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HomeMy WebLinkAbout2211 Trillium Park Lnj RECEIVED 2010 CITY OF SANFORDMAR31 BUILDING & FIRE PREVENTION PERMIT APPLICATION 20, Application No: Documented Construction Value: ALI laJobAddress: .2,411 klVtaw me, Historic District: Yes No Parcel lb 12-20-j0,-5*15,-0000-.1a_7_ 0 Zoning: Description of Work: AlIcAl Tak4hwit Unt Pla I n Review Contact Person: Title: Phone:( Fax E-mail:d -phneelarkMoc &WM07-9U-7040 — - (U7W0S'-573b _d 10 Property Owner Information 0, Name Phone: t"ho 71 - 301?(a S -77y &.4 t 1/11 1 treet: Resident of property? City, State Zip: Contractor Information Name Street: City"S. Phone: (40: -30606 Fax: State License No.: C&.e 04 Arch itect/E ng i neer Information Name-.;kd4"a a Blvlzon AL Phone: Street: Fax: C4Ity, St, Zip: E-mail: Bonding Company: Mortgage Lender: I.A ---------------- I Mdhoc "o/ Address, ddress: nq 13 7, f7-7f'2: PERM IT] N FORMATION Building Permit'*E l a Squar-65ifootage: Construction ' Type: No. of DwellingV/nits.;, Flood Zone: _K1 Electrical .0 New Service — No. of AMPS: Mechanical 0 (Duct layout required for new systems) Plumbing 0 IX 7 Ff- I 1Z.7 No. of Stories: z New Construction - No. of Fixtures- Fire Sprinkler/Alarm 0 No. of heads: Ft I()- it as COUNTY OF SEMINOLE IMPACT FEE STATEMENT STATEMENT NUMBER: 10100001 DATE: April 08, 2010 BUILDING APPLICATION #: 10-10000172 BUILDING PERMIT NUMBER: 10-10000172 UNIT ADDRESS: TRILLIUM PARK LANE 2211 12-20-30-515-0000-1070 TRAFFIC ZONE:022 JURISDICTION: SEC: TWP: RNG: SUF: PARCEL: SUBDIVISION: TRACT - PLAT BOOK: PLAT BOOK PAGE: BLOCK: LOT: OWNER NAME: ADDRESS: APPLICANT NAME: MERCEDES HOMES ADDRESS: 775 HARLEY STRICKLAND BLVD ORANGE CITY FL 32763 LAND USE: TOWN HOME UNIT TYPE USE: WORK DESCRIPTION: CITY-SANFORD SPECIAL NOTES: 2211 TRILLIUM PARK LANE / TOWNHOME UNITI WINDSOR LAKE TOWNHOMES FEE BENEFIT RATE UNIT CALC UNIT TOTAL DUE TYPE DIST SCHED RATE UNITS TYPE ROADS-ARTERTALS CO -WIDE ORD Condominium* 379.00 1.000 dwl unit 379.00 ROADS -COLLECTORS N/A Condominium* 00 1.000 dwl unit 00 FIRE RESCUE N/A 00 LIBRARY CO -WIDE ORD Condominium* 54.00 1.000 dwl unit 54.00 SCHOOLS CO -WIDE ORD Multifamily 2,450.00 1.000 dwl unit 2,450.00 PARKS N/A 00 LAW ENFORCE N/A DRAINAGE N/A 00 AMOUNT DUE 2,883.00 STATEMENT RECEIVED BY: %-Vol w i a.044--SIGNATURE: P&ASE PRINT NAME) DATE: NOTE TO RECEIVING SIGNATORY/APPLICANT: FAILURE TO NOTIF;( OAER AND ENSURE TIMELY PAYMENT MAY RESULT IN YOUR LIABILITY FOR THE FEE. DIS RIBUTION: 1-BLDG DEPT 3-APPLICANT 2-FINANCE 4-LAND MANAGEMENT NOTE** PERSONS ARE ADVISED THAT THIS IS A STATEMENT OF FEES DUE UNDER THE SEMINOLE COUNTY ROAD, FIRE/RESCUR, LIBRARY AND/OR EDUCATIONAL ISSUANCE OF A BUILDING PERMIT. PERSONS ARE ALSO ADVISED THAT ANY RIGHTS OF THE APPLICANT, OR OWNER, TO APPEAL THE CALCULATION OF ANY OF THE ABOVE MENTIONED IMPACT FEES MUST BE EXERCISED BY FILING A WRITTEN REQUEST WITHIN 45 CALENDAR DAYS OF THE RECEIVING SIGNATURE DATE ABOVE, BUT NOT LATER THAN CERTIFICATE OF OCCUPANCY OR OCCUPANCY. THE REQUEST FOR REVIEW MUST MEET THE REQUIREMENTS OF THE COUNTY LAND DEVELOPMENT CODE. COPIES OF RULES GOVERNING APPEALS MAY BE PICKED UP, OR REQUESTED, FROM THE PLAN IMPLEMENTATION OFFICE: 1101 EAST FIRST STREET, SANFORD FL, 32771; 407-665-7356. PAYMENT SHOULD BE MADE TO: SEMINOLE COUNTY OR CITY OF SANFORD BUILDING DEPARTMENT 1101 EAST FIRST STREET SANFORD, FL 32771 PAYMENT SHOULD BE BY CHECK OR MONEY ORDER, AND SHOULD REFERENCE THE COUNTY BUILDING PERMIT NUMBER AT THE TOP LEFT OF THIS STATEMENT. THIS STATEMENT IS NO LONGER VALID IF A BUILDING PERMIT IS NOT*** ISSVED WITHIN 60 CALENDAR DAYS OF THE RECEIVING SIGNATURE DATE ABOVE DETAIL OF CALCULATION AVAILABLE UPON REQUEST. CALL 407-665-7356. 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. 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. 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 1. 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. 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 exce ed the documented construction value when the executed contract is submitted, credit will be applied to your permit fees when the permit is released. Wo S ign a& of Owner/Agent V Date My CommissioN # DD 667814 EXPIRES: June 27,2011 Bonded Thru Budget Waty 86*8 Owner/Agent is Personally Known to Me or Produced I D Typeof1l) APPROVALS: ZONING: UTILITIES: ENGINEERING: COMMENTS: 44i4l dAll 4 Sign"c of Contractor/Agent U Date IXWAA-h w VTOWIX. L&& Print Contractor/Age SignatUre ofNotary-Ktate of Florida Date FIRE: D. A. CLARK COMMMION # DD 667814 XPIRES: June 27,2011 4 41 Bonded Thru Budget NoMry Spfte Contractor/Agent is 176'r'sonally Known to me or Produced I D _ Type of ID WASTE WATER: BUILDING:%VLdr c:;;%, 9--- Rev 11.08 RECEIVED 07 MAR I Z010 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: Documented Construction Value: Ai lage, Historic District: Yes D NoJobAddress: :2,?V1 09 PareelID: 12-20-30-57S%0000-11al 0 Zoning: Description of Work: A ial T"hime, Plan Review Contact Person: Dv&e, Title: Phone: &NIZ7-04c) Fax, -573 E-mail:47)qof b _dphu Property Owner Information Name Me a C' j4-yl, 3off( i(eldej Phone: t1h0-71 Street: '77Y Resident of property? City, State Zip: cwx F6 13z;6 3 — Contractor Information Name Street: City, S1 Phone: (48 5T-3LOF6 Fax: 1 07) 96- S 73(o State License No.:C,,8L Arch itect/E ng i neer Information Name: Bwbofi AWL Phone: W Street: City, St, Zip: Bonding Company: Address Building Permit a Square-Footage----'/Z//r No. of D*elling'V nits: Electrical 0 Fax: E-mail: 9,91- Zl- 0 7 2, Mortgage Lender: 941,71 1W tlawrl? Address:14/0 AJ Taft9=AZ 33,46-7 PERMIT INFORMATION Construction Type: Flood Zone: X_ New Service — No. of AMPS: Mechanical 0 (Duct layout reqqir,ed, Tpr new systems) Plumbina R in No.ofStories: ' 21 New Construction - No. of Fixtures - Fire Sprinkler/Alarm 0 No of'heads: Application is hereby rnade 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. 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 OM NER: 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. 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 71 3 ). 