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12-13520
Zephyrhills
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2012
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12-13520
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Last modified
7/18/2013 11:49:45 AM
Creation date
7/18/2013 11:49:44 AM
Metadata
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Building Department
Company Name
ZEPHYR HAVEN NURSING HOME
Building Department - Doc Type
Permit
Permit #
12-13520
Building Department - Name
ZEPHYR HAVEN NURSING HOME
Address
38250 A AVE
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1 Illill Illll IIIII IIIII IIIII illll IIIII IIIN I{III Ilill 1111 IIII <br /> ' 2012168439 <br /> NOTICE OF COMMENCEMENT <br /> Permit No. <br /> Property Idenrification No. ��'OZ b "�� "���D" �l 3 a�'�7���7 <br /> T'HE 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 the NOTICE OF COMMENCEMENT. <br /> I 1. Description of property(legal description: <br /> a) Street Address: �. Z ` 3 <br /> 2. Ge�a de criptiono�prov ents ( 1 .e.w�e i+ � oe C <br /> .t C ' �u <br />' 3 Owner Informa i n � � ^ � 1 A( ` /� 1 1 <br /> a) Name and address: U tMn w� IVuVS/nA �S dF��iu��i�I�S �nC �C��LoUr(�aN� �1 S�e�Q� <br /> b) Name and address of fee simple titleholder(if ther than owner <br /> c) Interest in proper[y <br /> Contractor Information n <br /> a) Name and address: � t Y�o � c 4a6a G„ l�ai raz B�Jd �Y� o � �' <br /> b) Telephone No.:�n�— 36��9 S� J Fax No.(Opt.) <br /> I 5. Surery Information (Rcpl,:1465770 Rec: 10.00 <br /> a) Name and address: DS: 0.00 IT: 0.00 <br /> b) AmountofBond: �10/04/12 C. Cook, Dpty Clerk <br /> c) Telephone No.: Fax No.(Opt.} <br /> 6. Lender <br /> a) Name and address: <br />� <br />' "/. Identity of person within the State of Florida designated by owner upon whom r�*+�P�����cumenta_mav be_served; <br /> PAULR 5 0'NEIL,Ph D PFlSCO CLERK S COMPTROLLER <br />� a) Name and address: I _ <br /> 10/04/12 03:51 m 1 of 1 <br /> b) Telephone No.: Fax No.(C OR BK PG ' <br /> 8. In addition to himself,owner designates the following person to receive a copy._______ $7 4 _.__25$8 J <br /> 713.13(1)(b),Florida Statutes: <br /> a) Name and address: <br /> 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 different date is <br /> sgecified): <br /> VVARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF <br /> i COiVIIVIENCEMENT ARE CONSIDERED TMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13, <br /> i F'LORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IPROVEMENTS TO YOUR PROPERTY.A <br /> NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST <br /> INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE <br /> COMMENCING WORK OR RECORDING YOU NOTICE OF COMMENCEMENT. - <br /> i STATE OF FLORIDA <br /> COUIVTY OF PASCO <br /> ignature OF O or ner's ed Officer/Direcror/Parmor/Manager � <br /> � ,�.b .c�,��.�Ey�;� <br /> Print Name ^ <br /> The fo going inshvment was acknowled ed before me this t day of �z���—___ ,20 lP�by �`��� <br /> (�A e�',3.{� � �Q�1�lt 1.►IST�A-TO/y (rype of authority,e.g.officer,trustee,attorney in fact)for <br /> (name of party on be f af om instrument was xecuted). <br /> �..... I�-'�. <br />� �Personally Kno �OR Produced Id�tification_ Notary Sign <br />� Type of[dentification Produced Name(print) ` ����- <br />�I Verification pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,I declare that I have read the foregoing and that the facts stated <br />' in it are true to the best of m kn w e � --�` <br /> Fow,�s�r,oc.rvsazoo, ��.••,y� Nonry P�aK saa a Fw�c. <br /> } � Tania BfuCE / �+nveorNenvd nsi va <br /> � My Canmis�ion EE07t 129 <br /> y y��aw� ExPiros 03N7f2015 <br />� ' <br />� <br />� <br />
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