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Home My WebLink About14-15141 i f CITY OF ZEPHYRHILLS 5335-8TH STREET (si3)�so-oozo 1 41 BUILDING PERMIT Permit Number: 15141 Address: 4529 BLOSSOM BLVD BLD 19 Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: ORANGE BLOSSOM RANCH Est. Value: Parcel Number: 15-26-21-017E-01900-0060 Improv. Cost: 15,112.00 Date Issued: 3/28/2014 Name: WALLACE CURTIS Total Fees: 115.00 Address: 4529 BLOSSOM BLVD Amount Paid: 115.00 ZEPHYRHILLS FL 33542-5660 Date Paid: 3/28/2014 Phone: 813-788-3505 Work Desc: REROOF SHINGLE I I AL 1 5. � `� i `_"C� , TAPE JOINTS OF INSP, 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 property. 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 accordance with City Codes and Ordinances. NO OCCUPANCY BEFO C.O. �JO' ONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER �"'`�� a�s-�eo-oozo Cit of Ze h rhills Permit A lication Fax-813-780-0021 i� % Y p Y PP � Building Department Date Received ..� � �` phone Contact for Permittin >.3 �%�/ -- �/ � �v/ Dwner's Name ��" ov� ;,S'B �'"7 �v�� /�.fs� Owner Phone Number �� p Owner's Address :Sp� U ✓ Z • ,3`� Z pymer Phone Number � Fee Simple Titleholder Name �n —� Owner Phone Number � Fee Simple Titleholder Ad,�ses;-=•�\ ,� .JOB ADDRESS i�J �^� SSU��1 G'" �� ' I/ _-----..._ __-- , :SUBDIVISION � PARCEL ID# S � ft' �('�� '�l��'� (�� J!! ` �._..` ROPERTY TAX.HDIIGE)__._...___.._......._. 'WORK PROPOSED B NEW CONS7R e ADD/ALT �]] SIGN Q Q DEMOLISH � INSTALL REPAIR IPROPOSED USE Q SFR Q COMM � OTHER 'TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q IDESCRIPTION OF WORK � fJ c' /7/� � �UILDING SIZE J��O Q �!- gq FOOTAGE HEIGHT � QBUILDING $ • A� VALUATION OF TOTAL CONSTRUCTION ��a QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. OPLUMBING � � � ' QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ,� ( � � 1 QGAS � ROOFING Q SPECIALTY Q OTHER f=1NISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO dU1LDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# � � ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURREP Y/N Address License# � PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# � —� MECHANICAL � COMPANY �IGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address — License# � QTHER — COMPANY �—(��e �� OQ /� �' SIGNATURE REGISTERED Y N FEE CURRE� Y/N Address fA � /'r-Si �'�� •! �C � ''�� License# ��.s .J/�✓—� RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bufiding Plans;(1)set of Energy Forms;R-O-W Permit for new consVuction, Minimum ten(10)woricing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisions/large projects COMMERCIAL Attach(3)comptete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW consVuction. Directions: Fill out application completely. Ovmer&Contractor sign back of application,notarized if over:2500,a Notice of Commencement(s required. (A/C upgrades over 57500) " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter hom owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW / i CITY OF ZEPHYRHILLS ' 5335-8TH STREET �sis)�so-oozo 1 42 BUILDING PERMIT Permit Number: 15142 Address: 4531 BLOSSOM BLVD Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: ORANGE BLOSSOM RANCH Est. Value: Parcel Number: 15-26-21-017E-01900-OOCO Improv. Cost: Date Issued: 3/28/2014 Name: JOHNSTON FAMILY TRUST Total Fees: Address: 4531 BLOSSOM BLVD Amount Paid: 4531 BLOSSOM BLVD Date Paid: Phone: Work Desc: SEE BP#15141 REROOF SHINGLE I L . � i� � i TAPE JOINTS OF I�ISP � 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 f) plans not at job site g)work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Complete