HomeMy WebLinkAbout14-15831 CITY O�ZEPHYRHILLS
" 5335-8TH STREET
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BUILDING PERMIT
PERMIT INFORMATION � LOCATION INFORMATION
Permit Number: 15831 Address: 6533 BRENTWOOD DR
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: SILVER OAKS
Est. Value: Parcel Number: 04-26-21-0020-00000-OOAC
Improv. Cost: 9,405.27 OWNER INFORMATION �
Date Issued: 12/09/2014 Name: BRADLEY FAMILY LIVING TRUST
Total Fees: 85.00 Address: 6533 BRENTWOOD DR
Amount Paid: 85.00 ZEPHYRHILLS FL 33542-0624
Date Paid: 12/09/2014 Phone:
Work Desc: REEROOF SHINGLE
CONTRACTOR S APPLICATION FEES
NEUMAN R OFING I C REROOF RESIDENTI L 85.00
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Ins e ions Re uired
DRY IN ROOF INSP
TAPE JOINTS ROOF INSP
FINAL
REINSPECTION FEES: Reinspection fees will com ly with Florida Statute 553.80 (2)(c)when extra inspection
trips are necessary due to any one of the followi g 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 bn 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 mana ement, state agencies or federal agencies.
"Warning to owner: Your failure to record a na�tice of commencement may result in your paying twice for
improvements to your property. If you intend�o obtain financing,consult with your lender or an attorney
before recording y, ur notice of commencement."
Complete Plans, Specifications Must Accompany Application.All work shall be pertormed in accordance with
City Codes and Ordina ces. NO OCCUPANCY BEFO C.O.
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CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MON�'HS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT QARD FROM WEATHER
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, 813-780-0020 City of Zeph�Iyrhills Permit Application Fax-813-780-0021
uilding Department
Date Received 3sz. �G$ _ �f8 7S
Phone Cont ct for Permitting
Owner's Name �' I Owner Phone Number I
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Owner's Address T• Owner Phone Number i
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Fee Simple TiBeholder Name Owner Phone Number
Fee Simple litleholder Address
JOBADDRESS � � � LOT# �
SUBDIVISION PA I CEL ID# � `
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED � NEW CONSTR B AD�/ALT Q SIGN Q Q DEMOLISH
INSTALL REIAIR
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
DESCRIP770N OF WORK � I C- G S�S y�-�
BUILDING SIZE SQ FOOTAGE � D / HEIGHT �
����� $G� (.,+�� 2 VALUA ION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SE VICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ ��\
QMECHANICAL $ VALUA ION OF MECHANICAL INSTALLATION y} `� 1
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QGAS Q ROOFING � SP CIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS FL OD ZONE AREA QYES NO
BUILDER A A �1, (�,� ��N ��..0 COMPANY 'v ��+ •���N� �V� ���
SIGNATURE �� � ���' REGISTERED Y/ N FEE CURREN Y/N
Address License#
ELECTRICIAN COM PANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
M ECHANICAL COM PANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address I License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address I License#
IIIIIItllillllllllllllllllllllllllllllllllllllllltllllllllllllllllll
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1'y set of Energy Forms;R-O-W Permit for new construction,
Min�mum ten(10)working days after submittai datb. 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)complete sets of Building Pians plus a I�ife Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Min�mum ten(10)working days aker submittal dat�e. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permi for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW co struction.
Directions:
Fill out application completely
Owner 8 Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
" Agent(for the conlractor)or Power of Attorney(for the owner)w uld be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Applicalion Onl )
Reroofs if shingles Sewers Service Upgrades A/C �nces(PlotlSurvey/Footage)
Driveways-Not over Counter ff on public roadways..needs RO
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' NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more restrictive than County regulation . The unde�signed assumes responsibility for compliance with any
applicable deed restrictions. ,
UNLICENSED CONTRACTORS AND CONTRACT R RESPONSIBILITIES: If the owner has hired a contractor or
contractors to unde�take work,they may be required�o be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both t e owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work,they are advised to contact the Pasco ounty Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contr�actor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Block"of this application fQ�r which they will be responsible. If you, as the owner sign as the
contractor,that may be an indication that he is not pr;operly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Reco�ery Fees may apply to{he construction of new buildings,change of
use in existing buildings, or expansion of existing bui�dings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understa ds,that such fees, as may be due,will be identified at the time of
permitting. It is further understood that Transportatio Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy"or final power r lease. If the project does not involve a certificate of occupancy or
final power release,the fees must be paid prior to p�rmit issuance. Furthermore, if Pasco County Water/Sewer Impact
� fees are due,they must be paid prior to permit issuan�e in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida�tatutes,as amended): If valuation of work is$2,500.00 or more,I
certify that I, the applicant, have been provided `th a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida Departme t 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"owne�'prior to commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify t at all the information in this application is accurate and that all work
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 i stallation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that II work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regula ions, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other ovemment agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take t�be in compiiance. Such agencies include but are not limited to:
- Department of Environmental Protection Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,WatedWastewater Treatment.
