Tax Area 30ZH FEMA Code X Residential Code ZHLALP6 Buildina Information - Use 01 - Single Family Residentiai (Card: 001 of 001) Year Built 1982 Stories 1.0 Exterior Wall 1 Concrete or Cinder Block Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle Interior Wall i Drywafi Interior Wall 2 None Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet Fuel Electric Heat Forced Air- Ducted A/C Central Baths 1.0 Line Descrlption Sq. Feet Repl. Cost New 1 BAS 2 816 $40,841 FOP 128 3 FCP $1,602 — 192 $2,402 4 FST 5 96 $2,402 FCA 360 — $4,505 Extra Features (Card: 001 of 001) Line Description Year Units Value 1 DWC 1982 Z 200 $225 UDU-M 2006 1 $364 Sales History Previous Owner ARNOLD MARY PEGGY Year Month Book/Page � Type Amount 2005 05 6387/ 1583 WD $90,000 1984 12 1383 / 1024 WD $35,000 1981 05 1129/ 1679 $8,100 http://www.appraiser.pascogov.com/search/parcel.aspx?sec=13&twn=26&rng=21&sbb==01... 4/5/2012 r O , r -I �� � �O � C �ln �n Z X Z ��� I ➢ Z c�- �m�o mz N Q����,�J�'� YY ���.��� p�r�T p I U X X X X X X X X X X X zA� ( �OZZ ° o ?0.00' �D� N J �! � ;S7 e W W I O D aJ m 22.5� 8.0� 16.0� � � � O A �� O ` J r)n -� �m � �O n7 � fp �O p 2 Z N ITC7 n � � O O �, o� o ° Dm \ r �_ � Z�v o Q �m i s.o' �`�'' Z N � --I O � � O (�D 22.5' , p D \ O p � � O cn �-� m a �L o � O = � o � mD� O D � vrn � op-v�i ? c'7 O � � � � c z�A O O� .. .� SZ m�� C7A rn C I � O vm� ='o r,.� � o � is.i� 23.3' pp m � p z 24.0� � O O �, - 0 c �o m • � I rn Z'�' N J rn o o�p� rn j,, �A A I X X X �t S 00'01'30" E 100.00' oaDo � � W, r,p pZZ I �m �vl ao 7Z.'n A-� r�*i m S `I � Z z � m O Z�'1 n C � '1 m a � O m N O � � O � � O �..r � • ' � _a n � � � � rn �' rn =-► �o �' �' O � n. � -< Z � � D O '� (7 --�' W �7 'p O m p O � � �- C� p � � � C7� "a O -p CD � Q -� �-�� -Q � � � 1 f'h � � h � O � � (� o 1 � � n � . � p � --�Fi O + °� 'L a� N O N m O fi j � CERTIFIED T0:� -v..,,,,.� , �,�j (n D .17 N m'o'�D�O r°n n� �m o� o� p �p� :OrF7,^^^ �O.o�'�I c �7 o m T C 0 O - o tC S'�j C WY�CI II O��A�w�0 �,'� N 0 � p.� � N N J L �'_+. � O. 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Garcia, Dpty Clerk Permit No. Parcel ID No NOTICE OF COMMENCEMENT State of County of THE UNDERSIGNED hereby gives notice that impravement uvill be made to certain real property,and in accordance with(;hapter 713,Florida Statutes, following infortnation is provlded in this Notice of Commencement:^� / 1. Descxiptlon of Property: Parcel Ident�cation No. � J"' '�C� � � — V l OC� -� GOGbi7 "' d��'/U Street Address: �IDY� '� c��,n� � A,� Ze�j7� h: /��S F-`L �3Sy Z ( 2� General Description of improvement �/o S��na i (1 � C On(`-�- T O J��,(,�,G�� �� 1„e��� : loT 1 S� �I�SY 14C I��S . 46 ��4s ?1�ef eo� c�co ro�tc/ i✓1 1�/qT l300l� l�� ^� P�qt loo Pub1�L I��,c S dF �0 40 C�ovnr�� FLOr: �. � 3. ) Owner Informatitin or Les�ee infortnation if the Lessee contracted�or the Improvem nt: � / �1 n 6 a r�- ^o c�C. �G�S '�f .35 o vbc�,,c"�"'`,�,� l�1 ��e�'r�r- ��� ., r h.` )15 � Address City St te Interest in Property: ���'�-(� Name of Fee Simple Titleholder: (If different from Owner listed above) Address � �/ City State 4. Contractor: �V'�� �l CC/�7`I-rcL' �D` �D Name �� �\D N Address City State ���' �ro Contractor's Telephone No.: N Z m 5. SUrety' ��� Name �w'° T �..ibN o Address City State �3 D Amount of Bond: a Telephone No.: ' o r 6. Lender: � � Name �� � � Address City State �~ � Lender's Telephone No.: � � 7. Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by � � Section 713.13(1)(a)(7),Florida Statutes: � � Name Address City State Telephone Number of Designated Person: 8. In addition ta himself,the owner designates of to receive a copy of the Lienors Notice as provided in Section i'13.13(1)(b),Florida Statutes. Telephone Number of Person or Entity Designated by Owner: 9. Expiration date of Natice of Commencement(the expiration date may not be before the completion of construction and final payment to the contractor,but will be one year from the date of recording unless a different date is specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE N0710E OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of perjury,1 declare that I have read the foregoing noti of commencement an t t the facts stated therein are true to the best of my knowledge and belief. � , r STATE OF FLORIDA COUNTY OF PASCO ignatur of Gwner or e,or Cwner's or Lesses's Auihorized OfficeNDirector/Partn an�ger Signatory's Title/Office The foregoing inst►ument was acknowledged before me this�day oL�,2p�by �� _ �_ eS of authority,e.g.,officer,trus ,attomey in fact)for (na of p rty on behal of whom i rument was executed). Personally Known��R prc�duced Identification❑ Notary Signature Type of Identification Produced„�/_nYC/ C�(�A-� Name(Print) �'"� ,J � •L ion#EE 040520 �� Expires�eoernber 12,2014 G ,�,� aonwarnutmyFaw�M..s�a.eooaes.ro�o: wpdata/bcs/noticecommencement�c053048 �'��,, . PAS,�Q -: STATE OF FLORIDA,C 4�F THIS IS TO CERTIFY THA����F T��EDOCUMEN�' TRUE AND CC�RRECT CO . . . 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