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HomeMy WebLinkAbout102 Mayfield Dr; 17-2509; screen enclosure (3)M AUG i 6 2017 l3 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: 1 -- d SD'3 Documented Construction Value: $ s V' Job Address: da ill Historic District: Yes No Rj Parcel ID: l L n < c5 o Residential Commercial Type of Work: New Addition Alteration Repair Demo Change of Use Move Description of Work: s oken P1,( U Plan Review Contact Person: Wh dj'u_ Title:: Phone: ` l- 3 - a l Fax: Email: al IJ0 L)S I de. utm jj Property Owner Information NameY, liii Phone: Street: l Ua ql ,l t em d.Ll '(n,, . Resident of property? : S City, State Zip: `>rQ/n_O_ ld Contractor Information Name On o Y-0 W Phone: q u-i --To- aso o Street: Al'' cm Fax: 4 m -I C) -am City, State Zi t'i 7 State License No.: (' l Q I Architect/Engineer Information Name: Phone: e Street: Si . Fax: City, St, Zip: b4''t— E-mail: Bonding Company: Address: Mortgage Lender: Address: WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners, etc. FBC 105. 3 Shall be inscribed with the date of application and the code in effect as of that date: 51h Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application % NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal. The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value, credit will be applied to your permit fees when the permit is issued. OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and 4oning. Signam of Owner/Agent `)Date U Print Owner/Agent's Name sLe,7 Signature of Notary -St of Florida Date s Notary Public State of Florid9 Daniel Thompson y pQ My Commission FF 961080 Fxp,r.03/25/2020 Owner/Agent is Per Produced ID Type of ID 404-W'0 t/co 6/,7A8 /d BELOW IS FOR OFFICE USE ONLY Print Contractor/Agent's Name l Date Signature of Notary -State of Florida Date o<N','PU`; : TfNAM.DOWNEY MY COhdMISSION # FF 218930 EXPIRES:,April9,2019o: Bonded Th u No Public Underwriters Contractor/Agent is Personaly own to Me or Produced ID Type of ID Permits Required: Building Electrical Mechanical Plumbing[] Gas Roof Construction Type: Total Sq Ft of Bldg: Occupancy Use: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: UTILITIES: ENGINEERING: COMMENTS: FIRE: Flood Zone: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application Property Record Card Parcel: 32-19-31-516-0000-0820 IrPMW6 Owner: BELL YVETTE A Property Address: 102 MAYFIELD DR SANFORD, FL 32771 Parcel Information Parcel 32-19-31-516-0000-0820 Owner BELL YVETTE A Property Address 102 MAYFIELD DR SANFORD, FL 32771 Mailing 102 MAYFIELD DR SANFORD, FL 32771 Subdivision Name CELERY LAKES PHASE 2 Tax District S1-SANFORD DOR Use Code 01-SINGLE FAMILY Exemptions 00-HOMESTEAD(2006) Value Summary 2017 Working 2016 Certified Values Values Valuation Method Cost/Market Cost/Market