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HomeMy WebLinkAbout2425 N Park AvePermit # : v (0- C� (.D )AA 1 Job Address: � 1\ l' Description of Work: K RO_ —) k Historic District: Zoning: CITY OF SANFORD PERMIT APPLICATION Y C UP0 I Value of Work: 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 Commercial Industrial Total Square Footage: Construction Type: # of Stories: # of Units: Flood Zone: (FEMA form required for other than'X) I a Parcel #: ' ` l /Dwelling y ' O 11 `y/ /- 'A5qeI finers N, amey� Addrli4s: L�'*—v a Y I t V (Attach Proof of Ownership &Legal Description) ,n/1% 1--e- Q 1 Y n n Contractor Na& ddress: I CCQ% ( n _ r•} �+ _ ' St. License Number: Phone & Fax.k - 11 ld-I ?f' 1 I Id LAX 4.01I(AfroM^ al Person: 4 �- % Q- JBonding Company: Address: Mortgage Lender: Address: Architect/Engineer:Phone: Address: Fax: Application is hereby trade to obtain a permit to do the work and installations as indicated. 1 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: 1 certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws rcgu ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Wing construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR P TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. 1F YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR .4Nl INC A NOTICE: In addition to the requirements 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 aecacics. Acceptance of permit Jfi=rification that I will notify the owner of the property of the require nts of Florida Lien Law. FS 713 of Nacre Signdtvte cf Notary -State of Florida 0-ner/Agent is Personally Known to Me or _ Produced ID APPLICATION APPROVED BY: Bldg: Special (Initial & Date) Expires I 11484 BW Osd Group Flonds Notem Aanrl_ h Date rl. ITI I ob &1latuContrac WAgcnt c P ntractor/Agent's Nnme Date Si nature of Nota -State " It.......... i3 g '� ►i s BARBARA.EDOUARp .._ Commission 0 OD107710 aR Expires 11/000 Contractor/Agent is _=F Known to RRlwd Irwoug" a•.........-4Z�) Fbnd�a_NglaryAnn..Ino, _PtoduccctlD •» ..................................i Zoning: Utilities: FD: (initial & Date) (Initial & Daic) (Initial & Datc) AFFIDAVIT REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS Company: l ry41 wrl CCC/j I ".,,'License #: © S O 15 Is. O011 l� s ►arc D21. PL 3a�0S Project Information ,� aaC�R..Y 'EQ�,� t'1 permit #: Owner: Pr name • Pft(k Subdivision: 4e_Loi�s, r-•� 2addrresss zi n 2 J1 —I -.9a3 Lot #: 4- J C� phone affiant, hereby affirm that I am the duly licensed contractor of record for the above re erenced permit, that all the foregoing infonnation is true and accurate, and that the dry -in, flashings at the above referenced address or lot has been installed in accordance with the applicable codes and standards. Contractor: siknature Printed name STATE OF FLORIDA COUNTY OF Orel,V�o�e. This instrument was acknowle ged before me this �� day of J (�ged .200 � by the above referenced individual, V\ C�n��h who acla�hat he/she'is a duly licensed contractor with C1 h , and who acknowledged that he/she was authorizedto a ecute this document. He/she is either personally Imown to me or produced I MIL . - V1 r11, _ as valid identification. WITNESS my hand and seal this �_ day of C , 200,(-'. �u E�bss 11/701jQpd a►w bf1011� LIMITED POWER OF ATTORNEY ate I hereby authorize