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 docurnented construction value when the executed contract is submitted, credit will be applied to your permit fees when the permit is released. Sign— of Owner/Agent V Ado Date SiMa6dre of Contractor/Agent Date Print Owner/Agent's Name Print Contractor/A.-enCs Name 0 /,#/ Signature of Notary -State of Korida D&A. CLARK Signature of Notary -Kate of Floridl Date My COMMISSION # DD 667814 EXPIRES: June 27,2011 C, D. A. CLARKBondedThruBudgetNOWY $OrACO MY COMMISSION # DD 667814 EXPIRES: June 27,2011 k FL;?-' Bonded Thru BUdgel Nota 1w Owner/Agent is Personally Known to Me or Contractor/Agent is _-Aersonally Known toVre or Produced ID Type of ID Produced ID _ Type of ID APPROVALS: ZONING: UTILITIES: W TE IWIATER: ENGINEERING: FIRE: ILDING: COMMENTS: Rev 11.08 J Address: gz- Contact NarneM.-4 -7 7VL -5- Contact Ph Plan Review Information onstru6tion 0 C/O 0 Fire Alarm 0 Fire Sprinkler 0 Hood 0 Tank 0 Paint Booth Total Fees: E -7n- -/,S- CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: 10 — kk2-9 Documented Construction Value: $ 4 20c) 00 JobAddress: 24\k pary, Historic District: Yes 11 N4 Parcel ID: k 1 —:20 — 2 0 —.514-0 000 — 107 0 Zoning: Description of Work: Plan Review Contact Person: Title: Phone: Fax: E-mail: Property Owner Information Name Wayots, Phone: 759(1 - 95 t - 7140 5 4*AO,t Resident of property? WOStreet: -1 -7 City, State Zip: L 32-7163 Contractor Information L'tv..&AName Pho_: 1-160 Street: 9%:)-\ Tv\mv 4ANA0.^ r. Fax: 44-0-1- 911— 32.5(a City, State Zip: <A. ab\,'a, '-L 3 4-7 fnct State License No.: CF-C 142 (44(o Arch itectlEngineer Information Name: Phone: Street, City, St, Zip: Bonding Company: H k Address: Fax: E-mail: Mortgage Lender: Address: PERMIT INFORMATION Ie- Building Permit 13 III's Square Footage: _V5V Construction Type: No. of Stories: No. of Dwelling Units: Flood Zone: Electrical E3 New Service — No. of AMPS: Mechanical 0 (Duct layout required for new systems) 93 D Y, 4 -% z Plumbing 1 New Construction - No. of Fixtures: 10 Fire Sprinkler/Alarm E3 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 be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, 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 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. 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. 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. Signature of Owner/Agent Print Owner/Agent's Name Date Signature of Notary -State ofFlorida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: to ig.ature fC.nttrct.,1Agent Date 1: C-44 Print Contractor/Agent's Name,. ate of Florida 15aYeI6110 q I" ... NICHOLAS LINSCOTT Y Comm# DD0681106 4- Expires 6/3/2011 Florida Notary Assn., Inc Contractor/Agent is )C Personally Known to Me or Produced ID !_____TType of ID WASTE WATER: BUILDING: Rev 11.08 o, Model Pricing- Linscott Pluming hic. Windsor Lake Estates: Ameila Plan $4900.00 Bonita Plan $4900.00 Diego Plan $4900.00 qJ '[S) I C) M#redes Homes Rlapfesentative Date Date4resentative 775 Hadey Striddand Blvd. * SULIte 110 * O=W City, FL 32763 - Tch (386) 851-7940 * F=- (386) 851-7941 http://www.mercedeshomes.com WC1510145 PLP if RECEIVED MAR 3 1 2010 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: Documented Construction Value: $ 614 660 i a Job Address: 2w laide Historic District: Yes [I No Parcel ID: 12- 2 0 - 30 0000 1 U_ 0 Zoning: Description of Work: Algal T"hme' Mni& Plan Review Contact Person: Title: Phone: &071,Z7-040 Fax MOF-573k E-mail:4d '742 lark A) C Property Owner Information Name Ale, W dt, r a C. Phone: 1140-715271— 30& Street: 141 "d,41,1111k1l, Resident of property? City, State Zip: aAu 6/y, F6 30;z 3 1 Contractor Information Name AllagAillohn, ao llmauj Phone: 44 0 7j 5 T — 3 6 S'6 Street: 73 1hadecl Atn 1k07)9bf_S)3(10 - U W 5141d, Fax: City, State Zip: kp'lae OtU & 3 2 76 3 State Lic'ense N"o.:C&,-, 2&3 Street: City, St, Zip: 1-1 Architect/Engineer Information 124d I.J La4L Phone: Fax: E-mail: Bonding Company: A) 04 Mortgage Lender: .84,111 1W Anwrl Address- Address: /q/_6 )U Awft&M "A Taftg. - - t A6 33,40 -7 Building Permit PERMIT INFORMATION Square Footage: Construction Type: No. of Stories: No. of Dwelling Units: Flood Zone: _K Electrical n Plumbing 0 New Service — No. of AMPS: New Construction - No. of Fixtures . Mechanical 0 (Duct layout required for new systems) Fire Sprinkler/Alarm 13 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 be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, 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 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. 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 7 1 3 ). 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 documented0 construction value when the executed contract is submitted, credit will be applied to your permit fees when the permit is released. Signa& of Owner/Agent U Date Print Owner/Agent 1141eV C31311" C) - Signature of Notary -State of Korida '04 D&A. CLARK Cl MY COMMISSION 4 01) 667814 d EXPIRES: June 27,2011 Bonded Thru Budget NQt8rY $8r*e' Owner/Agent is Produced I D APPROVALS COMMENTS: Personally Known to Me or Type of ID, ZONING)4' UTILITIES: I k ' VoENGINEERING: FIRE: L41i4 1-30flll) SigndK/re ofContractor/Agent Date AVWA Aw uTadIx 44& Print Contractor/Agent's Name Signature ofNoLary a -tee of Florida Date PU D. A. CLARK MY COMMISSION # DD 667814 EXPIRES; June 27,2011 4" Bonded Thru Budget Nola S w Contractor/Agent is Ae'rsonally Known towe or Produced ID Type of ID WASTE WATER: BUILDING: Rev 11.08 City of Sanford Planning and Development Services 877— Engineering — Floodplain Management Flood Zone Determination Request Form Name: Daphne Clark Firm: Mercedes Homes Address: 775 Harley Strickland Blvd City: Orange City State: FIL Zip Code: 32763 Phone: 407-591-3086 Fax: 407-905-5736 Email: daphneclarkinc(@-cfl.rr.com Property Address: 2211 Trillium Park Lane Property Owner: Mercedes Homes LLC Parcel identification Number: 12-20-30-515-0000-1070 Phone Number: 407-591-3086 Email: daphneclarkinc@cfl.rr.com The ason for the flood plain determination is: New structure Existing Structure (pre-2007 FIRM adoption) F-1 Expansion/Addition Existing Structure (post 2007 FIRM adoption) Pre 2007 FIRM adoption = finished floor elevation 12" above BFE