HomeMy WebLinkAbout12-13546 CITY OF ZEPHYRHILLS
� ' S335-8TH STREET
(sis)�so-oozo 13546
BUILDING PERMIT
Permit Number: 13546 Address: 5237 5TH ST
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: 11-26-21-0010-13100-0070
Improv. Cost: 5,400.00
Date Issued: 10/26/2012 Name: SWARTS, CHARLES & BEVERLY
Total Fees: 97.50 Address: 5237 5TH ST
Amount Paid: 97.50 ZEPHYHRILLS, FL. 33542
Date Paid: 10/19/2012 Phone: 582-301-6037
Work Desc: REPLACE 12 WINDOWS SIZE/SIZE
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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)wndemned 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.
"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 reoording your notice of commenaement."
Complete Plans,Specifications Must Acwmpany Application.All work shall be pertormed in accordance with
Ci Codes and inances. NO OCCUPANCY BEFO C.O.
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CONT CTOR SI TU PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
n,o-�ou-uu�u t;iry ot Lephymills Permit Application Fax-813-780-0021
Building Department ,, ����
��.
Date Received �_ �_l'�/ .�
( Phone Contact for Permittin � � _
Owner's Name C 1��, �, W i'�UCY S ��--3d r°G O�
Owner Phone Number 7
Ovirner's Address s�'� S� �7-: � ,� �� �;3S- p�er Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS .�,-3`] �T�` �T �.��H. � y��- `��,� ?� 35�1� �d�� LOT# �
SUBDNISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
VNORK PROPOSED NEW CONSTR ADD/ALT [_] SIGN [� Q DEMOLISH
INSTALL e REPAIR
PROPOSED USE � SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK � FRAME [�] STEEI �]
DESCRIPTION OF WORK �l� A� ��g Z(� N�,�„�� ` S (`z� F� �r'-L�
BUILDING SIZE SQ FOOTAGE C] HEIGHT
QBUILDING a
s 40:�.�rJ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY �] W.R.E.C.
OPLUMBING a �
C� �� �
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � 7 `�
,� ,S �
U� � _ -� I
OGAS Q ROOFING Q SPECIALTY � OTHER �,,� P
FINISHED FLOOR ELEVATIONS I '�f � �
FLOOD ZONE AREA QYES NO v
BUtLDER k , � COMPANY �ow ����,�(-�I`"�'�K�'*���t���,
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address 8:�� 7.,u, � . � �,. ��63)-��� �� � �06�Q Z�
Ucense#
ELECTRICIAN � COMPANY
SIGNATURE _ RECISrEREO Y/ N FEE CURRE� Y/N
Address License# �-
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
IIAECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N
Address License# �
OTHER COMPANY
SIGMATURE 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-O-W Permit for new construction,
Mfnimum ten(10)worlcing days after submittal date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facili8es 8 1 dumpster;Site Work Permit for subdivisionsflarge projects
COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W PeRnit for new construction.
Minimum ten(10)working days after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster.Site Work Permit for ali new projects.All commercial requirements must meet compliance
31GN PERMIT Attach(2)sets of Englneered Plans.
�w�wPROPERTY SURVEY required for all NEW constructlon.
Directions:
Filt out application completely.
Owner&Contractor sign back of applicaHon,notarized
If over 52500,a Notice of Commencement la requtred. (A/C upgrades over 57500)
" Agent(for the conbactor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of ApplicaUon 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"resUictions"
which may be more rest�ictive 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
cont�actor 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 a�e uncertain as to what Ifcensing 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 cont�actor 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 ticensed and is not entiNed to permitting privileges in Pasco
County.
TRANSPORTATION IMPACTIUTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understan s
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildi�gs, or expansio� 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, wiil be identified at the time of
permitting. It is further understood that Transpo�tation 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, ff 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, Flo�ida 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 "Flo�ida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Flo�ida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner", 1 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 ce�tify that all the information in this application is accurate and that all work
will be done in compliance with all appiicable taws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as i�dicated. 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 devetopment regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Watervvays.
