HomeMy WebLinkAbout13-14303 CITY OF ZEPHYRHILLS
r , 5335-8TH STREET
(sis)�so-oo20 �3
FENCE PERMIT
Permit Number: 14303 Address: 7943 MERCHANNILLE CIR
Permit Type: FENCE ZEPHYRHILLS, FL.
Class of Work: FENCE/NEW Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CRESTVIEW HILLS
Est. Value: Parcel Number: 35-25-21-0120-00000-0510
Improv. Cost: 3,837.00
Date Issued: 6/19/2013 Name: MILDER, SHANNON
Total Fees: 45.00 Address: 7943 MERCHANNILLE CIR
Amount Paid: 45.00 ZEPHYHRILLS, FL 33540
Date Paid: 6/19/2013 Phone: 813-598-1938
Work Desc: INSTALL 6'H 196 FT PRIVACY FENCE WHITE
BIG DOG FENCE INC (813)907-9877 FENCE 45.00
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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 properly that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
CONTRACTOR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
si�-�aaoo2o City of Zephyrhills Permit Application Fax-813780-0021
Building Department
Date Received phone Contact for Pertnittin
Owners Name p Owner Phone Number —f/G �� p
Oxmers Address 1� I Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number ��
Fee Simple Titleholder Address
JOB ADDRESS � y Y l� I r' � !'�/ ,3S LOT# �
SUBDIVISION ( PARCEL IDI� S� 'Z��O�ZD"DDOO O �fS f
loeru�o Frm�weovexrv r�x Nonce�
WORK PROPOSED e NEW CANSTR 8 ADD/ALT Q SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL Q
DESCPoPTION OF WORK L I � //� C , � �
BUILqNG SIZE �—� SQ POOTAGE �7 HEIGHT ��
QBUILDING $ �� •D a VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ � ���
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ,.f�j� �
��
QGAS Q ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N F�curtrtEn Y/N
Address License# ��
ELECTRICIAN COMPANY
SIGNATURE r�c�+s�rtEO Y/ N F�cura�n Y/N
Addreas License#
PLUMBER COMPANY
SIGNATURE r�c,�s�r�o Y/ N F�cura�n Y/N
Address License t �
MECHANICAL CpMppNy —�
SIGNATURE r�r�sterx�o Y! N F�cuzr�n Y/N
Address License f
OTHER COMPANY �1 � C�-a Ti� .
SIGNATURE REGISTERED Y/ N FeE CuRRen Y/N
Address �����t �0/rCJ! �r Y�'[a,C. ,GL� License S
111111111111111111111111111 111111111111111111111111111111111111111
RESIDENTIAL Attach(2)Plot Plans;(2)sets W Building Plans;(1)se[of Energy Forms;R-O-W Pertnit for new construdion,
Minimum ten(10)working days after submittai date. Required onsite,Construction Ptans,Stortnwater Pians w!Silt Fence installed,
Sanitary Facili6es&1 dumpster;Site Work Pertnit for subdivisions/large projects
COMMERCl/LL Attach(3)complete sets of Buildinp plans plus a Life Safery Page;(7)set of Energy Forms.R-O-W Pertnk tor new oonstruction.
Minimum ten(10)�wrking days after submittal dete. Reqie'red onsite,ConsWd'an Pl�s,Slamwater Plans w/Sitt Fence installed,
Sanitary Facilifies&1 dumpster Ske Work Pertnil fa aN new projeds.All comme�cial requiremerrts must meet compliance
SIGN PERMIT Attach(2)sets M Enpineered Plans.
""PROPERTY SURVEY requred for aq NEW constnx,tion.
Direetrons:
Fill out application completely.
Owner&Contractor sign badc of appliption,notarized
If over i2500,a Notice of Commencement is required. (A!C upgrades over f7500)
`" Agent(for the conUactor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Ony)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIOUSurvey/Footage)
Driveways-Not over Counter'rf on pubNc roadways..needs ROW
NqTICE OF DEED RESTRIC710NS: The undersigned understands that this pertnit may be subject to"deed"restric[ions"
which may be more restrictive than Counry regulations. The undersigned assumes responsibility for compliance with any
applicable deed restridions.