Lisa Whaley, Janet Wolfe, Oscar Weeks, Richard Charron and Edgar Inigo of Silver Streak Delivery to sign his/her name on my behalf in order to apply for a roof permit for the work to be performed at: Lot:57'"� Blk: Subdivision: �n Owner: XCI%1C�2.YFktqP/ Parcel ID:_ 10 ( I r 36-v {I v3� Address: a(-4 X15 M . VCt r SQrr O -J , F -C I All American Roofing North, Inc - License # CCC 055570 i2KWi,,a* ry)att,�IL4'LO Joseph Manning Licensed Contractor O;Nme.: Lesses: 'I. &oa-."Mich�ael Laura cob State of F,Jprida County: The foregoing instrijment was acknowledged before me this—k-7 day of by Joseph Manning. ar douard — Notary Public cO"'" n* w'.dv l w rft »�1ooe Personally known OR produced identification Type of identification produced DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD !Y �O Wf TRS, 1940 NORTH MON ROE STREET TALLAHASSEE FL 32399-0183 PH AALLLLNAMERICANEROOFING NORTH INC 944 W PROSPECT RD OAKLAND PARK FL 33309 ac—^ 4.70404 0 r DETACH HERE (850) 487-1395 STATE OF FLORIDA .'iC# 1 U L � I DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CCCO55570 07/02/04 040003918 CERTIFIED ROOFING CONTRACTOR MANNING,;. JO.SSPH ALL AMERICAN; ROOFING,NORTH INC IS CERTIFIED uadar th. pro+isiona c. C%.495 rs. XxDiratioa data: AUG 31, 2006 L0407020OF61 STATE OF FLORIDA _--- -- - - DEPARTMENT OF BUSINESS.AND CONSTRUCTION INnun rvvPROFESStrnz,�•IO-.ONAL_� _ REGULATION_ under the provisionsa OfLChapter.:. 89. -FS.' Expiration date: AUG 31, 2006 MANNING, JOSEPH ALIT, AMERIC 15 AN',ROOFING NORTH INC S DOLLINS AVENUE ORLANDO FL 32805 JEB BUSH GOVERNOR DISPLAY AS REQUIRED BY LAW DIANE CARR SECRETARY Earl K. Wood, Tax Collector Occupational License Orange County, Florida This license is in addition to and not in lieu of any other license required by law or municipal ordinance. It is subject to regulation of zoning, health and any other lawful authority4t jsjftl�a�n*Ojtober ember 30 of license year. Delinquent penalty is added October 1. ORLI�GINAL 09302006 1806-517833 1806 CERTIFIED ROOFING CONTR TOTAL TAX TOTAL DUE 15 S DOLLINS AV A — ORLANDO 30.00 30.00 1 WORKER ALL AMERICAN ROOFING NORTH INC MANNING JOSEPH S DOLLINS AVE ORLANDO >+L 32805-2174 MANNING JOSPEH This form becomes a receipt when validated by the Tax Collector. 8/11/2005 08:31 ilfl Csh 0046 Rag 0024 u0pf 0024001341 00'T 8/11/2005 s3.G0 Val. No: 0024-000863 �. PRODUCER INSURED FRANK H. FURMAN, INC. FRANK H. FURMAN #A091425 P. 0. BOX 1927 POMPANO BEACH, FL 33061 ALL AMERICAN ROOFING NORTH INC 15 DOLLINS AVE ORLANDO FL 32805 ID Y) CITY lITSi�RANC DATE (MMD^/01/090 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGF. COMPANY A AMERICAN CAS CO OF R_EA_DIN_ G PA COMPANY B TRANSPORTATION INS CO COMPANY C VALLEY FORGE INS COMPANY D 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. T TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION — - LTR POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY 2048537492 1 08/06 1/08/-07' GENERAL AGGREGATE I S 2, 000 , OOOX COMMERCIAL GENERAL LIABILITY -- - PRODUCTS . COMP/OP AGGI S2 , 0 0 0, 0 0 0 CLAIMS MADE F_X� OCCUR PERSONAL b ADV INJURY ' S _1 , O O O , O O O OWNER'S b CONTRACTOR'S PROT EACH OCCURRENCE ISI , _0_0 0: 0 0 0 FIRE DAMAGE (Any one fire) - 1 O 0, 000 MED EXP (Any one Person) i S 5,000 ✓ AUTOMOBILE LIABILITY 2048537508 1/08/06 1/08/07 1, 000, 001 X