- Department of Health & Rehabilitative Services/Environmental Nealth Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, I ce�tify 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 Iots less than one (1)
acre which are elevated by flll, 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 requfred for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(�)consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE F ER�R AN ATTO TS Y Y FUR PROPE RD N'FY OU 'N OTIC T�F BTAIN FINANCI TG, CONSUL7
WITH YOU D
FLORIDA JURAT(F.S. 117.0
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to r aHirme re me th s Subscxibed and swom to(or a ed)before me thls
Jo-I I-r 2 by r0--//-(z- by
o islare personally known to me or has/have produced Wh Is/are perso ally known to me or has/have produced
� as IdentlficaBon. � , ��''�����-r`S� as(dentlficadon.
r,��.-i�,� � _
-�� �..L i �� � _ Notary Public
�„Q Notary Public ------�--
.. , .—_ .,�� .«,
Com i�n�l '' JACQUELIN OGE"s �______ Commissi No •�' ••,
� '� �iss��r�2 2014 ;�; �"`_ �mmission#EE 040520
= ' . -�,: Name of Nota ntelMoe eoo-3asao�e
Name of t� '•
Pasco County Parcel: 11-26-21-0010-13100-0070 001 Page 1 of 1
Data Current as of: Weekly Archive - Saturday, October 13, 2012
Parcel ID 11-26-21-0010-13100-0070 (Card: 001 of 001)
Classification O1 - Single Family
Mailing Address Property Value
SWARTS CHARLES L&BEVERLY A Ag Land �p
5237 5TH ST Land $15,855
ZEPHYRHILLS FL 33542-4041 Building $47,690
Physital Address Extra Features $414
5237 5TH ST
ZEPHYRHILLS FL 33542 7ust Value �63,959
Leqal DescriDtion (First 4 Lines) Assessed (Non-School Amendment 1) $63,959
See Plat for this Subdivision
Taxable Value ;63,959
ZHMB1PG54LOTS78 & N1/2
OF 9 BLK 131
OR 8703 PG 3206
Land Detail (Card: 001 of 001)
Line Use Description Zoning Units Type Price Condition Value
� 0100 SFR OOR3 8,400.00 SF $1.80 1.00 $15,120
�2 � 0100 SFR OOR3 2,100.00 SF $0.35 1.00 $735
Additional Land Information
Acres 0.24 Tax Area 30ZH FEMA Code �Residential Code ZHLHLP2
Buildinq Information - Use 01 - Single Family Residential (Card: 001 of 001)
Year Built 1976 Stories 1.0
Exterior Wall 1 Concrete or Cinder Block Exterior Wall 2 Concrete Block Stucco
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall 1 Drywall Interior Wa11 2 None
Flooring 1 Carpet Flooring 2 None
Fuel Electric Heat Forced Air- Ducted
A/C Central Baths 2.0
Line Description Sq. Feet Repl. Cost New
1 BAS � 1,532 r- $57,297 -�
2 FOP 54 $524
3 FCP 216 $2,020
4 � FSP 160 $2,094
Extra Features (Card: 001 of 001)
Line Descrlption Year Units Value
1 DWSWC 1977 200 $188
r- 2 UDU-M 1983 1 �22(
Sales History
Previous Owner YEBBA HELEN
Month/Year Book/Page Type �ode Condition Amount
05/2012 8703 / 3206 WDeedty �� Improved $77,000
08/1976 0852 / 1100 � Vacant $6,500
http://appraiser.pascogov.com/search/parcel.aspx?sec=11&twn=26&rng=21&sbb=0010&... 10/18/2012
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
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Contractor/Homeowner: �� �l�'il�/1.S �/��l<"h ��G2��1.J'
Date Received: �������Z
Site: �� 3 7 �s� CST
Permit Type: ���14�� �� �t,�� YcGf� S� ��/s�Z2.
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.
