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HomeMy WebLinkAbout102 Quail Ridge Ct 04-245 window replacement0 F CITY OF SANFORD PERMIT APPLICATION Permit# 36)'S' s-co0cc--(9.2A0 Date: Job Address: Description of Work: 40e__ -*-- Historic District: Zoning: Value of Work: $ (05 v Permit Type: Building / Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required) Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial Occupancy Type: Residential Z' Commercial Industrial Total Square Footage: Construction Type: g # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel#: —/ (Attach Proof of Ownership & Legal Description)) Owners Name & Address:dOf,G s /qv S !_ 'IL 25: _ l Q Z- QC3 0191z' - /r— , Phone:: 440 _ 3 2 0— da 76D6 Contractor Name & Address: "C- i r j2pS z Q /`(C'6G j"/4-e !/J State License Number: Phone & Fax: D 7- Z t s Phone: Bonding Company: ! Address: Mortgage Lender: Address: OCT 2 Q 2 11113 Architect/Engineer: Phone: Address: Application is - hereby made to obtain a permit to:doahe wo issuance of a permit and that all work will be performed to permit must be secured for ELECTRICAL WORK, PLUM AIR CONDITIONERS, etc. Fax: certify that no work or installation has commenced prior to the ng construction in this jurisdiction. I understand that a separate FURNACES, BOILERS, HEATERS, TANKS, and 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 zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 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 veriLcation [ will notify the owner of he pr perty of the re u' Florida Lien La 7 ignature o Owner/Agent) ate nature of Contractor ent Date Print Ownwhkaent' s Name Print Contractor/Agent's Name Signature of Nota -State NEFWMT PETTICORD Dati Signature of Notary -State CommN D00181345 E*Mee 1l30/2007 800)432. 4254: Owner/Agent is y It or Contractor/Agent is Produced ID iue-se"........u.........ii..i.i':::.:.F Produced ID APPLICATION APPROVED BY: Bldg.`) E 1 Za 0 3Zoning: Initial & Date) ( initial & Date) Special Conditions: Utilities: e- l- Q3 nw .uwnom. 0 on 4IEgg .RT P ORD Cm if OWS1345 a On ( e00)432.4254 P sow OW"ry Assn., Inc o.n. n.0 n u u...... o.. FD: initial & Date) ( Initial & Date) 00 0 r I - czt; I X 42r 7f INSTALLATION ANCHOR 3/IS' DIA. TAPCON CGICRETE OR WINDOW WIDTH OTHERS MASONRY EXTERIOR FINISH w BY OTHERS A I 1/4" SHIM A G SPACE MAX. 1 1/4' MIN, EMBEDMENT D d a G H ' WINDOW 2 HEIGHT SHIM AS PEQ'D. SEE NOTES) SILL ST_OL BY OTHERS I. If I :/4' MIN. E"BEr 1=TALLATi2N A 3/I6' L:A. T PERIMETER CAULK BY OTHERS EXTERIOR I l.