ANY AUTO COMBINED SINGLE LIMIT 5 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY : S (Per person) X HIRED AUTOS -------- -- _... _- X NON -OWNED AUTOS BODILY INJURY (Per accident) GARAGE LIABILITY 'j IANY AUTO EXCESS LIABILITY X UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL OTHER 2024662194 2048537511 DESCRIPTION OF OPERATIONS/LOCATIONSNEMICLES/SPECIAL ITEMS i CITY OF SANFORD P 0 BOX 1788 SANFORD FL 32772-1788 (PROPERTY DAMAGE S AUTO ONLY - EA ACCIDENTS^ _- - - OTHER THAN AUTO ONLY: I EACH ACCIDENT AGGREGATE IS 1 08/06 1/08/07 EACH OCCURRENCE sl, _ 000,000 AGGREGATE S Z, 0 0 0, 0 O 0 IS 1 0 8/0 6 1 08/0 7 X TORYIIMITSI 1UTH ER EL EACH ACCIDENT Is 5 O O, O O 0 EL DISEASE-_ POLICY LIM] _! S __5O 0, 0 0 0 EL DISEASE -EA EMPLOYEE I S Soo, 000 ..................... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TME EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, AUTHOR REPRES - ..... SH A ..... 0 CORD ,CORPORATION 11988 W10 THIS Iti ,RU -HENT PRE 1+ IXM OF CIRWIT CtIW Je-r. �;'" • � PREPARED BY. INgLE C011rJiY NAME ��L/QTICE OF COMMENCEMEN %330 P9 0947; I1pp) CLERK'S # atm 1 14860 Permit NoADDR. T &*/ State of Florida r f REMINS AWS 10.00 106433P PA County of emi kx6 ION=/ BY t holden The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Des c 'ption of roe :legal tlescpption of t e ro erty nd street address if available) v? off' /-V , �s �1J_.(.M-� ;f a-) V r� � �tl- � I _ --,u � V 2. Geral descriutiQn of i 3. Owner information a. Name and.add b. Interest in prol c. Name and add W 4. Contractor a. Vame and d ss Phone number 5. Surety a. Name and address P t 1A-,mZ rLcCk->1 Fax number c. b. Phone number/ f Fax number '170RSE c. Amount of bond r I CURT 6. Lender.=L�q RIDA a. Name and address E CLER Ry— LT b. Phone number Fax number 7. Persons within the State of Florida designated b Owner upon whom notices or other document110 s m y be s rN provided by Section 713.13(1)(a)7., Flori a Sta to a. Name and address b. Phone number Fax number S. In addition to himself or herself, Owner- jdeign tes of t • ceive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. a. Phone number Fax number 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) Signature Owner S�vgrn to �1(orkalffirr�rned,n subscribed before me this �� dayof 7G, -1 20 0 by ' 1� '2�e-c.i WOO r1 Personally Known ✓OR Produced Identification Type of Identification Produced of Notary Public, State of Florida _ Commis�slonpp�dnl0 i r E)Orgs 11�M Coimnission Expires: l I Ob l a0. Sonoed -4254) (80.............Fiona Note ry Assn.. MC Permit # 62,1 Job Address: 0 Description of Work: Historic District: CITY OF SANFORD PERMIT APPLICATION 'Tp Vp-movc- C nd RglQy Zoning: Value of Work: Date: —7 — I I — OLP 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 Podgy Y Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial Occupancy Type: Residential Commercial ✓ Industrial Total Square Footage: Construction Type: # of Stories: L # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: v�(30 �Sb y - I -7ou ^_l1D 10 (Attach Proof of Ownershio & Leeal Descriotion) I lI as nonomg k Address: Mortgage Address: Architecti Address: Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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. 