- Southwest Florida Water Manageme t District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,DocKs,Navigable Waterways.
- Department of Health & Rehabilitative 5ervices/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks. �
- US Environmental Protection Agency-Asdestos abatement. -
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to th use of fill:
- Use of fill is not allowed in Flood Zone` unless expressly permitted.
- If the fill material is to be used in Flo d Zone "A", it is understood that a drainage plan addressing a
"compensating volume"will be submitte 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 Floo Zone "A" in connection with a permitted building using stem wall
construction,I certify that fill will be used�nly 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 adve sely affect adjacent properties,the owner may be cited for violating
the conditions of the building permit iss�ed under the attached permit application,for lots less than one(1)
acre which are elevated by fill,an engine red drainage plan is required.
If I am the AGENT FOR THE OWNER,I promise in ood faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I un erstand that a separate permit may be required for electrical work,
plumbing, signs, welis, pools, air conditioning, gas,lor other installations not specifically inGuded in the application. A
peRnit 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�hall issuance of a permit prevent the Building Official from thereafter
requiring a correotion of errors in plans,constructionlor vioiations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commgnced 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 Offi�ial for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If work ceases fo�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 117.03)
OWNER OR AGENT CONTRACTOR
Subs rib d and swom t (o�rmed)before me th' I Subsc ibe and sworn (or affirmed before me this
1 1 by V . � � (l by SON W. �EUMANN
Who is/are personallv known to me or has/have produced o is/are personally known to me or has/have produced
� as identification. PERSONAI,LY KNOWN as ident�cation.
l ���,�, . r�ri. �IotaryPublic ' NotaryPublic
Co�m/m�ission No. �/- l����1� Commission No.
/.hri�s,�j� t�� ._,^ i b t� • L/ fY! o•�
Name of Notary yped,printed or stamped Name of Notary ' ted s am e
�° N�TA�RY PUBLIC
�p�ARYq CkIRI�TI�K MAJOR ��
❑�7ATE OF FLORIDA
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"' � " �Comm#EE143314 E�� ��Pires 11f�1��15
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State of Florida License#CCC1326166 and#CSC058155
30427 Commerce�rive, San ntonio,FL 33576
Phone (813) 782-9080/Fag(�352) 668-4803 .neumannroofs.com
8 December 2014 �°�' � �
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6533-6535 Brentwood Dr � �
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Zephyrhills,Florida � '
RE: ESTIMATE — GAF Lifetime imberline IiD Roofing System, with upgraded
System plus Warranty for Steep Sl pe Applications.
TOTAL ESTIMATE: $ 9405.27
The scope of this estimate is to furnish labo ,material, supervision, equipment, fees and other costs
related to the completion of the subject pro erty; specifications listed below:
1. Record Notice of Commencement d obtain all required permitting.
2. Tear-off existing roof system down to deck substrate and re-nail roof deck to meet State Of
Florida Building Code.
3. Provide and install PeeT& Stick un�erlayment.
4. Provide and install6"new drip edg�around entire perimeter, matching the existing face
dimension. Color: Brown
5. Strike lines to ensure a uniform shi�gle installation.
6. Provide and install new GAF Pro-Starter Strip at drip edge system.
---- 7.--Provide and install new GAF-Timb�rline HD-Shingles with stain guard. --
Color: Barkwood �
8. Provide and install GAF SeaI-A-Ri� ge Cap Shingles.
9. Provide and install new 16"valley etal in all valleys.
10. Provide and install new pipe boots d vents. Boots and vents will be painted to match
specified roof color.
11. Provide and install Cobra Rigid Ve t III ventilation with color match cap shingles.
12. Sweep magnets around the perimet r area of work to collect loose nails, staples, and other
, various scrap sheet metal compone�ts.
