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16-17144
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2016
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16-17144
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Last modified
2/20/2017 10:53:38 AM
Creation date
2/20/2017 10:53:38 AM
Metadata
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Building Department
Company Name
C G M HOLDINGS TRUST
Building Department - Doc Type
Permit
Permit #
16-17144
Building Department - Name
C G M HOLDINGS TRUST
Address
38010 MEDICAL CENTER AVE
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-� . - i ii�iii iiiii iiiii iiiii iiiii iiii!iiiii iiiii iiiii iiiii iiii i�ii <br /> �, 2016032052 <br /> 'j � NOTICE OF`COMMENCEMENT <br /> MR1#4850 Rcpt:1751790 Rec: 10.00 <br /> DS: 0.00 IT: 0.00 <br /> PermitNo. 03/02/2016 K., D. K. , Dpty Clerk <br /> Tax Folio No 35-25-21-0070-00000-0010 <br /> THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Section <br /> 713.13 of the Florida Statutes,the following information is provided in thisNOTICE OF COMMENCEMENT. <br /> 1.Description of property(lega!description)PASCO MEDICAL ARTS CENTER PB 23 PG 24 LOT 1 LESS NORTH 47.00 FT THEREOF <br /> TOGETHER WITH AN EASEMENT FOR INGRESS <br /> 35-25-21-0070-00000-0010 <br /> Address: 38010 MEDICAL CENTER AVENUE,ZEPHYRHILLS,FL 33540-1383 <br /> 2 General description of improvements:ROOFING <br /> 3 Owner Information <br /> a)Name and address:.�o� C G M HOLDINGS TRUST,MCTAGGART&CHEEMA&GROSSBARD, <br /> ��''' ��MEDICAL CENTER AVLNUE,ZEPHYRHILLS, FL 33540-1383 <br /> b)Name and address ot'f'ee simple title holder(if other than owner): N/A <br /> c)Interest in property: OWNER . <br /> ontractor Information <br /> a)Name and address: MILBAR ROOFING INC. 15911 U.S.HWY 301 DADE CITY FL 33523 <br /> b)TelephoneNo • 352/567-6047 Fax No.(Opt.) <br /> 5. urety Information <br /> a)Name and address: <br /> b)Amount of Bond. <br /> c)Telephone No.: Fax No.(Opt.) <br /> 6.Lender N�i <br /> a)Name and address: <br /> Phone No. <br /> 7 fdentity of person within the State of Florida designated by owner upon whom notices or other documents may be served: <br /> a)Name and address: <br /> b)Telephone No.: Fax No.(Opt.) <br />� 8 In addition ro himself,owner designates the fol(owing person to receive a copy of the Lienor's Notice as provided in Section <br />' 713 l 3(i)(b);Florida S[atutes: <br /> a)Name and address: <br /> I b)Telephone No: Fax No (Opt.) <br /> 9 Expiration date of Notice of Commencement(the expiration date is one year from the date of recording unless a <br /> different date is specified): <br /> WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF <br /> COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,SECTION 713 l3, <br /> FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TW10E FOR IMPROVEMENTS TO YOUR PROPEE�TY.A <br /> NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FiRST <br /> INSYECI'iON. IF YOli lNTEi�D TO CSTAIT: F:*:P.T:�:*1�,�!�'':S'-�?T Yn�?R•�ET[DER OR P.N ATTORNEY BFFORE <br /> COMMENCING WORK OR RECORDING YOUR NOTICE OF COM ENCEMENT. <br /> STATE OF FLOF_�IDA <br /> COUNTY OF F'�c� �. <br /> Signaturc of Own or Owner's Authorized OfficedDirectodPartnedManager <br /> �ti t.� ,�' �'�1,�(CW1,�Q _ ( .i�l�1C rl�F�N�i� J <br /> Print Name and Title � <br /> The foregoing instrument was acknowledged before me this 2(o dae f author�,e. officer,trusOt�ttorney in fact)for I <br /> �Jv��t:1r � ��v.�,ti:� as � ��_ —�CYP g. <br /> � (name of party on behalf of wliom instrum t s uted). A L <br /> tification Nota Signature IVI <br /> Personally Known OR <br /> Producedlden rY � <br /> Type of Identification Produced Name(print) Nntarv p��h�ie__statenf Florida <br /> - . . My Commission Expires August 19,2016 <br /> ---AIYD---, ' ' � � C�r� No EE���?� <br /> Verification pursuant to Section 92,525,Florida Statutes. U�ider.penalties of p jury,I declare tha have rea regoing and that <br /> the facts stated in it are true to the best of my knowledge a d belief. <br /> �Signature of Natural rson Signing(' line# I0.)Above <br /> PpULA S 0'NEIL,Ph D PRSCO CLERK & COMPTROLLER <br /> FORMSMOC,rvsd2007 03/02/201�331 m P� ��v <br /> - OR BK <br />
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