Number of Buildings,--",-- uildings 1 — v 1 Depreciated Bldg Value 135,745 117,229 Depreciated EXFT Value 350 363 _ Land Value (Market) 30,000 23,000 Land Value Ag Just/Market Value " 166,095 140,592 MPortability Adj Save Our Homes Adj 58,435 35,146 Amendment 1Adj— P&G Adj 0_$0 Assessed Value 107,660 105,446 2016 Tax Bill Amount Tax Estimator Save Our Homes Savings: Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund $107,660 50,000 57,660 Schools $107,660 25,000 82,660I City Sanford $107,660 50,000 57,660 SJWM(Saint Johns Water Management) $107,660 50,000 57.660 l County Bonds $107,660 50,000 57,660 Description Date Book Page Amount Qualified Vac/Imp UIT SPEC AL4WARRANTY DEED 7/1/200505845 0013 189,100 Yes ._ Improved Method Frontage Depth Units Units Price Land Value LOT 1 30,000.00 1 $30,000 Description Year Built Fixtures Bed Actual/Effective Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages 1 I SINGLE E 2005 11 t 4 FAMILY i i 2.5 1,234 3,216 % 2,810 CB/STUCCO FINISH i $135,745 142,141 Descri lionp 15796 POWER OF ATTORNEY Date; I- hereby name and appoint s `` of AA C 4 ;( hNM,%fMMl\ to be my lawful attorney -in -fact to act for me, and apply to the for a ffe, permit for work to be performed at a location described as: Parcel ID M Section Township Range _ Subdivision Block Lot Subdivision Name: o Owner of Property: I Project Address: City: S -Q6 Zip Code: and to sign my name and do all things necessary to this appointment. Contractor's License Number) The foregoing instrument was ackno e d before me this tJ day of of20L ,by Rob2rarU-ey who is personally known to me or who produced as identification and who did not take an oath. Seal Notary Public (Print name) ;, ,tpY 7; ^ TINA M. DOWNEY MY COMMISSION # FF 218930 uF EXPIRES; Aprd 9, 2019 Aonded Thru Nuury Public Undarvrltam Notary Public (signature) - Rev 03/13/13 fX2 REVIEWED FOR CODE COMPLIANCE PLANS EXAMINER DATE SANFORD BUILDING DIVISION RECORD COPY NJ A ujfyl A PERMIT ISSUED SHALL BE CONSTRUED TO BE A LICENSE TO PROCEED WITH THE WORK AND NOT AS AUTHORITY TO VIOLATE, CANCEL, ALTER OR SET ASIDE ANY OF THE PROVISIONS OF THE TECHNICAL CODES, NOR SHALL ISSUANCE OF A PERMIT PREVENT THE BUILDING OFFICIAL FROM THEREAFTER REQUIRING A CORRECTION OF ERRORS IN PLANS, CONSTRUCTION OR VIOLATIONS OF THIS CODE WIND DESIGN STRUCTURAL DESIGN CRITERIA: ULTIMATE WIND SPEED (3 SECOND GUST) - 130 MPH BUILDING EXPOSURE - C BUILDING IMPORTANCE FACTOR = 1.0 MEAN HEIGHT 30' OR LESS HEIGHT & EXPOSURE ADJUSTMENT COEFFICIENT = 1.29 m Lu 1i 3"x0.024x1-LB ELITE COMPOSITE S PANELS OR EQUIVALENT. FPA#: 751.1 I b XZ. 17-2509 I REBY CERTIFY THAT ESE PL S cV B VILD/NC ESIGNED FOR AN ULT I AXE- , D EE 130 MPH IN ACCORD CE WIT T ST RA SANFORD REQUIREMENTS OF HE 5TH ION E 2014 FLORIDA BUILDI CODE. Off" Rw& 8/3/ WILLIAM H. S, P.E. 