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15-16463
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2015
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15-16463
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Last modified
3/7/2016 9:04:29 AM
Creation date
3/7/2016 9:04:29 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
15-16463
Building Department - Name
FROST,GARY
Address
38449 9TH AVE
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� � i iiiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiii iiii <br /> 2015116799 <br /> PCey No. Permit No. Rcpt,:1700009 Rec: 10.00 <br /> DS: 0.00 IT: 0.00 <br /> 8�OT9C� �F �O�E�I��lCE�Cf��9,r 07/23/2015 K. R. M. , Dpty Clerk <br /> TFiE UNDERSIGi��D hereby gives notice that irriprovement will e ;i , 2(Q- 2,� _ Ob��°��Z�r �� <br /> Made to certain, and in accordance with Chapter 713,Florida State d <br /> Statues,the following information is provided in this{Uofice of 384� C��k4 �� �e�yQ�,�g <br /> Commencement: � � � <br /> 1. Description of Property: Parcel No.: ��a�q. � 10 ,�c.�t,.$�C�z✓o� Zept►�Q�1�tLS <br /> (Legal description of fhe prope and sYree a dress if availa6l�) <br /> 2. Generai Description of Improvement: <br /> H .� � ' 'e � - �, 2� � <br /> 3. Owne Information: iVame: I �{���tb <br /> Address: 5117 �as- L�.� � e.. City �c,�,-�o.. State 1GSZip ?Z3d ���,� <br /> Interest in Property: wa3.GZ. <br /> Name and �ddr�e-ss ofi Fee Simple Ti�leholder(Ifi ol er fihan owner) : _ <br /> � <br /> � �. Contractor: i�ame: TLC ROO�I(�G LLC I <br /> Address: PO �OX 1745 I City DADE CITV Sta�e FL Zip 33526 � <br /> Phone No. 352-�73-4073 Fax IVo. 352-473-4073 � o J� <br /> 5. Surety: fVame N/� Amount of Bond: � �w� <br /> Address: iT I Cify State_Zip ' ��m <br /> Phone No. I Fax No. � <br /> 6. Lender: Name:�/A. � .. � �� <br /> Address: City Sfiate_Zip N0D� <br />' Phone No. Fax No. w�"� <br /> �~D <br /> 7. P�rsons writhin the Stat�ofi Florida designated by Owner upon whom notices or other doc�aments may be 3 0 <br />� s�rved as provided by Secfion 713.13(1)(a)(7) Florida S�atutes. : -o � , <br /> f�ame: � "�''� <br /> I Address: I City Sfate_�ip ,No�� <br /> Phone No. I Fax Rlo. ���o <br /> S Ir� addition�o himself or herself, Ouvner dESignatel's tJ/� or '� � <br /> -� <br /> To receive a copy of the L�inor's}Votic�as provid�d in Section 713.13(1)(b), FIOPida S4�itJfeS. : m <br /> 9. �xpiration dafe of Notic�ofi Commencement(the expiration date is 1 year oi recording unless a differ�nt � <br /> date is specifted.) <br /> Me'ARPlIPdG TO O!R!RlEF?:Eaft1Y PE�Vft9�tUTi S MIaDE BY THE OWRfEP2�FTEi2 THE EXPfRAl70P1 OF TPrOE ft10Y10E OF COEIAM�R9CE{1AENT ARE <br /> CONSIDERED IMPEdOPER PAYIIE1�t�TS US�DER CHAPTER 773,PB,RT 9,SEC 773.13,FLOR1D�a S�ATUTES,.�ND CAN RESULT lN YOUR <br /> PAdYIR1G T4MICE FOR!@APROVEtll1ER1TS TO YOUR PROPERTY.F1 RlpY10E OF COMkl�ENCEf1flEl�fT fl11UST 6E RECORQED.�M�POS i ED Oftl YHE <br /> JOB SITE BEF062E THE FIF+�ST INSPECTIOW.IF YOU IPlTEND TO OBTAIN FIfVAR9C1A1G,CONSULT UHIYW YOUR LENDER Of2 AI�ATTORNEY <br /> B�FORE CO E1� C{P9G 1R! RK OR RECORDING YOUR R10TICE OF COMA9El�CEMEM3. <br /> � <br /> Signature of Owner or Ovmer's A ed Officer/Director/Partner! anager Signatory's Title/Office <br /> '°'Sigee�4ure Requieed 6y same below by`X„mark°°" <br /> State of I l C�r1,s�r 5 County of J�t,G�II�c! <br /> The forgoing instrument�was acknowledged before me this l7 day of�,20J�by L�5�,'� � ,��n ,fh <br /> /�/ D / (Printed name of person acknowledging) <br /> as /U d�ir l2./ ! t�(��� " for <br /> (Type of aufhority e .,office,trus4ee,attomey in fact) (Name ofi party on behalf of who i�strumen4 was execute� <br /> �'��� ���.�.�c' � <br /> Signature of Notary Print . tam o <br /> Personally known�OR Produced�dentfication Notary Public-State of Kansas <br /> Type of Identification Produced: � My Appt. Expires O8 - p/a.�;S <br /> !le�ca4ion pursuanfi to Section 92.525,Florida S�Yufes:under f�es�al�ies of perjuPy,l declare 4ha4 I have eead the 4oeegoing and 4hat 4he fac9s <br /> s8ated ics it are 8rue to the 6es4 of e�y knowledge and belief. <br /> - - --- - - - � <br /> I <br /> � <br /> I <br /> � <br />
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