Plans,Specifications Must Accompany Application.All work shall be performed in accordance with Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O. CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-78U-0020 City of Zephyfiills Permit Application Fax-813-780-0021 Building Department Date Received 3��'^rL Phone Contact for Permittin 3 ��/ __ �,S1CO Owner's Name '. �9 � S +'� /�19N� Owner Phone Number 7�� /, r �Owner's Add e �� O�.SO�`7 � Owner Phone Number Fee Simple T eholder e �"�� Owner Phone Number � �._.. Fee Simple Titleholder ress v +' JOB ADDRESS .S-� O SQ 6�l< � r / LOT# �� SUBDIVISION PARCEL ID#�S�!��` `OI� � � G�— D�� (OBTAINED fROM PROPERTY TAX NOTICE) WORK PROPOSED B NEW CONS7R 8 ADD/ALT (� SIGN Q Q DEMOLISH INSTALL REPAIR �T PROPOSED USE Q SFR Q COMM Q OTHER �TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q DESCRIPTION OF WORK / � � /i��-c S ��✓ Zv /�c,d BUILDING SIZE � �� SQ FOOTAGE� HEIGHT �� QBUILDING $ ��/, � VALUATION OF TOTAL CONSTRUCTION �ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. OPLUMBING $ QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �( I �/� � � QGAS � ROOFING Q SPECIALTY � OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER COMPANY SIGNATURE 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 REGISTERED Y/ N FEE CURRE� Y/N Address License# � � OTHER COMPANY �� /l�'� SIGNATURE REGISTERED I N FEE CURRE� Y/N Address 0 � � �Y-sl �'L.�L��'/ �icense# ��S,•JS1S RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buiiding Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Pians,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 Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, Sanitary Facilities 8 1 dumpster.Site Work Permit for all new proJects.All commerciat requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. •""PROPERTY SURVEY required for all NEW consVucBon. Directfons: Fill out application completely. Owner&Contractor sign back of application,notarized If over 52500,a Notice of Commencement is required. (A/C upgrades over 57500) "' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW / , CITY OF ZEPHYRHILLS 5335-8TH STREET (sis)�so-oozo 5143 BUILDING PERMIT _ Permit Number: 15143 Address: 4539 BLOSSOM BLVD Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: ORANGE BLOSSOM RANCH Est. Value: Parcel Number: 15-26-21-017E-01900-OODO Improv. Cost: Date Issued: 3/28/2014 Name: JONES DEBORAH JEAN Total Fees: Address: 208 CRANBERRY BEACH BLVD Amount Paid: WHITE LAKE MI 48386-1921 Date Paid: Phone: Work Desc: SEE BP#15141 REROOF SHINGLE I AL . ,��" .�" ( ` I TAPE JOINT OOF INS 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 property. 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 accordance with Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O. CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER a�s-�eo-oozo City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received ��k'-- /� phone Contact for Permittln /✓ __ '7 J � Owner's Name �r/(�F' �Oy'�` a�' �"9��' Owner Phone Number Owners Address �OyfC1 /97 l /��'" Owner Phone Number � Fee Slmple Titleholder Name �` � Owner Phone Number � _---� ��/� Fee Simple Titleholder A�s JOB ADDRESS S�� ' �S G��I � �� LOT# �� SUBDIVISION PARCEL ID# �S �Z��q� '�1 7.L O ��"�',f� (OBTAINED FROM PROPERTY TAX NOTICE) `-�....,_ WORK PROPOSED � NEW CONSTR 8 ADD/ALT [� SIGN o o DEMOUSH INSTALL REPAIR PROPOS�D USE Q SFR Q COMM � OTHER �— TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q DESCRIPTION OF WORK � /��' f��/ /rQ� BUILDING SIZE .