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.. ! NOTICE OI JMMENCEMENT 09046999 FS 713.13 , PERMIT# Rcpt : 1236184 Rec : 18.50 DS: 0.00 IT: 0.00 PARCEL IDENTIFICATION NUMBER: 02 -26 -21 -0010 -02500 -0020 04/06/09 Dpty Clerk THIS INSTRUMENT PREPARED BY: Chris Cooke PAULA S. 0' NE IL , PASCCOO CLERK & COMPTROLLER 04OR6 8 5b 1 PG 260 260 RETURN TO: Stevens Construction Inc. 6208 Whiskey Creek Drive Fort Myers, Fl 33919 STATE OF: Florida COUNTY OF: Pasco PROJECT NAME: Florida Hospital Zephyrhills - 12 Oaks Medical Office Building The undersigned hereby gives notice that improvement(s) will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property (legal description of the property, and street address if available) See Attached - 12 -Oaks Office Building, 6748 Gall Boulevard, Zephyrhills, Florida 33541 2. General description of improvement(s) Interior demo of existing space & renovation /alteration of existing interior for new medical offices and exam spaces. New Fire Protection. G.C. Project No. 09 -1289 3. Owner Information Name: Adventist Health S/S Inc. DBA Florida Hospital Phone No.: 813 -783 -6189 Address: 7050 Gall Boulevard, Zephyrhills, Florida 33541 Fax No.: 813.783.6106 4. Fee Simple Title Holder (if other than the owner shown above) Name: Phone No.: Address Fax No.: 5. Contractor's Name & Address ∎.. it Name: Stevens Construction Inc. Phone No.: 239 - 936 -9006 ■ Address: 6208 Whiskey Creek Drive, Ft. Myers, Florida 33919 Fax No.: 239 - 936 -9010 6. Surety (if any) Name: Phone No.: Address: Fax No.: Amount of Bond: $ - 7. Lender (if any) Name: Phone No.: Address; Fax No.: 8. Persons within the State of Florida designated by owner whom notices or other documents may be served as provided by § 713.13(1)(a)7, Florida Statutes: Name: Mike Gardner - Florida Hospital Zephyrhills Phone No.: 813- 783 -6189 Address: 7050 Gall Boulevard, Zephyrhills, Florida 33541 Fax No.: 813- 783 -6106 9. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in § 713.13(1)(b), Florida Statutes: Name: Mark A. Stevens - Stevens Construction Inc. Phone No.: 239 - 936-9006 Address: 6208 Whiskey Creek Drive, Fort Myers, Florida 33919 Fax No.: 239 - 936 -9010 10. Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is specified): 9/25/2010 WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT M T BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A • EY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Verification pursuant to Section 92.525, Florida Statutes. Under . , `alties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to • est of my kno -; . nd belief. L Signature of Owner: / A4, At /y1J68 Iv. 1I?l&,t/ ' (Note: per Section §713.13(1)(. , lorida Statutes (Print Owner's Name) �1 "Owner must sign _.and no one else relay be permitted to sign In his or her ead.•) Date L/ — % _ - , 9' r� n Signed: V� State of: rt&�(7k(,„ . County of: VOA g A e The foregoing n instrument was y�nowledged before me this V day of I t p.) , 2009 By: 1tl C U[C'e I (C:ar it ii_t.). / � L Who is personally known to me or !/ has produced: as identification, and * did take an oath did not take an oath. 1/� �.F'f DR i?1)_ /�E1� lV� 0 Notary Printed Name: Notary Signature: (notaries seal must appear below) r i 1 AURA D VS �, S• /•M �_ sSS • �V� W1Y�S"f((�ra. 0 4. , Cornmit< DD0772985 ? J Expires 3127/2012 s N „Fn Florida NoferyAan., Inc