1 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: 1 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 ' verificati at I will notify the owner of the roperty of the requirements of Florida Lien Law, FS 713. Signature of Owner/Agent' "� t Date ig ature of Contractor/Agent ate -P, Owner/Agent's Name i b ontractor/Agent's Name 1-10v UVFul of Notary -State of Florida rd of Notary -State of Florida Date Vxgent i% Vown to Me or m" E Commissltln i1 Eres 11iZd _ APP10Yg: Fonda Nota;Y�A;O: .I..,.0ttial & Date) Zoning: NN..N..................NN �"ri, BARBARA Contra Agent is _ Pers n �.,� to Me �ml33� 0 DD10710 _ Produced ID Cams f f�10a (000132-4254) Flonda N�.'ay�//AX ..................................... N.N.,'.. Utilities: FD: (Initial & Date) (Initial & Date) (Initial & Date) LIMITED POWER OF ATTORNEY /t/f'to I .D to I hereby authorize Lisa Whaley, Janet Wolfe, Oscar Weeks, Richard Charron and Edgar Inigo of Silver Streak Delivery to sign his/her name on my behalf in order to apply for a roof permit for the work to be performed at: /, , / Lot: Blk: 17 Subdivision:Trt'09-44 �/or(. Owner: d-ty (R&INt4A Parcel ID: 01-ae) c30''J D`���701�'001 Address: ���D -a 70 1 Sl-` (Ves-t , Set, -74d, FL3a All American Rooting North, Inc - License # CCC 055570 t Jose Manning Licensed Contractor 7Esses: a e: Laura acob Nam . Michael Murdocl State of Ptnrida County: T foe oing instr me t was acknowledged before me this day of h Manning. n - Notary Publ Personally known OR produced identificatio.................................••»• Type of identification produced" com�+N�10�10 a ea►esd wouw (�N4s2AM Fbno� Notr1► �`' Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 1 http ://www. scpafl. org/pls/web/re_web. seminole_county_title?parcel=012030504170000 10... 7/12/2006 3.4 �. ✓� 1a.o - '- DAVID JOHNSON, CFA, ASA: r PROPERTY APPRAISER10 �y f SEMINOLE COUNTY FL. W1.A 1101E. FIRST ST .��t *-Y I i�1 • • �' SANFORD, FL 32771.1468 407-665-7E 6 r _ 1.A A 2006 WORKING VALUE SUMMARY GENERAL Value Method: Market Parcel Id: 01-20-30-504-1700-0010 Number of Buildings: 1 Owner: FREYMAN ALEXANDER Depreciated Bldg Value: $57,094 Mailing Address: 600 W 27TH ST Depreciated EXFT Value: $3,819 City,State,ZipCode: SANFORD FL 32773 Land Value (Market): $20,136 Property Address: 600 27TH ST W SANFORD 32771 Land Value Ag: $0 Facility Name: Just/Market Value: $81,049 Tax District: S4-SANFORD- 17-92 REDVDST Assessed Value (SOH): $81,049 Exemptions: Exempt Value: $0 Dor: 1902 -VETERINARIAN CLINIC Taxable Value: $81,049 Tax Estimator SALES 2005 VALUE SUMMARY Deed Date Book Page Amount Vac/Imp Qualified 2005 Tax Bill Amount: $1,339 WARRANTY DEED 02/1986 01709 0905 $76,500 Improved Yes 2005 Taxable Value: $67,080 WARRANTY DEED 05/1985 01643 0578 $55,000 Improved Yes DOES NOT INCLUDE NON -AD VALOREM Find Sales within this DOR Code ASSESSMENTS LEGAL DESCRIPTION PLATS: Pick... LAND LOT 1 (LESS PT W IS EXT FROM NE COR TO SW COR & BEG SE COR LOT 2 BLK 17 Land Assess Frontage Depth Land Unit Land RUN N 30 DEG 02 MIN 28 SEC E 83.30 Method Units Price Value FT S 11 DEG 18 MIN 02 SEC W 50.86 FT S 00 SQUARE FEET 0 0 10,068 2.00 $20,136 DEG 00 MIN 00 SEC E 22.24 FT S 90 DEG 00 MIN 00 SEC W31.74 FT TO BEG) BILK 17 DREAMWOLD PB 4 PG 99 BUILDING INFORMATION Bid Year Gross Bid Est. Cost Bid Class Fixtures Stories Ext Wall Num Bit SF Value New 1 MASONRY 1954 5 1,352 1 CONCRETE BLOCK - $57,094 $142,736 PILAS MASONRY Subsection / Sgft UTILITY FINISHED / 72 Subsection / Sgft OPEN PORCH UNFINISHED / 486 EXTRA FEATURE Description Year Bit Units EXFT Value Est. Cost New COMMERCIAL ASPHALT DR 2 IN 1979 8,844 $2,936 $7,341 6' CHAIN LINK FENCE 1990 315 $883 $1,890 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=012030504170000 10... 