•:Lr. 6t NI I'- `.Y. VllU`N LHi-:UL SECTI N A —A WINDOW HEIGHT CAST SILL OTHERS G 11/4" MIN. EMBEDMENT - INSTALLATION ANCHOR 3/16' DIA. TAPCON SHIM AS REQ'D. o CONCRETE OR MASONRY SEE NOTES) BY OTHERS 0 J [ a a a EXTERIOR 7/ B D PERIMETER CAULK q EXTERBYRFINISH OTHERS OX & XO ELEVATION — WINDOW WIDTH 1/4' SHIM VIEWED FROM EXTERIOR SPACE MAX. SECTI N B—B' WINDOW WIDTH NOTES: 1) SHIM AS REO'D. AT EACH INSTALLATION ANCHOR W/ LOAD BEARING SHIM. MAX. A ALLOWABLE SHIM STACK TO BE 1/4". USE SHIMS WHERE SPACE GREATER THAN 1/16" 6 PRESENT. 2) WINDOW FRAME MATERIAL: POLY VINYL CHLORIDE. A E C 3) 3/16" DIA. TAPCON INSTALLATION ANCHOR MUST BE OF SUFFICIENT LTH. TO ACHIEVE MIN. OXO ELEVATION VIEWED FROM EXTERIOR EMBEDMENT OF INTO MASONRY OR CONCRETE. 4) LETTER DESIGNATIONS ON THE TAPCON LOCATION CHART INDICATE WHERE CONCRETE SCREW ANCHORS ARE TO BE INSTALLED WHEN USING THE EXTERIOR ELEVATION AS A KEY. 5) ALL FACTORY APPLIED HOLES NOT DESIGNATED FOR CONCRETE SCREW ANCHOR SHOULD uIrIDOw BE FILLED WITH #8 SCREWS OF SUFFICIENT LTH. TO PROVIDE MIN. 5/8 IN. EMBEDMENT HEIGHT INTO SUBSTRATE. INSTALLATION ANCHORS, WHETHER TAPCONS OR g8 SCREWS, TO BE 6" FROM END MAX. AND 24" O.C. MAX. 6) CAULK BEHIND WINDOW FLANGE AT SILL. WITH LATEX CAULK. 7) USE LATEX CAULK OR EQUIVALENT FOR PERIMETER SEAL AROUND EXTERIOR OF WINDOW. 8) IF EXACT WINDOW SIZE IS NOT LISTED IN ANCHOR CHART, USE ANCHOR QUANTITY LISTED WITH NEXT LARGER SIZE, FOR THE APPROPRIATE DESIGN PRESSURE REQ'D. 9) GLASS THICKNESS MAY VARY PER THE REQUIREMENTS OF ASTM E1300 GLASS CHARTS. INSULATING GLASS IS SHOWN, SINGLE GLAZING ALSO QUALIFIED. 10) INSTALLATION AS STATED HEREIN COMPLIES WITH THE FLORIDA BUILDING CODE. DESIGN PRESSURE CAPACITY OF WINDOW & INSTALLATION IS 70 PSF. MANUFACTURE DAME MASTER FILE # -- _ PREPARCO BYE PRODUCT TECHNOLOGY CORP., 250 INTERNATIONAL My., SUITE 250. HCATHROV, FLORIDA 02746 PHONE 407 805-0365 FAX 407 805-0066 i TAPCON LOCATION CHART WINDOW OUANTITY IN QUANTITY IN SIZE HEAD & SILL EACH JAMB 2 PANEL UP TO 40 PSF UP TO 40 PSF 36 X 37 A,B,C,D G,H 36 X 43 A,B.C,D G,H 36 X 49 A,B.C,D G,H 36 X 55 A,B,C,D G,H 36 X 61 A,B,C,D G,H 36 X 62 A,B,C,D G,H 42 X 37 A.B,C,D G,H 42 X 43 A,B.C,D G,H 42 X 49 A,B,C,D G,H 42 X 55 A,B,C,D G,H 42 X 61 A,B,C,D G,H 42 X 62 A,B.C,D G,H 48 X 37 A,B,C,D G,H 48 X 43 A.B.C,D G,H 48 X 49 A,B,C,D G,H 48 X 55 A,B.C,D G.H 48 X 61 A,B,C,D G,H 48 X 62 ABC D G,H 54 X 37 A,B,C,D G,H 54 X 43 A,B,C,D G,H 54 X 49 A,B,C,D G,H 54 X 55 A,B,C,D G,H 54 X 61 A,B,C,D G,H 54 X 62 A,B,C,D G,H 60 X 37 A,B,C,D G.H 60 X 43 A,B,C,D G,H 60 X 49 A,B.C,D G,H 60 X 55 A,B,C,D G,H 60 X 61 A,B,C,D G,H 60 