UNI.ICEN3ED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
corrtradors to undertake work,they may be required to be licensed in accordance wiUi stffie and local regulations. If the
contractor is not licensed as required by law, both the owner and contrador may be ated for a misdemeanor violation
under state law. If the owner or irrtended contractor are unoertain as to what lioensing requiremerrts may apply for the
intended work,they are advised to cordact 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 properiy licensed and is not eMitled to permitting privileges in Pasco
Couniy.
TRANSPORTATION IMPACTNTILI7IES IMPACT AND RESOURCE RECOVERY FEE3: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
use in e�cisting buildings,or expansion of existing buildings, as specified in Pasco CouMy 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 Impad Fees and Resource Recovery Fees must be paid prior to
receiving a"certficate of occupancy°or final power release. If Uie project does not involve a certificate of occupancy or
final power release,the fees must be paid prior to permit issuance. Furthertnore,ff Pasco County WaterlSewer 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 AfNairs. 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'S/OWNER'S AFFIDAVIT: I certity that all the infortnation in this application is accurate and that all woric
will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is
hereby made to obtain a pertnit 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 perfortned to meet standards of all laws regulating
construction, County and City codes, Zoning regulations, and la� development regulations in the jurisdiction. I also
certify that I understand that tt►e regulatioru of other govemment agenaes may apply to the intended work,and that it is
my responsibility to identify what ac�ions I must take to be in compliar�ce. Such agenaes indude but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, WeGand Areas and Environmentally Sensitive
Lands,WatedVVastewater Treatrrient.
- Southw�est Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Artny Corps of Engineers-Seawalls,Docks,Navigable Wate►ways.
- Department of Health 8 Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmentat Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Rurnnrays.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone'Y"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 permittir►g 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 ovmer 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,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 inGuded 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 Offiaal 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 morrths of pertnit issuance,or if��rork authorized by
the pem�it is suspended or abandoned for a period of six(6)morrths after the time the work is commenced. An extension
may be requested,in writing,from the Building Offiaal for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the eutension. 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 T1MCE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO BTAIN FINANCING,CONSULT
WITH YOUR LEND R OR AN ATTORNEY BEFORE RECORDING YOUR C COMMENCEMENT.
FLORIDA JUR.4T(F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subsaibed and swom to(or affimied)before me this Su�sJcriQbe-d,a�swom to(w affimied)before me this
by �O�Z�bY
Who is/are personaly known to me or hasmave produced Who is/are pe�nown to me or has/have produced
as identification. ��.
N�ry P� �`^-'�`^C Notary Public
Commission No. C�� � j�
=.: ��'."'c C.,��mmission#EE 0405Z0
Name of Notary typed,priMed or sfamped Name
.n
���P,f�.�•�� C1oMed Thru Troy Fdn Inwtit�te AOa385�M19
BIG DOG FENCE INC. �: � , i� , /3
31116 ELOIAN DRIVE
WESLEY C.HAPEL, FL Home Phone•
33545 Bus.Ptrone"
M�e Phone. �'/3 —5 �93�'
Tel. (813)907-9877 Fax.Number.
Fax. (813)994-7827 Email: �a.n,n oA;. �i/d e r,�rS�of�,4.;l.[arr+
EmaiL•setvkelbigdo$fence.torn Emait:
No/Cut#: I f�S3oD Go�
PROPOSAL AND CONTRA�CT
cuSTOMfR: S�.Q.v,r►o� m;!d F.r- Subdivision: C�es f i%:ec✓ f/,'//s
,�or�ss: 79y3 h�er�h�.-hr;�l� c���l� cr� ze�tiM�ti;��s . FL z�coa� 33�y�
JOB SRE: �r„� City Z�Code
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�R`Total Heis�ht '-5' 6'-T-8' Wood.Pr�erre Ti+eated � .
