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12-13601
Zephyrhills
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2012
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12-13601
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Last modified
8/22/2013 10:41:32 AM
Creation date
8/22/2013 10:41:30 AM
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Building Department
Company Name
SC NURSING HOMES OF ZEPHYRHILLS
Building Department - Doc Type
Permit
Permit #
12-13601
Building Department - Name
S C NURSING HOMES OF ZEPHYRHILLS
Address
38250 A AVE
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i iiiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiii iiii <br /> 2012206969 <br /> . Repl:1479998 Ree: 10.00 <br /> D5: 0.00 IT: 0.00 <br /> 12/06/12 D. Bonllla, Dpty Clerk <br /> pRULR 5 0'NEIL,Ph D PRSCO CLERK & COMPTROLLEk <br /> 12/03/12 �2,�5�p� 1 of'n� <br /> OR BK jy PG `.t <br /> NOTICE OF COMMENCEMENT <br /> Permit No. /3��� <br /> Property Identification No. /�- uo" Z I -oo�p -��a0 0 - �D�� <br /> Tf�iJNDERSIGNED hereby gives notice that impmvements 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 /> 1. Description of property( a!descrlption:) <br /> a) Street Address: �$250 �E ZEr�h R I�u'/ L 3355�2 <br /> 2. General description oi�mprovements (mg�„ERA7�R /fBFJhlceirtsa/ <br /> Owner Information /� T <br /> ,a) Name and address: So��n �e•,�ea-1 ��5�lby [�p o�' ��+Q!'�i( �aR(ar3. —�c't�a. <br /> b) Name and address of fce simple t�tleholder(�f other than oWder) -' <br /> ) Interest in property <br /> 4. Contractor Information ^� S e <br /> 8> Name and address: 2 A'bH� R�6C" �/�S �1G.tG yG6L n�a �,,,�Y /,�,�� 3��c �/ 3?z,j`fl <br /> b) TelephonCNor , Faac No.(Opt.) <br /> 5. Surety Information <br /> a) Name and address: <br /> b) Amount of Bond: <br /> c) Telephone No.: Fax No.(Opt.) <br /> 6. Lender <br /> a) Name and address: <br /> 7. Identity 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.: Faz No.(Opt.) <br /> 8. In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section <br /> 713.13(1)(b),Florida Stgutes: <br /> a) Nacne and address: <br /> b) Telephone No.: Faz No.(Opt.) <br /> 9. Expiration date of Not�ce of Commencement(the expiration date is one year from the date of recording unless a different date is <br /> specified): <br /> VVARNING TO OWNER:ANy pAYMENT5 MADE BY THE OWNER AFI'ER THE EXPIRATION OF THE NOTICE OF <br /> COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13, <br /> FLORIDA STATUTES ANp C�g�SULT IN YOUR PAYING TWICE FOR IPROVEMENTS TO YOUR PROPERTY.A <br /> NOTICE OF COMMENCSMENT 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 ICE OF COMMENCEMENT. <br /> �o"'� noary weue sa�s a Fwraa <br /> STATE OF FLORID � Tini� BfUCe <br /> COUNTY OF PAS �- � MY C�bion EE071128 <br /> a w Expin�0�/07201 S ture OF Own r r's OfficedDirecfndparmedA4amgtt <br /> iY"r .ea ft.�r �'�_ <br /> � Priat Name — <br /> fore oin i t was adcnowiedged before me UtQI � day of ��'-�'�� Zp 10� <br /> �u�L��'� � ,by �� <br /> name of ��3'Pe of authority,e.g,officer,trustee,attomey in fact)for <br /> ( party on behalf of m ins t�u ment w e x e o a t e�, <br /> Personally Known_OR Pro��Id ti£cation_ Notazy Signa <br /> Type of Identificallon Produced N Name(print) �"�v� � <br /> Verification pursuant to Section 92,525,Florida Statutes.Under penalties of pery'ury,I declare that I have read the foregoing and that the facts stated <br /> in it are true to the best of my know�edge and belief. <br /> FORMSMOC.rvsd2007 <br /> Sipume ofNatmal Pemon Signing A6ove <br /> �VO�C��+I <br /> ��'r ' � � ` �C�G STATE OF FLORIDA, COUNTY OF PASCO <br /> � , �i� THIS IS TO CERTIFY THAT THE FOREGOING IS A <br /> TRUE AND CORRECT COPY OF THE DOCUMENT <br /> * ' Inyu�flYe7rusi � * ON FILE OR OF PUBLIC RECORD IN THIS OFFICE <br /> °� ��� * <br /> WITN�S MY HAND A OFFICIAL SEAL TH(S <br /> * • � �_DAY OF ,�,..�r� <br /> * �87 �* PAULA R & COMPTROLLER <br /> ��"��'OF Fl.C�P �v_____----___ <br /> UTY CLERK <br />
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