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12-12979
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2012
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12-12979
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Last modified
2/12/2013 1:16:49 PM
Creation date
2/12/2013 1:16:48 PM
Metadata
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Template:
Building Department
Company Name
YINGLING ADDITION
Building Department - Doc Type
Permit
Permit #
12-12979
Building Department - Name
OBERHOLTZER,WILLIAM
Address
39209 7TH AVE
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I Ililll illll IIIII IIIII IIIII IIIII IIIII IIII I IIIII lIIII IIII IIII <br /> 2012063594 <br /> Rept:1429009 Ree: 10.00 <br /> DS: 0.00 IT: 0.00 <br /> 04/17/12 D. Bonilla, Dpty Clerk <br /> PRULR S 0'NEIL Ph D PRSCO CLERK & COMPTROLLER <br /> NOTICEORCOMMElHCEMENT 040R BK2 ���"1' PG� ���� <br /> Permit No. <br /> PmpertyIdeirtificxtionNo. /Z"Z(t'2�'d 6 Z�—Q�.30����'L� <br /> 1T3E tJNDERSIGNED hereby give informs you that the itnprm,ement will be made to certain real property,ead in accordance with <br /> Section 713.13 of the Florida Stahrtes,the followmg information is prov�ded in this NOTTCE OF CO N��g� ,` ftl v� <br /> I.Descriptionofproperty(lega[desaiptlo y Y�^ I'�+,1t' '¢ddr tios, to trPtiyrl,;� <br /> a)Slreet Adthess: � S <br /> 2.Qenerat description of improvements. 2 <br /> �G N <br /> 3 Owner InTormaqon . <br /> a)Namt and address: fAI;ll�n. Oberh�1 fi��r-�9Zot �'�A✓e -�i��iy{k;l4 .2t 13 Z <br /> b)Name and address offee srmple Mleholda(if other ffian owner) ''—� <br /> c)I�erast m property <br /> 4.Cantracior Iaforma[i� <br /> a)Name and eddress; _ � <br /> b)Teleph�e No._ Y S f <br /> S.Surety Information / — — Fa�c No.(Opt) <br /> a)Neme and address: <br /> b)Atnomu ofBond <br /> c)TelephoneNo.: FaxNo.(OpL) <br /> 6.Lender <br /> a)13ame and ad�ess: <br /> Phone No. <br /> 7.Idemity of pason wrt}vn tha State of Florida desi�sted by owuer vpon whom notiees or other docamaRS msy be served: <br /> a)Name and addru�s: <br /> b)TelePhoffiNo•: Fax No.(OpL) <br /> 8.In additim►to hroisei�oWmei designates tke foltflwing penon i�o receive a copy of the Lienor's Notice as provided"v�Section <br /> ?13.13(Ixb�Florida Stawies: <br /> aj Name and addtsss: <br /> b)Telephone No: z FaxNo.(Opt) <br /> 9-FxPiration date of Naticg of Co�en�at(the expi�etion date is one year fiom the date of record"mgmless a diffei�t date is <br /> specified): <br /> WARNINtG TO OWNER ANY PAYA�NCS MADE By TH6 flWNER pFTLtR��g,gp�TTOW OF THE NOTICE OF <br /> COMMENGTsME1VT AR8 GpPISIDERED p4ip'ROPER PAYMENI'S UNDEIt CHAPT'Eg 713,PART I,SEC1701Y 713.23, <br /> FLORIAA STATUTES,AHiD CAN RESULT IN YOUR PAYING TWIC6 FdR IbI£ROVEbISNiT3 TO YOUR PROPERT'Y. <br /> A N07'ICS QF COMMENC�MENT MUST BE RECORDED AND M)SI'SD ON TH8 JOB S1TE BEFORS TBE FIRST <br /> P,�ISPECTIOiV. IF YOII IIYTEND TO OBTAII�i FINANCING,CUNSULT YOUIZ LBNDER OR A,N ATTORNEY BEFORE <br /> COMMENCING FVORK OR RECORIIING YOIIR PTOT[CE OF COMMELYCEN�I+iT, <br /> STATE OF FLORIDA � <br /> COUNTY OF PASCO <br /> Si ofO�waor s �� <br /> . <br /> 'rrt nme F <br /> E <br /> T�foregoin insuumenttyas aelmowled ed b fore me this,��y nf 20�by <br /> �l�t C � 8�1� C1F' G (type of authority,e.g.o$cer,uvste�,s�mey • <br /> u'fact�f'°r e ( of parry on behalf of w ent was executed). � �� <br /> /� a <br /> Personally I{nown_OR Produced Identification �Notary Signature l., <br /> p�p (� �.p /=� '2�, � � � <br /> Type ofIdentification Produced j�l V 1.���,, Name(print) `J�-t`-���C�—(.,/► U '+�. �� <br /> �� . <br /> Verification pursuaat to Section 92.525,Florida Statutes.Under penalties of perj�vy,I declare thai I have read the foregoing and that � ��� <br /> the facts stated in it are true to the best of my imowledge and belief. , + � <br /> � <br /> �/ �� $�� <br /> � r <br /> sigouureofNatu�al crs � <br /> FORMSINOC,rvs�I � <br />
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