44271 aN H QU Q w o + Q flL v C t- 24" w E- z¢zt7p IX2 i w¢C¢zF- M z F v zuoF z zxoowXv`Zw_, cv w F- vZ) 2w—'et0o wZwcnx3cn xSF00 ~Z(n zUzo ex wZ 2 x O 0 O:D2 O O Q SWCLIww :' .. O.w ac cl wJZ z¢a u c0 DECK BEAM ATTACH TO EACH POINT OF CONNECTION WITH 3 912 TEK USE H-BAR X 3/4 KNEE BRACE DETAIL UPRIGHT (RISER) SUPPORT FOR MAIN BEAMS z 1:0:0E E:91 (' I 2X2X_125 ANGLES SUPER W/6 # 12X3/4 INTO GUTTER BOTH GUTTER AND UPRIGHT UPRIGHTS AT GUTTER DETAIL 2" X 4" STRAP W/4412X3/4 INTO 2 X 2 & PURLIN 2X? IX2 BEAM SCREWS X 3/4 2X4 4 # 12 TEK 2X5 4 # 12 TEK 2X6 6 # 12 TEK 2X7 6 # 12 TEK 2X8 6 # 12 TEK 2X9 8 # 12 TEK 2X10 10 # 12 TEK GUSSETT CONNECTION 4 4 12 X 3/4 TEK INTO 2X2X.125 ANGLEINTO UPRIGHT DOUBLE CRIMP NOTE: SINGLE CRIMP IS ACCEPTABLE IX2 fAPCON 3 "X3/8 36" 24" 2X_ BEAM I w 54 3oM W o zI,-- ISG o BEAM SPAN o NOTE: NO SET DISTANCE BETWEEN BOTTOM OF KNEE BRACE & TOP OF GUTTER 4" WIDE X 1/E" STRAP AT EVERY BEAM W/ (4) # 12X3/4" IN GUTTER LIP. (2) # 12X2" INTO FASCIA I-- 7" GUTTER p 0o U RE- GUTTER CONNECTED TO SOFFIT FASCIA a 24" QC, MAX W/ Ox 912X2" SELF'1'APPING SCREWS GUTTER CONNECTIONS CABLE DETAIL 5-1/2" 00000 0 N O 0 O 1 FASTEN CABLE TO UPRIGHT & GIRT IN CORNER AS SHOWN W/8 TEK SCREWS. THIS 5-1/2" CORNER GUSSET ANGLE BRACKET CAN BE USED IN LIEU OF A 7" CORNER GUSSET ANGLE BRACKET. ABLE NOTE: IF CONCRETE_ THEN USE 912X3" FASTEN GUTTER TO FASCIA EVERY 24" O.C. W/ #I2X2" FASCIA a 1-LDT TAPCON 3 "X3/8 7" SUPER GUTTER ENLARGED TOP VIEW BEAM TO ATTACH BEAM TO GUTTER GUTTER W/2"X2"X.125" ANGLE USING (4) #12X3/4" IN EACH SIDE 0 o E BY CERTIFY HAT THESE PL , HAVE DESIGNED FOR UL T WI Tli SPE'ED 130 MPH EN A ORDANCL WI THE ST CTI REQUIREME TS OF THE 5T DITION T FLORIDA LDINGCO A H. RO TS, . # 42712 HOUSE WALL 4 ROOF SMB) — PLAN VIEW ELEV 12 HEAD W/5" X 3/16" TAPCON MINIMUM 1-1/2" EMBEDMENT INTO CONCRETE START 6" MAX FROM UPRIGHT, THEN 24" O.C. ixz CONCRETE DECK MIN (4) CONCEALED #10 X 1-1/2" WASHER HEADED SCREWS ROOF PURLIN 12 X 3/4" SMS TO FASTEN SMB @ 2" O.C. MAX 1 X2 OPEN BACK BASE RAIL 1) 1 /4"X2" EMBEDMENT TAPCON 2"X2"X1/8" ANGLE 4) 412 X 3/4" TEKS 1) 1/4"X3" EMBEDMENT TAPCON MAX 6" FROM UPRIGHT AND 24" O.C. 1 X2 OPEN BACK BASE RAIL 2X2 HOLLOW FASTEN 1X2 O.B. TO 2"(X)H" W/ 410 SMS @ 24" O.C. MAX 6" FROM TOP & BOTTOM 1) 1/4"X3" EMBEDMENT TAPCON MAX 6" FROM UPRIGHT AND 24" O.C. 1X2OPEN 3 BACK a BASE RAIL x v d 4 n v EXISTING 4" CONCRETE SLAB W/ EXISTING REINFORCED 8"X12" CONT.FOOTER ULT 130-170 MPH ASD 110-130 MPH TYPICAL DETAIL EXTERIOR CORNER @ BOTTOM RpD VERTICAL MEMBER pUR 7A SMB OR HOLLOW • ee 2"x4" STRAP W/ 2) # 12x3/4" TEKS INTO PURLIN & —A UPRIGHT PURLIN TO POST CONNECTION START MAX @ 6" FROM END, THEN 24" O.C. INTO BLOCK WALL: USE #12 HEAD W/3" X 3/16" TAPCON FOR SMB CONNECTION: USE # 12 X 3/4" * NOTE*: FOR THIN PAVER DECK, # 12 HEAD W/4" X 3/16" TAPCON MAY BE USED IN LIEU OF 5". 