� Post Spnced ,'-8'-10'-12' Board on Board: -W/Lat �
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CMin f3nk Shado�r Booc: - W/Lat Iq�q r
Color: Gatv Brn BUc Gm Stodcade:Camc�c-C�ncave
S�3-ftki•�.T32wr,
FabriC: _Mesh X ga. Pidcet:SpaCed_DE-PT Post =nsert
Ter�sion Wire: 14ga 9$a No Runners: 1-1/4° - 2x4" �
B/1Nire: 3-6 Strd: 15.5ge 12.'SgEt Pkts�: 1/2x4"-5/8x 4"-5.5" p��� w/�/� t�s�' �T�+�cv•
Tap Rail: 1-3/8"-1-5/8" _ga. Line Past: 4x4-4x6 �'
Une PoSt: 1-5/8� - 2° _ga. Gate PosC 4x4-4�,-Gx6
End Post: 2-1/2" - 3" _ga. Deon Rost: _Cothic_Miter Car�str�ctian Nctes:'
C/Pos� 2-1 RA- 3" � �' V�i�l: �- tan
Sgl/G Post: 2-1/2" -3° -�a Shrte �4ss,c Or',vac�� Bottym of Fe�oe: foUow gade�5trinS�a�rt w/�rade teMel w/grade
Dr/G Past: 2-1/2"- 3" _ga Style ,/ Past tied Lo aor�cnete w/9ga�lv_w�e sirddng°
Gate Frames: 1-3/8"-1-5/8"-2° Une PnsC 4'Pld-5'Pkt � � Gate P�t Set in Concne�e 100 lbs bell at bottiom
Wa/k GQte Onerana End Post: 4"Pkt-5'Pkt " � Gat,e Hinge Paat{P1/C}_Heavy WaU _I-Beam Aluim.i�uert
36"w 42"W C/Pos� 4"Pkt-5"Pkt � Line Pest set in 50 tbs yorKrebe
���� G/Pbst: 4�Pkt-5"Pkt � Ha�dware SS{P1/C� ✓white _btack
rs�in Grn - Brnz _ H��Mr�Steel fWood}blacic pninLed
72"vv Wht - Blk - Bm - Tan � �ic �lew EnS BaU _Federatior►
Driv�t Galis Ob�a • Style _Ext _Irrt Solar
Li/1e Po6t Y '2-��2" G+oSS StreeL fs{�d .Sl'_
Sin�e Swing:__/ h.X_w. End Past 2" -2-1/2° SEC TWS RNG Lot# S�Blodc
Doubte Diive:_/_h.�w. G-Po� 2"- 2-112° TH15 PROPOSAL MAY BE VYITHDRAVIM BY BIG DOG FENCE ING.IF NOR'
Roll: _/_Jl.x_w. 5/Gatie Post 2"- 2-1/2"- ACCEPTED WITt1iN 30 DAYS. THlS PROPOSAL SFIALL BECQME A
CarrdleMer. _/_Lh.x w. Dr/Gafie Post Z"-2-1/2"- BIl�ING CONTRALT UPON ACCEPTANCE
�P'ern�it lnduded: ��Yes NO �E I�1IERSE SIDE FOR TERIiAS OF CONi1tACT.
_Not R�equired
�l CONTRACT Page 2-2
AGREEMENT made this �� day of S y��� ,2013,by and between BIG DO('FENCE INC.her�inafter
referred�to as"BDF"and,hereinafter referred to as"Customer."
In consideration of the mutual covenants contained herein and the consideration to be paid by Customer to Big Dog Fence
Inc.,it is agreed as follows:
1.Customer shall pay to Big Dog Fence Inc.the sum of$ 3�3 �`� for the work described herein.Payment shall be
made to BDF by the Customer upon completion,unless otherwise specified.
2.BDF agrees to furnish all necessary labor and materials to construct the improvements described
herein as per the specifications and drawings,if any,shown on the reverse side.BDF further warrants all materiaLs will be as
specified and that all work will be completed in a workmanlike manner according to standard practices.
