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Home My WebLink About801 E 2nd StECEIVEI I 6 2011 ' JAN CITY OF SANFORD BUILDING.& FIRE PREVENTION BY: PERMIT APPLICATION Application No: ''_ Documented Construction Value: Job Address: g(\ . Historic District: Yes No Parcel ID: —1 Q1 —?Jl " / (]Cm Zoning: Description of Work f-C Plan Review Contact Person: Title: Phone:Fax: E-mail: 1Property Owner Information pp ( f Name Phone: Street: (?D1 2""-eP Resident of property.' : CIS City, State Zip. an Contractor Information Name Phone:''->( S iC Street: ` ; l Y-n Fax: c City, State Zip:Lto L w rO State License No.: Archi ct/Engineer Information Name: Phone: Street: Fax: City, St, Zip: E-mail: 9 Bonding Company: Mortgage Lender: Address: Address: PERMIT INFORMATION Building Permit Square Footage: Construction Type: Ce-v No. of Stories: No. of Dwelling Units: Flood Zone: i Electrical Plumbing New Service - No. of AMPS: New Construction No. of Fixtures: Mechanical 11 (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads: 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 Ile secured for electrical wort:' plumbing, signs, wells, pools, furnaces, boilers, hcatcrs,. tanks, and air, conditioners, etc. 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 COMMENCEMENTMAY 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. . 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 A Lien Law, FS, 713. 6 The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in order to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the" plan review fee" based on :past: permit 'activity levels. Should calculated' charges exceed the documented construction value when the executed contract is submitted, credit will be applied to your permit fees when the. permit is released. 4c Signature of Owner/Agent Date < Signature of Contractor/Agent Date S as C Tint Owner/Agent's Name Print Contractor/Agent's WNe Z 40 Signature of Notary -State of Florida Date Signature of Notary -State of FlYrida CHELSEA, FLYNN MY COMMISSION # DD923803 EXPIRES: Soptanber 09, 2013 FI, Notary Discount Asw- Co. 14100-3•NOTARY. - - Owner/ Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced ID Type of ID Produced ID Type of ID APPROVALS: ZONING: UTILITIES: WASTE WATER: d ENGINEERING: FIRE: BUILDING: COMMENTS: Rev 11:08 IBM POWE R OF ATTORNI ICY Date, t - _[_0 thereby name and appoint ;_Y- of to be my lawfizl. attorney in fact to act for me and apply to the So n-KJ dI Division. of Duildtr ; $afety for a t" - rCx permit for work to be performed at a location described as: Section 'zbwy,',ship Range Lot dock Subdivision. - 9 31 - 1 O —don - L)o t O Address of Job) G S bD Owner of Property an&Address) and to sign my name and do all things necessary to this appointment. Type or :Print Natne of Certi,fxed Contractor and Corttractor's License Number Signature of Certifed. Conti -actor t The fore oing instrwm !nt was acknowledged before me this day of 20 f d by o is personallyknowzl to who produced as id.cnti.ficatYo.n any? who did not take oath. NEIDY S: ESPINOSA a"". public State of Florida I State of Florida ;,,YP a p,, Notary iresJun2,7012 z » • °: My Commission ExP 794084 Commission # DID Assn. E COunty. Of V ( ^-' s °' gondedThroughNationalNotaryFan„o Seal Notary ic, Or. n.go ri , Florida L. Seminole County Property Appraiser Get Information by Parcel Number mm Page 1 of 2 910 1 a.oJ ayka l ` CAVID JONNSDN, CrA, AS/ s„? A 7 $B""•y#'&, A"'^.«t,+: y PROPERTY T+ ; DAPPRMSER30 1----M 4.0 ..' A SLMIINOLE COUNTY FL, 2' L g 1107E FIRSTST SANFORD. , IRST 4S 7968 G 1: h .. l84. p,.