Post 2007 FIRM adoption finished floor elevation 24" above BFE (Ordinance 4076) T, A— R- 7-, a&,, "VIL,"'FAMS"" ""4"m 0 F F 1,C_(,, NLY' Flood Zone: X Base Flood Elevation: Datum: FIRM Panel Number: 121 U 010 F Map Date: The rpferenced Flood Insurance Rate Map indicates the following: E I i ne parcel is in the: 0 floodplain Fj floodway F-1 A portion of the parcel is in the: 0 floodplain El floodway The parcel is not in the: gfloodplain 7 floodway The structure is in the: Ej floodplain F-1 floodway The structure is not in the: Xfloodplain 7 floodway If the subject property is determined to be flood zone 'A', the best available information Used to determine the base flood elevation is: 4( Reviewed by: Date: r3clA,'O TAEngr-FilesElevation CerthicateTlood Zone Determination Request Form.doc 7 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION, - Application No: 1. . I Documented Construction Value: $ 614 Job Address: kilX" Aoi la a 6 Historic District: Yes 11 No Parcel ID: 12- 2 0 -30 woo - 1_7_ o Zoning: Description of Work: A1101 el Plan Review Contact Person: hoe Title: Phone:( V Fax 7)q6T-5'73b E-mail:4a Property Owner Information Name I'lle'vda &nj ac, Phone: 60-71 Street In el 16111d y? 67 1-F-14 VA, ff n Resident of propert City, State Zip: 11' 6/y, F6 azz 3 Contractor Information Name #&&kj Aom Phone: 1"'140?1f &116A - Street: -77 A4111a Sft Fax: I - i W Alud 1/4071 City, State Zip:6000V JhJ it .32-763 State Lic'ense 'N'o.:C& 288 11 r-hitect/Engineer Information Name: kW494 Phone: Street: Fax: City, St, Zip: Bonding Company: kI'A Ir Address- Buildin g Permit a Square Footage: Mr No. of Dwelling Units: Electrical 0 New Service — No. of AMPS: E-mail: Mortgage Lender: 460,11 9 I Addressl4go Aj muftho& Taft K: tt 33% 0 -7 PERMIT INFORMATION Construction Type: No. of Stories: 21 Flood.Zone: K Mechanical 0 (Duct layout required for new systems) Plumbing 11 New Construction - No. of Fixtures: 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 be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers., heaters, 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 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,: OU 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 entitie's 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 7 1 3 ). 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. 1,/,, "k, - 4 0SigriE—& or owner/Agent V Date 0010 Print Owner/Agent's Name 311f . signature ofNotary-State of orida '49e' DWA. CLARK o MY COMMISSION # DO 667814 EXPIRES: June 27,2011 Bonded Thru Budget NotarY Ser*e' Owner/Agent is Personally Known to Me or Produced I D Type of I D APPROVALS: ZONING: ENGINEERING: COMMENTS: Signdk,(re of Contractor/Agent Date 0 Print Contractor/Age signature of Notary-Ktate of Florida Date U. A. CLARK MYCOMMISSIOWD667814 EXPIRES; June 27,2011 s' Bonded Thru Budget Notary rvIcv Contractor/Agent is AcIrsonal ly Known to YM or Produced ID _ Type of ID UTILITIES: WASTEWATER: FIRE: BUILDING: Rev 11.08 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: Documented Construction Value: $ JobAddress:_2 Zil 7_AjC_1-1C)/K P/9-AzK 1,A-) — Historic District. -Yes[] Nol] Parcel ID: Zoning: Description of Work: /,570 ,q,1111P -00-w 5 Plan Review Contact Person: Phone: Fax: E-mail: Property Owner Information Title: Name Phone: -10-2 2-2,:F- 5_5_jrj Street: 1 -2 0C 1. 5j—z-o Resident of property? 116) 0 City, State Zip: 3 2- 2z 6' Contractor Information Name 121-' <_ 6-0 Phone.- '10-2 dP6 ?-206 or -2 2,3 Street-. J?2,f (rA 64',_5 04-2 o9 — Fax: City,StateZip: Zy.,W7-XA 7,4Aor 02,1,F? State License No.: 1:-FC 13 0'/ / -2 Arch ltect/E ngineer Information Name: Phone: Street: City, St, Zip: Bonding Company: Address: Fax: E-mail: Mortgage Lender: Address. - PERMIT INFORMATION Building Permit 13 Square Footage: Construction Type: No. of Stories: In No. of Dwelling Units: Flood Zone: Electrical A New Service - No. of AMPS: 15-0 Mechanical 13 (Duct layout required for new -s.-,;stems) Plumbing 0 New Construction - No. of Fixtures: Fire Sprinkler/Alarin 13 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 per-forined 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, tanlL--, 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. XI"ARINING TO OWNER: YOL-R FAILURE TO RECORD A NOTICE OF CONINIENCENIENT 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 Y01LIR NOTICE OF COMMENCEMENT. NOTICE: In addition to the requirements ofthis permit, there may De 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. A copy of the executed contract is required in order to calcul ate a. plan review charge. If the executed contract is not submitted, we reserve the riaht 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 en the permit is released. Signaturc of &w cr—/Ag..t Datc S ignaturc of Contractor/Agcnt Datc nald C-, Print Owner/Agent's Name Print Contractor/Agent's Name SiFnatureof'.4A;jry-Slatt: off4wida Date a V T* Owner/Agcnt is Personally Known to Me or Contractor/Agcnt is X Personally Known to Me or Produced ID T,W of ID Produced ID Ty peofID APPROVALS: ZO--,N-IN(j-, COMMENTS: U)`TILITIE S WAS 1E WATER: ENGINEERING: FIRE: BUILDING: pc,,. Notary Public State of F71-0riffa— Margaret A Rzeszut My Commission DD613510Rev11.08 Expires 0 1 /26/2011 CERTIFICATE OF ELEVATION Acldress Z,2 (f TXIL-LIUM P,494 LA -vie Legal Description- Lot 10-7 WINDSOR LAKE TOWNHOMES Plat Book 7Q Pages 44 Seminoie County, Plon"da The Finished Floor Elevabon of the structure on t-ot WINDSOR LAKE TOWNHOMESS meets or eXceeds the requirements set forth in the ""'4 of Sanford. Building rode Chapter 18 ev H, A Date Fieldwwork Complbted: 21 'ZOIDorhinick, Fl,',, 9,iidne F" tida'tuveyor,,.ancl M pper Reg. No. 2005 Work Order No. 55 1e) IMPORTANT.