3.If this is a residential job,Customer represents and warrants that helshe is the owner of the property or Renter described
herein.If this is a commercial job,Cnstomer represents that he/she is the owner of the property described herein,or an
Authorized Representative,or Agent representing the following Business or Organization,titled as,
or renter/contractor who has a contract to
improve properiy owned by
and that part of the improvements contracted for by the owner include the work described herein.
4.Customer agrees to locate,relocate,stake and clear fence lines,and assumes full responsibility for same.Customer
agrees to indemnify and hold BDF harmless for any liability or damages that may result from Customer's failure to properly
locate,stake and clear fence lines.Customer further agrees to advise BDF of any deed,subdivision,or other restrictions which
may affect construction of the fence or other improvements to be constructed by BDF,and agrees to indemnify and hold BDF
harmless from any liability or damages that may result because of the failure to comply with deed,subdivision,or other
restrictions.
5.BDF will call the local Utility Locating Service for public utilities only,BDF does not assume any responsibility or
liability for any damage of any nature to underground obstructions not mazked or flagged by customer.Customer agrees to
clearly"mark"any underground obstructions other than public utilities in the area of the fence line or the improvements to be
const�ucted by BDF.Customer assumes responsibility for any damage to underground obstructions caused by Customer's
failure to locate and mark accurately with paint or flags,their existence.For purposes of this Agreement,underground
obstructions include but are not limited to all improvements constructeci underground including utility pipes,sprinkler pipes,
cables,wires,foundations,and the like.
6.It is agreed by and between the parties,that any alteration or deviation from the above specifications involving extra cost
is to be performed by BDF and will become an extra charge over and above the price stated herein.
7.Customer agrees to pay in full the price stated herein upon completion of work.Any failure to pay within three(3)days
after completion of work,excluding Sundays and Holidays shall be considered a default and BDF shall be entitled to recover
the full amount of the invoice plus interest(finance charge)at the rate of 1 1/2%per month(18%per annum)until the contract
price is paid in full.In the event it becomes necessary for BDF to take collection action,Customer agrees to pay all costs of
collections including reasonable attorney's fees and costs.
8.It is agreed between the parties that BDF will retain$125.00 from deposit if said contract is cancelled by customer and
customer further agrees to a 25%restocldng fee plus return freight cost for all special orders.No return for custom orders.
9.It is further agreed between the parties that the fencing materials shall remain petsonal property until the contract price is
paid in full.In the event the Customer fails to pay the contract price,BDF shall have the right to peaceably repossess and
remove all materials installed by it on the premises.Customer further agrees that BDF shall have a11 of the rights of a secured
party,as the same is defined under the Florida Uniform Commercial Code,and that said rights shall be cumulative and in
addition to any other rights wtuch BDF inay have in accordance with Florida Law.
10.If Credit Cazds are used to pay total,or any amount toward total,the amount charged through terminal will be assessed
an extra.3.5%processing fee.Credit card checks will not be assessed the extra fee.
11.BDF is not responsible for warping or cracking of wood products.
12.BDF will warranty labor for instatlation of residentiaUcommercial for a period of 1 year.
13.BDF will warranty labor for installation,(residentiallcommercial gate operator)for period of 90 days.
14.This agreement is the entire agreement of the parties and cannot be changed except in writing signed by both parties.
There are no warra.nties or representations except as are expressed herein.BDF specifically disclaims a11 EXPRESS and
IMPLIED WARRANTIES,including any WARRANTY OF MERCHANT ABILITY or FITNESS FOR A PARTICULAR
PURPOSE.
IN WITNESS WI�REOF the parties have hereunto signed their names on the day and year first above written.
Additional Information BIG DO(' FENCE INC.,Alan Lanier,GM.
