HomeMy WebLinkAbout13-14561 CITY OF ZEPHYRHILLS
. 5335-8TH STREET 1�61
(813)780-0020
FENCE PERMIT l
Permit Number: 14561 Address: 5203 8TH ST
Permit Type: FENCE ZEPHYRHILLS, FL.
Class of Work: FENCE/NEW Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Subdivision: CITY OF ZEPHYRHIL�LS�
Square Feet:
Est. Value: Parcel Number: 11-26-21-0010-18400-0040
Improv. Cost: 4,035.00 Name: EILAND, JUANITA
Date Issued: 9/23/2013
Total Fees: 45.00 Address: 5203 8TH ST
Amount Paid: 45.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/23/2013 Phone: . (813 782-3063
Work Desc: INSTALLATION 132 X 6 FT VINYL FENCE W/25 WALK GATES
LOWE'S HOME CENTERS IN (407)832-8085 FENCE 45.00
1..� /
� � V
���
lJ�-�
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.
The payment of inspection fees shail 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
_ � c�� �
CONTRACTOR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
v�v-�v�-���.. v�a� v� �.,N������,� ... . ..�.��... .��.._�.._..
Building Department
, " A
Data Received Phona¢ontact f.or Per�nittin Yl 3
Owne�'s Name � � Owner Phona Numbsr - g " 3�b 3
Owners Address Z-D Owner Phone Number
Fee 8impie Titleholdsr Name Owner Phone Number
Fee Simple Titleholder Address
JOB AQDR�38 ��-O 3 ST `i �i�I S �`L ��S � LOT 1� � '�' $
3UBDIYISIDN � 2 ' �� i 1 S PARCEL ID� 'Z6^21 - OO l� � r"'��" U�('0
(OBTAINEEI FROM PROPERTY TAX NO'FICE)
WORI(_PROA..O$f� e NEW CONSTR 8 ADD/ALT [_,J SIGN [� [� DEMOUSW
INSTALL f7EPA1R
PROt�08rE4.USE Q SFR [] COMM � OTHER
TYPE OF CON87RUCT10N Q BLOCK Q FRAME C,.] STEEL Q �1
DE3CRIPTItiN OF WORK /V S?q!/ 3 2.� O�" (O� N� 1,�Y L r cn�c.e � Z S � A�� g A'r�:5
BUILDIN(3 81ZE � 8Q FOOTAOEC� HEt�3HT
QBUILDING S � VALUATION OF TOTAL CONSTRUCTION
�� �,oa
�]ELECTRICAL (�S� AMP SERVICE Q PR0C3RESS ENERGY Q W.R.E.C.
�_
QPLUMBIN(3 3 �f�/�c�J„ r
� f�'�l� �
QMECHANICAL S VALUATION OF MECHANICAL INSTALLATION
0
GAS Q ROOFING Q SPECIALTY �] OTHER `f� / �
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
G C�ti2.a 1��
BUILDER COMPANY L Ow�eS �cn+C Cea�'G2� �r/t-
31GNATURE REGISTERED Y/ N FeE Cu�E� Y/N
address O �01� � �� a�A�tdv ��-878' ucense# IC�roG � SO ��'i�!�
ELECTRICUIN COMPANY
81(iNATURE REGISTERED Y/ N FEE CURREA Y/N
Address License# C �
PLUMBER � COMPANY
31�NA'TURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURltE� Y/N
Address License# C
OTHER COMPANY
SIONA7l1RE REOISTEREp Y/ N FEE CURRE� Y!N
Address License# � �
RESID�NTIAL Attach(2)Piot Plang;(2)sets of Buliding Plans;(1)set of Energy Forms;R-O-W Permft for new constructlon,
Minimum ten(10)woricing days after submittal date. Required onsite,Constructlon Plans,Stortnwater Plans w/Siit Fence i�st�lled,
Sanl�r,�Fadl(tles&1 dumpster,SFte INork Permit for subdiv�sions/large pro)ects
COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Perrnit for new consfrucdon.
Minimum ten(10)working days after submittal date. Required onsiie,Constructlon Plans,Stonnwater Plans w/Sift Fence installed,
Sanitary FadllUes 81 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compilance
SICiN PERMIT Attach(2)sets of Engineered Plans.
•"""PROPERTY SURVEY required for all NEW construcdon.