� �v � s� SQ FOOTAGE HEIGHT �� QBUILDING $/S—�j �CQ VALUATION OF TOTAL CONSTRUCTION QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. QPLUMBING a �]MECHANICAL $ VALUAT�ON OF MECHANICAL INSTALLATION � � ��j' OGAS � ROOFING Q SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# � —� ELECTRICIAN COMPANY SIGNATURE Re�isrEReo Y/ N FEE CURRE� Y/N Address License# � PLUMBER COMPANY SIGNATURE REGISTERED Y l N FEE CURRE� Y/N Address License# � MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# OTHER COMPANY ��"t�� SIGNATURE REGISTERED N FEE CURRE� Y!N Address 0 � � JrY �'^=r°f� �C(1 �i4r� � �� license# ��5 3,I s^ � RESIDENTIAL Athach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Permit for new construction, Minimum ten(10)woricing days after submittal date. Required onsite,Construction Plans,StoRnwater Plans w/Silt Fence installed, Sanitary Facllitfes 8 1 dumpster;Site Work Permit for subdivisions/large projects COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW consVuction. Directlons: Fill out application comptetely. Owner&Contractor sign back of application,notarized If over i2500,a Notice of Commencement is required. (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 . CITY OF ZEPHYRHILLS 5335-8TH STREET (si3)�so-oo20 1 5 4 BUILDING PERMIT Permit Number: 15144 Address: 4537 BLOSSOM BLVD Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: ORANGE BLOSSOM RANCH Est. Value: Parcel Number: 15-26-21-017E-01900-OOAO Improv. Cost: Date Issued: 3/28/2014 Name: BENJAMIN ELAINE M Total Fees: Address: 4537 BLOSSOM BLVD Amount Paid: ZEPHYRHILLS FL 33542-5660 Date Paid: Phone: Work Desc: BP#15141 REROOF SHINGLE I L . 1i / ( � � I TAPE JOINTS O F I 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 accordance with City Codes and Ordinances. NO OCCUPANCY BEFO C.O. a CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyfiilis Permit Application Fax-813-780-0021 Building Department Date Received �,� �� / Phone Contact for Permittfn / / -- ��s � / Owner's Name � /(/ � p S�/7 -9NI' ( Owner Phone Number /��j.s�� Owner's Address Owner Phone Number � Fee Simple Titleholder Name � Owner Phone Number � Fee Simple Titleholder Address �� JOB AD[3RESS ti �3�/ ,� pS,f'0 /Y�' LOT� �� SUBDIVISION PARCEL ID# S^ - — ' �—Q� d6-a�6a (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH INSTALL � REPAIR PROPOSED USE Q SFR Q COMM � OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q DESCRIPTION OF WORK BUILDING SIZE �� D� �� SQ FOOTAGE�� HEIGHT QBUILDING $ / -�' /� �� VALUATION OF TOTAL CONSTRUCTION / F" QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. QPLUMBING $ QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � ��S�� y' ��. QGAS � ROOFING Q SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � f�2 BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# ELECTRICIAN � COMPANY SIGNATURE ReGisTEReo Y/ N FEE CURRE� Y/N Address License# � PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# � MECHANICAL � COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# � OTHER COMPANY l(� -{'�� G�' � l"� SIGNATURE REGISTERED / N FEE CURREK Y/N Address ` G �� L '�rS S`�'«�� License# rp G',S—,�S_S � RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)woiicing days aRer submittal date. Required onsite,Construction Plans,Stormwater Pfans w/Silt Fence installed, Sanitary FaGlities 8 1 dumpster;Site Work Permit for subdivisionsllarge projects COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)workf�g days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&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 required for all NEW consVuction. Direct(ons: Fill out application completely. Owner&Contractor sign back of application,nota�ized If over;2500,a Notice of Commencement is required. (A/C upgrades over 57500) " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW - iiiiiiiiiiiiiuiiiiiiiiiiiiiiiiiiiuiiuiiiiiiiiiiiiiiiiiiii . i 2014047647 Rept:1693868 Rse: 10.00 D5: 0.00 IT: 0.00 03/28/14 E. Mungufa, Dpty Cle�k PHULR S.0'NEIL,PM.D.PqSCO CCERK i COMPTROLLER I NOTICE OF COMMENCEMENT 03�28�ia�9�a�a�• ! ef 1 , OR BK P� 3249 Pemut No.