By. � ,
Down Payment 50%:$ ��/�� °° Customer. �'� ��,�^'c� ,
Balance Due Upon Completion:$/q�g, `O �t:�S h�.h n cx� rn � ��'`Cr
Title:
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Pasco County Parcel: 35-25-21-0120-00000-0510 001 Page 1 of 2
Data Current as Of: Weekly Archive - Saturday, June 15, 2013
Parcel ID 35-25-21-0120-00000-0510 (Card: 001 of 001)
Classification 01 - Single Family
Mailing Address Property Value
MILDER SHANNON Ag Land �o
7943 MERCHANIVILLE CIR Land $i5,o8z
ZEPHYRHILLS FL 33540-2074 Building �48,�ia
Physical Address Extra Features $i,i52
7943 MERCHAN71/ILLE CIR
ZEPHYRHILLS FL 33540-2074 7ust Value $65,948
Leclal De5C1'iptiOn (First 4 Lines) ASSeSS2Cl (Non-School Amendment 1) $65,948
See Plat for this Subdivision
CRESNIEW HILLS PB 53 PG 124 Taxable Value $65,948
LOT 51
OR 8843 PG 1792
Land Detail (Card: 001 of 001)
Line Use Description Zoning Units Type Price Condition Value
1 0100 SFR OPUD 6,500.00 SF $2.47 1.00 $16,055
2 0100 SFR OPUD 100.00 SF $0.27 1.00 $27
Additionai Land Information
Acres 0.15 Tax Area 30ZH FEMA �Residential Code CVHLLPI
Code
Buildinq Information - Use 01 - Single Family Residential (Card: 001 of 001)
Year Built 2005 Stories 1.0
Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall 1 Drywall Interior Wall 2 None
Flooring i Ceramic Clay Tile Flooring 2 Carpet
Fuel Electric Heat Forced Air- Ducted
A/C Central Baths 2.0
Line Description Sq. Feet Repl. Cost New
1 BAS �— 1,350 $48,168
2 �— FGR � 360 $5,138 �
3 FOP 90 �— $821
Extra Features (Card: 001 of 001)
Line Description Year Units Value
1 DWSWC 2005 616 $1,152
Sales History
Previous Owner WORKFORCE HOUSING VENTURES INC
Month/Year Book/Page Type C de Condition Amount
02/2013 8843 / 1792 Warranty 1� Improved $81,000
Deed
08/2011 8584 / 1362 Warranty 17 Improved $88,000
Deed
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http://appraiser.pascogov.com/search/parcel.aspx?sec=35&twn=25&rng=21&sbb=0120&b... 6/19/2013
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, 06/19/13 D. Bonilla, Dp Y _
I , NOTICE:OF.COlYIIVIENCEMENT
� PecmitNo. � .PRULA S 0'NEIL�Ph D.PRS�i CLOf 1 COMPTROLIER
06/19/13 �2$�� p� 3435
PropatyldencScaHonNo. 3S-e2 S-��-O�:t0-DOOJp--OSlO OR BK -
't7�E[JNDERSIC'NID lurebY&va mformS yaatLet the imptuvemea�m'�be mrde to caLm real prapaty.md'm, eceadmw with
Satim 77 3.13 of the Florida StatuEe;.►he follewiog infa�matiaa is provided in.thls NO'I7C80F COM1YiENCF.IY�NT.
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1.Descriptioaafpropaty-(legsidercripNa+:) Pc-!A. �o or 88Y .QG t7_9.1
a stnetwadras; 74N3 m�-����v�l!e G.� zevh I" L, 3:3sy0
2UEnen!drsaiptiou uf imP[m'em�ntx !a ff h;Y�i vi.�..�' Pr'��[cc.:. r ti c e. 2 NS�-a 1(
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3.0�$�����y: 41.r „•i rt�'lder - 79`l3 thet`Gha�`�'v�llt C�� 2epl��r,Tl,_Ifs�rL.335Yo
b)Nacis and addm:s af fee simple tideholda(if otLv t}un owner)
c)Intunt ia pmpafy
`"� ' 4.Cmtractor laformsoon
a)Nsmemdaddras: 'r �e� ' (e loi � !' W r'�-1 3 355/5
b)Telep6noe No.: 8'/3 9 0 -9 8�� Fa,i No(OpR.) �i Z-94 '-'7 a 7
S.S�udy Infotmetion
a)Name md addcess:
b)Amouat of Hond:
c)Telephamc No_: Fax No.(Opc)
6.Ltivda
a)Name�d ad�ss:
PL�No.