Dlrsctlons:
Ffll out appl(catlon completely.
Owner&Contractor sign back of applicadon,notarized
If over t2500,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 autho�izing same
OVER THE COUNTER PERMITTINCi (Front of Applicatlon Only)
Reroofs if shingies Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
Driveways-Not over Counter if on publfc roadways..needs ROW
NOTICE OF DEED R��TRI�TIONB: The undersigned understands that this permit may be subject to"deed"rest�ictlans"
whi�i rr•►ay be mArs r�e#�ic�Eiue than County regulations. The undersigned assumes responsibility for compliance wifh any
appN�abie deed rest�ictions.
UNL•I�ENB�ED �t�N'�iA+CTOR3 AND C�WfiRACTOR RE�PONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and Iocal regulations. If the
con�actor is not lic;en$�d as required by law, both the owner and contractor may be cited for a misdemeanor viotation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, theyar�9,advised to contact the Pasco County Building Inspection Division—Licensing Se�tior�at 727-84Z-
800.9. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portfons pf 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 Iicensed and is not enti�ed to permitting privileges in Pasco
County.
TRlf►f�(SP(�RTATION iMPACTIUT1LiTIES IMPACT AN� RE80URCE RECtN/ERY FEE8: The undersi�ned understands
that.Transpartation Impgct Fees and Recourse Recovery Fees may apply to the construction of new buildings, chan e af
use in existing buildlr��, or.expansion of exiating buildings, as specfffed in Pasco County Ordinance number 89-0�'ai��
90-07, as amended.. The undersigned also understands, that such fees, as may be due, will be identffied at the time of
permitting. It is further understood that Transportatfon Impact Fees and Resource Recovery Fees must be paid pfbr to
�eceiving a "certi�Cate of oceup�ncy" or flnal power release. if the project does not involve a cert�icate of occupancy or
final powrer rel�ase, the-fees must be paid prior to permit issuance. Furthermore, ff Pasco County Water/Sewer Imp�ct
fees.�e.•due,..thtey must tae p.ald prior to permit(ssuance in accordance with applicable Rasco County ordinances.
CO�I��"RUCTION`L1EN LEKW(Chapter 713, Florida 3t�tutes, as arn�e�nded): if valuation of work is $2,500.00 or more, I
certlfy that I, the appll+cant, have been provided with a copy of the "Florida Constructlon Lien Lauv�—Mo�evu��er�s
P�otection Guide" prepared by the Fiorida Department of Agriculture and Consumer Affairs. If the applieant is someone
other than the"owner", I certify that I have obtained a copy of the above described document and promise in good fait�i to
deliver it to tfie"owner"prior to commencement.
CONTR�►CTOR'8/OWNER'8 AFFIDAVIT: I certify that all the information in this application is accurate and that aiF work
will'be done in compliance with all applicabie laws regulating construction, zoning and land development. Appl(cation is
hereby r�ade to obtain a permit to do work and fnstallation as (ndicated. 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 regutating
construction, County and City codes, zoning �egulations, and land development regulations in the jurisd(ction. i also
certify that I understand that the regulations of other government agencies may appiy to the inte�ided work, and�tM�� it is
my responsibflity to identify what actions I must take to be in complfance. Such ageneies inelude but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, VNetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management District-WeNs, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawails, Docks, Navigable Watervvays.
- Depa�#tnent of Health 8 RehabNit�ative ServiceslEnvironmental Health Unit-Welis, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
Fede�I�Avlation Authority-Runways.
I undecstand that the following restrictions apply to the use of flll:
Use of ffll is not aUowed in �'lood Zone"V" unless expressly permitted.
If the flll material is to be used in Flood Zone "A", it is undefstood that a drainage pian add�essi"ng a
"compensating volume" wi�l be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If th� flll material is to be used in Flood Zone °A" in connection with a perrxiitted building using stem wall
co�s6�wetion, I certify tHaf flil will be used only to fill the area within the stem wali.
If fill materiai is to be used in any area, I certify that use of such flll wiil not adversely affect adjacent
properties. If use of fill is found to adversely affect ad)acent propertfes, the owner may be c(ted for violetit�g,
the conditions of the bullding permit issued under tMe attached permit application, for lots less than one ('F)
acre which are elevated by flll, an engineered drainage ptan is required.