---------- IPropen��ldcntiticationT�o.lS'a�a 'e�j"6�7G--v� iO0 -QOPjO I! THE l�'DFRSIGNED hereby give:nforms you that the improvement will be made to certain real property,and in acw�dance with ' Secnon 713.':3 of the Florida Statutes,the foUowing informarion is provided in this NOTICE O��9Q��J`� r p t.Descr:iption of ptoperty(legal descrip�iox:��O-� (3�c�Sc�'�'� �0.�!1'1 Cp✓1�D 5_ `�t Se7�,2-7�G� � 7 " a)Sheet.4ddress: O ri� ¢. � � 2.General description of improvements: -}� _ _ F- W Y 3.Owner Iniortnation 1 Q Z V � w a)\ame and address: �Ur�-�s_U�2 i\liaw�S l.4'rja� Ib�Som ��1►0�� 2 h r ; .!,�_335'-k� � � � � � J U b)Name and address of fee simple titDeholder(if other than owner)_ /�l �Q _. � z � p �� } c)Incerest in property /00 l o � — U cn � O �' ontracror Information J� r /- 1, ,n ��f �/ C�' � � p S w `V a w � a1\ame and addtess: � 1s UB�WiS(�o. p��p�� / I�JL �37G�/ �, W � f � � � bl Telephone Nn.c 8��"q —�Fax No.(Opt.)_g�,��- LO L7 0 = �' -� � �.Sunrry Int'ortnation 7.- � �" 'J � � a I Name and address: N u-t LL' � V U � �OOu. ot5 b;Amount of Bond:, __ � r y�.. � � Y c,1 elephone No.:___ Fax No.(Opt.)� _ Q y-- � � 6lcndtr V `r �'` � W a�Name and address: F=- � � '� _ 'Q i-- J Q. L� Phone No. C1 � u � z � --� � ?.Identity of person within the State of Flo 'da designaud by owner upon whom notices or oth r documents may be served: � F., � CL d y_ � a)�iamc and address: i// � f.Y" � i.i_ _ <C � � b)Telcphone No.: /V Fax No.(Opt.) - -- ry�, ix' `•' (� y � a� t�.� ;.:� � - V 3.In xddition to himself,owncr designates the following person to receive a copy of the Lienor's otice as provided in Saction u„ ?13 1:(11(b),Florida Statutes: A, O �-�- Z � � a)'�ame and addrcss: �V W U� � J J bl Telephone No.: /� 'Q� Fax No.(Opt.) Q c!) = V--� 9.Expiration date of Nonce of Commenccment(the expiration date is one yeat from the date of recording unless a different date is F- = d' �'- a m specifiedl __._.._ —.. _ � ~ ~ �� wA}tNING TO OW'.VER: ANY PAYMENTS MADE BY THE OWNER AFTER TIiE EXPIRATION OF THE vOTiCE OF .� �` * * COMMENCEMENT ARE COIVS[DERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTiON 713.13, � FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMEIYTS TO YOUR PROPERTY. �G 6 a NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE F[RST � � fNSPECTION. iF YOU INTEND TO OBTAIV FINANCING,CONSTJLT YOUR LENDER OR AN ATTORNEY BEFORE �! ��eI�� CO'�IMEI�CING WORK OR RF.CORDING YOUR NOTICE OF COMMENCEMENT. �`��:�"� � • :.�. • � ST.�TF.OF FCORIDA � ��•�n� � 1 � � C01;1T\'(1F PASCO Q:u, �iQ��. O � . � � �� SigniWro of Ownu m Owner'S Authoriud Ofticermirect�r/ParmerManager� +� � � �� _ � - Pnnt Name � � '1'I,e forcg9 in ns�yt�ent was aclmowledged before me this a e.�day of J�N• ,20�y,by �S � • * (T�_/�'9e'�(�1'1�/'�as (type of authority,e.g.officer,mistee,attorncy ia iaci)for__ _ (name ofparry on behalf of whom instrument was executed). Persunally Known__OR Produced[denRfication� Notary Signature ____ T of IJentification Produced gas.��0`-39 gyq-�p ) W= Name rint i �,�A�,9bN�� —--- ' EXPIRE$: 13.2p11 �Venfication pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,I � and chai the Cacts stated in it are hve to the best of my lrnowledge and belief. ��.� �°� /h�,P�.►M�� ----- Si turc of Naaral Pcrson Signing Abovc �ORMS�N04rvs4':OOi