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07-6882
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07-6882
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Last modified
3/6/2009 4:33:54 PM
Creation date
1/10/2008 9:11:09 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
07-6882
Building Department - Name
S C NURSING HOME
Address
38250 AV A
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<br />...~.. <br /> <br />7. <br /> <br />Pennft Number <br /> <br />Parcel Identification Number 1426210010013??oo10 <br /> <br />1/111111/1111111I '"11/1''' 111I1 11111 I111I 111I1 1111111I111I1 <br />200712S267 <br /> <br />Prepared by: Rachel Miles <br /> <br />Return to: <br /> <br />Rcpt: 1116649 Rec: 10.00 <br />DS: 0.00 IT: 0.00 <br />07/23/07 Dpty Clerk <br /> <br />Rachel Miles <br />5180 Rishley Run Way <br />Mount Dora. FL 32757 <br /> <br />R <br /> <br />JED PITT"AN~ PASCO COUNTY CLERK <br />07 /23/07 0~ : 3J!pm 1 40'611 <br />OR BK 757 t PG <br /> <br />NOTICE OF COMMENCEMENT <br /> <br />State of Florida <br />County of Pasco <br /> <br />The undersigned hereby gives notice thatimprovement(s) will be made to certain real property,and in accordance <br />with Chapter 713, Florida StaMes, the following information is provided in this Notice of Commencement <br /> <br />1. <br /> <br />Description of property (legal description of the property, and street address If available) <br /> <br />MOORES FIRST ADDITION PB 1PG Sf PORTION OF BLOCKS 12 13 & 14 & VACATED AllEY & VACATED A AVE & <br />4TH STREET DESC AS <br />38250 A AVE ZEPHYRHILLS Fl33542-5759 <br />General description of Improvement(s) <br />1?f~or 01 (..D1o,) SLbl'''' ~~~ <br /> <br />2. <br /> <br />3. <br /> <br />Owner Information <br />Name St.>Dt .Ml.b dE4"<l1t4u ._<-.." b~ 0" L Telephone Number 8 J 3- , 5< - SOD!, <br />Addres", ^ A.it!: -~.rLi.,.I,JJoC.. eo. ..,:['ClI.7 Fax Number ~1.$-?83- ISiJ <br />"StsZSt II ." l("..o ...;" r"~IT""'-"... r~ ~ ~~ . . <br />-. _. - --- -"- Interest .n Property: <br />Fee Simpl~ Title Holder (If other than owner shown above) <br />Name N J ~ Telephone Number <br />Address Fax Number <br /> <br />4. <br /> <br />~ <br /> <br />Contractor <br />Name MILES ROOFING INC <br />Address <br />2030 SOUTH OLD MILL DRIVE DEL TONA FL 32757 <br />Surety (if ,ny) <br />Name 'I.l If <br />Address <br /> <br />Telephone Number <br />Fax Number <br />Amount of bond $ <br /> <br />6. <br /> <br />Telephone Number 386-561-0616 <br />Fax Number 352-385-5117 <br /> <br />Lender (if any) <br />Name tJ IA <br />Address <br /> <br />Telephone Number <br />Fax Number <br /> <br />8. Persons within the State of Florida,desigliated by Owner upon whom notices or other documents may be <br />served as provided by 5713.13(1)(a)7., Florida Statutes. ,,- f'A <br />Name ~EYAN fv^",S Telephone Number ~Ol- ,\1., ~ 301~f <br />Address 6ci COQt:"r(.A4131> -s..-r- Fax Number <br />3111""c. zoo, o~(,I\A'DO, Fe <br />9. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as <br />provided in 5713. 13(1)(b), Florida Statutes. <br />Name Telephone Number <br />Address Fax Number <br /> <br />10. Expiration date of notice of commencement (the expiration date is one year from the date of recording <br />unless a different date Is 8plicified): ~ .' _ ~ . ' <br />(.;;J.~-07 ~..;;z;.._ <br />Date Signed Signature of 'Owner umm:per 5713. 13(1)(g), "owner <br />must sign ...;:mdno one else may be permitted to sign in <br />his or her stead." <br /> <br />("~ <br />Swom tOJnd subscribed before me this 1.'3 day of :s u \~ <br />&...,. p. f'. lv..w\VLMfl.. v <br />who is personally known to OR <br />as Identification. <br /> <br />, $1 ()b -, <br /> <br />by <br /> <br /> <br />,<o).~V~ Be 11"-- . . <br />~~>>'i"'''~ V ....."VorlO <br />f,,:' :*i MY COMMISSION' 00229949 EXPIRES <br />~~ .: ,; August I, 2007 <br />~~iff.,~, ' BONDED TH/lU TROY FAIN INSlJRANCf. IHe <br /> <br />Form Revised: 3198 <br />
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