If I arri the AGENT I�R TWE OWNER, I promise in good faith to inform the owner of the permitting conditians set fo�tM in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, w�ils, pools, air conditioni�g, gas, or other installations not specffically included in the applica�lorr: A
permit issued sMall be constrwed to be a Iicense to proceed with the work and not as authority to violate, cancel, alt�r, or
set�aside any provisions of the technical codes, nor shall issuance of a permit prevent the Bulldirig Official from thereafter
requiring a correction of�rrors in plans, construction or violations of any codes. Every permit issued shalt become invatid
unless the work authori�ed by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspertde'd or ab�ndoned for a period of six (6) months after the time the work is commenced. An extert�lon
ma� be requested, in w�iting, from the Bk iceasesOforininety(0)rc nsec tive days,thn)o isc onsi e ed abalndonedg�ate
justifiable eausefor tfis extension. If�n►or �,
'� YQ1JR FAtLURE TO RECORD A N�TICE OF COMMEN�EIN�NT NF�►Y R6SULT IM.1(:Q�R
WAi�1lNG T�Q O�IV ,., a�'
P/lYING TWICE FOR.I, ;�.ROVEMENT3 TO Y4U�PROPERTY. IF YDU Il�t"I�Ei�7`O�BT�NN`FH+�At�IV�► CONSULT
,. � Q NG lf -
FLORIF�A'Jlif�AT'(�.S.117:b�)
OWNER OR A(3ENT CONTRACTOR
Subscrtbed and swom M(or afflrmed)before me this Subscrfbed and swom to(or afflrmed)before me this
by by
Who islare personally krrown to me or ha ave proiiuced Who e/are persoAally kn�wn to tete Or has/ha�ventlfi�ca�
as Identlflcatlon.
Notary Public Notary Public
Commisslon No. Commissfon No.
ed, rinted or stamped Name of Notary typed,Printed or stamped
Name of Notary iyp P
, p , � , . - . . � . , . , . , . � -� ;r '� , • ! , ' 1 . ' �
r�....,.�.. � .- �. .. ... ,. ., .... . . _ .� . , . �. .f•,.. • ` ' -• -.�:..��<, . .�..,..... .. .�. .. .. . ., .. .. ... . , . .. ,
L,_�__,_.�.—�.._...---.,.�., --• —.r.._.. ,,....,. ... .....�....._.�_._... . —�� —..._.�_._.._.�._..�..�..._. .. . ......._...-- --
:�°7�.� `,�r'•'`',r�,t.. y�33" "mr.i�C�(�fj. '<.^tt: '�' �`;' ' '' 'r'"•' - .. "s:9�''�•y�+ .r�..,., 'e
'!`SF:.o. tVy;1�, \•'.i� '•y. } ,T '�` �"'=�!' ��`
1 S m�'•� !.'�F ' � �iJ`!:��•'+ '}� {� \ 5' ��.�
'+,''�•� ,�
� l, R'�}; �"!.��it�r.� �.'�`.t4L,:. '.i ,N
��G,�..�� ..,,. .'��:�...;:�,.�: . �..;,:� �� ��� ,� ���� �t�` _�� ����T� Q 0 2 3�2 l.
� . .
t;;.i�.,r,�.:;,•. .f�•�' , �y1� .•.'r . .
��1••�.tr .�li? ` � '°' r�;.i,�
;�' w '•��fi�"!, ."� � •-��• `���r �:,
.;,.: ,'� '7 1'�F•=.'��`,.r.;',
' `r F.�. � :�.'>^�� ':Si� .
�:���� �� ~��� d,� S�
..�.•: .'"..' �:�!?a • i 1:�.�.w.>. ' . � • ";yi
'�� KvsTfu.LEU S s sPec�wsr/ ;NUt�EI�-. T Ep: ( .
���'� '(Z.7.Gr •:,:4 .��l:Z/(�•. '�: .�. l.11ri�1 .. ,�t�
;. _ ST(.)R NO. � STR£ETAU�liE3S ' •`' . . � . ADOa� ^•.•-.^' ,. :
';� S ��.z .641� �t c� o � . . . . �,",
;.,.'�` ��i �� .:;,;� :.� �'"�b:'. �'.
,.� �. ;.