4) #12 X 3/4" TEKS Fm # 12 HEAD W/5" X 3/8" TAPCON a (1)412 HEAD W/ 5"X3/16" TAPCON MINIMUM 1-1/2" EMBEDMENT INTO CONCRETE START 6" MAX FROM UPRIGHT, THEN 24" O.C. xz ix2 CONCRETE DECK THICK PAVERS) PAVER DECK ATTACHMENT: MIN (4) CONCEALED 910 X 1-1/2" WASHER HEADED SCREWS 12 X 3/4" SMS TO FASTEN SMB c1 2" O.C. MAX HOUSE WALL ATTACHMENT/ FACE OF GUTTER: 2X2 pULIN —) TO BLOCK WALL USE 12 HEAD 2" X 3/16" M ®® ® X 2 INTO WAIL 2X_B N •° • 2 ? S„ FASTEN TO BEAM * TO WOOD OR ALUMINUM, W/ #12 X 3/4" X 4" USE #12 X 2" SCREWS Q N U M - O I HERE CERTIFY T ,. THESE P S l' VE B DESI QED FOR AN U TIMATE W D S ED OF 13 H IN ACCO ANCE WIT T STRU L QUIRED.IENTS F THE 5TH D ON 0 2014 LORIDA BUIL NG CODE: R/2/7 7 WILLIAM H. P.E- # 42712 if x DETAIL ONLY USED E°F Tlflrj R %lf/I'kvi FOR ROOF TO SCREEN WALL WHEN CARRY BEAM IS r c 1 x _sue- >t_ ATTACHMENT USE # 12X5 SELF TAPPING, (4) PER 4' PANEL, (2) IN USE C%';fc l i Z f_r ?fV PER T PANEL d 2X2 TOP PLATE iS1Z 7w r s=R-s 7/7 Fi.2i1 ,'3E171 LT'. c L /) i'i 31F F X2 CHAIR RAIL 1X2 BASE PLATE SCREEN ROOM ATTACHMENT FASCIA COVERED ROOF DETAIL FASTEN 3" REC. CHANNEL TO PANELS W/ (1) # 12X3/4" EVERY 8" O.C. MIN. 5 PER T PANEL TOP AND BOTTOM OF CHANNEL INS. ROOF FASTEN CHANNEL TO FASCIA W/ (1) #1OX2" EVERY 12" O.C. IF INTO BLOCK WALL, ATTACH W/ (1) 12X2" TAPCON EVERY 12" O.C. YHEREBY CFRiTFY 3XAT T1 DESIGNED FORA TIMA 130 MPH IN ACC ANCE REQUIREMEN OF THE 51 FLORIDA B' DING C 2014 11 W1LL19K1 H. ROBERTS, P.E. 712 CLEAN COMPACTED 18"XI8"X18" DEEP 2,500 PSI MIN) ISOLATED CONC. FOOTER ALUMINUM UPRIGHT SIZE SHALL BE SPECIFIED ON PG. 1 OF THESE PLANS WHEN AN ISOLATED FOOTER IS TO BE USED 2,500psi (min) rnlaroc r ONOLITHIC 5 CONT. REBAR FOR FOOTER O 12"X12" IN SIZE. FOR 12"XI6" TER (2) # 5 CONT. REBAR SHALL SQUIRED. MONOLITHIC FOOTER DETAIL SCALE: NOT TO SCALE 18 ' c+1 r-%r- %/I rI A vvi -- IY. 1 .V ISOLATED CONCRETE FOOTER DETAIL SCALE: NOT TO SCALE CLEAN COMPACTED ALTERNATE ATTACHMENT: ATTACH POST TO FOOTER W/ 2X2X.125 ANGLE UTILIZING (3) I2X3/4" INTO -POST & (1) 412X3" TAPCON INTO FOOTER (2) ANGLES PER POST. ANY PARALLEL SIDES PAVER DECK 2,500 PSI (MIN) CONCRETE MONOLITHIC FOOTER 1) # 5 CONT. REBAR FOR FOOTER UP TO 12"X12" IN SIZE. FOR 12"Xl6" FOOTER (2) # 5 CONT. REBAR SHALL BE REQUIRED. I ISOLATED PAVER DECK FOOTER DETAIL (OPTIONAL SCALE: NOT TO SCALE FOOTER SIZE TABLE A B SPAN 8" 8" UP TO 16' 8" 12" 16' TO 28' 12" 12" 28' TO 40' 12" 16" 40' & GREATER NOTE: NOT APPLICABLE ON JOBS W/ / 13 RTIFY TTI EXISTING CONCRETE SLAB C1R ULTIMA C ORDANCEXSOFTHE5Ta WILLIAM THE 2.614 Legend of Symbols and Abbreviations: ELEVATIONS E: ERrs>i GO' ; peOpol2o REROD: Steel Reinforcing Rod Boundary Line Brg. Bearing Field Field Measured P.C.P. Permanent Control Point P.T. Point of Tangency Centerline Cale. Calculated Fnd. Found P.I. Point of