* In these,spaces, copy the corresponding InfbirmatIon from Section A. Building Street Address (Includl Apt. it Sulte, nd/orBidg. No.) or P.O.' Route and Box No. In ZZ X I L city _state ZIP Code32773imm SECTION D -SURVEYOR, ENGINEEP,.ORARCHITr:CT-,,CERTIFICATION (CONTIRUtD) Copy.,both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments T- Check here if attachments SECTIO,l E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE A 1 0 AND ZONE A'(WITIjQ.UT BFE) For Zones AO and -A (Without BFE), complete Items EI-E5. If the Certificate is intended to support a LOMA or LOMR'-F request, complete Sections A, B, andC. For Items El'E4, use natural.gi-acle, if available. Check the measuremenLused. In Puerto Rico only, -enter m6ters. El. Provide elevation infon"nation f8r the followind and check the appropriate boxes to show whether the elevation is above.or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (includin I g basement, crdwispace, or enclosure) is []feet Dmeters Dabove or , Qbelo,w the HAG., b) Top of bottom floor (including basement, crawl pace,,or enclosure 1a Deet Ometers E:Iabove or []below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Sectiqj A items 8 and/or"9,,isee',paaes'8-9 of Instructions)-, Me ne)d higherfloor elevation C2.b in the diagrams) of the building is feet " meters [I above or U below the HAG. E3. Attached garage (top of slab) is feetF-Imeters Flaboveor F belowthel-IAG. E4* Top. of platform of machinery and/or equipment servicing the buildingis feet n7meters nabove,or. F] belo W- the HAG.-,,. E5. Zone'AO, only: ,If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordlm6ce?MYes []No F] Unknown. The local official must certify this intbrmation in,Sectlon G. SECTION F - PROPERTY OWNER (OR OW I NEI'MIREPRESENTAME) CERTIFICATION The property owner or owner's authorized representative who complates Sections A, B, and E for Zone A (without a FEMA-issued or Gomm F) unity -issued B or Zone AO must sign here. The statements in SeGffansA, B, and E are correct to the best of My knowledge. Property,Owner's or Owner's Authorized Representative's Name Address city State ZIP Code Signature Date Telephone Comments StUTION 6 - COMMUNITY111W. ORMATION (OPTIONAL) The local official who is authorized by law or ordinance4o administer the communitSes flo6dplaln management ordinance can -complete Sections A, B, C (or E), and G of this Elevation Certificate.' Complete the applicable itern(s) and sign below. Check the measurement used in Items G8 and G9. G1. El The information In 'Saction C was. taken from other documentation that has been signed and sealed by a licensed'surveyor, engineer, or architedt Who is authorize I d bylaw io'ce'rtify elevation information. (Indicate the source and date of the elevation, data in the Comments area -below.). G2. A community official completed.Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE or Zone AO. G3. The following information (Items G4-G9) is provided for community floodplain management purposes. G4. Permif.Number Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for F-,New Construction 17 Substantial Improvement G8. Elev@tion of as -built lowest floor (including basement) of the building_- F] feet L1 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site El feet meters (PR) Datum, GI 0. Communitys design flood elevation feet meters (PR) Datum Local Oftial', Title Community kan'-,e Telephone Signature Date El Check here ifattachmen, FEMA Form 81-31, Mar 09 Replaces all previous editior U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE Federal Emergency Management Agency National Flood Insunanear Program importaft Read the instrucbons on pages 1 -9. OMB No. 1660-0008, Expires March 31, 2012 SECTION A - Al A2. B *1 1 at Address (Including Apt nit; . Su to d1or Bid No.) or P.O. Route and Sox No. TV`17 7X I L L I L1A, ul city , - State TION MO. UJULUUt;1L-U11y1LUUe-.L-a1. A1091 14 Long. , 1!DI VV elzrf Horizontal Datum: LJ NAD 1927 W NAD 1983 A6. Attach at least 2 photograph$ . of the building, If the Certificate Is being used to obtain flood insurance. A7. Building, Diagram Number A8, For a building with a crawispace or enclosur'e(s): A9. For a building with an attached garage: a) Square footage of crawlspace orenclos!'re(s) sq ft a) Square footage of attached garage sq ftV b) No. of permanent flood openings in the dmwispam or b) No. of pennanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade -&ZA.. within 1.0 fbot above adjacent grade -Iiza. 7—A sq in - irc) Total net area of flood openings, In A8.b c) Total net area of flood openings n A9.b sq incl) Engineered flood openings? 1:1 Yes 0 7— d) Engineered flood openings? F1 Yes 0 N6 SECTION S - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP CommNnfty Name & Community Number ia ne te B3. State B4. Map/Panel Number t7o, A.- B5. SuiTL,( r— 86. FIRM Index D . ate B7. FIRM Panel EffectivelRevised Date B8. Flood Zone($ 9. Base Flood Elevation(s) n AO, use base flpod dep ggd, -7,g. Z007G-0-1 - 10- nuicat" , uje source uI trie Dase -Iooa Elevation (ut-t) ciata or base flood depth entered in Item 89. FIS Profile L [119IRM Comi nunity Determined Other (Describe) B1 1. Indicate elevation datum used for BFE in Item 139: [1 NGVD 1929 nWVD 1988 El Other (Describe) B12. Is the building located in a Coastaj-Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes XNODesignationDateAIZACBRS [] OPA SECTION C'., BUILDING ELEVATION INPoRmATiON (SURVEY REQUIRED) C1. Building elevations are based on: Construction Drawings* F-l'Building Under Construction* Finished ConstructionAnewElevationCertificatewillberequiredwhenconstructionofthebuildingiscomplete. C2. Elevations - Zones Al-A30, AE, AH, A (with 6FE), VE, VI-V30, IV (with I BFE), AR, AR/A, AR/AE, AR/Al-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building qiagl m I specified in Item A7. Use" the same datum as the BFE- Benchmark Utilized -Eftollte- C-0 tpu, &ICA(44144 k0- 171U!L_Verdcal Datum AM VIC) Jq2 Conversion/Comments Check the measurement used. a) Top of bottom floor (including basement, crawlspam or enclosure floor) feet meters (Puerto Rico only) b) " Top of the next higher floor -Feff WN feet Hmeters (Puerto Rico only) c) Bottom cif the lowest horizontal structural member (V Zones only) feet Elmeters (Puerto Rico only) c!) Attached garage (top of slab) Deet 11 meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building feet, F meters (Puerto Rico only) Describe type of equipment and locabon,in Comments) f) Lowest adjacent (finished) grade next to building (LAG) feet 0 meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) feet n meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including feet E] meters (Puerto Rico only) structural support SECTION D!,'- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, br architect authorized by law to certify elevation information. I certify that the information on this d4r0cate represents my best eflbrts to interpret the data available. ot I understand that any false statement may be punishable by flne or imprisonment under 18 U.S, Code, Section 1001. Check here if comments are provided on back,of form. Were latitude and longitude in Section A provided by a- 41licensedlandsurveyor? Xlyes E] No e,s NameCertifie License Number Title Co eP,1?