X 62 A,B C D G,H 66 X 37 A,B,C,D G,H 66 X 43 A,B,C,D G,H 66 X 49 A,B,C,D G.H 66 X 55 A,B,C,D G,H 66 X 61 A,B,C,D G,H 66 X 62 A,B,C,D G,H 72 X 37 A,B.C,D G,H 72 X 43 A,B,C,D G,H 72 X 49 A.B,C,D G,H 72 X 55 A.B.C,D G,H 72 X 61 A.B,C,D G,H 72 X 62 A,B.C,D G,H 73 X 37 A,B,C,D H 73 X 43 A,B,C,D GA 73 X 49 A.B.C,D GA 73 X 5S A,B.C,D G,H 73 X 61 A,B,C,D G,H 73 X 62 ABCD G,H TAPCON LOCATION CHART WINDOW QUANTITY IN QUANTITY IN SIZE HEAD & SILL EACH JAMB 3 PANEL UP TO 40 PSF UP TO 40 PSF 73 X 37 E,F,J,K G,H 73 X 43 E. F,J,K G,H 73 X 49 E,F.J,K G,H 73 X 55 E,F,J;K G,H 73 X 61 E,F,J,K G,H 73 X 62 F K G,H 79 X 37 E,F,J,K G.H 79 X 43 E,F.J,K G,H 79 X 49 E,F,J,K G,H 79 X 55 E,F,J,K G,H 79 X 61 E,F,J,K G,H 79 X 62 E,F,J,K G,H 85 X 37 E,F,J,K G,H 85 X 43 E,F,J,K G,H 85 X 49 E,F,J,K G,H 85 X 55 E,F,J,K G,H 85 X 61 E,F,J,K G,H 85 X 62 EFJK G,H 91 X 37 E, F,J,K G,H 91 X 43 E,F,J,K G,H 91 X 49 E,F,J,K G,H 91 X 55 E,F,J,K G,H 91 X 61 E,F,J,K G,H. 91 X 62 EFJK G,H 97 X 37 E,F,J,K G,H 97 X 43 E.F,J,K G,H 97 X 49 E,F,J,K G,H 97 X 55 A.B,C,D.E,F,J,K G,H 97 X 61 A,B,C,D.E,F,J,K G,H 97 X 62 A.B,C,D,E,F,J,K G,H 103 X E,F,J,K 103 X 43 E.F,J,K G,H 103 X 49 A,B,C,D,E,F G,H 103 X 55 A,B,C,D,E,F G,H 103 x 61 A,B,C,D,E,F G,H 103 X 62 ABCD F G,H 109 X 37 E,F,J,K G,H 109 X 43 E,F,J,K G,H 109 X 49 A,B,C,D,E,F G,H 109 X 55 A,B,C,D,E,F G,H 109 X 61 A.B,C,D,E,F G,H 109 X 62 ABCDEF G,H 110 X 37 E,F,J,K G,H 110 X 43 A,B,C,D,E,F,J,K G,H 110 X 49 A,B,C,D.E,F,J,K G,H 110 X 55 A,B,C,D,E.F,J.K G,H 110 X 61 A,B,C,D,E,F,J,K G,H 110 X 62 A,B,C,D,E,F,J,K G,H DATE:3/ 15/02 I SCALE: NTS I DWG.: RPLUS0013C SHT2 OF 2' PREPARED BY: PRODUCT TECHNOLOGY CORP., 250 INTERNATIONAL PKY., SUITE 250. HEATHROW, FLORIDA 32746 PHONE 407 805-0365 FAX 407 805-0366 DIS TALL.=Ti01•I C0NC3E E GIA. TAPCOI'I 3'! CTHERE E1-ERICP NISH 141 ':HIM SPACE MAX. I I_ IM S RE:9'D. E NOTES) L -700L OTHERS a" -MIN. BEDMENT NC TA.ILL, 2/16' CJA. TAPCON ilEIN n EXTERIOR PERIMETER. CAULK 3Y OTHERS WINDOW HEIGHT I I WlraDow v HEIGHT II i CAULK 3EHIND JNDOW =L,NGE Y OTHERS wINDOW IDTH MAX. (7 YP.) i IE'NE ' .-OM E` T CE7 IOR H I N D 0,./ IN 1 D T H EMBEDMENT SPACE MAX. SHIM AS PCOID. — INSTALLATION .ANCHOR SEE NOTES) \_ Q 3/16" DIA. TAPCON- F CONCRETE OF. M ASONRY BY OTHERS I EXTERIOR PERIMETER CAULK BY OTHERS XTERIOR FINISH —! BY OTHERS c`C-T B- NOT i) SHIM AS REO'D., AT EACH INSTALLATION ANCHOR N/ LOAD BEARING SHIM. MAX. ALLOWABLE SHIM STACK TO BE 1/4". USE SHIMS WHERE SPACE GREATER, THAN 1 / 16" IS PRE=ENT. WINDOW FRAME MATERIAL: POCY )/INYL.CFiLORfDE. C) C/16" DIA. TAPCON INSTALLATION -ANCHOR MUST BE OF SUFFICIENT LTH. TO ACHIEVE MIN. EMBEDMENT OF 1-1/4" WTO MASONRY OR CONCRETE. 