Intersection R Radius Right-of-way Line C.B. Concrete Block Gov't.: Government P.L.S. Professional Land Surveyor R.L.S.: Registered Land Surveyor Overhead Utility Line, Ch. Chord L.B. Licensed Business P.O.B. Point of Beginning R/W Right-of-way Easement Line Cone.: Concrete O.R. : Official Records P.O.C. Point of Commencement Sec. Section A Central Angle Consl.: Construction Pav't.: Pavement P.R.C. Point of Reverse Curve Srr : Septic Tank ARC Arc Length c/s Concrete Slab P.C. Point of Curve P.R.M. Permanent Reference Monument T.B.M.: Temporary Bench Mark Blk. Block Elev. Elevation P.C.C.: Point of Compound Curve P.S.I. Point of Street Intersection W/ With B unda Surve 'o . l'k .i/A/L. iv/,, rae I L:5 2t1t; / QlD. Sd ~ `/ p 3\ FNO. S/S v O ZU v •c R !00 \ J ,CE oO P. L ar 1 G9P0. ti i WfzL o N I o h w 2 V. 89 38 /7. „E PLAT s FiELo -00. C q{ `71i'I Qj 0 0 I I D.PA/N/6rE c vvVjc00/ EtP 0 p 1500<4--ewr m k E 0 m if 00 2 PLAT Way O u. Rc r f ;FE.4 0 3°.2 30` 3 Eat °' N oRL,S.Z414Pia 3f v $ ¢ U to a . .._.. LE FlIP 1 `MV v 4 . 3° S t 2 1(15 1 o - c- X t L) ckla, Oj Si Fcaae E[EV. 3/.3$ { `Y i vn 1 S UIa C A) E v ti' v f0 2 5raey S ` i(- S S O(Iift'1J ,o'f , a ' t, r AT p / rR rn I 01 f po ;i too 0 C} n/orEs N : .. d,a;A3 o.l z.o' \ N /oz /9yFiE[o oQivE oQ 30 E ?r1 30,:04 O E ioE c6 rTi9c/%EO % Ept<1 .t41, v !?/.9r p /JiJEr62 LOCS+TEL7 PLAT t'F/.•. 6 3 ,00n,r yA/ro .9s S s+ow.. fir 9 3° 2 coo 5 r vr./'-/ry VIE EAtE.MEN FiE[0 i 0 CA PAP 28' 0: . I „" 2 . • •. of W/ cAv QNIp3ArPa 2g,' 0 - 1 y S ,89 /.71!r/ Pl.QT Q s sr; 3G3 O r Q Ar ti . L ar SO- r-ELE.-X LA Es , ,s%QSE ; i SG,80•v/s•o•' r cCoeoi,u To An I.v LAT Boo n- 6s P.4GEs 29 AV,0 20; PvBLrc 11 E4Wos O., CERTIFIED TO: ,may' :-6.y.1 2TGE' C t/.TL9/VT}/ O/Pi9/ I hereby certify that this map depicts a survey performed under and thasupt thi- YII T CE /9/p f GSL y eeOfvax> /O/ sieve and is correct i the best h my knowledge and belief; and that this survey meets the minimum technical standards set forth by the Florida Board of Professional Land Surveyors in Chapter 61G17-6, Florida Administrative Code, pursuant to Section 472.027, Florida Statute SMITH DRAFTING & SURVEYING, INC. 311 E. RICH AVE. DELAND, FL DELTONA, FIL St ey E. Smith 386) 734-7047 (386) 789-2855 Florida Registered Land Surveyor DRAWN BY: L • L . GdO R/C/V REVISIONS: `BAo T ZoFZ o ' ""I Certificate Number 3736 CREW CHIEF: sus a GeaoE vousE N. Q. L/iavi.v/EC ,P /0 o NOT VALID UNLESS SEAL IS EMBOSSED SCALE: . vc _ SUrzdEy . E EUS+.—ionis Z 0 Sv[Y ice. zoo 5 MG Note: No instruments of record reflecting easements, limitations, owner - DATE: ships, reservations, restrictions and/or right-of-ways, if any, have been pro- OCTOBE 2Z004 1 vided to this surveyor, except as shown. No underground installations or WO # utilities have been located, except as shown. REQUIREDEID INSPECTION SEQUENCE B P# , -) - 2 Sn9 Address: in?