D �%�'�/�--
Kalvin S 'tzer—P s Examiner Date Contractor andlor Homeowner
(Required when comments are present)
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�--= LICENSED • BONDED • INSURED
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Pasco County Building Schematic Page 1 of 1
Generalized Building Schematic
11-26-21-0010-13100-0070
Card: 001
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Pasco County Property Appreiser
Page Layout Modified: 10/4/2010 3:18:46 PM
The Local Time Is: SO/5/2012 11:33:52 PM
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Pasco County Property Appraiser Page 1 of 1
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Data Current as Weekly Archive - Saturday, September 29,
� �� 2012
����e Parcel iD 11-26-21-0010-13100-0070 (Card:
R+��ds �,e��h aoi ot oai
Classification 01 - Sin le Famil
����� Mailing Address Property Value
����� SWARTS CHARLES L&BETTY A Ag Land �p
"" ���~ = 5237 5TH ST Land $15,855
s!' w�' ZEPHYRHILLS FL 33542-4041
" '��� ° . Building $47,690
��;;� �� ` '� PhySiCal Address Extra Features $414
�� ;: ° � ° `'`�`, _ 5237 STH ST
ZEPHYRHILLS FL 33542 7ust Value �63,959
�. � �m Legad DeSCriptiot� (Flcst 4 Unes) f►ssessed(Non-schoo�
� Amendment 1) $63,959
See Plat for this S�at�divisron
'�`� �a°� �` ' ''°��- � ZH MB i PG 54 LOTS 7 8&Ni/2 Ta�cable Value
�" �i��'�*,, #63,959
f'" OF 9 BLK 131
4 OR 8703 PG 3206 �
°�s ;, u ,.,a�, •w.�::
r __ __�;. .�,4_:,� _._h_w�� l.and Detaii Card: 001 of Q01
tine Use Descri tion 2onin Units T Price Condition Value
1 0100 SFR OOR3 8,400.00 SF $1.80 1.00 $15,120
2 0100 SFR OOR3 2,100.00 S� $0.35 i.00 $735
Additional Land Information
Acres 0.24 A ea �QZH C�e X Residentiel Code ZHi�ti�P2
Suildinq Infor�nation - Use 01 - Single Family Residential (Card:
001 of 001)
Year Built 1976 Stories 1.0
Exterior Wall Concrete or Cinder Exterior Wall
1 Block 2 Concrete Block Stucco
Roof Gable or Hip Roof Cover Asphatt or Composition
Structure Shingle
Interior Wall Drywali Interior Wail None
1 2
Flooriny 1 Carpet Flooring 2 None
Fuel Electric Heat Forced Air- Ducted
A/C Central g�� 2,p
lane Desc.ri 'on . Feet Re 1.Cost New
1 �A� 1,532 $57,297
Z �Q� 54 $524
3 FCP 216 $2,020
4 ��F 160 $2,094
E�ctra Features Card: 001 of 001
•--- ^---._�--- ----- ••-_..- ••-�--- '
http://appraiser.pascogov.com/ 1015/2012
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AppilCat�on Type •R I
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Appilcatlon Status approved
xApproved by DCA.Ap vvals by DCA shall be revlewed and
retffled by the POC a Jor the CommVsslon fP necessary.
Camments ��
Archlved t-
Producc Manufadurer Simonton w�ndows
Address/PhonelEmali i Cochrane Ave
Pe�nsb�ro,WV 26415
(800)746-6687 Ext 2329
nPPaey_davles�stmonton.com
Authorized Signature Tffhany Davles !� I u;���
tlffany_davtes�slmonton.c � � SN��,�,('QM�t y,t,j_;�,r ^r
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Technlcal RepreSentative Tiffany Davles C��:�, ;Vh['1;),°vr��t,L ' , r�' ��_t;; �
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Add�eSS/PhOr1P,JER1811 PO 80%164b CITY �)r 71'[�rr�.r,�,li , �,,�n .� � �l '