- es 1. 1) exi-r Vany Nap stat Lva om ZIP Code SCUD tu - - - / - --- - V : 2-', Signs 967 1, W Date TeephoneA &7 - EMOK &m 81-3 1, Mar 09 see'reverse 'Side for continuation. q 4', s all previb'iu editions FLOOD CERnnCAnON PLAT OF BOUNDARY for. MERCEDE5 HOME5, INC. BASED ON THE FEDERAL EMERGENCY MANAGEMENT AGENCY FLOW INSURANCE RATE MAP. THE STRUCTURE SHOWN HEREONDESCRIP77ON: LOT 107, WIN050P\ LAr\E TOWNI-fOME5 DOES NOT LIE WITHIN THE 100 YEAR FLOOD HAZARD AREA. THIS STRUCTURE LIES IN ZONE ' X '. RECORDED IN PLAT BOOK 70 PAGE(s) 44 7HRu 51 PUBLIC RECORDS OF 5EMINOLE COUNTY; FLORIDA COMMUNITY PANEL NO. 120294 0070 F CTIVE DATE - TRACT "A" MAP REVISION DATE:\SEPTEMBER 28, 2OD7. COMMON AREA 93 - G7 - (OV LQ c;- 989'22'4i,,w 589'22'41"W5,59*22'41"W559'22'41"W 389-22-41"W 58S)22'4 W I G. 17' -1 5.33__. r I G. 17 7On 2 24 "W 7 TRACT "A" .TRACT "A" COMMON AREA MMON AREA 00 oC) Ln 0 z C) 0 0 Ol 5' 10' 20' 1 1 F ir _i 5CALE: ]"=20' ABBREVIAVONS/L L.B.-LICENSED BUSINESS ARC -ARC LENGTH CH. -CHORD R -RADILIS A DUTA (CE]NTRAL ANGLE) P.C.-POINT OF CURVATURE tP. T.-POINT OF TANGENC ' Y P.I.- POINT OF INTERSECTION i - CENTERUNE by LOT 107 LOT 105 LLJ 07D 0 o Ln0 0 cni n LOT 109 1 LOT I 10 1 LOT I I I 0 0 Ln c) Ln tu n - 0 LOT 1 12 0 0 Ln 01n 589'2 2'41 W 589'2 2'4 1 W 589'2 2'4 J W 589'2 2'4 1 "W 112 2'4 1 "W 58)-22'41 1 G. 17' 15.33' 15.33' 15.33' 15 33' 1 G. 17' 93.G7 - (OVERALL) 0 q 0r SOUTH LINE OF ZV INGRESS/EGRESS EASEMENT TRILLIUM PARr\ LANE 13A5ELINE Of GEOMETRY' q OF, 24' INGRESS/ TPACT "A" COMMON APTA EGRESS EASEMENT' W3'2E'Zl'lV THE UNDERSIGVED AND CAVON& INC. LAND SURVEYORS and MAPPERS MAKE NO RESERVATIONS OR GUARANTEES AS TO, THE PERTAINING TO EASEMENTS RiGHTS OF WAY, SETBACK UNES, AGREEMENTS AND 07HER MATTERS, AND FURTHER THIS INSTRUMENT IS NOT INTENDED TO REFLECT,OR SET FORTH ALL SUCH MATTERS SUCH INFORMAT70N SHOULD'BE OBTAINED AND CONFIRMED BY OTHERS THROUGH APPROPRIATE TITLE VERIFICATION. N07ES: 01 1. BEARINGS ARE BASED ON THE 0 `BASELINE OF GEOMETRY' BEING S897241-W. z 2. UNDERGROUND IMPROVEMENM ROOF OVERHANG! AND FOOTERS HAW NOT BEEN LOCATED. 1'ELEVATIONS ARE BASED ON NGVD OF ' 1929.' 4. BUILDING 71ES ARE TO FOUNDATION,- - 5. BUILDING 77ES ARE NOT TO BE ' USED TO,' CONSTRUCT DEED OR PLA TIED LINE BEARINGS AND DISTANCES SHOWN,Weh_56W-Aht, MEASURED AND PEI? RECORDED'PLA r- OTHERMSE NOTED. r.m.._rv[N I MLV QL CURVATURE @ FOUND 112- IRON PIPE (LS 2005) 1, I . - I A D.&U.E. - DRAINAGE & UTILITY FOUND IRON ROD VONF p INC EASEMENT U.&S.E.- UTILITY & SIDEWALK 0 FOUND IRON PIPE LAND SURVEYORS AND MAPPERS EASEMENT 300 SOUTH RONALD REAGAN BOULEVAR30sc U.Ew- UTIUTY EASEMENT FOUND CONCRETE MONUMENT LONGWOOD, FLORIDA 32750-5499m D.E.- DRAINAGE EASEMENT TELEPHONE (407) 830-9080 - CONC.-CONCRETE FAX No. (407) 339-3636, A/C -AIR CONDITIONER PAD E-MAIL: CAVONE 0 CFLRR.COM W.O. STAKE LOT 2008-1781 W.0. STAKE HOUSE 2008-1781 W.O. FORM CHECK 2010-396 W. 0. FOUNDA DETAIL OF LOT 107 WIN05OR LAKE TOWNNOME51H Ol 5' 10' 20' TRACT "A" 6,,,,,,4 COMMON AREA 5CALE: 1"=20' 589o22'4 1 W 3' x 3- CONC G. 17' A/C PAD COVERED 52!- STORAGE AREA TRACT "A" COMMON AREA b uj0L) LOT 106 0 c' 0I_jz _0 C', v)mwa Uj Ln 0 Lz) V5 owulx a) 0 z 0 P6 . o Ln 0 CONC PAD W/ TRANSFORMER 15.63' CONC CABLE BOX 0.51' CO WALK C4 0 to C14 CABLE LIGHT lf:' 569-2 2'4 1 VvPOLE A, RISER 5' CONC WALK AD[)KF-55: 221 1 SOUTH LINE OF 24 INGRESSAGRESS EASEMENT TRILLIUM PARK LAN - OF 24' INGRESS BA5EUNE Of GEOMETRY' EGRESS E TPACT "A COMMON AREA_ 55T22'4 11 w URWY Nci-r,VALID UNLESS EWBOSSED REMSION HE SlGNATUPk AND RAISED SEAL OF — PA UCEENSED.ISURWYOR AND MAPPER — - RECERTIFIED', DATE ic D 0 Loz c i uiw FINAL LOCA 770N B-2-2010 FOUNDATION LOCATION B-2-2010 FORMBOARD LOCA 71ON 4-29-2010 8__,:l_k2008r-G wam, C'ER NUMBER 2005 STAKE HOUS UMBER 5073 STAKE LOT WO. nNAL__20Q_-filfi_ W.O. RECERT UAVU tILt:VWNUZiUK LAKk-lH-LlU1-17Z.UWU CITY OF SANFORD BUILDING,& FIRE PREVENTION PERMIT APPLICATION Application No:. Documented Construction Value: $ q-SqO Job Address: J2 I_axe Historic District: Yes 0 No K Parcel ID: jDescriptionofWork: Plan Review Contact Person: Phone: Fax: Zoning: Title: E-mail: Property Owner Information Namele4-coss 4!nq' Phone: Y 01_y 7 AlStreet: Resident of property? /\j City, State Zip: tta gu' Contractor Information Name 0,Mdj__t ix ipq Phone: y6l Street: Ldf q0-sx- Fax: City, State Zip: State License No.: Arch itect/Engi neer Information Name: Phone: Street: City, St, Zip: Bonding Company: Address: Building Permit 11 Square Footage: No. of Dwelling Units:' Electrical 0 Fax: E-mail: Mortgage Lender: Address: PERMIT INFORMATION Construction Type: Flood Zone: New Service — No. of AMPS: Mechanical 0 (Duct layout required for new systems) No. of Stories: C Plumbing 0 New Construction - No. of Fixtures: 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 pennit and that all work will be perforined to meet standards of all laws regulating construction in this Jurisdiction. I understand that asepArate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners, etc. OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will he done in compliance with all applicable laws regulating construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT'I,N 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: ln addition to therequirements of this pennit, 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. 