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HomeMy WebLinkAbout13-14042 � CITY OF ZEPHYRHILLS � 5335—8TH STREET ' (si3)�so-oo20 14042 BUILDING PERMIT ,;,4�, ,a�;�� � ��;�,, .���. Ro<', Permit Number: 14042 ��Address: 5429 8TH ST HISTORIC Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-12100-0040 Improv. Cost: 3,985.60 �s;�.=a° >,�{��; Date Issued: 3/29/2013 Name: FEE, WILLARD W/JUDY Total Fees: 82.50 Address: 5429 8TH ST -HISTORIC Amount Paid: 82.50 ZEPHYRHILLS, FL. 33542 Date Paid: 3/29/2013 Phone: (813)782-2050 Work Desc: REROOF/ROOF OVER FLAT ROOF/ADD 12 X 30 PORCH W/ROOF 'H' �� 9 �,��, ��` � .5 (� � V �JY�G� V ' �F, `�,�&',_��',V•��B R1- � ',�� � �rt d��;� �4 TAPE JOINTS OF IN P FINAL � -� -� REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c)when extra inspection trips are necessary due to any one of the following reasons: a)wrong address b)condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d)work not ready for inspection when called e) permit not posted on job site� plans not at job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your properly. 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 acxordance with City Codes and Ordinances. NO OCCUPANCY BEFO C.O. �'L l ! ,/l,'^,? L-C� �2"—f' CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER i � s�� ... G ..,.� � °s f�,, `� �� .�' � � N ,�,... �z�� �--_ - ��1��� � � �� City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: J/��l/� ,-�� �� Date Received: ��I�— �,_�j Site: ,� � Z� �� � � Permit Type: 2E rC`� ('> ��� ��� � Z x ,�j0��� �� (� � Y��� Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑ � � , � � � � � ? - ', � t/'�I ��P- C� t�� ��^C n ,. ( /!( ' L' � �/ � f� �i�1°�t/ � � �l � S ! �i �� �ft e% This comment sheet shall be kept with the permit and/or plans. ,�� - ,� f ,,����:�`�`� , , / ��.� � f .� �� =��%�-� � 1�%C��i�� �-�/ ���_ Kalvin Switzer� 1�Examiner Date Contractor and/or Homeowner (Required when comments are present) 9�3-�8Q-ap2Q City of Zephyrhilis Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for Permittin . � , Owner s Name •;..�;��- Owner Phone Number r Owner'sAddress � /ii .�% 2 �,�C � -,��.,r.�- y"�'�`°.�:'', ��'~� Owner Phone Number � '�'�� �% 3 y r �..�'.:'s` r�; �° Fee Simple Titleholder Name Owner Phone Number �— Fee Simple Titleholder Address JOBADDRESS r3 � �"� .��",,-t;< r, :�'. - c . �0/�T,�'r '� '" LOT# SUBDNISION PARCEL ID# //- »Gt;- _ ��;;,, _ ,�„�,.�: (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED B NEW CONSTR 8 ADD/ALT � SIGN Q [� DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM [� OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q DESCRIPTION OF WORK ` ,J f f /: � , , A� t:� 1'��A; "-1� d'i�t..d +'r�.�- "'�` ,3'C.r�d r� .S- ,'i�:r".'�.'. BUILDING SIZE � SQ FOOTAGE� HEIGHT ] Q BUILDING $ VALUATION OF TOTAL CONSTRUCTION 3�8s', �a QELECTRICAL $ AMP SERVICE O PROGRESS ENERGY Q W.R.E.C. QPLUMBING $ ,����y � QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION , . QGAS Q ROOFING Q SPECIALTY � OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO c.