�,�' •C � .< . 6TAT .7]C'(. • • � �. • � zir �
�:' C�' � �,;, !�F • Y •L� � ,.�,� �. . �-t. ��;';�2, ,r,
,.
r err+orr x+ •� N • • • �
�I 3• .�� 3��� , . :�:.ly ,.�°�g2-:�66 3 . �;.
� s::�• r..
: �� .� � .� ,.
"` � LT � � WWE'3'COPFTIaACTOR~L'IE[N£EfJ{1tNBFR" ' ';X.' ' cnsH e/wK. ', �� RCG :i�;i..` .
T'i��`;� II U1� %=`` , }} �4 C.ARD :� � ' CHARGE „C �
;Nf',� !L+'"� �I � '�!! _ r' , ., ..�.�M,.'.�'?.F: -.'r• 'S•.
..1` �l ; .erl� .• 9 y� � .�:•+r�: ',�. }`�
;Xi`:} .;�3i .i •i,� ,M" �.� i:,,'..FS:•.%- "'�+r
i't. :�. s � ..ryi c;,!o,"'�'� -r,'
.e � '�.°• - �;;.
?�� ��.
3 ��k '`•�4�;{'
� �'•
.v .
"Y5r? I i'�• 1 .
,i'< t., �.� :fi. �e..".r�: .�ro
�`Y;:l.: y_y'.
�TRFFTMUfiE33 � � � CRY' • b1R1'F: l.fF'
.. , `�,�R L� /) , . . � .
. . . . .✓ �I•I.✓ • • � ' A�. . �
\'.'...v� . .� . "• n •. 'w! ' '� . . . ..r.:���1'.�uV/M'vr-• !SY'YWiLi � '. I .. . �.1. ; ...!...,, . � _
� . 1 . A . �' .
Additiana/ Specifl�atlons: The E�nv.iror�nsental Protectlan Agency ,(�,�� hss:.r�quested that �;:��. Mat�ls •
l.�we's notlfy installation customers tli8t a lead based p�aint hazard iri�ay exist in dw�l�ings built �f �� .*7'ax
- .-_ r-_.
_.. , ......___...
prlor�g 1978. S�ee pampttilAt�EPA 7�7=K=9J�tfq� for details: .. . . ':!� . . . . .. -� :, : •I�iwr � � �
� ...,. . ;,, � ...
. uwCS W�t� �n5-�11 I���.��.I�� Y°� �b�� Lv4,+f�• I'r,�ac� ''".'.ili'I :� ` _.•r�. _._._.....__ ._ .
�l : N �"•1C�i,- �;
�-�t 5 w��.►_1 Z_ S: .c.�i a �, c� .�� . �'��� ����:.: :ti1�.: �,��r, � .l%►nPS . _ �����i` �{pzS'----
�►n :hP. .k�.�. .�n�'1� t�� ��i''v� �+,•���✓ '�/�P�j��r�l'�.E' . �
.,`�oY i�tmuc/�� � -CX.I:���� :���i.t� ��h� Chc.e, .. .� .. .....� :.•,� -. .. , . . . , .
.. .. r . . � . . . .� R. . ;'fT ti.a�r .. . . .. „ . . .. . .
.. .. •... � • _' , ,. _ . . r ' .. �. 4 i. '�1:'' �. _.....�n.� .. . .
- . .� ' . . � ' ' ' . t. , '
4�-. ` � . C _
. .y�' . "� � • ]✓� '. •:���� � � �'�� 7• 'Y �
. . . . . . t• • ry . ,.. �}.r t� �5s•.%:�w�.'' �
.� /n�.'W:..yr7' V��VG(��,.yV �.;1.�.�4 a. :._ _...f' I.�t~]1��1:�', 1!��i.2:.I�.1.:� .� .,y.�;�' y". f: ` ' / , �
1 � ` ..�7,��M '�1';.:;:'�.45�;..;i ,.;�tj:'+�� . . h
.�O IS ,C011lfll ��'':�` ' � `
.,,;., !�?►1'r ��abl�"av Ifa6� ltV9A9��to�'�vkfiiC�J.'4g enHcip�ted�o`.. �'�{%�7�ri%�. <`�;;��2.�' � �['f�11 in'dete�•.
... , , :, , . . .:, ,, t
. .,.
Esllmated oonl�pletian d'ste fs• . �h-, ���'��� [HII 1M ida�s�. ' � '' . , � , .. :� ' � , ,
. . . , . n .