• i { 407-669 ri546 IF VALUE SUMMARY 2011 2010 VALUES Working Certified Value Method Cost/Market Cost/Market GENERAL Number of Buildings 2 2 Parcel Id:. 30-19-31-510-0000-0010 Depreciated Bldg Value 68,588 72,243 Owner: HUNT PAULINE P Depreciated EXFT Value 480 480 Mailing' Address`. PO BOX 1914 Land Value (Market) 11,016 11,016 City, State,ZipCode:. SANFORD FL 32772 Land Value Ag 0 0 Property Address: 801 2ND ST E SANFORD 32771 Just/Market Value 80,084 83,739SubdivisionName: NORMANY SQUARE Portabjity Adj 0 0TaxDistrict: S1-SANFORD Save Our Homes Adj 13,039 18,457Exemptions: 00-HOMESTEAD (1995) Amendment 1 Adj 0 0Dor. 01-SINGLE FAMILY Assessed,Value (SOH) 67,045 65,282 Tax Estimator Portability Calculator 2011 TAXABLE VALUE WORKING ESTIMATE . Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund 67,045 42,545 24,500 Amendment 1 adjustment is not applicable to school assessment) Schools 67,045 25,500 41,545 City Sanford 67;045 42,545 24,500 SJWM(Saint Johns Water Management) 67,045 42,545 24,500 County. Bonds 67,045 42,545 24,500 Potential Portability Amount is $13,030 The taxable values and taxes are calculated using the current years working values and the prior years approved millage rates. SALES 2010 VALUE SUMMARY Deed Date Book Page Amount Vac/Imp Qualified Tax Amount (without SOH): $863 PROBATE RECORDS ,11/2008 07089 1790 $100 Improved No 2010 Tax Bill Amount: $611 WARRANTY DEED 06/1993 02593 1906 $100 Improved No - Save Our Homes (SOH) Savings: $252 PROBATE RECORDS 11/1992 02513 1299 $100 Improved No 2010 Certified Taxable Value and Taxes . DOES NOT INCLUDE NON -AD VALOREM ASSESSMENTSFindComparableSaleswithinthisSubdivision LEGAL DESCRIPTION LAND Land Assess Method Frontage Depth Land Units Unit Price: Land Value PLATS:i Pick FRONT FOOT& DEPTH 51 132 .000 225.00 $11,016 LEG LOT 1 NORMANY SQUARE PB 3 PG 11 8015 E . BUILDING INFORMATION Est. Cost Bid Num Bid Type Year Bit Fixtures Base SF Gross SF Living SF Ext Wall Bid Value New Building 11 SINGLE FAMILY 1918 8 1,747 1,999 1,747 SIDING AVG $41,428` $103,569 Sketch Appendage l Sgft : ENCLOSED PORCH UNFINISHED / 192 Appendage I Sgft OPEN PORCH FINISHED / 60 NOTE: Appendage Codes included in Living Area: Base, Upper Story Base, Upper Story Finished, Apartment, Enclosed Porch Finished,Base Semi Finshed Buildin 2 SINGLE FAMILY 1918 3 938 1,876 938 SIDING AVG $27,160 $67,899 Sketch Appendage / Sgft OPEN PORCH FINISHED / 126 Appendage/ Sgft GARAGE UNFINISHED 1812 NOTE: Appendage Codes included in Living Area: Base, Upper Story Base, Upper Story Finished, Apartment, Enclosed Porch Finished,Base Semi Finshed I http://www. scpafl.org/web/re_web, seminole_county_title?PARCEL=3019315100000001... 12/28/2010 PROPOSAL / INVOICE SUBMITTED TO; DATE: w NAME: " w?tea"` SENEZ ROOFING, LLC STREET: TRUST VALUE a INTEGRITY Toll Free: 1-866-350-4050 CITY: Office: (386) 7744950 • Fax: (386) 775-3338 PHONE' , x, s'z'r5 *tlt"'' y I e1060E. INDUSTRIAL: DR. SUITE K ORANGE CITY, FLORIDA 32763 FULLY LICENSED &.INSURED5. STATE CERTIFIED #CCC1327898 X COLORS: Shingles r Rubber www.senezroofing.com Drip Edge "'" Vents '' WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR: 1. Tear off existing roof and haul all debris off site. Clean job site thoroughly, and Magnet ground for nails. 2. Replaed all fully rotted wood decking. Major fascia wood work may be extra,,Aluminum work not.included. 3. xInstall new felt paper dry -in. xK--._-. Install secondary water barrier. x ' Re -fasten decking. 4.. Replace drip edge with all new painted drip edge. Cement: in all e'aves'and rakes with quality roof cement. i 5. Install valley lining in all valleys —Cement in shingles over metal/lining. —California Closed Cut Valley. 