��Z��C�,`��7 i BUILDER COMPANY SIGNATURE `� L `, � � _ REGISTERED Y! N FEE CURRE� Y/N Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# � MECHANICAL COMPANY SIGNATURE REGtSTERED Y/ N FEE CURRE� Y/N Address License# —� OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Addreas License# 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,ConsUuction Plans,Stormwater Plans w!Silt Fence installed, Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisionsAarge projects COMMERCIAL Attach(3)complete sets of Building Plans plus a Lffe Safety Page;(1)set of Energy Fortns.R-O-W Pertnit for new constnicUon. Minimum ten(10)working days afler submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary FadliBes 8 1 dumpster.Site Work Permit for ali new proJects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. ""PROPERTY SURVEY requ(red for all NEW construction. Directions: Fill out application completely. Owner&Contractor sign back of application,notarized If over s2500,a Notice of Commencement is requlred. (A!C upgrades over sT500) " 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 misdem�an�op yiolation under state law. If the owner or intended contractor are uncertain as to what licensing requirements ma a I 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 nvt entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT/UTILITtES 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 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 �eceiving 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 wo�k 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 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 Fforida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: Use of 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 "compensaiing 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 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 1 am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for 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 justi�able cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S.117.03) � _ . '� � CONTRAC ' � OWNER OR AGENT� � ' '�� Subscribed and swom to(or afflrmed)be re me s Subscribed and swof to or affirmed)before me this by by Who is/are personally known to me or has/t�ave produced Who islare personally known to me or ha as de Ufication. as idenUficadon. 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'Se"5'�� .. - . v�+ „ kr - APPLICATION FOR A HISTORIC DISTRICT � , "CERTIFICATE OF APPROPRIATENESS" ay sra�t•Application # Contributing: Yes/No Date Submitted: ����;P"�"`� - '\...-. ' t� % (Applicant, Pfease provide information between the double lines) ������ PropertyAddress or Location: J�''�� `'�F� ��� �'"j#%' ��'�'" ��``.��',�,fi+'� ��,Pr�,��; t��'„,�,,,, Owner's Name: �JU 1 1..���' ��a ����~. S�: Phone: �;.+� �,� �� ��„ "'�1,��'.! Applicant's Name &Company(if different): � ApplicanYs Mailing Address: �`".�- �� `�j �°; �`� �`,�•�' ���..`w,� '.��"�,.,�.,�}� w�, �. . , `, , , � ���.... App. Contact Info: Phone: �,,/g,�, � Fax: Email: Type of Property: Residential Commercial� Public or Other PROPOSED RESTORATION/RENOVATIONS/REPAIRS/RELOCATION/ ETC: Exterior Walls Signage Exterior poors Lighting ""'""'""°""""'°-- Windows _}�New Main Building Addition to Existing Buildin �_Porches New Accessory Bldg. gar , ,sii Awnings or Canopies �_New deck,ramp,patio,etc. Fencing Building, Demolition or Relocation • � Exterior Painting&Color Changes —�Generai Repairs(describe below) ���"' �Roofing Other'(describe below) Detailed description of proposed work: attach other sheets if p essary '�' '�-'�, �� i ��X� '". ��'�� v ,�" �s}y�'� '�' '� ,.d ,.