- Mh-f I.BVILDING (PERMIT Min Max .. Inspection Description Footer / Setback Stemwall Foundation / Form Board Survey Slab / Mono Slab Prepour Lintel / Tie Beam / Fill / Down Cell Sheathing — Walls Sheathing — Roof Roof Dry In Frame Insulation Rough In Firewall Screw Pattern Drywall / Sheetrock Lath Inspection Final Solar Final Firewall Final Roof Final Stucco / Siding Insulation Final Final Utility Building Final Door Final Window Final Screen Room Final Pool Screen Enclosure Final Single Family Residence Final Building (Other) 10'I[in Max Ins ectionn Descri Lion Electric Underground Footer / Slab Steel Bond Electric Rough T.U.G. Pre -Power Final Electric Final Min Max Ins ection IDescri ti®n Plumbing Underground Plumbing Sewer Plumbing Tub Set Plumbing Final 1YdECHANICAL, PERIIRIT,;: Min Max Inspection Descrij2don Mechanical Rough Mechanical Final Min 1Max Gas Unde Gas Roug Gas Final REVISED: June 2014 THIsaasu asl>sl lEi1Y lmlll mmlll mm111 mini Imml SINSA -NT j EP ED Y: Name: GRAFT MALOY, SEMINOLE COUNTY Address: f CLERK OF CIRCUIT COURT & COMPTROLLER BK 8982 I='s 796 (1F'ss) CLERK' S r 2017089004 NOTICE OF COMMENCEMENT RECORDED O8/a1/2017 02:15:34 PM RECORDING FEES $10.00 State of Florida RECORDED BY ,ieckenro County of Seminole / (( rr Permit Number: ( Parcel ID Number; 3D' q-3I -lh Ddt d ladz The undersigned hereby gives notice that improvement 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. Legal dpscdoon of the 3 GENERAL DESCRIPTION O IMPROVEMENT: ` Qe, eJ) :- ! M Q 1:L 1A T-0 OWNER Address: A --!I I Fee Simple Title Holder (if of er than owner) Name: Address: Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section 713.13(1)(b), Florida Statutes. Name: Address: In addition to himself, Owner Designates Section 713.13(1)(b), Florida Statutes. of To receive a copy of the Lienor's Notice as Provided in Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a different date Is specified) 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 MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IFiYOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in It are true to the best of my knowledge and belief. Owner' s Sig ature Owner's Printed Name Statute 713.13(1)(g):. The owner must sign the notice of commencement and no one also may be permitted to sign In his or her stead' State of County of The foregoing Instrument was acknowledged before me this e12 day of b YJG / fC e y _ . Who Is personally known to me Name of person making statement" OR who has produced identification of identification produced: JL#/" y60'F6 12 i .'+ i 0, jZA 04, 001 L FNotary Public State of FloridaDaniel ThompL Notary Slgneture ae_My Commission 80 '*" 0Expires 03l25/20u''hc L =" t=i: cpti a: l S,etirj, y tUJ. lid 1: v 1`110- f N C