13. Haul away all roof-related debris. �
� 14. Our liability insurance coverage is based on completed operations.
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FL License#: CCC1326166 GAF License#:ME20454
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State of Florida License#CCC1326166 and#CBC058155
30427 Commerce rive, San Antonio,FL 33576
Phone(813) 782-9080/Fag 52) 668-4803/www.neumannroofs.com
15. All estimates/contracts are subject to Building Department approval in the appropriate I
county/city.
16. Payment schedule: 1/3 down, 1/3 u on delivery of material, 1/3 upon completion.
Unit Pricing Schedule fo�Unforeseen Conditions:
1. Replace any rotted or damaged declting $65.00 per sheet. (2 sheets at no cost provided with
reroof by Neumann Roofmg).
2. Replace any rotted fascia$6.50 per ineal ft.
3. If there are multiple layers of shing es on the existing roof; we will add$30.00 per square
per layer of roofmg to cover the te off cost.
1Veuax�ann Roofm 's Coxnr�it3nent to u li :
• All work will be supervised by proj ct managers to ensure quality work is preformed
according to our proposed contract.
• All work will be completed in a tim ly manner, excluding acts of nature beyond our control.
• All carpentry work will be perfortne in conjunction with roofing work, in a timely manner
following general workmanship qua ity.
• All work will be completed by skill d and knowledgeable craftsman to ensure production of
high quality of work. �
• The job-site will be kept free of debris throughout the duration of the pro�ect.
— o-T-he per-imeter-o.f-the-pr-ojec�area wi�-l-be-swept with-.magnets-to-pick up-an-y-loose-nails; —
staples, or other various scrap sheet etal components.
• Any existing gutters will be cleaned of all organic and roof related debris prior to project
close-out.
• Neumann Roofing, LLC is fully ins ed with workman compensation and general liability
insurance.
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FL License#: CCC1326166 GAF License#:ME20454
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State of Florida License#CCC1326166 and# CBC058155
30427 Commerce�rive, San Antonio,FL 33576
Phone(813) 782-9080/Fag(�i52) 668-4803/www.neumannroofs.com
It is understood and agreed the Neumann Roofing,L C will be held harmless for alleged or actual damages/claims as a
' result of algae,fungus,or mold. It is understood the� oofmg contractor and the roofing contractor's insurance will
exclude all coverage,including defense,damages,re ated to bodily injury,properiy damage and clean up directly or
indirectly in whole or in part for any action brought y mold,including fungus and mildew regardless of the cost,event,
� product or workmanship that may have contributed concurrently or in any sequence to the injury or damage occurs.
"This document has been prepared for those parties nancially responsible for services rendered. Reliance upon this
document or upon information,observations or opin ons contained herein should not be made by any party other than the
intended recipient designated on the title sheet of thi�estimate or report. The intent of this evaluation is to prepare an
opinion of the probate scope and/or cost of work to e performed based upon the parameters set forth by the client and
the individual needs and conditions found within the structure at the time of inspection. This opinion assumes a specific
scope and methodology. The user is cautioned that anges in either scope or methodology would have a reciprocal
effect on this opinion. If this should occur,we reser�e the right to review such changes and then modify our opinion
accordingly. Furthermore our opinion assumes resu ting work will be competitively bid and,as such,it is advisable to
solicit multiple bids for such work."
Wt�R12A1lT�'�':
• 5 Year 100%Workmanship/La or—Provided by Neumann 12oofing
• Upgraded GAF Weather Stoppe System Plus Warranty
Warrantv Ouestions Answer
Overall coverage period � Lifetime
U -front(100%)coverage eriod 50
Covers roofing s stem? Yes(entire system)
Cost of installation labor included? Lifetime
Installer certified? Yes
___ Tear-off cost included7 �_ __Yes
� Good Housekeeping protection or roofing stem? Yes
TOTAL Estimate: $ 9405.27
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30427 Commerce�Drive, San Antonio,FL 33576
Phone(813) 782-9080/Fag(�i52) 668-4803/www.neumannroofs.com
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❖ Upgrade options:
0
0 10" Solar tube=$3 5.00 '
0 14" Sola�tube=$4 9.00 '�
o Provide and Install elux Glass Curb I�ount Skylights
� ■ $193.92 (2g2�� /�'" �� (Homeowner's Initials)
� ■ $274.22 (2x!�� F � , � (Homeowner's Initials)
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• Proposed price is valid for 30 day from proposal date. Subject to price increases after
30 s�ag�s.