� c P �a✓ a� .s. � , � , The Historic Preservation Board requires that the following information MUST be included with an application prior to the application being accepted by staff: • Detailed Plans,including a site°la�and elevation(s); � • Color and material samnles; �k • Manufacturer's sales literature; � • Photoaraahs:and � • Any ofher supqortina documentation to show that the proposed work is consistent with the adopted Department of Interior Standards. , �� ` � �/l�� �-l--/� �'.�l.a '�`� ��� SIGNATURE�OF THE OWNER and/or APPLICANT (Applicanf do NOT write BELOW this line) ACTION TAKEN: Date: �� ��'By Staff: Approved Denied Reason for Denial: L�J'By HPB: Approved � Approved with modifications noted below*and/or on attached sheets Denied � *HPB Condition(s)of Approval: , � f Signed: � �.� Date: J I �.? CITY OF ZEPHYRHILLS BUILDING DEPARTMENT Owner: �t� ',C./�I l..t.� `.X �-- ,..� �;�,., � �`e�'� -J (1�c. r—c � Job Location/Address: ,.��.�'�` ,��' �� {.:� "f- , � � _ .� . - - �" �� `i 4�/' � S 1"J f a �. Pazcel I.D. #: /-, rs?h � �/ - UD/�� - /�1!�D � �t��'Cj SHOW ALL EXISTII�TG&PROPOSED STRUCTURES GIVIl�IG DIlvIENSIONS&SETBACKS UTILITY BUILDINGS MUST SHOW SIZE &FOUNDATION INFORMATION L �s � � ,7iz o r��s�d � � ` � . �l � o�� � , �� �° � � ,.. � � � FRO1rTT PROPERTY LINE �'1 — — — STREET — — — — — — — — — _ _ (NOTE EXAMPI,ES 1&2).. Example 1. Setbacks for Rl &R2 Zoning Example 2. Setbacks for R3 Zoning �— � ar �� 10' ' �,.�J��� PE _.�..�---�=- R X ' 0 I 10, � EXIS'flllG � ia p S 1� ta 0 T �� S I �� E N D (3 ., ; . -7 , 20' �1'•SIN(HEFM�.Y! 30'DUPIFX FRONT PROPLRrY LDtE lRDA7'PxOPt&77 LDit - - - STRLCf - - - - - - - - - - - - -- SfBECI' -- - - - - - - - - - � DISCLOSVRE ST�'►'F•�•NT .FOR OWNER CI.TY OF ZEPHYRIiSI�I+S Bt7=LD2NG DEPARTMENT =�1 • have read and fully understand and agrae �to the provisions of �this instxvm�t. The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroo£ing his or her own domicile, •that he or she actually occupies, or wi11 occupy �y said domicile, and same is not for •rent, lease or sale. That he or she shall comply v�rith the following conditions: 1. That the ovmer aad_he or she alone sha11 act as the builder for a11 phases of construction. - 2. That the owner will co�ply with a11 provisions of tlze City of Zephyrhills ordinances and codes pertineut to the buildiag. 3. That in the event various pha.ses of constructioa are subcontracted, he will engage only �properly licensed subcontsactors and will personally supervise such work. 4. That in the event the Buildiag Inspector shall rei"re corrections to be made, the owner will assume full responsibility to insure •they are made, and upon cc�mpletion wi11 ca11 for a r��n-�ctioa before proceeding with the building. 5. That the owner sha11 assume �fu11 responsibility for the coastsuction aad wi11 not axpect_ supervision of his work from the City of Zephyzhills Building Depastment. 6. 2'hat prior to final inspection aay adciitional fees, including reinspection fees, must be paid ia fu11. A written requast from this office sha11 constitute an official notice -to pay additional fees.. 7. That the owner sha11 comply with a11 City, State and Eederal laws in regBrd to social security, workman's compeasation, lien 1aws, etc. , where applicable. 8. That the owner sha11 comply wit�i al1 the safaty codes issued by the Florida Industsial C��ssion. 9. 