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15-16060
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2015
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15-16060
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Last modified
3/21/2016 11:14:10 AM
Creation date
3/21/2016 11:14:09 AM
Metadata
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Building Department
Company Name
ORANGE BLOSSOM RANCH
Building Department - Doc Type
Permit
Permit #
15-16060
Building Department - Name
ROSSO,ELGER PAT & JANICE M
Address
4536 BLOSSOM BLVD
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�IIIIIIIIIiiIIIiiIIII4I111111�111111111111�IlIl�IIIllllllllll <br /> a¢�i����2z9 `___----------- <br /> � <br /> 9 �' <br /> 1653429 �eC: 1�.� <br /> Rcpi.� iT: 0.00 <br /> D5: 0.00 , DP{,y �lerk - <br /> 0111312015 C. F.______—._--- <br /> PAULA 5.0`NEIL�Ph D PRSCO G1ERKpf G1PIPTROI-LER <br /> 01/�R a 01� i�"t� P� ����_— <br /> NCD�'ICE �D�'Cd.�11i�MEN�CEIV�ENT <br /> Pern�i�Na._..._ <br /> Property identificatton No. i5-26-21-d17E-00600-QOCO <br /> THE�FNI3ERSTGNED hereby give inforrns you that the impravement will be made to certain,rea]property,and w accordance with <br /> Sectio�723 13 of the F�orida Statutes,the fallowing infarmatian is pravided in this N6)TICE O�'C(�MMEN�CElWIENT. I <br /> 1.Des�ription ofpropercy{legal descr.rptior:;) ORAI'1GE BLOSSOM RANCH CONDO 5 CB 1 PGS 26-27 BLDG 6 iTNIT C&COMMON <br /> a),Stceet Address: 4536 BLOSSOM BLVD,ZEPHYR.HILLS,FL 33542 <br /> 2.Gen`rat descnption of improvennent�s: REMOVE AND REPLACE SHIN � <br /> 3 Owner In�armation � IS-26-2I-01'7E-00600-OOCO j r <br /> a�ti"ame ai�d address �r�'�y,� �/�s S a n'1 �R�v� � (�o rrC��� <br /> b)Narz�e and address of fee simple titleholder(if other than qwner) 4536 BLOSSOM BLVl�,ZEPIIY1tIITLLS,PI,3�5�_ <br /> c}Interest in property 100°l0 <br /> 4 Can actar Information <br /> a�Name and address• YQWELL'S ROOFING COMPANY,222Q ULD GY�RESS CREEK RD,LOL,FL 34639 <br /> b)Telephone No : g 13_944-4561 Fax No. {4pt.) 813-948-6102 . <br /> S.Sure y Tnforn�ation <br /> a}Name and address: ��' � <br /> bl Amount of Bond: <br /> c)Telephone NQ.� _ �ax No. {Opt.}� - - <br /> b�.en er � <br /> a)Name and address: i�i� <br /> Phane No, <br /> 7. Iden ity c�f persan wit}un the State c+f Florida designated by owner upon whom notices or other documents may be served: <br /> a)�fame and address• GAIL BACKMAN-37724 ALISSA DR,ZEPHYRHILLS,FL 33542 � <br /> b)Telephone I'1o.: cs I 3 -�7 �S�'s'� 3 5���` Fax No.(QpC.� -- <br /> S.ln addition to himself,owner designates the following person to receive a copy of the Lienox's Notice as provided in Section <br /> 7I3 13�(1){b},Flozida Statutes. <br /> a)Name and address: �(�J�- <br /> b)Telepl�one Na.. Fax No.{Opt.) � _ <br /> 9.Exp' atinn date of Notice of Coznme;ncement(the expizarion date is one year from the date of recordmg unless a different date is <br /> specifi d)� ._ <br /> WARNING TO QWNER: ANY PP,YMEI+tTS MADE BY T�fE 4W�IEFB A.F'TER TFIE E�KPIRA.TION 6�F'I'I3.�E Nt?`I'ICE�3F <br /> COIYII�Y]ENCEMENT AI2E COI�TSII"JER]ED YIVipR07PE7Et PAYM�NTS UNDER CIiAPT7ER.713,P�.RT I,SE�CT'ION 713.x3, <br /> FLORrI)A STATUTES,AND CAN]RESULT IN YC9UR P.�YIN�TWICE FC�R 1MPRC9`�EI�Y�NTS TU YOUR PR�3P�RT'Y'. . <br /> A 1'�d'�'TCE O c� COMlYi[�T3CEMENT MUST BE REC0�3I1ED_A1�tD POSTED ON THE J�OB SI'd'E BEF(�RE THE FIRST <br /> INSP��TI{?N. 1F YOU II�TEND TO+�BTAIN FINANCIN�,C+tJNSULT Yt�UR LIEN93EI2 OR AN ATTOP.1�tEX BEFOR� <br /> COMMEN�II�G WflRK OR RECO�tDING�QUR lYt}TICE OF C{�MMENCEMENT. <br /> sT.aTE I F FLCIRIDA <br /> CC3Ull'T� t7F PASCO �• � ��"'� <br /> Si ature of Orvner ar O er's Authorized Officerll3ireclorlPartnerlManager <br /> Jt ��4G L... L � �f—l-GK.r�N,�-r� __ <br /> Pnnt Name <br /> The foregoing instrument was acknowledged before me this t9 T� day af J�'I�� ,20�''��b ° L.. ��C�f�.r'�11.1 <br /> � as (type of authanty,e.g,af cer,trustee,a rney � <br /> in fact)for (name of party on behalf af whozn instrument was executed �!�C�t"��'R���"' <br /> Pe son�llv linown OR Praduced Idenhfication Nota Si nature —�'�"��.� <br /> z , �, zY g _ <br /> i �'" - <br /> Type o�Identificatton Produced Name(print) __ _ <br /> ,��----� ,. ..�,. <br /> . M'r��'' J4HN G.YQ <br /> , :+� � MY C MISSION�SR. <br /> Venfication ursuant to Section 92.525 Florida Statutes.Undet enalties of er �i-e th���l�:e���2�f8�or oitio ancl that <br /> � � � � � � i�,•••.. • 6anded Thrv Nolary PuWic UndanvriEcts <br /> the facts stated in it are hue to the best ofmy lrnawledge and belief. 'Rf��'� <br /> � � _=.�:�_��_ _ --___ <br /> Sign ure oFNaiural Pcrsan Signing f�bove <br /> FORMSlNOC,rv5d2007 <br />
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