• In the event it is necessary to colle t any amount of money owed hereunder by referral
to an attorney, �olle�tion �gency, �x court�roceedia�g9 it is agr��d�hat N�uaaaann
Roofing,LLC shall be ent�tled to eimlbursement for all costs of collection of unpaid
ar�aounts by Owner/Agent and for reasonable attorney's fees and costs for the breach,
�r enforcement of any ter�as of th s entire service agreeanent. r�se�wie�cha�-ge of 1.5%
per month will be due on all invoi es thirty(30) days past duee
• �Ve accept cash, check or credit c rd for payment. If you choose to pay by credit card
the following fees will be added to your contract/invoice amount:
Visa/Master Card—add 2%; AM X—add 3%. Fees are non-negotiable.
_. —Acce.pt _B_y_: — __ _—___Ne oo ,_�L� -- _
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30427 Commerce rive, San Antonio,FL 33576
Phone(813) 782-9080/Fag 652) 668-4803/www.neumannroofs.com
CONS�RUCTION LIEIV LAW
� Florida State Statutes 713.015: Mandatory p+ovisions for direct contracts. (1) Any direct contract greater
' than $2,500 between an owner and a contractor, related to improvements to real property consisting of
single or multiple family dwellings up to and in�luding four units, must contain the following notice provision
� printed in no less than 12-point, capitalized, boldfaced type on the front page of the contract or on a
�
� separate page,signed by the owner and dated:
ACCORDING TO FLORIDA'S CONSTRUCTION IEN LAW (SECTIONS 713.001-713.37, FLORIDA STATUTES),
THOSE WHO WORK ON YOUR PROPERTY OR�ROVIDE MATERIALS AND SERVICES AND ARE NOT PAID IN
FULL HAVE A RIGHT TO ENFORCE THEIR CLAII FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IS
KNOWN AS A CONSTRUCTION LIEN. IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY
SU�CO�JTRACTOFtS, SU�-SUBCONTR�.CTORS, �fft MATERIAL SUPPLIERS, TNOSE PEOPLE WHO ARE OiIUED
MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE ALREADY PAID YOUR
COI�TRACTOR IN FULL. IF YOU FA!!.TS� PAY Y�UR COMTRACTOR, YOUR �ORlTE3,4CTOR MAY ALSO HA!/E;4
LiEN ON YOUR PROPERTY. TFiIS MEANS IF � LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINS`T
YOUR WILL TO PAY FOR LABOR, MATERIA_JS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR A
SUBCOIVTRACTOR MAY FIAVE F,41LED TO PP�Y. TO PROTECT VOURSELF, YOU SHOULD STIPULATE IN THIS
CONTRACT THAT BEFORE ANY PAYMENT IS ADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU
WITH A WRITI'EfV RELEASE OF LIEN FROM A� Y PERSON OR COMPAiVY THAT HAS PROVIDED TO YOU �►
"NOTICE TO OWNER." FLORIDA'S CONSTRUCT ON LIEN LAW IS COMPLEX,AND IT IS RECOMMENDED THAT
YOU CONSULT AN.ATTORNEY.
(2)(a) If the contract is written, the notice rr,ust be in the contract document. If the contract is oral or
implied,the notice must be provided in a document referencing the contract.
(b) The failure to provide such written notice �oes not bar the enforcement of a lien against a person who
has not been adversely affected.--------- --- --
(c) This section may not be construed to adve sely affect the lien and bond rights of lienors who are not in
privity with the owner. This section does not pply when the owner is a contractor licensed under chapter
489 or is a person who created parcels or offer parcels for sale or lease in the ordinary course of business.