6. Replace lead boots and goose"necks on all existing vents and pipes. Paint to,rnatch venting or, drip; edge. 7. Replace,( . ).existing skylight(s) with"neww, skylights(s)..( d Flash Chimney. )Cricket Chimney. 8. , Install new asphalt Architect Shingles — AR (algae/fungi resistant) — 30 year manufactures warranty. 9. Nail all shingles with 11/4" roofing nails. 10. Replace (--)-lengths of ridge vent.Replace (...)-off-ridge vents. Install ( apt') new off -ridge vents. Install, 4,new solar powered attic fan Vents. k11. Low Pitch Roof: Install Peel-n-Stick dry -in, and Single -Ply Modified -Roll -Rubber -Membrane — 12 Year Manufacturer' s warranty. Replace drip edge with all. new painted galvanized drip edge. 12. AlCmaterials used and work installed is properly applied in accordance with current Manufactures, State, and County Codes and Specifications. Senez gets the roofing permit and schedules appropriate roof inspections. All specified work completed is fully guaranteed for five (5) years. Roof material carries standard manufacturer's warranty. ALL MONEY, IS DUE UPON COMPLETION OF WORK: d 4 A,__. vd Fey Please make check payable to: SENEZ ROOFING Total Cost of all Work: $ all taxes and fees are included) r ° ..eye J' p... WE HEREBY' PROPOSE TO FURNISH, LABOR AND MATERIALS -COMPLETE IN ACCORDANCE WITH THE ABOVE SPECIFICATIONS, FOR THE ; SUM OF $ ANY EXTRA WORK, MATERIALS; OR SPECIFICATIONS THAT ARE HAND WRITTEN ON THISCONTRACT ARE INVALID UNLESS INITIALED BY CUSTOMER AND BY THE OWNER/PRESIDENT OF SENEZ ROOFING, LLC. 1) Please remove vehicles from driveway and garage/carport by 12 noon the day before the job. Remove any items on walls and furniture and check that all fixtures in house or porches are secure that may fall or bounce off due to banging vibration.while roofing; we are not responsible. Please have yard mowed prior to job.start to help with magnet pickup of nails. 2) Customer is responsible for: removal of anything around the house that is breakable (i.e.: ornaments bird baths, hanging plants, etc.), removal of anything attached to the roof/decking inside the attic and outside prior to job start and reinstallation or adjustments after JJJA com I et% iq n 6.e.: solar, satellites, air conditioning components, alarms, pipes, etc.), covering furniture or flooring below skylight openings and re -ins allation f ar(ything thaf must be refioved to prosp erly repair any rotted wood areas (Le.: fascia, soffit, siding, gutters, etc.) R, , l r 'f ". wy/ l r/' r w % `` 1 AUTHORIZED AGENT ( PRINT .•,•' a° r",! - J ._•- v" ` DATE: I NOTE: THIS PROPOSAL MAY WITHDRAWN BY US IN T IIATY (30) DAYS. i ACCEPTANCE OF PROPOSAL: l THE ABOVE PRICES, SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED. I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS AND CONDITIONS SECTION: ON THE REVERSE SIDE OF THIS FORM COMPLETION OF FINAL INSPECTION BY THE MUNICIPALITY FROM WHERE THE PERMIT IS ISSUED IS NOT CAUSE TO DELAY PAYMENT TO',§ENEt ROOFING PAYMENT IN FULL IS DUE IMMEDIATELYUPONCOMPLETIONOFSPECIFIEDWORK. ACCEPTED: PRINT & SIGNATURE p`i ayr- ' ° I ! r' •, o ,.DATE: PRINT & SIGNATURE DATE: Rev. 12/09 FM 2 " 115i.