5tate 1aw rem,;*-es constxl,iction to be done by licensed contractors. You have applied for a permit undes an exemption to that law. 2'he exemption a1loFrs you, as the owner of your property, to act as your own contractor Frith certaia restrictions even though you do not hane a licesise. You must provide direct onsite supervision of the construction yourself. You may bvild or improve a one-f'amily or two-family residence or a farm outbuildi.ng. You may also build or improve a commercial bvilding, provided your costs do not exceed $25,000. The building or residence must be for your own use or occupancy. It may not be built or substantially �.mproved for sale or lease. If you sel.l or lease a building you have built or substasitially improved yourself within 1 year after the constr�iction is complete, the law wi11 pres�e �that you built or substantially improved •if for sale or laase, which is a violation of this exemption. You may not hire ari unlicansed p@rson to act as your contractor or to supervise people working on yovr building. It is your responsibility to make sure that people employed by you have licenses rec�,;red by state law and by county or muriicipal liceasa.ng ordinances. You may not delega.te the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being doa�. Aay person working on your building wlzo is not licexased must work untier your dirsct supervision and must be employed by you, which meaas t�at you must deduct F.I.C.A. and Frithholcling tax and provide workers' compensation for that employee, a11 as prescribed by 2aw. Your constxuction must comply with a11 applicable laws, ordinances, building codes, and zoning recJulations. owr�R�s s= �tn� 'rGi��} vl-y�� �1�---�- r,n� ALL.�^.SS �./+-� l I� f�FC ff/F� � �•/`+'.. �Vl\L' / �. ���� .+..{�� � If �f h _-_-- ` .� W=TNESS PERMLT # . .� '�' ,s� .ti, � � i. Y r�' a'�� � � ' r�" � �J � _ �s� �,e �a, , �`� c� � � � �, �— i.� � ;,x °► c �� �� �1' `. � �•'� � l '`a y �_ � � :�� � �� —~ V:� �� � � � �� � � � �� r4 ' ., .J , - �}. � '`� v � �� - � �,, ..,�..,._.. ____� --_ _ --- "``� �—� � ''` ,�, � . -- � �- � � ; � � \� j� � � �i � -� � $ ; 4 � � � � 4.. I � -�- - - � � �Y � � � � ; ! ; r� � r� . : " ' � +� , - �---- - -- -- -.._ � o �^' — ---- � ` � � @� � � ��i � � � � � .'_ 5 r + � i � � � Y � �.� � '�C� � � � S ...i r7 � ,s' �'y. � � C :��� � J L � 4� � �.� � ,.r+-�-.«..-„__.�Y.�.»,-�.-..4.�j,„....,......�.�. ....,pa-., - �,����•�,- i'°'.., __ .._�...r_..... _ m=._._.� ..,.._-,_,...a.,,�,- - -....,.�......-,� �_�._ � , j � 1 � '/ I � � � � . (� -�4 _� .� ��. ��j�'� � '`'� �' ; ; � � � '� � �y �,�, , � � , � ' ,° `o. ,, �_� ; � i ' '�' v , � ,� ` ..�. �� � � � � � � � � � � � ;� I r ; .� � �, � �� � �' ,-�`° � � � � � � �.�.� ��' ���' � � ' � �, �,,, � ' . `�' �� �.,� � ` •�"` „ , � a:�, , � � � � � � ,� � `,` k's � • t._ � •{ � ----- � 4 � \ � � � � P � � , � �� .� �r� �� . .�`'� '� T� --� r ' ��� ����� - . 1 � • � � '� ' .� �� � ....>.. �� � � � ��V��� ; � � �-� . � � �� � . .: � � � �6 1 w...r ( �:,�.��,..�' �,� � t��', �-, � � r�. .�, _ .� ��.X$� � ' � ��� ����� � � � �ta�°�� �'���'��- ���� �;� � f • - - - #. � , —�-�� ���,�;�� —�-- ----�--_�__ ___ _� � �._`.___.._�___�__ _..�.M....._.... _ ._— ; � � �.-�_ �._.�.�.. � �._ �.�.�..�,, � �� � �,,, ; � � { � ��,��: ,��_�_ � ; � � : . � � � , � s � � ,� r�—,��� a � �� � � � � ��� � i . < < � F ,;� �� - -� ; �°������- E �� � . � �� �.. ��� � , , �-• `��V�� .�.� d �,, �(Al� .�.� �` p 4� �qeaf � �` ��l � � � � � ��.� � ��.�,� � � ',___ �_� ` , � � ��� - `x `� "�.� �, ��.������7 � � �� n�W,� _ �� � `�, �'� � � ..___ �rF �vc��� D�� � �_....__ .` „��,��, � F � � . �..