7/12/2006 •, .Jru, r:• AFFIDAVIT INREGARDINGNG ROOF DRY -IN AND FLASHING INSPECTIONS Company: A ` Il ' `� ' ' l ei l CCf n Rco�qicense M CV 06555- —7 D -155. S. Oolkns m�c- OIC. I . -F L 32-8' U5 j / Project Information Owner: A L t t o c4 r- -F Permit M 'e. n �l IVY name I O h . (A) e—J1 Subdivision: � Yearn Wort d Cl Y dress C514 -903(0 I 01� 314 -- 9 U3(D Lot #: pion I, V► \ n( , affiant, hereby affirm that I am the duly licensed contractor of record for the above re erenced permit, that all the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address or lot has been installed in accordance with the applicable codes and standards. Contractor: signature t3'0S-e,C)h anrwl_3 printtd name STATE OF FLORIDA COUNTY OF This instrument was acknowled ed before me this (/ day of �u' , 20U!f, by the above referenced individual, k 1'l►1 who acknowledged that he/she is a duly licensed contractor with PAMWOA KOOPIff4 and who acknowledged that he/she was a thori ed to ex ute his do'^^cu,,�� t. He/she is eithePpersonally known to me or produced VW as valid identification. WITNESS my hand and seal this �� day of WSJ, 20 o ary P clic N.M.I......... O�w,.nr ...... >E,.�4i -�� .. .E ... 4.1h�i�F� pQ EN Commission 0 DD/87710 Expires = 11rVrj. Flonoa Notary NOTICE OF COMMENCEMENT r Permit No. Tax Folio Noy"�y-�7AI-CL7 State of Florida County of Seminole The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of propertjlegal description of tb,e property and street add. �rbn'1 NE CORTp SW CQR -�' 3e�_S�i✓'p� L C. E 83.30 FT s tI DC3 I - Cnoo , a� 2. General description of improvement: 13Zn. Roc;' r,n ReaQ e4- Mali) Lk► r ,a Inct,VI t 3. Owner information a. N�qe and ddre�s b. Interest in property c. Name and address 4. Contractor a. Naomi and adcjke� b. Phone number 5. Surety a. Name and address CAL VY) 0-r7 - Owner) ss if available) Z-Ot I LESS P I W IS C- � eil k 1 �, grlj fJ o �D e 0a m i tj a9 s+- Sa rd L 3a C HeDLOCom. Re(-+ (-,ra-L,01 a m r I 1111111 III 11111111111111111 b. Phone number Fax nuA c. Amount of bond SEMIN01 -9 COUNTY. 6. Lender BK 06324 Pg 02081 Qpg> a. Name and address M E RK + RECORDED 0 330:54 PH b. Phone number Fax nuMbODINI; FEES 10.00. 7. Persons within the State of Florida designated by Owner upon whom not#MDahqVdqqWTVV may be served as provided by Section 713.13(1)(a)7., Flo d S to a. Name and address b. Phone number Fax number 8. In addition to himself or herself, Ow signates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. a. Phone number Fax number 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) Signature of Owner w rn to (or affirmed nd subscribed before me this _� day of L(l , 20 b by �) ca V11 Personally Known OR Produced Identification , o; Type of Identification Produced W '"aiiir�" BARBAR/► E Commission 0 ~ �.°;,R.�"� Bonded ignatu e of Notary Public, State of Florida it800.43z+zsei Florida Nota Commission Expires: �! /ar%p���...................................»�„ .. :J 11(11 N � Z W CC L