4) LETiER DESIGNATIONS ON THE TAPCON LOCATION CHART INDICATE WHERE TAPCON ANCHORS ARE TO BE INSTALLED WHEN USING THE EXTERIOR ELEVATION AS A KEY. 5) tJOT ALL INSTALLATION HOLES ,.FOR ANCHORS SHOWN ON ELEVATION ARE APPLIED BY FACTORY IN ALL SIZE. ALL FACTORY APPLIED HOLES NOT DESIGNATED FOP, CONCRETE SCREY/ ANCHOR SHOULD BE FILLED '.VITH ;48 SCREWS OF SUFFICIENT TH. TO PROVIDE MIN, 5/8 IN. EMBEDMENT INTO SUBSTRATE. !NSTALLATION NCHOP. S, WHETHER TAPCONS OR '8 SCREWS TO BE G" FROM END AND 24" O.C. MAX. 6) CAULK BEHIND 'NINDOW F!_.4NGE '/lITH LATEX CAULK. 7) USE LATEX CAULK FOR PERIMETER SEAL AROUND EXTERIOR. OF WINDOW clANGE EY OTHERS. 3) IF EXACT WINDOW =!ZE IS NOT LISTED IN ANCHOR CHART, USE ANCHOR bUANT1T'( LISTED SYITH NEXT LARGER SIZE. FOR THE APPROPRIATE DESIG I PocccURE REO'0. 9) GLASS THICKNESS MAY VARY PER THE REQUIREMENTS OF ASTM _I 00 ;LASS CHARTS. 10) INSTALLATION AS STATED HEREIN COMPLIES WITH THE FLORIDA BUILOING CODE. DESIGN PRESSURE CAPACITY OF WINDOW ;i INSTALLATION IS 40.0 RSF. ti ESL WINDOW PoOS 1 TITLE: - j` ;_Ji J INS I AL_i7 I iN DE:NIL: i7# DIREC- - MASONRY E IiGINEEn' NANUEL :,lARTINEZ I ilKW ;n jUAiE y/_,•/(Jc DISCIPLINE: ISCALE: I'G. r:q,P.-Ir::. r;U1= =IV1_ L 3 FL. REG. :U: ,i 718c _ REV. -E TTE?: I:r EEi r 31IiOCPMEO n,, zPQOLCI ::C.4 gLCCY CCRP.. .150 INtERNAIICI w 'w Y.. :'I7E E?0. 'CHIN 0. TLQRI -2716 ?10E — COS-0165 i r[ .0) E05-O366 X I /}, ' : C N L'C l.r', i i C PJ i1r', F j I lEOW PROS TITLE: ?NSTALLA! _ON ANCHOR. CHART FOR DH r Lu. WINDO' WHEN! :INSTALL ED iN MA ONR,Y / _ BY W D DUCK. DRAtiYN BY: APPROVED BY: 1D' TE: Li , /02 SCALE: NTS IDVIG.:RPLUS00 i 2C -n T S G- 2 I i ! v/If\IDOW GUAr iTITY IN QUANTITY w JI r HEAD c SILL EACH JAMS UP TO 40 PSFUPTO40PSF 78 x 25 A,E.C.D G,H 18 % 31 A.E.C.D I G,H 18 X 37 A.E.C.D G,H 18 x 43 A.B,C,D G.H 13 ;< 49 a,B.C.D G,H 18 X 55 A.9.C.D G.H X 51 I A,B,C.D G.H 18 is 67 A.B,C,D G,H 18 X 73 A.B,C,D G,H 13 z 75 ARrD r,H I 24 1Y 25 A,B.C,C i G,H 24 >; 31 A.B.C,D G,H 24 X 43 A,B,C,D G.H 24 X 49 a.B,C,O G.H 24 X 55 A,B,C,D G,H 24 X 61 A.B,C.D G,H 24 X 67 A,B,C,D G,H ! 24 X 73 a,B,C,D G.H I 2 ?5 4.B.C,D G,H i i 30 x 25 A.2.C,G I G.H 30 X 31 a,B,C.D G,H 30 X 37 A.B.C.D G,H 30 X 43 A,B.C.D G,H 30 X 49 a.B.C.D I G,H I30X56A.B.C,D G,H 30 X 61 A.B.C,D G.H 30 X_ 07 a,E.Gp G,H 30 X 73 A.B.C,D G,H 30 A.B.C,D G.H 30 ;( 25 A.B.C,D G,Hi36X3tA,E.C,D G,H 36 X 37 A,B.C.p G,H 36 43 A.B.C,D G.H 36 X 49 B.C.D G.H 36 ;< 55 A.B.C,D G,H 36 X 6i B.C.D I G.H 35 X 67 A,E.C.p G,H i 3o Y. 4 a a r.D P SON LOCAI IOf I ;-iAR