® ® CERTIFICATE' OF LIABILITY INSURANCE. OP ID sx DATE (MM/DD/YYYY) 05 1o%io THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO`RIGHTS UPON THE CERTIFICATE HOLDER. THIS ., CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER; AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder, is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject tothetermsandconditionsofthe. policy, certain policies may require an endorsement. A statement on this certificate does not confer, rights to the certificate' holder in lieu Of such endorsement(s). PRODUCER. Ryan Insurance & Financial Svc 302 W New' York Avenue Deland ,FL 32720 Phone:386-738-2000 Fax:386-738-2053 NlAtoll NAME: PHONE. AIC, No): ac, No, E:t ADDRESS: PF CUSTOMERID#: SENEZ-1 INSURER(S)AFFORDING COVERAGE "` NAIC# INSURED S'eneZ Roofing -LLC 1060<E. Industrial-Drive;Ste K Orange, City FL' 32763 INSURER A: WesternHeritage` lns. Co. 37150 INSURER B: Nw Mutual Fire Insurance Co. 23779 INSURERC: INSURER D :. INSURER E :.- - INSURERF: COVERAGES CERTIFICATE NUMBER`. REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED..' NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS _ CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE. INSURANCE. AFFORDED BY THE POLICIES -DESCRIBED HEREIN IS. SUBJECT TO ALL: THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY) MMIDD/YYYY) LIMITS A GENERAL LIABILITY' X COMMERCIAL GENERAL LIABILITY CLAIMS - MADE LKOCCUR. X' SCP0798573 05/ 03/10 05/03/11 EACH OCCURRENCE 1000000 PREMISES (Ea occurrence) 50000 MED EXP ( Any one person) 1000 PERSONAL -&ADV INJURY 1000000 GENERAL AGGREGATE 1000000 GEN'L AGGREGATE L IMIT APPLIES PER: X JECT POLICY PRO- iOC., PRODUCTS - COMP/OPAGG 1000000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS - SCHEDULED AUTOS HIRED AUTOS NON - OWNED AUTOS 77BA8312783001' 04/19/ 10 04/19/11 COMBINED SINGLE LIMIT Ea accident) :. 300000. BODILY INJURY (Per person) BODILY INJURY (Per accident) X PROPERTY DAMAGE Per accident) X UMBRELLA LIABEXCESS LIAB OCCUR E EACH OCCURRENCE- HCLAIMS- MAD AGGREGATEDEDUCTIBLE' RETENTION $ LWORKERS COMPENSATION AND EMPLOYERS' LIABILITY-;-- Y /N ANYPROPRIETOR/PARTNER/EXECUTIV OFFICER/MEMBEREXCLUDED?EF] Mandatory In NH) _. If yes, describe under DESCRIPTION OF OPERATIONS below ' ` WC STATU- TH- TORY LIMITS ER_ E.L:EACH ACCIDENT . E.L. DISEASE - EA EMPLOYEE E.L. DISEASE. - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Attach ACORD 101,Additional Remarks Schedule, if more space Is required) :- City of Sanford is listed as additional insured in respects to the gener, al liability policy: iCERTIFICATEHOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CYSANFO THE EXPIRATION. DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE. WITH THE POLICY PROVISIONS City of Sanford AUTHORIZED REPRESENTATIVE PO' Box 1785 Sean D Ryan Sanford FL 327711988-2009 ACO D OkM hts reserved: ACORD 25 (2009/ 09)- The ACORD name and logo are registered marks of ACORD A I ---J I_- -._ _ __ I _ _ __ I I_ __. _... ___ I IL _. _ ._._. I__ _. I I...:.... I I_ _ :_ _ I I - _-.- 1 DATE (MMIDD/YYYY) ACORD,u CERTIFICATE OF LIABILITY (INSURANCE05i08i2007 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Affiliated Agency Ops ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 16 South River Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wilkes- Barre, PA 18702 Tel: ( 800) 673-2465 Fax: (570) 820-7968 INSURERS AFFORDING COVERAGE NAIC # INSURED Employee Leasing Solutions, Inc. I Phone: ( 941) 746-6567 INSURER B: INSURERC: - 1- 1401 Manatee Ave W. Suite 600 INSURER D: Bradenton, FL 34205 INSURER COVERAGES THEPOLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ---- ANY' REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR - MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - - INSR LTRADD'L INSRDTYPE OF INSURANCE POLICY. NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY - EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occ ran S CLAIMS MADE` D OCCUR MED EXPA PERSONAL& ADV INJURY:" GENERAL AGGREGATE GEN' L AGGREGATE LIMIT APPLIES