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 pennit 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. Signature ofOwner/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID APPROVALS: ZONING: ENGINEERING: COMMENTS: Signature of Contractor/Agent Date Print Contractor/Agent's Name Vot', L 6 Signature of Notary-Stat"e of Florida Date BRENDA G HARNISH Ay cOMMISSION # OD946431 EXPIRES December 14,2013 Contractor/Agent is _ ersl Produced ID Type of UTILITIES: WASTE WATER: FIRE: BUILDING: Me or Rev 11.08 Orlando Division Mercedes Homes, Inc. 775 Harley Strictland Blvd. ORANGE CITY, FL 32763 Tel: (407)591-3101 Fax: (386)851-7949 ACE AIR CONDITIONING, INC. ShipTo: "WINDSOR LAKES - SUNCOR** 2985 ENTERPRISE ROAD Lot : 107 Debary, FL 32713 2211 Trillium Park Ln. Tel: (386)668-8,651 Fax: (386)668-7758 SANFORD, FL 32773 Attention: MATT JOHNSON ORLACAICO) DUPLICATE PO Number: 004-550-000731 CDS: ORL-000009-10 Fax No: (386)668-7758 Order By: Print Date: 04/27/2010 Tel. No: (386)668-8651 Purch. Agent: Order Date: 04/27 Disc. Terms: n/a Ship Via: Date Req: Terms Code: Small Trds Rcvd 15th 30th Taken By: Req. No: Line Description QuanUtyUofM U nit Cost Total Amount Disc%.:.. Draw*/6 Amount Due Project' LAKES - SUNCOR-:.: Lot. 107 ModellElev..-:1415.02 - CASCADE 3BDR CB/ Swing: NIA 20 0- HV)ACCraft. 1220.0 - HVAC, 0010 000OBase - BASE MODEL, HVAC ROUGH 1.00 EA 4,54:0.47400 4,540.44 40.00% 1,816.18 Alloc: H2ORL,004-550,107,1220,00 Sub- Total: 1,816.18 Taxes: 0.00 Total. 1,816.18 Purchase Orders and Variance Purchase Orders must be submitted for payment no later than 60 days after closing of the house or townhouse in order to be paid for the amount stated on purchase orders. Any billings after 60 days will not be paid and returned to sender. Supplier Page I of I BE IT KNOWN, that EDDIE PALIVIATUR has made and appointed, and by these presents does make and appoint yr-&-k 4w4d, true and lawful attorney for him/her and in his/her name, place and stead., giving and granting to said attorney, general, full and unlimited power and authority to do and perform all and every act and thing whatsoever requisite necessary to be done in and about the premises as fully, to all intents and purposes, as could be done if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that said attorney shall lawfully do or cause to be done by virtue hereof. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 26 day of May —, 2010 . Jobsite Address/information (if Needed): Mercedes Homes Resident 2211 Trillium Park Lane Signed and Notarized: Lot 107 Sanford FL 32771 ACE AIR CONDITIONING, INC EDDIE PALMATEER - LICENSE # CAC1813533 State of FLORIDA County of Seminole County Th e fg-re oinjg in%"ment was acknowledged by me ay of May 2010 0biw0,f who is =ersorn a 171kno n by me or who hasy produced identification. BRENDAG HAR I NISH My COMMISSION # DD946]431 14,201 3EXPIRESDecember14, 2013 407) 390-0153 A ori.dallotarywvce.com SEAL) Notary Public State of FLORIDA My Commission Expires. COUNTY OF SEMINOLE IMPACT FEE STATEMENT Lq STATEMENT NUMBER: 10100001 DATE: April 08, 2010 BUILDING APPLICATION #: 10-10000173 BUILDING PERMIT NUMBER: 10-10000173 UNIT ADDRESS: TRILLIUM PARK LANE 2221 12-20-30-515-0000-1080 TRAFFIC ZON-E:022 JURISDICTION: SEC: TWP: RNG: SUF: PARCEL: SU13DIVISION: TRACT: PLAT BOOK: PLAT BOOK PAGE: BLOCK: LOT: OWNER NAME: ADDRESS: APPLICANT NAME: MERCEDES HOMES ADDRESS: 77S HARLEY STRICKLAND BLVD ORANGE CITY FL 32763 LAND USE: TOWN HOME UNIT TYPE USE: WORK DESCRIPTION: CITY-SANFORD SPECIAL NOTES: 2221 TRILLIUM PARK LANE / TOWNHOME UNIT/ WINDSOR LAKE TOWNHOMES FEE BENEFIT RATE UNIT CALC UNIT TOTAL DUE TYPE DIST SCHED RATE UNITS TYPE ROADS-ARTERIALS CO -WIDE ORD Condominiumf 379.00 1.000 dwl unit 379.00 ROADS -COLLECTORS N/A Condominium* 00 1.000 dwl unit 00 FIRE RESCUE N/A 00 LIBRARY CO -WIDE ORD Condominium* 54.00 1.000 dwl unit 54.00 SCHOOLS CO -WIDE ORD multifamily 2,450.00 1.000 dwl unit 2,450.00 PARKS N/A 00 LAW ENFORCE N/A 00 DRAINAGE N/A 00 AMOUNT DUE 2,883.00 STATEMENT dwkw C/044--SIGNATURE: RECEIVED BY: PLIASE PRINT NAME) DATE: NOTE TO RECEIVING SIGNATORY APPLICANT: hSULT FAILURE TO NOTI4 O&ER AN ENSURE TIMELY PAYMENT MAY IN YOUR LIABILITY FOR THE FEE. * D** DISTRIBUTION: I-BLDG DEPT 3-APPLICANT 2-FINANCE 4-LAND MANAGEMENT NOTE** PERSONS ARE ADVISED THAT THIS IS A STATEMENT OF FEES DUE UNDER THE SEMINOLE COUNTY ROAD, FIRE/RESCUE, LIBRARY AND/OR EDUCATIONAL ISSUANCE OF A BUILDING PERMIT. PERSONS ARE ALSO ADVISED THAT ANY RIGHTS OF THE APPLICANT, OR OWNER, TO APPEAL THE CALCULATION OF ANY OF THE ABOVE MENTIONED IMPACT FEES MUST BE EXERCISED BY FILING A WRITTEN REQUEST WITHIN 45 CALENDAR DAYS OF THE RECEIVING SIGNATURE DATE ABOVE BUT NOT LATER THAN CERTIFICATE OF OCCUPANCY OR OCCUPANCY. THk REQUEST FOR REVIEW MUST MEET THE REQUIREMENTS OF THE COUNTY LAND DEVELOPMENT CODE. COPIES OF RULES GOVERNING APPEALS MAY BE PICKED UP, OR REQUESTED, FROM THE PLAN IMPLEMENTATION OFFICE: 1101 EAST FIRST STREET, SANFORD FL, 32771; 407-665-7356. PAYMENT SHOULD BE MADE TO: SEMINOLE COUNTY OR CITY OF SANFORD BUILDING DEPARTMENT 1101 EAST FIRST STREET SANFORD, FL 32771 PAYMENT SHOULD BE BY CHECK OR MONEY ORDER, AND SHOULD REFERENCE THE COUNTY BUILDING PERMIT NUMBER AT THE TOP LEFT OF THIS STATEMENT. THIS STATEMENT IS NO LONGER VALID IF A BUILDING PERMIT IS NOT*** ISSUED WITHIN 60 CALENDAR DAYS OF THE RECEIVING SIGNATURE DATE ABOVE DETAIL OF CALCUIATION AVAILABLE UPON REQUEST. CALL 407-665-7356. I !-- III II k - - DATE: 3&&d I / I HEREBY NAME AND APPOINT: GUSTAV BOTES, DAPHNE CLARK EACH AN AGENT OF: MERCEDES HOMES INC. TO BE MY LAWFUL ATTORNEY IN FACT TO ACT FOR ME AND APPLY TO THE BUILDING DEPARTMENT OF: t (// — C/ FOR A BUILDING PERMIT FOR WORK TO BE PERFORMED AT LOT NUMBER: _/0 7 ADDRESS: P2/ PARCEL ID: -/0' 70 AND TO SIGN MY NAME AND DO ALL THINGS THAT ARE NECESSARY TO THIS APPOINTMENT. JASON MICHAEL VENEZIA NAME OF CONTRACTOR.) SIGNATURE OF CONTRAC10R.) STATE CERT. # CBC 1254283 CONTRACTOR'S STATE REGISTRATION NUMBER.) The foregoing instrUment was acknowledged before me this DATE: A 4 a BY: JAeON M&AEL VENEZIA Who is personally known to me and did not take an oath. STATE OF FLORIDA NAME: COUNTY OF ORANGE, My Commission #: L, W I W2009 My Commission Expires: Acsn.. Inc NOTARY: SIGNATURE OF NOTARY: NOTARY SEAL. FLOOD CERTIFICATION PLOT PLAN for. MERCEDE5 1-10ME5, INC. BASED ON THE FEDERAL EMERGENCY MANAGBAENT AGENCY FLOOD INSURANCE RATE MAP. THE STRUCTURE SHOWN HEREON DESCRIP77ON: LOT / 07, WlND50R LAKE TOWNflOME5 DOES NOT UE WITHIN THE 100 YEAR FLOOD HAZARD AREA. THIS STRUCTURE LIES IN ZONE * X '. RECORDED IN PLAT BOOK 70 PAGE(s) 44 thru 5 1 PUBLIC RECORDS OF 5EMINOLE COUNTY, FLoRID].A COMMUNITY PANEL NO. 120294 0070 F EFFECTIVE DATE. TRACT "A" MAP REMS30N DATE.