I QUANTITY IN QUANTITY IN I WINDOW I HERO do SIL_ EACH JAMB ! SiC UP. TO 40 PSF UP TO 40 Psi 42 X 25 A,B,C.D G,H 42 X 3t A,B,C.D G,H 42 x 37 a,B.C,D G,r. 42 ;: 43 a,9,C,D G,H I 42 X 44 A,9.C.D G,H 42 :< 58 i A,B,C,D G.H I 42 ., 0"1 B,C D G.H 4' X 73 A,B.C.D I E.F.G.H,LJ A B C D G.H,I,J 8 x C8 A.B,C,D G 48 X 31 A,B.C.D I G,H 48 X 37 A.B,C,D G,H 48 43 a,B.C.D G.H 48 a 49 A,B.C.D G,H 45 x' 5 A.B.C,D G,H 48 of A,B.C:D G.H I 48 X o7 A, 9.C,D E.F,G,H.I,J 48 X i3 A.B.C.DI,J 43 x 7` A B C D F.G.H,!,J i 52 X 2= a.B,C.D,K.L G.H ! 62 X 31 A,B.C,D.K,L G,H 52 X 37 A.B,C.D.K,L G,H 2 X ?3 A,B,C.D.K.L G,H 2 X 49 A,B.C,D,K.L G,H 53 :X SS A.B,C.D.K,L G.H 52 'f, of A.B.C.D.K.L G,H 2 X i3 A,B.C,D,K,L c2 X ?` A.B.C.D.K,L G.H.I,J nSPAr(Ev 67'=RGOUCi TECHNOLOGY CORP., =5u INTERNATIONAL ='H7.. :UItE _^SG. "i.i:i iiROW. FLORIDA .:2746 'HONE 407 606-.]355 FAX 407 °^_5-'Soo Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 1 PC Personal Property IPlease Select Account PARCEL DETAIL Back L R r ' Ln cmintJr Ctxtnt. Z prrtvw4 prawr c rr cti 1 m Ilul 1. 1<trsttil. f I y a 111'lt 4r+^ enc_Snr CR 46A i 2004 WORKING VALUE SUMMARY GENERAL Value Method: Market Parcel Id: 32-19-30-5GS-0000- Tax District: S1-SANFORD Number of Buildings: 1 02A0 Depreciated Bldg Value: $80,265 LAKE DOUGLAS G & 00 Owner: AMY S Exemptions: HOMESTEAD Depreciated EXFT Value: $1,916 Address: 102 QUAIL RIDGE CT Land Value (Market): $18,500 City,State,ZipCode: SANFORD FL 32771 Land Value Ag: $0 Property Address: 102 QUAIL RIDGE CT SANFORD 32771 Just/Market Value: $100,681 Subdivision Name: KAYWOOD REPLAT Assessed Value (SOH): $85,972 Dor: 01-SINGLE FAMILY Exempt Value: $25,000 Taxable Value: $60,972 SALES Deed Date Book Page Amount Vac/Imp 2003 VALUE SUMMARY WARRANTY DEED 09/1999 03788 0576 $95,000 Improved 2003 Tax Bill Amount. $1,230 WARRANTY DEED 08/1986 01762 1379 $77,500 Improved 2003 Taxable Value: $58,957 Find Comparable Sales within this Subdivision LAND LEGAL DESCRIPTION PLAT Land Assess Method Frontage Depth Land Units Unit Price Land Value LEG LOT 2A KAYWOOD REPLAT PB 30 PGS 27 & LOT 0 0 1.000 18,500.00 $18,500 28 BUILDING INFORMATION Bid Num Bid Type Year Bit Fixtures Gross SF Heated SF Ext Wall Bid Value Est. Cost New 1 SINGLE FAMILY 1986 6 2,030 1,485 CB/STUCCO FINISH $80,265 $85,845 Appendage / Sgft OPEN PORCH FINISHED / 16 Appendage / Sgft GARAGE FINISHED / 529 EXTRA FEATURE Description Year Bit Units EXFT Value Est. Cost New FIREPLACE 1986 1 $1,100 $2,000 ALUM SCREEN PORCH W/CONC FL 1986 240 $816 $2,040 NOTE: Assessed values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes. If