530o Bnscoe Road �
�.� ParkersburQ,WV 26102
(800)542-9116 Ext 9329
t�f�any_davles�simonton.eem
Quatlty Aswrence Repres�ntaHve AAMA
AddresslPhone/Emall 1627 Waiden Offite Square`�" �VV -,-_ /� „�
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5chsum5burg,TL 6Di73 {vlr��F ZC�� v✓�%''
(84>)303-5664 P�/�NS� NYR�1��S
webmaster�aamanet.or9 XqMlNER
Category winaows
Subcategory Double Hung
Cbmplianee Method Certificatlon Mark or Gsting
CertlFlcaqon agencV Amer+can Arcfiltectural Manufacturers Assoclation
Va�ldated By AmeNcan Architectural ManuPactu�ers Assoclatlon
Refet�nced Scandard snd Year(ot Standard) Standard Ycar
AAMA 450 200b
n�+Ma�50 2010
AAMA/WDMA/CSA 101/I.5.2 A440 2005
EqulvalenCE of Produd SCa�dard5
_ CertlflCd By
',`�:
� MAY. 1, 20121, 3: �9PN�e O�BRADCO SUPPLY CORP N0, 0683 p�P - 2' ofs
�� prpduCt Approvel Method Me�od 1 Optbn A
D�ce 5ubmitted 03J27/2oi2
Date Validated 03/27/2012
Date Pend�ng PBC Approval
Date Approved 04/05/2012
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- Summary ot Products _�_._.l
Model�Number or Narne esai on
516>.i 07-Q9,07-10�nd 07-20 eflectlons 5500,PMsm Platinum,Sears 9300 Vlny)
Double Hun
Lin►ihs of Use ertlfication Agency Certificate
ApproVed for use in HVH2:Na FL516T Rii � C�� n�.09 DH 37xB4 R60 ndf
, Approved for use outsida NVHZs Ye4 FL5167 Ri - 07-20 w v 07-
zmpsd ResistaM;No Qua{{ty Assurance Contrait Explrat}an Date
Design Pressurc: +60/-60 07/28/2013
Other:37x84 �a1lation instrvetlons
5� RSl II I 1 - - 0 7- DH 2 .
VerlFled 8y:Amer�tan Architectorai Manufacd.irers
ASSOCIatlon
Created by Independtnt Tri1rd Party:
Evaluat�on Reports
Created by Independent 7hird Parry:
5157.2 07-09,07•�0 and 07-20 Reflectlons 5500,Prism Platlnurn,Sears 9300 Vinyl
oovb�e Nun
timita of U9e Cerelficstion Agenep CertiHcate
Approvcd for uqe tn HYHZ:No FL�167 R1 i _ r�C 07-09 DH 36Y63 RSO odf
Approved fp�usG oWSide HVHZ:Yes 167 1 07-d H 65. df
Impact R¢sist,in�No FtSi67_Rli C GC 07-0 DH 42x64 RSA n�tr
�esiyn PrcSSUYe:N/A FL5f67 Rtl G GAC 07-09 DH 47x72 R50�j
�j. Othar.4gxg0(+J-25 PSF),56x84(t/-25 RSF),53x�6 FLS167 Rii C C�,c o7.no nu dQ,.gd�5.p�
(+/-50 P5F),36x63(+/-50 PSF},42x64(+J-50 PSF}, 167 1 7•49 D}{ 0_ �
7x71{+/-50 PSF),37x76{+/-65 PSF) fl516 li�� r C,e p?-09 DH 56x84 R?S n�1I
FL5i67 R71 C CAC 0�-1A p7.Z0 walver tg 0�-09.adF
uapty Assursnee Contraet EYp;ration Date
03/13/2033
nsEnllarion instructions
FL5167 R11 I7 IN006�07-a9 07-9A 07••?0 DN 2X n�f
vert�e0 By:AmE�ic�n Archl[etiuraf ManuPaclurers
usodation
Creat2d by Independent 7T�Ird Party;
valuatSon Reports
Greated b independent m�rd Pa •
5167,3 07-09,Q7-10 and 07-2d ReAeeeto�s 5500,Prlsm Piatinum,Sears 9300 vinyl
Double Nun uv�qt Transom
Unmhs of U6e Cere�cation Agency Certificate
ppfo ed for use ID iiYHZ;No 1 7- W oVer DH 37�r1p7
Approved for use outside HVH�Yes df
Impa�t Re�istaot:No R51i7 Ril C �A�p7-09 PW nv�r DH 5 xym
Deslgn Pre�gare;N/A R55, f
Other;53x1p7(+/-55 P$�&37x107(�-/-65 PSF) 167 R C - a7•ZO w to 7-
Qualhy/1s5urancc Contract Expiratlon Date
oa/ia/to�a
nstallstlon instrudions
167 R NO b -09 07-1 - 0 DH w-
2X.