Acce ted and A roved: I
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PRINT NAME DATE
Client Initials Neumann Officer
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2014192888 �Q Z U � �
AFTER RECORDMG—RETURN TO:
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Repl:1646635 Ree: 10.00 � z� O �� J �
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12/09/14 E. M., Dpty Clerk a� O = Q �
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PERMIT NUMBER: � O = —� �
NOTICE OF COMMENC MENT >° �- ~ � — O
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The undersigned hereby gives notice that improvement will be made to certain deal property,and in accordance with Chapter 713, � � } U � °�
Florida Statutes,the following information is provided in this Notice of Comme�ncement. O E-- LL � O Y
oa-ss-z�-oozaaoaoaooAC V=� o � �� �
I. DESCRiPI'�ON OF PROPER7'Y(Legal description of the property&street address,i available)TAX FOLiO NO.: �� � � Z W ��
SUBDiVIStON SILVER OAKS PHASE ONE B�ocK Taacr Lor BLDG orvrr � �w ? p � U �
6533 BRENTWOOD DR ZEPHYRHILLS,FL 33542 PG 46 PORTION OF TRACT A DESC AS C�M AT NW COR TRACT A TH N72DEG 34'4T E 91.50 FT ALG �h � a Z O J
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2.GENERAL DESCRIPTION OF[MPROVEMENT: � � � �
Remove existin roof s stem and re lace w(th GAF Timberline HD roofi s stem p � � O �
3. OWNER INFORMATION OR LESSF.E IIVFORMAT[ON IFTNE LESSEE CONTRAC'�'ED FORTHE IMPROVEMENT: � � ¢ —� Q
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BRADLEY FAMILY LIVING TRUST BRADLEY RONALD J 8 JOAN LITTEE 6533 BRENTWOOD DR 2EPHYRHILI.S,FL 33542 � z �Z — _
n.Name and eddress: � � � � O � a �}A
b.��tcresc in property: FEE SIMPLE
c.Name and address of fee simple tiUeholdtt(if difTerent Gom Ovmer listed above): �� � �j
� a. a.corrrancroe�srvnMe: JASON NEUMANN/NEUMANN ROOFING,LLC �('jJ • ' 'o �
cootractor�saddress:30427 COMMERCE DR,SAN ANTONIO�FL�33576 y.phonenumber:352-668-4875 �y� d .. �-D
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S. SURETY �fa Iicable,a co of the ment bond is ettach d�
C PP PY PaY �� �„ �
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a.Namc and address: � . �' y�,� � s {�
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b.Phone number. c.Amounl of bond:S p o � �
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6.8.LF,NDER'SNAME: � �'��� �
Lender's address: 1 b.Phone number. ��� V I�
7 Persons within the State of Florida desig�ated by Owner upon whom noticds or other documents may be served as provided by � .* �
Section 713.13(1)(a)7.,Florida Stamtes:
a.Name and address:
b.Phone numbers of designated persons: I
i
8,a.in addition to himself or herse(f,Owner designates I of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),IFlorida Statutes.
b.Phonc number of person or entiry daignated by Owner.
9. Expiration date of notice of commencement(the expiration date may not be before the wmple6on of construction and final
payment to the contractor,but will be l year from the date of recording unless a different date is specified): ,20_
WARNMG TO OWNER• ANY PAYMENTS MADE BY THE OWr1ER AFTGR L7�'PIRATTON OF THE N07'[CE OF COMMENCEMENT
^"CONSiDERED IMPROPER PAYMEN'1'S UNDER CHAPTER 713.PART f,S CTTON 713.13.F1ARiDA STATCfI'ES.AND CAN I
RESULT IN YOUR PAYMG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
� RECORDED A O N THE J B 4 O F T SP I � T BTA1N FINAN IN T
WffH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCMG WORK OR RFCORDiNG YOUR NOTICE OF COMMENCEWIEN'C.
Under penalty of perjury,i declue that i have read the foregoing notice of co I mencement and that the facts stated therein aze true to 1
the best o y knowledge and belief. �
/��uce-Ld ff ,�S�dli�Y
Signature of�n r o Lessee,or er's or Lessee's (Print iVame and Provide Signatory's Tit�)
Authorized OfficedDirector/Part rlManager)
PRULR S 0'NEIL,Ph D.Pii5C0 CLERK &COMPTROLLER I
State of FLORIDA 120R BK 9'1'Z0 P�o 2745 �
County of PASCO .
The foregoing instrument was aclmowledged before me this 8'��" da�of J �,o�20 l�
by Ron[�1[� S�t'��J1 0 � ,as
I (name of person) ( e of authority,...e.g.officer,trustee,attomey in fact)
II� for
i (name ofparty on behalfofwhom instrument was executed)
I
Personally Known_or Produced Identification �ype of Identi i catio d
,pF��E
, �{�1�i; �,�y�MISS�pNtFF145714 otary Public)
'�,.� '- EXPIRES:Auyust ts,2018 mt Type,or Stamp CommissionedTlame ofNotary Public)
Rev.I0-01-I I(S. •oF41'..•°•� BoidedilwNmaiYPu6ficUndenRen