, ., ; .-. ..,' , . . , , ..
..
; :
Y�
�,. .
,.
�, ;�� • �`+• . .
_ .. ,
,. .
, .
,,, ..
_....�.:...._.: •
,..•
NOTICE TO CI�TOMER . • , r�. , .. • � , .,"... , ; ... . , , -•-. , ,, ,. ... ; . ,. , -- ,
'A�ii�"i�t,1iste�in tMls eoi�tract.and speeiffc�tio,it shdAt(&�ars�to�6e in'stalled uridet:conditibns'agw�trpc5nv�t km&'�f purcfi8s�a•snd�i the prics appaaN�►g pn this,
contrsct fb'rm.•This.A'ssum�s�ur.�exist�ng s�ii�tsuctures,�supei+st'ru�CUre-and�poMts af'atte�hmerd�.��xtra lebor br'mate�'ra�'�n�t1t'�tl iR�allation'neee9sitsted
b1['dgfe�CtlVe siibstivCtures,5upsxstrilCiui�-r.Paiii#s df atfficfiirient,ciP�he'rftoviriq o�.fixtu'ies.ot;�A��ia�#"se b1ApY1:3Cexti`�E�'tti.cestncner. r'• . ,
.. t , �.� ` „•:... �,±�;�s ... '•' f-; _ • ' ', .,'• �a,i`;:1,'w
00'NOT SIGN TFi1S CONTRACT UNTIG C'�MPLETE AND YOU.HAVE I�EAp'1`aiE'�ERMS ANI�.CONDI'f'iONS�ONTAIWEQ'ON TFiE
.. . .
' 'R�EVL�SE�SIDE OF THIS•cowr�t�ac� aY�S�GNr � ��oV1�;:�fOl�;Af�'
. . _ .
''S��'i�Ni�'Af�ltf AC.GR�E'TO'1'li�T�FtIVIS�``�4ND`G`O�t?QN�
'�CI��Aik�f�i�G TFf�T'•YO�'�UC.VE'READr:�UN��R=
�T FbFfT'���OW��M&.��Y��t�E�•SlDE`OF TH1`S C."t�N1"RJ1CT`YdU`ARE��
, ;EM1T;'Ls�b;'FQ A,COPY OF T'Hf$C�SNT'RAGT AT T E.''I'1141E�OF.SIGN�4, � ''";,.�,. ., �.,..'�` ..:' � � .. , � :, � .
. , . �'U�,; "'.{
- •,.. .;:... ;�.r�, � : , . . . �,, .
WITNE5S OUI�H(�Nf)(S)/AND SEAL(3)BELpW'�'I,IlS��. DAY QF. ` .�� �Cr , :~ ��� � "
,. y .': _ , _ �_�,� ,
( . , �, , � � ;. ,;;.,
' . � ., - • ' , • , , r �;' t , ."'_"'�"� 1 (3oa!)
, ' _ • (S�(lf) , :a�.•'`.: ",:� 'r� ,., .� �. ,"(SLY�fj.
"�cllst �s' " ' - ' • ' , ,. � � . ' . � , • . — •_._..
' 'Sp'o�ise., , , , .
, .. . �
y, • : w..>� _ ..
. _.. .�.
, • "�
,
t; ., . ,.. ,. .. .._. �.� : ' _
�_ ,.. ' •�.,�. . _•� .�-. �....�..; `.
} s . ' ..�
.'�"e'��,
�.
. .. •� �� �� ~ ... ._ .� __ `x- —���..' •;1.:'•, . ._ r. ��.� ... _ . � . � � � �.. • • • _ . . — . . .�...
• � � . . ..� � . . —. �. .. • •.. � ' ••�i-..... .. . ... .� .. �� � � . � .
.� 1
.. j��t �� , �;
�
w
,
___�.�. _.�...� � ��
1 / "
� �
� ` �
„1 Q'
�eY7
�.. �
i�
r'.�' '/�
I �
• ~� i �
S '�
�
I�
�
� �
���ti� �� �
� �
� �
� �
�...�v 1 .f
v� - k �
�
2
� �
� �
� ��
� �
�S �\
� � � �
� �: .. � �
�
� ,�: `+n �
...�_ �'
�
� �
r �
-�
�
�
�
�.,.