7.Ideetity of pe�soa wittiin the Statcof Flazida des3gneted by owuer opwi whom namas or athc do�a�s may be scved:
a)Name end address: � '
ti)?elepho�No.: Fmc No.(OpG) .
B.In eddidm m himsel�owner deai�the followieg pasun w�acive a copy of the Lkno�s Noeca ss prarided'm Satiou
713.13(!xb).Florids S�: -
a)Nsmemdaddtess • FaxNa:(OpL)
b)Telep6one No.:
9.F.xpLrtion dau ofNotix of Commencemaut.(the ex�atim daoe b one5'ar IIvm 1Le date of coco�d�8 wlas e diffetwt date is
specifi°d). .
� � WARNIIQG'L'O OWNHR: ANY PAYN�i(5 3MFADS SY THE OWNSR AF!'ER Tfi'S BRPQL►7TON OF THE NOT'ICE OF
� COMMLiVCEMENT ARE'CQNSlDgREU aVIPRUPEA PAYNtE1H1'S UNDSR CSAPT&R T33.PAItT I,S&CCiONi T1333,
FLORIDA STA'TOTE.S;AN1D CAN1'RESULT AY YOUR PAYIIVG TWICB FOR IMPROVSIKENTS TO YOUR PROPSRTY_
A NOTiCB OF C011flVIEN10EMEN['11'Ii1ST.BE-RECORI1B11 AND POSl�D ON 7�JOB SITS BBFORB 1'E�P1R.RT
INSPLCT[ON, iF YOU:INTSNA TO OBTAIIV FINANCING,CONSUI.T YOUR LBNDER OR AN ATTORN6Y BEP'ORE
COMMfiNCIA1G FVORR OR RECORDINGYOUR NOTICE OF COMMLtYCS1V[ENT. –/�
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COUIYIY 08 PASCO y v
S"�m�e, or .�AMlmf�d Nae6c�Lo,t°
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� as � (�YP��f�!�Y.�&.offi�t�,�e,,enomcy
m fad)tor r (ffime of puty on bahelf of' wae
Pe=someUy Known � OR Produoed Idmti6cetion_ Notffiy Sip�eAae
Type of ide�fication Produad td�e(prmt} J�'7/1 f^F�r /f�/Qr�""/
VuiScaHou�uswnt to Sr�tlon 925?S.Flortda S�tce.Undac pweltid of pe�j�vy.I declse tlad I Lave read.tha�6�mB�t�
t6c facts siaad in it are true oo the best ofmy]mmvledge aad beliet
–��e'alNwal Yasm S�i?{we?b—�
,�'!'';��'.f�,�1VIFER A.MARTELL
if�1• MY COMMISS[ON N EEIS3562
�'�� exvi►eFS:�u,zo�s
�JOa�.NOruer Fl�Na+�rOiwwnAua.Co.
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TH!� �:,' -��� �.:-'���FY 7�!AT THE FOF2�GOING IS A ,�1` ' � G
TRUE P,N�� �;���RECT GG?Y OF THE UUCUMENT ��'. ,��
ON FiLE C);� .�� PiJ�3LIG REu�RO IN THIS OFFICE •' *
INITNES�.i\�:ti'HAND APJD C�FFICIAL SEAL THIS �.
� • rnTn�d"Y✓e'/+'�.i.5� •
G��' DAY OF ,�k 2 C%1,`j _ :,� \ *
�A L,4;7 ,U'NEIL, CLERK& COMPTROLLER * � `��iJ •*
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