- SEPTEMBER 28. 2007. COMMON AREA 93.67 - (OVERALL) C-) 569*22'4iv 589'22'41"W559*22'4i'IW589*22141'W589122'41'W 589'22'4 W 5.33'-l 5.33'-,,,,,.--1 5.33'-,,,_ e.- I 5.33'-__,,, 1 G. 17 4 00' 1 AIC A)C 4.00' A/C Alc A/C l_AqAI 0.50' El Alc E LAPAI - q 0. 50. b I LANA_ NAI- L J_ANAI LAN., TRACT "A" COMMON AREA MODEL: L MODEL: MODEL: MODEL: MODEL: MODEL: DECA5CADE CEDAR 5hERWOOO5hl 5HERWOODOD CEDAR CA5CADE 15.G7 15.33' 7 15.33' J 5.33' 15.33' 15.G7 0 LOT 1074LOT 0108 LOT 109C LOT I 10 LOT I I I LOT 1 12 0n 0 C) —00 c\j 0 C) c\j m Ln pin b min n o0 In 0ZI z 0ZI 0 z D z 0 0' 5' ]a, 20' 5CALE: 1'=20' ABBREWATIONSILJ LB. -LICENSED BUSINESS ARC -ARC LENGTH CH - CHORD RADIUS DELTA (CENTRAL ANGLE) P.C.-POINT OF CURVATURE P.T'-POINT OF TANGENCY P.I.- POINT OF INTERSECTION C - CENTERUNE 589'2 2A l'W 5(59'2 2A l'W 559*2 2A 1 W 589'2 2A 1 "W 2 2'4 1 "W 589*22A l'W i G. 7' 15.33' 15.33' 15.33' 15.33' 1 1 G. 17' 93.G7 - (OVERALL) SOUTH LINE OF 24' INGRESS/EGRESS EASEMENT 0 b U-) TRACT"A" COMMON AREA O 50' c 00 z FROP05ED fIN15hfD fLOOR f-LEVATION=44.00 TRILLIUM PARr\ LANE NOTES. 1. BEARINGS ARE BASED ON 7HE 5A5ELINE OF GEOMETRY' cNi OF 24' INGRESS/ BASELINE OF GEOMETRY' BEING S8922'41'W TRACT"A" COMMON ARfA f- EGRESS EASEMENT z BUILDING 17ES ARE TO FOUNDATION A LOT HAS NOT BEEN STAAM #4 THE FIELD. 569-2 2'4 1 W IMPROVEMENTS SHOW4 HEREON ARE PROPOSED. P.R.C.-POINT OF REVERSE I THE UNDERSIGNED AND CAVIONE INC LAND SURWYORS CURVATURE and MAPPERS MAKE No RESU?VATIONS OR GUARANTEES D.&U.E.- DRAINAGE & UTILITY AS TO THE INFORMA17ON REFLECTED HEREON PERTAINING EASEMENT TO EASEUENTS RIGHTS OF WAY, SE78ACK LINES, U.&S.E.- UTILITY & SIDEWALK AGREEMENTS AND 07HER 14ATTERS AND FURTHER THIS EASEMENT INSTRUMENT IS NOT INTENDED TO REFLECT OR SET FORTH U.E.- UTILITY EASEMENT ALL SUCH IMATTERS. SUCH INFORMATION SHOULD BE D.E.- DRAINAGE EASEMENT OBTAINED AND CONFIRMED BY OTHERS THROUGH CONC.-CONCRETE APPROPRIATE 77TLE VERIFlCA770N. THIS IS NOT A SUIRWY. THI:; s 7*A VONE, INC. r-a 0" LAND SURVEYORS AND MAPPERS MU w -'H A FL pLz400SOUTHRONALDREAGANBOULEVARD LONGWOOD, FLORIDA 32750-5499 TELEPHONE (407) &30-9080 FAX No. (407) 339-3636 E-MAIL- CAVONE 0 CFl_RR.00M vo FLORIVA u( DETAIL OF LOT / 07 WIND50R LAKE TOWNHOME5 0' 5' 10' 20' E 6=mJ LOT 107 IS ON PAGE 46 TRACT "A 5CALE: 1'=20' COMMON AREA 559'22'4 l'W 4.00' A/C 0 I-A&JAIJ 0.50' TRACT "A" COMMON AREA MODEL: CA5CADE PC NTERLINE OF WALL ON LINE 15.G7 0 LOT108 0 0 c 40C, 00 9 Ln 0.50' G.001 b AREAS: IN SQUARE FEET) LOT - 954 R/W - N/A 559*22'4 1 W GROSS AREA - 954 1 G, 17' Di[PROVEMEN'M. FOUNDATION -657 DRIVE _ N/A ENTRY - 23 A/C PAD - 9 b PATIO(S) - 82 PUBUC WALK -81 SOUTH LINE OF 24' APRON -N/A INGRESS/EGRESS EASEMENT NET AREA - 102 TRILLIUM PARr\ LANE BAHLINE Of GEOMETRY' OF 24' INGRESS/ TRACT'A' COMMON APEA EGRESS EASEMENT 559*22'4 I'W I . J, —.0 41w n 2005 uler. aw.) I PLOT PLAN 1 7-17-2008 y — CADD FILE.*MNDSOR LAKE- TH-LI07-112-DWG vv.u. zuuo- I 1-FFICEFORM11OOA-08 PERMIT FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Performance Method A Project Name: Cascade - 1415 Builder Name: Mercedes Homes Street: 2211 Trillium Park Lane Permit Office: 07-( OFI*Plrojrlj City, State, Zip: Sanford , FL , 32771- Permit Number: /0 - Owner: Mercedes Homes Jurisdiction: Design Location: FL, Daytona Beach 1. New construction or existing New (From Plans) 9. Wall Types Insulation Area 2. Single family or multiple family Multi -family a. Concrete Block - Int Insul, Exterior R=4.1 684.67 ft2 b. Frame - Wood, Exterior R=13.0 632.00 ft2 3. Number of units, if multiple family I c. Concrete Block - Int Insul, Common R=4.1 424.67 ft2 4. Number of Bedrooms 3 d. other R= 336.00 ft2 5. Is this a worst case? No 10. Ceiling Types Insulation Area 6. Conditioned floor area (ft') 1415 a. Under Attic (Vented) R=30.0 707.00 ft2 b. N/A R= ft2 7. Windows Description Area c. N/A R= ft2 a. U-Factor: SgI, U=0.63 172.51 ft2 SHGC: SHGC=0.35 11. Ducts b. U-Factor: N/A ft2 a. Sup: Attic Ret: Interior AH: Interior Sup. R= 6, 210.2 ft2 SHGC: 12. Cooling systems c. U-Factor: N/A ft2 a. Central Unit Cap: 31.0 kBtu/hr SHGC: SEER: 14 d. U-Factor: N/A ft2 13. Heating systems SHGC: a. Electric Heat Pump Cap: 35.0 kBtu/hr e. U-Factor: N/A ft2 HSPF: 8.5 SHGC: 14. Hot water systems 8. Floor Types Insulation Area a. Electric Cap: 40 gallons a. Slab -On -Grade Edge Insulation R=0.0 630.00 ft2 EF: 0.92 b. Raised Floor R=19.0 77.00 ft2 b. Conservation features c. N/A R= ft2 None 15. Credits None Total As -Built Modified Loads: 25.45 Glass/Floor Area: 0.122 PASSTotalBaselineLoads: 32.71 1 hereby certify that the plans and specifications covered by Review of the plans and VVfRE Si- this calculation are in compliance with the Florida Energy specifications covered by this N,, 0 Code. Prepared By: Ace Air Conditioning Jim Evans calculation indicates compliance with the Florida Energy Code. PREPARED BY: y Before construction is completed DATE: 1-2--/ HVAC/Me,ch;3N'c_a!,WW6A,;, this building will be inspected for compliance with Section 553.908 A[ 3 I hereby certify that this building, as desigWd., i , s'ih compliance Florida Statutes. with the Florida Energy Code. W-F OWNER/AGENT:- BUILDING OFFICIAL: DATE: DATE: - - ---- ----- I- Compliance requires certification by the air handier unit manufacturer that the air handler enclosure qualifies as certif ied factory -sealed in accordance with N 111 O.A.3. Compliance requires an air distribution system test report, by a Florida Class 1 Rater, confirming system leakage to outdoors is not greater then 42 cfm at 25 pascals pressure difference in accordance with N1 11 O.A.2. 1/20/2010 11:22 AM EnergyGaugee USA - FlaRes2008 Page I of 5 FLOOD CERTIFICATION PLOT PLAN for. MERCEDE5 MOME5, INC. BASED ON THE FEDERAL EMERGENCY MANAGEMENT AGENCY FLOOD INSURANCE RATE MAP. THE STRUCTURE SHOWN HEREON DESCRIP 71ON: LOT 107, WIN05OR LAKE TOWNtJOME5 DOES NOT UE WITHIN THE 100 YEAR FLOOD HAZARD AREA. THIS STRUCTURE LIES IN ZONE * X ". RECORDED IN PLAT BOOK 70 PAGE(s) 44 thru 5 1 PUBLIC RECORDS OF 5EMINOLE COUNTY; FLORIDA] COMMUNITY PANEL NO. 120294 0070 F EFFECTIVE DATE.