�
a
�� � ��
`"` � S�
�� i 1
_._.�Y._.... ".._...""'",.� ��
c� �`' �
rt<. �.
C�.1 � ` • ,7� �
« � �
�'� c.,w�
�,�j, � �.`^
{D
47 {
w � .T....
�
...� �
� �� �
�"'.t "' '
Q' )
U'G �,.,,�... •............u....�.f
� { _
� L,� V J
M �
� �.
�
x � �
� �
�`" � �J �
w {� ��' •J
. (�''���r� � �--��....
� �'"� �
q \
`� �
�
�ti�
w �
� � .
Q
� � � --�' --
� � � ,
� � �� � �
� � �
' � c�.�/��
����� �q� �' °� 7a�m�'� �``� IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIillllllllillllllllllll ��
. � I��n � fJ �. z0i3isas�e �
�T�r�p q r='� 33�.� S/H �-----.--- - - -
'permit Number i _I ' __� �_____ —__T_ __��
Parcel ID Number .��f,.� �. .,;��Q�g�p�_�y� Rcp!:1551704 Rea: 10.00
DS: 0.00 IT: 0.00 �
NOTI CE OF COMMENCEMENT �09/23/13 C. Miner, Dpty Clerk _ �.
State of Florida 4 �
County of , �_•,.,,<:;r,�,.:i<,i:�;.:r�c; {:�i:.i�:� .:f.;:. ,'r,C T .. ..,. � ... . . �. .
THE UNDERSIGNED hereby gives notice that improvements wili be made to certain real property, and in acxordance with Section 713.13 of the
Florida Statutes,the following information is provided�inrt��Q�C,�O2h`�a10EE�AA6�fy �hC,�Asr sy,��e�_�-o F�n Ts Y,Sj�.i. A��of5
1.Description of property(legal descriptibn): y ����
!1.�.�?.nR._.GGO�j, P6_1�Y1�..�' .Yqs_ro�c '1�Ga P�l.y1�aR!?6�1���}7?
a)Street(job)Address: p �^��,� y, ,,
��.._....,�__.___�_�-� + �-�� . .L__.35__Q_ot�_.---.._._._._�. ._.._..__..__.._..__._. ._. ._._._. _
2.General description of improvements: 1� �y�
....�. ._._..--..---..__.�_--..-----._._.._.......__.__�___�...___.._..._._..__._..-•-•_•--.---._.�.._._. .._.._._.._. _..__. _
�N S T A tc. ���J C 8
3.Owner Information or Lessee information if the Lessee contracted for the improvement: �
a)Name and address: ��n �-��iL � ?
._.� - - _..�__._:.:�:._�.�3..._.$f�1a..5s.._� ..h�.c!.�.s7_.�.�_.._r���8
b)Name and address of fee simple fitleholder(ff different than Owner ti'sted above) N�� _
-------- _.._.._--- . .,--
c Interest in property: __._. _.._._..__..__Q��( '
.___.._._..__._._.._.._...__:._.._._. .__. ._. _ ._. ._ ..._.._ _.
. 4.Contractor Information �`-�-��-�-----------._._.__�.__.__.
a)Name and address: ��ui�.� �� , C�y���.�� •'S'„� � �o �30:�
7sc�j.Y�.�c��le..��L
b)Telephone No.: _����,}__`.?Z.�_"�F��____.�..:-----. Faic No.'(optional) ____,..—__.�.__.._.._�.._.�.._......-•--•--.._.�.��-1...�.
S.Surety(if applicable,a copy of the payment bond is attached) - - �
a)Name and address: _�� � -� r
b)Telephone No.: - � , • _ . ,
._.._. ._. .�__. .-_--.---.__._. .__. .__. .__,. ._...---.._.___.__._.._._._.-.---.._..__..__.:_..______.:_.._._:�..�.__.__.._..__,_._.,.
_._. .__.
c mount of nd: $ �-- � _,___
---•--•--• �---.—_.----. .--..-___._..�..____.��_.._..�__.._._._._..—NAULR S 0'NEIL,Ph D PpSCO CLERK B COMPTROLLER '
6.Lender .' � �09/23/13 1:38a
a)Name and address: �{�q `� - �OR BK �93� pG '
b)Telephone No.: ._�'."" - �_ .___._.._. ._._...___._____ . __........__ 1 .__. ._.... _�._,_________'0 2464 . -
� � � . ._._.�. ._. ._.._. ._.