�� � � � � . :��� — - �� s ` � `r e � � =``� ; � �. � � � ; � � � � � � ; � ., � : � �' � r.. . ,�� � ���r-� � ___ _ � __ _ . _ _.___.,____ � � . __ _ �_ �---� �����r �' , —. � � ,, � a. ; �-- �� � � ti_ � E ` � i ��, �' � ' + V � � __ ----�--,� �--��--� ___ Illllllllllllllllllllllllllllllllllllllllllllllllillllllllll . 2013055715 . Repl:1508344 ITeC0.00�00 D5: 0.00 �►erk 04/01/13 C. Mlne�, Dply PR�Lii S 0'NEIL,Ph D PFlSCO CI.ERK 6 COMPTROLLER 04oR1BK �849 1PG�3197 NOTICE OF COMMENCEMENT Permit No. Property Identification No. dI-�zd-2/-DDIO���j pO"00`t(� TI-IE LINDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Section ' 713.13 of the Florida Statutes,the following information is provided in the NOTICE OF COMMENCEMENT pq��(�Z� (a+"1�H�2�pk rh�(�f�/31 ol>s4S/�f� Lof-3A11�a�SV�-"l�i'rc) 0�4/0� 1 Description of prope (!e al d s�lpefon:)�Ch'cAn 1 I��01�JY`S h�P 2(�s6L� ,' ��2)� f'�s e p C�y��'� f a) Strcet Address:S Z 4 5r 2. General description of improvements i-erdt�Q /rP rcn2 R>.�.- Q� �I �� f�n��C=�J r 3 Owner Information �;r fQr � �� re a) Name and address: l� K. b) Name and address of fee simple titleholder(if ot er than owner) � t r = ,3 yL c) Interestin property 4 Contractor Infortnation a) Name and address: �"� f�.s �G(���� b) Telephone No.• Fax No.(Opt.) 5 Surety Infortnation a) Namc and address: b) Amount of Bond: i c) Telephone No. Fax No.(Opt.) I 6. L,ender a) Name and address: 7 Identity of person within the State of Florida designated by owner upon whom noticcs or other documents may be scrved; a) Name and address: b) Telephone No.. Fax No.(Opt.) 8. In addition to himself,owner desig�ates the following person to receive a copy of the Lienor's Notice as provided in Section ,t ,� 713.13(1)(b),Florida Statutes: � * a) Name and address: `�G� � '• * b) Telephone No. Fax No.(Opt.)_ G 9 Expiration date of Notice of Commencement(the expiration date is one year from the date of recording unless a different date is � iL specified): �' 3\� ti � WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF � rt � • COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13, 0 � o b � FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IPROVEMENTS TO YOUR PROPERTY.A � �'� � NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THF.JOB SITE BEFORE THE FIRST ` INSPECTION.IF YOU IIVTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE �� ���� COMMENCING WORK OR RECORDING YOU NOTICE OF COMMENCEMENT �S � � ' STATE OF FLORIDA > I * � '�' COUNTY OF PASCO �%�/���Zp/ 9�!/ �..C-G SignaNre OF Owner or pwner's Authorized OfficedDirecwdParmedMamgcr 1�f/i'.L,C�i('�� Lrl � C�i 2 �- W �n / "�w � � Print Name U � � J The fore�joing instrument was acknowledged before me this2�day of /V luY C,N 20�by � z j Q 2 `J V ��,`�am � �� az (type ofauthority,e.g.officer,tnistee,attomey in fact)for Q � U C�� (7� j ___ (name of party on behalf of w 'nstrument was executed) d ()�= cv , lL W f— W a W ~' ersonally OR Produced Identification No Si a � � � — �r O z a �'' o = - � Type of[dentificalion Produced Name(p NE�S Z W O � � U � �j� Vcrification pursuant to Section 92.525,Florida Statutes.Under penalties of pe , ',IK�t r��' g and that the facts stated = F'— >- O�. in it are true to the best of my knowledge and belie£ �wr � 1-- a tLl � Y U �LO � Fow.�srt+ac.N,�oo� Q 2 C,U SipuneeofNr�eJ Pawn S�pnyAbovc F— O >- UmQ U L � � ~ � az oJ t�' U �� 0 Z \� O I ooQO � o r�, cn �wc� � � Q � w � z .� v�i �-_- �p�',_. Q >- a m