ver�fled By:American Archleecturaf ManuPacturers
Associstlon
Created by Indepe�dent Third Party:
Evaluatton Reports
Created b IndependeAe Third Pa •
5367.4 07-20(Nailing Fin Installaqon) ReAeaions 5500,Pnsm�latlnum,5ears 9300 viny�
Double Mung
lim!!a of use CertiAcation Ay�cy Certtflcat�
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� 2012170835
Pertnit No. Parcel ID No !J - �-6- ' l ` �� I D -->3 r o,�-oO"��
NOTICE OF COMMENCEMENT
State of �t--� �� p � County of 'r 1/�S��
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,
the following information is provided in this Notice of Commencement:
1 Description of Property Parcel Identification No. 1 l - �-�2�'`" O O t d `-�3 �C� �- OC3� �
StreetAddress: ��-�� �`�— � T ��'��J�/�/,L,�,S��L. �y-��l Z"�d�'�
2. General Description of Improvement U'�� G�['�'" Z �N '� S� 2L� ��
� � 2�" o ��7�-,�. Co s T .�; '�d0.�O
3. Owner Information or Lessee information if the Lessee contracted for the improvement:
�
t-}��i?� (�. �w a�•�Ts
Name ���
5 Z 3 7 ..�'—' �� �iAh�fi Rf�l�.,LS
Address �p City State
Interest in Property: �12(� I��/ �gNG� 3 3 5�/1� ���f/
Name of Fee Simple Tideholder:
(If different from Owner listed above)
Address � rp .�L��� �� ����� � City� �`��� �,��` State
4. Contractor. �Pof�i� D..
'�gz.o am��Y1 5 � D., +�-P� �L'
RAddress City State
Contractor's Telephone No.: $( 3 -7 g� � � ( 3S 33��s�—��g
5. Surety�
Name
Address City State
Amount af Bond: $ Telephone No..
s. �ender: Rcp!:1466645 Rec: 10.00
S: 0.00 IT: 0.00
Name 10/09/12 E. Munguia, Dpty Clerk
Address City 5tate
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:
PRULA S 0'NEIL,Ph D PRSCO CLERK & COMPTROLLER
Name 100R BK ���� PG�277�
Address City State
Telephone Number of Designated Person:
8. In addition to himself,the owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes.
Telephone Number of Person or Entity Designated by Owner•
9. Expi�ation date of Notice 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 NOTICE 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 ANQ POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITM YOUR L6NDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YouR NOTICE oF COMnnENCEnnErvT.
Under penalty of perjury,I deciare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best
of my knowiedge and belief.
STATE OF FLORIDA � � '
COUNTY OF PASCO
Sign ure of Owner or ssee,or Owner's or Lessee's Authorized
Officer/OirectodParineNManager
C�!�► N�
Signatory' TitlelOffice
foregoing instrument was acknowledged before me this�day of�,20/�by �� ��'�� `--
l�(T �.r as C��� 1/�f� (type of authority,e.g.,officer,trustee,attomey in fact)for
i(� (name on behalf of who instrument s executed).
Personaliy Known❑�Produced Identi ication Notary Signature
Type of Identification Produced-��-s�-�/-,� Name(Print) �
,�
� , r �,,,,rmp-�`"p"""`a
�` ..m+�,:�' "�eStV��'' �
- ,,,nr��"`'�`��- "¢�� s=W'�ati.,�.i.`�3iH G' "l�"ti'a"3 ${
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` � .,�' . ;ly •
i
wpdatalbcs/noticecommencement�c053048
,��j►� . • • .L'�ip� STATE OF FLORIDA,COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FQREGOING�5 A
�b� G�,1 TRUE AND CORRECT COPY OF THE DOCUMENT
ON FI�E OR OF PUBLIC REC�RD IN THIS OFFICE
* � r�G«twe�r • � WI)' S MY HAND AND OFF CI L SEAL�i�_
* • � _°� �* DAYOF _
2
. P ULA .O'NEIL, CLE K COMPTROLLER
# ]88� * �' UT'Y CLERK
�'l • • P
BY
��0�FI.O�
