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Home My WebLink About14-12893 • CITY OF ZEPHYRHILLS 5335-8TH STREET � (si3��so-oo20 12893 BUILDING PERMIT Permit Number: 12893 Address: 5121 19TH ST Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-20100-0060 Improv. Cost: 30,000.00 Date Issued: 3/13/2012 Name: BACK, WILLIAM & DINA Total Fees: 237.50 Address: 5121 19TH ST Amount Paid: 237.50 ZEPHYRHILLS, FL. 33542 2poq Date Paid: 3/13/2012 Phone: 813 355-1195 � Work Desc: 304 SQ FT ADDITION/835 SQ FT PORCH 8� GARAGE ADDITION HOMEOWNER PLUMBING FEE 17.50 MECHANICAL FEE 17.50 HOMEOWNER HOMEOWNER � � � - �� ,�) / I � l�� . � �►� FOOTER BOND DUCTS INSU�I+4TED SEWER MISC. ROUGH ELECTRIC LINTEL 1-(7 l z C'Pj I �l/ MISC MISC. 1ST ROUGH PLUMB "«�9 PRE-METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE-SLAB l 2-� -0� SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80(2)(c)when extra inspection trips are necessary due to any one of the following reasons: a)wrong address b)wndemned work resulting from faulty oonstruction 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 acaessible. 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 reconl 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 recoMing your notice of commencement." Complete Plans, Specifications Must Acoompany Application.All work shall be performed in acaordance 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 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 . Building Department Date Received 8 r 3 3�� _ ��yS Phone Contact for Permittin Owner's Name w��L��'� Q . p�c�. Owner Phone Number es�� /�cS ,� L�F Owner's Address -39�0,� LJ�INO�L fj1�E. ��fl IGS,FL ,3�SyZ p�y�er Phone Number Fee Simple Titleholder Name Owner Phone Number � Fee Simple Titieholder Address JOBADDRESS ��2r / 9� � Z�YR-H7�`ri�L 3'3� 1 r LOT# � SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR 8 ADD/ALT SIGN 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 �--� SQ FOOTAGE� HEIGHT QBUILDING $ VALUATION OF TOTAL CONSTRUCTION QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. QPLUMBING $ � �l�3' ` � V► QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � �� GAS Q ROOFING Q SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER �� /� _ �/ � COMPANY '�+ • �7v�1f dW'�'E� SIGNATURE �y"'' REGISTERED Y/ N FEE CURRE� Y/N Address 3�/D-S C��If3L /9'1�E- Z-1�1LLS License# S G ATURE N I;%�/�//',J�� j � ��%� COMPANY L '/ I/ J�� REGISTERED Y! N FEE CURRE� Y/N Address l.icense# � PLUMBER � � �� COMPANY SIGNATURE REGISTERED Y! N FEE CURRE� Y/N Address License# � -� MECHANICAL / ,Q, , � �� COMPANY SIGNATURE (�� REGISTERED Y/ N FEE CURRE� Y/N Address License# � � OTHER COMPANY SIGNATURE REGISTERED Y J N FEE CURRE� Y/N Address License# � � RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fonns;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 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 8 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. Owner&Contractor sign back of application,notarized If over s2500,a Notice of Commencement is required. (AIC upgrades over E7500) "' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMI7TING (Front of Application Only) Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurveylFootage) Driveways-Not over Counter if on public roadways..needs ROW CITY OF ZEPHYRHILLS • • 5335-STH SIREET (sis)�ao-oozo 9686 BUILDING PERMIT Perm t Number: 3 86 ��: Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. Ciass of WoNc: 434-ADD/ALT RESIDENTIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block• Section• Square Feet: Subdivision: CITY OF ZEPHYRHILLS� Est.Value: Parcel Number: 11-26-21-0010-20100-0060 Improv. Cost: 49,000.00 Date lssued: 10/27/2009 Name: BA K, W LLIA 8 D NA Tota� Fees: 552.00 Address: 5121 19TH ST Amourrt Paid: 552.00 ZEPHYRHILLS, FL. 33542 � P$�d� :�� Phone: 813 355-1195 o sc: 304 Q ITION/835 . FT P CH 8 A E A DI N PLUMBING 5EE �35.00 MECHANICAL FEE 35.00 ��C_' i , - v r n.��D� ,� _ 2�� -,�"/ �'.,� le . . ,C d� �,<�c y �s� u: �� _j� ,v `�� ; . ��c FOOTER BOND DUCTS INSUWTED SEWER MISC. ROUGH ELECTRIC UNTEL MISC MISC. 15T ROUGH PLUMB 2' -� PRE-METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE-SLAB f Z-1 -p� q — SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. REINSPECTION FEES: Reinspectlon feea wlll comply with Florida Statube 553.80(2)(c)when extra inspection tri�ar+e neoessary due bo any one of tl�e followin9 ressons:a)wrong addre�b)oa�tlemned vrrork rc�uftlrq from faulty oon�6vc�lon c)repairs or oorrections not made when inspections called d)work not ready for inspectlon when called e)permR rat pos6ed on job sibe�ptans not at job sibe g)work not aooes�ible. NOTICE: In addltion to the requfrements of this permit,there rnay be additionai r�estrictions appliqble bo tfiis property that may be found in the public reoords of this county,and there may be additlonal permits required from otfier govemmental endties such as water management, stabe agencies or federal agencies. The rrt�ins 'on fees shall be made befnre a furtl�er its will be issued to the rson ownin same "Warnln�tio owne�: Your failure bo reoord a notlae of eommenoement may result in your payiny twtce fior improvemeMa bo Your ProPertfl. If you inbend bo obtafn tinandn�,conpilt witl�your lender or an atborney be?ora i r notioe of commenaemer�t." � �Z� CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT DCPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER . a��-�en-oozo City of Zephyrhills Permit Application �� Fax-813-780-0021 • eda�ng oepartrnent o�.�:� ' P►�.��o.�.�,,� 13 3ti _ ll9 S Ownsr's Nams �L.�. � � r7�i� Owr»r Phon�Number ��" �� Owners Addnss �� J�� S ' Z-l�/ � Own�r Phon�Numba�- Pp Slmpla 71Wholder Nams Ownsr Phons Numbsr� F�a Slmpb Tltl�holdar Addrus JOBADDRESS / /9��N S- EE� J�Cp�Siy �LS IGL LOT* �-� sueonr�s� � ,,,R�a�, - - /-�py0-�Zd/00 -0060 1�*��eor raorEmr,�x ho�q WORK PROPOSED e NEW CONSTR ApD/ALT Q SION Q MpVE Q DEMOLISH INSTALL REPAIR PROPOSED USE SFR Q COMM Q OTHER �----'� TYPE OF CONBTRUCTION BLOCK Q FRAME Q STEEL Q OTHER DESCRIPTION OF WORI( tJ' /Yf �/ O� D � G'•-�ry� ,�I/ BUILDING S¢E �� / SQ FOOTA(iE � � E�� BE�1kf I6 BUILDING VALUATION OF TOTAL CONSTRUCTION s 0O p _va Q ELECTRICAL f AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. Q PLUMBING s l ,�a= �Z� Q MECHANICAL s VALUATION OF MECHAMICAL INSTALLATION �� Z O �s Q ROOFING 0 s�a,�,��rv � OTHER FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QyEg QNp BUILDER � � , COAIPANY ,A� SIGNA7URE qeqBTenm Y� N t�cuqpo�T Y!N Addnss l Z 7�7� .S r .Z�1(�S f[ I � �� License# e�cTwcuur �OM�OWN ( 0 c.w� cowra+v Ha'� su3w►rureE J' r+EG�s�o Y! N �E cxinr�r Y/N wdarw � �'— Licenss# PLUMBER �� I, � COMPANY �� SIGNATURE � � r�asrea� Y I N F�aa+aertr Y I N Address � � � � Ucense# MECHANICAL '� � v �� COMPANY �'��`M✓ � SN3NATURE o Y I N �e cursr�r Y!N ��u ` � Ucense# � O7HER " � /J �� COMPANY � �'`" � 8NiNATURE f��- qEc�s�Eo y/N �E a�r Y!N Addrosa �- � � License# RESIDENTIAL Attach(2)Pbt Plans;(2)sets of BUNclirg plans;(1)sel of Energy Fortns:R-O-W PertnR for naw oonsNictlon, Minlmum ten(10)woAcing daya aftx submlltel date. Requlrod w�aite.Caretructlon pLns.3�ormwater Plans w/Sltt Fence IrrefeYed, Sanitary Fadlltles 31 dumpslx,SNe Wak Pertnit for aubdfdslonylarpe p�aJeC(y COMMERCIAL Atlach(8)oompleta aefs of BulWk�p Plans plus a LHe Sa(eb PaOe;(1)sel o�Er�py Fams.R-O-W Permlt for�e�w conetructlon. hMnimum ten(10)workinp days aftar submitlal date. Required ar�site.Cq�strucYon Plans.Stortnwater Plans w!Silt Fance hstaped, SaMtary FadNtles&1 dumpsler.Site Work pertnit for all new proJecb.,qll aommerclal requirements must meet compllance SNiN PERMIT Attach(2)sels of Enylneered plans_ ••••PROPERTY SURVEY requked for ell NEW consUucyqi. Olnctions: Fill out applicatlon compleldy. Owner 8 Contradw sign badc oi applicatlon,notarized If ov�r 52500,a NoUce of Comm�rw�m�M Is rsqulrod. (A/C upprades py��f3ppp) •• pgenl(for the conUactor)a PoMrer o/Attomey(for tlie ov�)warid be aomeorre wMh notarized letler ham ovmer auUwrizlnp eame OVER THE CWNTER PERMITTINO (Front of Appllcatlon pny) Reroofs SeNrers Service Upgrades A!C Fenoes(PbUSurvey/Faolage) Drlvewari-Not over Canler if on pubNc roadways..needs ROW . . , . � � . ' � . . . _:i;: _ , , � - � . . ' � .. . � {'•�. � � . 1 _t' . _. 7 � . 1 • - . � . . � • � �Gi�M , w +`� 1� p . � �t +!Y - � � �, � • y► O _. V ~ se�.'_ - � O 3 a� � - - - A� : _ _ . _ _ . . o �` 19��n ti � . � �q /r�d o .. � 10�S� l - " l3 �o`� :�. � i�o.o• s•r i -7- . , �CALE� I"•ee�' `: :. r BURVc�Y OF: Lote 6, 7, an� B, Block 201 , CITY Og ZEPHYR�iILI.B, ae per plat thereof reearded in Plat Book t , Page 5�, pub].ic Rea�srde of Pasco Coe�nty, Florida. � � ... ...,._.. _.�.hia. �csr�if.3.,e:�.,t�ha�..�ve made �he surve,y a� shown hsreo�, �b+RL .t.ba... . ..___.:. _. r: gurv�}► is correct tn tlie besL cf oulr knc�wled�e and beli.ef end that thia plat i� a true �rep�esent�Rtion thereof. MULLIA'$ A.iD �HOLJta �� t .�`-=` � fiorbert hot�� `lori a vrveycr�a Re�Ciatr�tion No. 5�:1 . .. FORt F�ancis H. Che,.rlton ; - � ORDER NC. 1�3g Jamiary 27, f 965 � �/�. ��- /9��; . � 33.ssLz . � DISCLOSURE BTATF�t+�rNT FOR O�PNER CITY OF ZEPfI7CR�IILI.S BUII.DING DEPAR'1't�NT I. �l��jj�. �J . ��7`�iY�- have road and fvlly undoratand aad agr�e �to tha provisioas of this inatr�nt. ThQ uridarsignod atatas aad affirms that he or ahe is d�sirous of constructing, ran�v:ting, :dding to or raroofiag his or har o�an d�.icilo, that h� or shQ actually occupias, ar pill occupy by said do�.ailo, and �amQ is not for rQnt, leas• or sale. That ha or sho ahall comply pith the £ollo�ing conditiona: 1. That the ownar and ha or she alone shall act aa the build�r for all phasos of con8truction. 2. That tho oanar Nill co�ply xith all provisioas of the City of Zophyrhills ordinaacas aad aodps portinoat to tho .building. 3. That in tha evont various phasos of construction aro subaoatractod, ha will �gage only proparly liannsod subcoatractors and rrill parsonally suparvise such �rork. 4. That in tho evoat tho Building Inspoctor shall roi�ire corractiona to be mada, the owaar will assuma full roapoaaibility to insuro thoy az� mad�, and upon complatioa ►rill call for a roa.nspQetioa boforo proc�ding with tho buildinq. 5. That tho o�anar sha11 assumo full rospon�ibility for ttw construction and Kill not axpect suporvision of his vrork from tho City of Zrphyrhills Building Dwp�rtmont. 6. That prior to firia]. inapoction s�► additional fa�s, includisig rwiasp�etion £ows, must bo paid in full. A xrittaa roquast fron this office ahall constituto an official notice to pay additional f�a. 7. That th� ovmar shall comply Kith all City, StatQ and F�ral laxs in raqard to social socurity, �rorkman's comp•nsstion, lioa laas, Qtc. , �►laQro appliaable. 8. That tho oxnar shall ao�ply xith all th� safQty cod�s isauad by the Florida Industrial Ca�mission. 9. Stato lap requisss coastruction to bo dono by lic�aod contractors. You have appliod for a poxmit usider an �ca�ption to that la�v. Tha �comption allops you, ia tha o�or of your proparty, to act as your owa contractor pith aortain restrictions av�n though you do aot havo s lioenso. You must provide diract onsite euporvision of thQ conatructioa yoursalf. You aay build or improvo a one-fami.ly or tpo-family rasidenw or a farm outbuilding. You may al8o build or i.mprove a co�rcial building, provicLd your costs do not oza�d $25,U00. Tha buildiag or rQsid�ac� must bQ for your own uso or occupancy. It may not bo built or substantislly improvad for sale or loase. If you aall or loaao a building you havo built or substantially iaprovod yours�lf �aithia 1 y�ar aft�r the aonstruction ia compl�to, the la�v �vill prasuno that you built or aubstsntially improvod if for salo or loaso, Mhich ia a violation of this oxamption. You may not hire an uri].iaonsod poraon to act as your contractor or to supornisw pooplo o�orkinq on your building. It is your roaponsibility to mako sura that poop2� a�ployQd by you hava lioaasws raquirod by state la�+ aad by aounty or municipal licansing ordinancc�s. You may aot doloQat�a tha raspoasi.bility for suporvisiag work to s licoasod contractor who is not liaons�d to por£orm tho work boi.ng dono. Ariy paraon working on your buildiag who ia not licwasad aust �vork undor your dir�ct suporvieion arid must bQ employod by you, which maans that you must dpduct F.I.C.A. aad orithholdiag tax and provide �vorkars' cosponsatioa for that a�ploy�, all as pr�scaribod by lsw. Your construction must aomply with all applicsble laws, ordinancos, building codps, aad zoning ��agu�ation�� O�R'S SIGNATCTItE ✓ � /D-22-�q ADDRESS PH0�7� WITNE33 P�32bIIT � to WILLIAM D.BACK and DINA BACK,his wife, whose post office address is: 5121 19th St Zephyrhills RL 33542 heroinafter called t�e granbee: (Whenever used herein t6e term"�r"and"grantee"include all the parties to thie inatrument aed tha deirs,kgnl representatives�nd aasigns of iodividuels, �ud tlk succeeeors and�seigns of coipocstiona) Witnesseth,that the g�antor,for and in consideration of the sum of *�*NO CONSIDBRATION t** and other valuable considerations,receipt whec+eof is hareby acla�owledged,hereby gcants,bargains,sells,aliens,remises,releases,conveys and confinns unto the grantee,all that certain land situate id Pasco County,Florida,viz: Lots 6, 7 and 8, Block 201, City of Zephyrhills ns per plat of the Town of Zephyrhill� recorded in Plat Book 1,Psge 54,Public Records of Pnaco County,Florida. T�b iasMo�e�t was prep�red by Morrow Ba�i�e�e Solrtion, f�c.,SS36 6TH Street,Zep�yrhill�,FL 33S�Z,who cerd8e�t6st �'ProWred tke same trom iR[ornatio��ive�bo kim by tLe psrti�s,and seilher the markehWlty of Htle�or u�ctinry o[legal daeriptbu b henby�wtnnbeed. Said property is not tlte homestead of t6e Grantor(s) aeder the lawa aad constitutioa o! the Sbte o!Plorids in t6at oeither Gra�tor(s)or any meonbera of the horsehold oi Graatorts)raide thereon,nor is k wntjguous t6ereta Parcel ID Number:I1-?.�rZ1-0010-20100-0060 Togetlter wit6 all the tenements,heroditamerns and appw�tenances thereto belonging a in aurywise apperlaining. To Have s�ud to Hold, the same in fee simple forever. ' And the g�antor hereby covenad�s with said grantee that the grantor is lawfulty aei�od of said lsnd in fce simple; that the grantor has good right and lawful euthority to sell and convey said land;d�at the gsator heteby fully watra�tts the title to said land and will defend the seme against die lawful claims of all persons whomsoever;'and that said land is 6�ae of alI encumbrances except taxes accruing subsequant to December 3i,2007. In Witness W6ereof, the said grantor 6as signod and sealed these presents the day and year first above writt�. Signed sealed and delivered in our presence: �' �d�� -�-L;�� 03 s3 ;B (s�l) t EMANUEL B.BACK WiMas Printed Nama � L- � d Y�� wddrrxs: 39038 Citedel Cir,Zephyrhill�,FL 33542 ^ � ($�A�� L A J.B K witnees Prin Name U � 0 Y1/�1 L✓ pdd�as: 39038 Citadel Cir,Z,ephythills,FL 33542 TWO DIFI�EI�SNT H�J!77NESSBS � State of Florida County of Pasco The farogoing inshumern was acknowkdg�ed before me this jQm day of ]uce�2008,by EMANULL B,BACK�ad wife LULA J.BACK, who is/are parsonally known to me or who has produced driver's license as identification who did/did not take an oath. � � C�/Vti✓ � '• .108EPH VICTOR MORliOW ry Pr .•. :'= MY COMMI3810N�DD83l1TT t Ns EXPIRES AptN 07.2011 My CowuLstor EYpira: p (Nohr7 Seal) DBED ladividusl Wananty Deed With Non-Homede�d-L.egal on Face NQ�CE OF CO�NCEMENT I IIIIII I�II Ilui IIIII ilIII{INI IIIIIIIIII IIIII Iluillll IIII �� Permit No.�.Bw�I Rr.'p y:12!fJ.7�77 R�C: 10.W Tax Folio No. /— DS: 0•� [ 2��-1l—On/D�?D/DO—QG�'p IT: 0.00 10/27/09 _Dply Clerk THE UNDERSIGNED hereby gives notice that impnovanents wil)be.itiade to oertain real pt+operty,and in acxordance with Section 713.13 of the Florfds Stat�tt�s,the fotlowing i�fonttatIon is providod in this N01'ICE OF C011ZML�NCEII�NT. �.�;�,of�+r c��: LoTs �,7. �8, �4�2n/ ci>�' oF zE��y�e�iic�s a)Strea(J�ab)Addn�s:C'1�2 I �q-7z) c�r. ,��r ve � FG 33;Se 7 2.Ge�eral descriptim�of improvpn�s:-�E��f.L1.aL�r�.,��T'��:� ?Zi_.EYlSTL/�/' /,�ir^.✓�c ��'l f�.Y ��yd<w/ � 3.Owner Infosroation � a)N��a�:[�JIIG/AaI �D/•✓�o B,9c�k' S/2/ /9rf,t ST' Z�y y,�u�cts, FC b)Name and addtess of fce sunple trtldwlda(if oth�than ownor) �/.-.,4- ' c)Ir�in property 4.Con�actos Infornietion a)Nsme and atidt+�ss: �.�11/ • b)Telephone No._ iRL — ?/�—�/�i, Fax No.(Opt.) S-Su�ty Infoanation "-r. '�.��-.��.`..• �• a)Nam�and address: � b)AmouM of Bond: c)Telephone No.: Fax No.(Opt), ��a s. o�r�t�, PASCO CLERK L GOPpTROLLER 6.� �e�z��0s i °��33 a)Name and sddress:�/f�. OR BK �� p� Phone No. 7.Identity of peison within the State of Florida designated bY awn�r upon whom notices or otlxa docume�s may be servcd: a)Name and address:�,��/l1t�dL�_�jal1X� b)Tel�phone No.: Fsx No.(Opk) 8.Ia addition to himset�owner desi�the fnllowing pecson to raxiv�e a oopy of the Liawr's Notioe as providod in Saxion 713.13(lxb),Florida Stattttes: ' ��N��:�I A. b)Telephone No.: Fax No.(Opt) — 9.E�iration dste of Notice of Commencemdrt(tLe e:pira�ioa dste is one yar from tie date of recordi�ule�s a dit�er�t date b specl�: WARNING TO OWNER ANY PAYN�NTS MADE gy TRE OR'NER Ai�TER T�EXP�tATION UF 1�NOTICE OF COMMENCEII�NT AItE CON3IDERED L�lYIPROPER PAYMENT'S ilNDER CHAPTER��y p�T�,g�ON 713.13, FLORIDA STATUTES,A1�iD CAN RESUI,T IN YOUR PAYING TWICE I�+pR IINPROV�MENTS Tp YOUR PROPERTY. A NOTICE OF COMMLNCElYIF1VT MU3T BE RECORDED AND M�STED ON 1'BE JOB 3TTE BEFORL THE FIRST 1NSPECTION. IF YOU IIVTLND TO pgI'AII�1 pTNANCII�JG,CpNSULT YOUR LENDER OR AN ATTORNEY BEFORE COMIVIENCING WORK OR RECORDING YOUIt NOTICE OF 1rIIKE11iCEMENI; STA?B OP RLORIDA /� counrrroF�xram�s QAsc� l0. r��jr,� Si�ofOweera0aeer's pffioe� • �/i��, n, gAc,e n'vII Name 'Tlie fo�egou�8 ins�ui►ent was scimowledged t�tfore nie tliis��da of (�� Y --��,l�,Q�„—_20�i .tiy ��i F�. � LY�}� � �r,n t. D � l�'�►�-�- (type of aat�ority,ag.o�icer,trustee, attorney in fact)for (name of pa�{y oa beb�tif of w��oo inahve�ent w�aa ezecntad} P��Y�� OR Produoed Identification � Notary Signahne Type of Identification Produced 1Z. ��,�@�„ `�c�,.,p��nt} �� Verifica�ion '�!�'�'`� pursuant to Sectioai 92.525,Florida Statutes.Under peneldes f perjurY,I declare d�et I have read the foregoing and�at the facts s�in it are true to the best of my k�rowlodge and belief. :� — � � '"0� ►dorn Puhlc ew.a RoAlr ��• •'�"'"-M'�� Sigruhue of Natural Person Signi�(in line N 10.)Above �! y;y�<�hrtllNfpll p0661QM M w� -xpkas:1RNSrl010