you recently purchased a homesteaded property your next ear's property tax will be based on JustlMarket value. http://www.scpafl.org/pls/web/re_web.seminole_county_title?parcel=3219305 GS000002Y... 10/30/2003 III J flri[IBE, parcel ldentllicaliint Idunlher Z c,-d_c- f'repaled by Clll: 14NIJOW PhOS OF FLORIDA, Relum lu: 252.9 SILVER STAdi ROAD PLANDO, PLOR:1uA 32804 407) 29.1-777B I0 T1(.;E- 10F C0M1AE110EME111, LMORSE, CLERK OF CIRCUIT COURT COI m 666 PS 0106 S # 24 031980134 11/04/2003 1zs1WI PH S FEES 6.00 BY S O'Kelley v.RtlgtU t;tirr MAIdYANNE -MORSk_ pt,.(RK-OF CIVUI7 COURT. SEPAL LE COU R{OA Sl'ite of FLORIDA hS f[NOI,G _ EPUfv .F C'ounly of _=--_-_ -- . r NOV The underslgiled hereby gives notice that inlprovenlerlt(s) will be trade to cerlain real property. and in nccorclarlce with Chapter 7 13,'Florida Sl.atules, tile_ followilIg infonllation is p1mided ill Illis Hutice of Commencement. 1. Uesc;,rlJt(lon of'pro )elty (legal description of [lie pitipeity, and street address if available) 27 Gonetal descill.t(lull of hnprovelnenl(s) la t rlunla Rr.r LAccrlrrrr 1. Uwnter infor nalion ' I Iain O t/!4s. Gy9. S i9,G` Telephone Number Ac.lclress pZ i}%C i C Far, IJumber 32 70 p 7-71 Irtlelest in Piupeity: i. Foo Sinlllle I ille I lolcler (if outer Ilian owner shown @hove) IJarfie Telephone flumber Address 14/A Fax f lumber c:ctnU lctol Ilame '1'IlR 141.11nOSJ PROS OI' r1,01,11DA Addl PFS 25J_9 S.LLVER STAR .ROAD ORLANDO, FL. 32804 Sruel'y (if an}) fl nre' 1cJdresS N/A L_,udr3r (if arty) Ilante Address N/A Telephone f.lumber 407-291-7778 Fax 11timber 407-291-11818 Felel. lilotle I Iutnl.ter Fax ( lumber Amount of bowl Telc 11hone I Iumher Fox Humber he, Isofis wilhirl the stale of Florida clesigllatecJ by Owner upoil whorl notices or other documents rrl N, i.1e served rls irc,vided by 713, 13(I)(a)7, f=lorida Statutes. flame . Telephone I lumber Ad( IIess Fox Homher In adclilioli to himself or herself, Owner designates the following to receive a copy of the Lienor's I lotice ns providediu713.13(I)(Ll) Florida statutes. Dante; Telephone Numhet Address Fax Flumber iU. ifff?' tal d elate of notice Uf -mil nenceillent (tile expiralion date is one year from the date of recording unless differentdateisecified): --_`_ i rle S gl eSignature of Owner iJoter per 71:3. 13 1 I111JSI sign... and no one else may be pennitled to sign in his or )let stead." S% YMI, herore rile this kilowru to me 0R _ — wr-u.h.wed is y daof,*/! a.L.- --- ----- 2 p 0 by E> gkes WarAw Banded mm (8001 414 who is __ lieisonaliv as identilicaliorr.