PER: PRO- POLICY ' ECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT Ea accident) BODILY INJURY - Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY Per accident) HIREDAUTOS NON - OWNED AUTOS PROPERTY DAMAGE Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT OTHER THAN - EA ACC ANYAUTOAUTO ONLY: AG . EXCESS/ UMBRELLA LIABILITY EACH OCCURRENCE OCCUR. CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND - EMPLOYERS' LIABILITY WC STATU- OTH- X TORY LIMITS ER A i ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/ MEMBER EXCLUDED? EM W C1 09947 ` f OI /O 1 /20 1 O O 1 /O 1 /20 .I 1 E. L. EACH ACCIDENT. 1.000,000. E. L. DISEASE - EA EMPLOYEE 1.000,000 E. L. DISEASE - POLICY LIMIT. 1,000,000 -. 1IFes, describe under - SPECIAL PROVISIONS below OTHER Client ID: #5902007 I ' Valid in the State of Florida DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS EastGUARD Insurance Company COVERAGE APPLIES ONLY TO THOSE EMPLOYEES LEASED TO BUT NOT SUBCONTRACTORS OF: carries an A.M. Best Senez Roofing LLC. Qualifiers Name: Isaac Senez Rating of A- (Excellent) I ` Fih glOi i str,sgkh and a financial sib Aprox active employee count: 23 Category ofVlll CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Sanford - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Building Department IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P. O..BOX 1785 Sanford, FL 32771 REPRESENTATIVES. AUTHORIZED REPRESENTAT! ACORD CORPORATION 1988 4=11to°n11 ammno III nw"muw11A 11 NmnomIII M an|loin THIS INSTRUMENT MOMSE, CLERK OF CIRCUIT COURT NINDLE COUNTY _ 0750 Pu 1079; (1ug) S 20110()2215 State~~''~ > CORDED0l 06)1t 02:06:42 pN RECORDING FEES 10.00 RECORDED BY T Saith lFU COMMENCEMENT Permit Number ama||DNumber<p|O) " 7/- --yc — -- S / (J— The undersigned hereby gives notice that'knpmvomon(*1U be made to certain mo| pmpony, and in accordance with Chapter 713. Florida Statutes, the following Information Is prov.1ded In this Notice of Commencement. DESCRIPTION OEPROPERTY (Laga| description of thepm GENERAL DESCR|PT|ONOF|K0PROV`EK«ENT and street address ifavailable) OWNER INFORMATJON off Name and address: CONTRACTOR Name andoUg 7 Persons within the State ~.^ Florida Designated -' Owner__upon '_n'notice —or _—other _ _—'s—.' provided byOncdnn71113( 1)(h) Florida Statutes.Nat- no and address; f nadditionh,Nmuel[Owner Designates receive ~copy `. the -'~^-' - NO: lice -' Provided in uocpvn nx. mp/\o/,Florida Statutes. Expiration Date of Notice of Commencement: The expirationAate Is 'I year from date.0.111mopyding, unless a different date IsspocIfled WARNING -TO OWNER.-, ANY PAYMENTS; MAPE BY THE OWNER AFTER THE EXPIRATION THE NOTICE DF COMMENCEMENT FL' PRIDA STATUTES, AND CAN RESULT, IN. YOUR PAYING TWICE FOR IMPROVIMENTS TO YOUR PROPERTY. A NOTICE OFCOMMENCEMENTMUSTBERECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION, IF YOU INTEND TOOBTAIN I FINANCING) CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMME . NCING WORI< OR RECORDING YOUR NOTICE OF COMMEN . CEMENT. COUNTY OF3EM| NOLE STATE OFFLORIDAOWNERSSIGNATURE OWNERS PRINTED NAME NOTE: Per Florida Statute 113-130) (9), ownernlust sign ...... . d no one also, may be permitted to 81911 It, Ills or her stei The foregoing InstrUnient was acknowledged before me this C:_-Q day of 20 t by Name oT person maKing statenient L_p type of identificat I !oil producod OR who I'las produced identification* VRSU NTTO E TON83.5 S.FL00DA T TUTcu. VERIFICATION' ' \NGANDTHAT THE FACTS STATED |M[T ARE TRUE T- THE BEST OF MY KNb V EDGE REOFNATURAL PERSON S, on".., OMMISSION Notary S g" nmre d ThruNOWY Public Underwritersz/