- TP ACT "A" MAP REVISION DATE-- SEPTEMBER, 28, 2007. COMMON AREA '33.G7 - (OVERALL) 559'22'4 l'W 589'22A 1 "W 589'22'4 l'W 589'22'4 1 W 589o22'4 1 W 58E)'22A W 15.33' 15.33' 1 5.33'-l 5.33'-.., r I G. 17' G. 17 01 4.00' A/c A/C 4. A09 A A/C 0A/c 0IAC A)IAI' - - A po ILAI Nc E 0.50' 0.50' LANAILANAIIAI - 9 r v I I9 .9 _ANA TPACT "A" COMMON AKEA MODEL: MODEL: MODEL: MODEL: MODEL: MODEL: CA5CADE CEDAK 5HEKWOOD 5HEKWOOD CEDAK CA5CADE 15.33' 15.33' 15.33' 15.33' 15.G7' p15. G7 LOT 107 LOT 108 LOT 109 LOT I 10 LOT I I I LOT 1 12 0cl, 0') b 6 c\j o 0 Ln n In Ln o 0 L' 0 0 z z z 0.50' T-1 G.001 u 6, b G.001 589'2 2A J'W 589'2 2A 1 "W 589'2 24 W 559'2 2A 1 "W 589'2 2A l'W 589'22'4 1 15.33' 15.33' 5.33' 15.33' I G. 17' 1 G. 17' 0. 5' 1 Ol 20' 5 ALE: I"=20' ABBREVIATIONSIL LB.-UCENSED BUSINESS ARC -ARC LENGTH CH. -CHORD RADIUS DELTA (CENTRAL ANGLE) P.C.-POINT OF CURVATURE P.T.-PONT OF TANGENCY P.I.- POINT OF INTERSECTION CENTERLINE 93.G7 - (0Vf_PALL) C) C) C) t SOUTH LINE OF 24' INGRESS/EGRESS EASEMENT TRILLIUM FARr, LA 13A5ELINE Of GEOMETRY' OF 24' INGRESS/ Llr - — - — TIRACT "A* COMMON AREA EGRESS EASEMENT 553'22741W P.R.C.-POINT OF REVERSE 1 THE UNDERSIGNED AND CAVIONE, INC LAND SURVEYORS CURVATURE and MAPPERS MAKE NO RE.SERVATIONS OR GUARANTEES D.&U.E.- DRAINAGE & UT'UTY AS TO THE INFORMATION REFLECTED HEREON PERTAINING EASEMENT TO EAS13WENTS, RIGHTS OF WAY, SETBACK LINES U.&S.E.- UTILITY & SIDEWALK AGREEMENTS AND OTHER MAT7ERS AND FURTHER THIS EASEMENT INSTRUMENT IS NOT INTENDED TO REFLECT OR SET FORTH U.E.- UTILITY EASEMENT ALL SUCH MATTERS SUCH INFORMA77ON SHOULD BE D.E- DRAINAGE EASEMENT OBTAINED AND CONFIRMED BY 07HERS THROUGH CONC.-CONCRETE j APPROPRIATE TIME VERIFICATION. cq G ') NNbLn 16C7 "A' COMMON AREA 0. 50' PKOPO5ED fIN15HED f LOOK f LEVATI ON = 44. 00 0 o0 z NOTES. 1. BEARNGS ARE BASED ON THE BASELWE OF GEM(EVY' BEWG S6922'47-W. Z gLqLDING 77ES ARE TO FOUNDARON. I LOT HAS NOT BEEN STAKED )N THE FIELD. IMPROVEMENTS S40INN I IEREON ARE PROPOSFO THIS IS NOT A SURVEY. V A I.-2170NE INC. 9 - 0' LAND SURVEYORS AND MAPPERS 300 SOUTH RONALD REAGAN BOULEVARD LONGWOOD, FLORIDA 32750-5499 TELEPHONE (407) 830-9080 FAX No. (407) 3,39-3636 E-MAIL: CAVONE 0 CFLRR.COM EDETAIL OF LOT 107 WIN05OR L dOME5AKETOWNE LOT M IS ON PAGE 46 TRACT "A" COMMON AREA 5 c59'2 2A 1 W lme_ I G. 17' -.. 4.00' A/c op LA&Al 0.50' qk F TKACT "A" COMMON AREA MODEL: CA5CAIDE 15.G7 0 0 Ln C) 0 z 00 O'O= 0' 5' 10' 20' 6=r%4 1 5CALE: J'=20' CENTERLINE Of WALL ON LINE 0 Ln 0 z LOT 105 0. 50' G.001 0 AREAS: IN SQUARE FEET) LOT 954 5(59'22A l'WR/W N/A GROSS AREA - 954 1 G,l 7' IMPROVEMENTS: FOUNDATION -657 DRIVE N/A ENTRY 23 A/C PAD - 9 0 b q PATIO(S) - 82 0 PUBLIC WALK -81 SOUTH LINE OF 24' APRON -N/A INGRESS/EGRESS EASEMENT NET AREA 102 ± TRILLIUM FARK LANE BASELINE Of GEOMETRY' OF 24' INGRESS/ TKACT 'A' COMMON AREA EGRESS EASEMENT 589-22'4)W in I, it rz REVISION DATE DRA *W"*\ A FL C 0'14SED SUR 7 YW *lA';'MAPPER DOMINICK F. CAYUNF,- PRESIDENT FLORIDA SURVEYOR 4 MAPPER NUMBER 2005 LICENSED BUSINESS NUMBER 5073 PLOT bv CADD FILE. MNDSOR LAKE- TH-007- I IZDWG IA/ r-) D n n A I -, c7, r:, MAN). WJW--*, (1PRK W- CIRUJIT UUMT THIS INSTRUMENT WAS PREPARED.L;. S@4111[11 (31"Ty Jan Hall BK V1331 Pg 0658-t Qpg) BDR Title Corporation 775 Harley Strickland Blvd., Ste. 110 CLERWIS # 2010013255 Orange City, FIL 32763 WC11RUED OP1051POI0 08-.03:08 AM REUINDINS RIS 10.00 RINDED AY J Evkenroth(all) Building Pertnit No. o Tax Folio No. 12-20-30-514-0000-1 NOTICE OF COMMENCEMENT FS 713.13 Ulr DERSIGNED notifies all parties that improvements will be made to certain real property, and in accordance with Chapter 713, Statutes, the following information is provided in this Notice of Commencement: 1. Description of Property, Lot 107, WINDSOR LAKE TOWN -HOMES, according to the Plat thereof, as recorded in Plat Book 70, Pages 44 through 5 1, inclusive, Public Records of Seminole County, Florida. 2. General Description of Improvements: Single Family Residence 3. Owner Information: a. Name and Address: Mercedes Homes, LLC 775 Harley Strickland Blvd., Ste. 110, Orange City, Fl 32763 b. Interest in property: Fee Simple c. Name and address of fee simple titleholder (if other than Owner): Same 4. Contractor (name and address): Same as Owner 5. Surety Information: a. Name and Address: b. Amount of bond: 6. Lender Information: a. Designated Contact: Tracey Edwards b. Name and Address: Bank of America, N.A. 21410 N. Westshore Blvd., Ste. 1000, Tampa, FL 33607-4519 813) 282-4149 7. Name and address of person within the State of Florida designated by Owner upon whom notices or other documents may be served (as designated in Florida Statutes, Section 713.13(l)(a)(7): 8. Expiration Date of Notice of Commencement (I year from recording date unless specified): WARNING TO OWNER: ANY PAYMENTS MADE BY OWNER AFTER THE EXPIRATION DATE OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTE, 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. IF YOU INTENT TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ATTORNTY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. le - MERCEDES By: na Quintana i President Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perju;ry, I declar 10(t I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. MERCEES - ME C By: N a- ristina Quintana i tjti Division President INOTE: per Section 713.13(1)g, Florida Statutes "Owner must sign ... and no one else may be permitted to sign in his or her stead."I STATE OF FLORIDA COUNTY OF ORANGE The foregoing instrument was acknowledged before me this 2010 by Cristina Quintana as Division President for the Orlando Division of MERCEDES HOMES, LLC a Florida limited liability company, who executed and acknowledged execution of the foregoing Notice of Commencement on behalf of said coompany. He/she is personally known to me or has produced Driveros License as identification and did did not X take an oath. APRIL MIAROMLL P, Notary Seal) NOTARY PUBLIC NOTXRTPUBLIC STATE OF FLORIDA Name: Comm# DD0929579 My Commission Expires: VExplres 9/30/2013