7.Persons within the State of^Florida designated by Owner up0n whom�no6ces or other documents may be served as provided by Section
713.13(1)(a)7.,Florida Statutes: . . . ' • ; . .-
a)Name and address: ' "� � �
_.._..l`.�.�.�__....__..__.__._..__...__..�___.____._.___._______._.________.__..�..--•.---•---__._.___..__.__.._. ._. __._._. .�.
b)Telephone No.. Fa�c No.:(optional) __
. .__..---.._.--•--_. ._.._. .___._._.._---_._.._..._..:_._._.__._ _..._... .__.:__._._._. _. _._ __.
.a.in addition to himself or herself,Owner designates ' ' of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Fbrida:Statutes. : �- ��� ^
b)Phone Number of Person or entity designated by Owner: ` ' �
____.=-------------_�-_-_---.;...—._:____..._..__.._--------. .__.._. ._.....
9.Expiration date of notice of commencement(the expiraiion date may not be before the completion of consUuction and firial payment to the
contractor,but will be 1 year from the date of.recordin unless a different date is s � � " - ;20
�..--•-- 9 peCified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER.AFTER TWE IXPIRATION OF TWE.NOTICE OF COMMENCEMENT ARE ,
; CO�LSIDERED tMPROPER PAYMEM'$UNDER CHAPTER 713,PART I,SEC710N 713.13,FLORIDA STATttTES,AND CAN RESULT IN YOUR i
` PAYING T1MCE FOR IMPROVEMENTg TO YDUR PROpERTY.A NOTICE OF COMMEIVCEMENT'MUST.BE RECORDED AND POSTED ON i
; THE JOB SITE BEFORE�THE FIRST INSPECTION. IF YOU INTEND T'0 OBTAIN FINANCING; CONSULT WITH YOUR LENDER OR AN i
� ATTORNEY BEFORE COMMENCING WbRK OR f3ECORDING 1(OUR'NOTICE OF,CAMAAENCEMENT. 't-� � ` �
��Unde �� of perjury,I declare that 1� ��read the foregoing notice of commencement and tliat the facis.stated therei �����true to the best of my
k led ge nd belie�, - . ,. ' . , C�
�� s �,�--__.._.
na ure of ner or Lessee, , or s(Author¢ed O(ficedDirector/ParNedManager) ' Pr n Narrtie�and�Provide Slgna�ory's TitleJOiBce)
e foregoing instrument was acknowledged before me this � � �. day of • 20 !
y _..._--'�'�-g-���t=i L►aNd as p �— , _. :�..---..�..______
fOr --r�-N� _ (h'PB�g�MY�e.g.otfirer,wstee,attomey in fact)
. _...._.__�.._.___ _.. �a$• � ,
(Name of Person) • � � �. ,:: , .'-_.
�V � .,,, (type of aiAh6rity,...e.g.officer,trustae,attomey in factp�
for �V (name of pacry on behalf of whdm instrument was execxited).
._. .__. ._.._._. ._._._......____. ._.._. ._.----.�. '
Personally Known Q• roduced ID � '
Type of ID _ _^�� Y _ Notary Signature
�y Print name � "-- '-"
S�'t7.'G� � �7 J / � , . ......._ '
INTABNA A.BIICNANAq �
MYCOAl1118810N�01�
D�RES;JNIa0.P017
m��aaaa�oA�asaw�ana
��►c �
STATE�F �LpRIpA,CQllNTY OF PA$CO ,��I`� • � ' • ���
THIS I�TO CERTIFY TMAT THE FOREGOING IS A �3", Gi�
TRUE AND CORRECT COPY OF THE DOCUMENT
ON FILE OR 4F PUBl.IC RECORD IN TMIS OFFICE '� �c
JJ�TNESS MY HAN D OFFICI�!L^SEAL THIS "f � r•�c�,a w¢r+�++.�� ,
�3Y d DAYO� ` Y1C'✓ 2 u� ,k ' , f;;��`� ,, �
P A U L A S. O'N E I L, L K C O M P T R O L L E R ;., �� '*
"� y;:.;.,, x8�7
BY UEPUTY CLERK �.,.�•,� ' • � pP
'��'��OF Fl.