HomeMy WebLinkAbout268 Live Oak BlvdCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: 1 Documented Construction Value: $ mo - M
Job Address: 2GR U va Cla %-YA Historic District: Yes ❑ No 15
Parcel ID: ll-1�1='Y )-!'Y Lk U i ` I Zoning: ' �Ca`(l`fiUCG1
Description of Work: yn-ICC & �.
Plan Review Contact Persona 1 �c �r�. t _nY�i�1.r Title: A me ,� ^ _, n �\
Phone: (:2 Fax: E-mail: a- .(
Property Owner Information
Name Phone:
Street: , Resident of property?:
City, State Zip: Ci'(1 ►y�Y�, �% '�
Contractor Information
Name Phone:
Street: Fax: C= )A)Ak 2313
City, State Zip: State License No.: C_ C
Architect/Engineer Information
Name: 4A Phone:
Street:
City, St, Zip:
Bonding Company: /U'A
Address:
Fax:
E-mail:
Mortgage Lender: AQ A
Address:
PERMIT INFORMATION
Building Permit II
Square Footage: Construction Type: No. of Stories:
No. of Dwelling Units: Flood Zone:
Electrical O Plumbing 0
New Service - No. of AMPS: New Construction - No. of Fixtures:
Mechanical O (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of beads:
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, beaters, 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.
ti/Lo/ L --
Signature of Owner/Agent �r�U Date
Print Owner/Agent's Name
Signature ofNoty4Y�-$W oENDY yT�`TS a�
Comm# DD0751560
Expires 311812012
G`Nsan.. Inc
Florida Notary ............•
....
Owner/Agent isPersonally Known to Me or
Produced ID Type of ID
0 12)1M12
Signare of Contiector/Agent oak
Z.'(-rX 4as 1 Aa M&
Print Contractor/A is Name
Signature of Nota: 4j,ElVrida..........: Date
WEN STAATS
Comm# DD0751560
rJ t Expires 3/1612012
'' ,u✓� Florida Notary Assn., Inc
AY.....Hn .rH........,H i............... Rf
Contractor/Agent is X Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE:
COMMENTS:
Rev 11.08
BUILDING:
COLLIS ROOFING, INC.
P.O. Box 520668
Longwood, FL 32752.0668
Ph. (321)441.2300
Fax (321) 441.2313
Lic. k CCC058022
Date: December 29.2011 Phone:
Attention: TDC Construction Fax:
Job Address: 1268 Live Oak BLVD
Collis Roofing, Inc. proposes to supply the labor and materials necessary to apply your roofing as follows:
A) Remove old shingles and underlayment to bare deck and dispose of properly.
B) Inspect existing decking for water damage and re -nail according to code.
C) ALL NECESSARY WOOD -WORK IS BILLED ON A TIME AND MATERIAL BASIS, AND IS NOT
INCLUDED IN THIS PROPOSAL. A SEPARATE -INVOICE WILL BE SENT TO THE CUSTOMER ONCE
THE JOB IS COMPLETE. (x: initial)
1. Supply and install code approved CertainTeed Roofer's Select D-226 Felt to deck using simplex nails.
2. Supply and install code approved 2'h" galvanized painted drip at all eaves, directly to the deck.
3. Supply and install code approved 2 W' galvanized painted cave drip at all rake/gable ends. (Drip Color: ).
4. Secure the cave metal with mastic and then apply starter shingles at all eaves with the seal strip at the edge of the roof.
5. Supply and install all lead flashings for plumbing penetrations.
6. Supply and install code approved painted galvanized 4' off ridge roof vents OR code approved painted aluminum 10' on -
ridge vents as required (Please specify vent color: ).
7. Supply and install standard galvanized preformed valley metal.
8. Supply and install CertainTeed Landmark dimensional shingles per manufacturer's specifications and all applicable
building codes (Please specify shingle color: 1.
9. Clean up all debris and walk perimeter with a roll magnet.
10. All materials to be installed to manufacture recommendations.
11. Collis Roofing, Inc. will provide all applicable permits.
12. All workmanship to be warranted for five years from date of completion of building (Sample Attached).
The above work shall be performed in a substantial workmanlike manner for the sum of: $4,850.00
With payment to be made as follows: 100% upon completion.
Order Material Now — PRICING EXPIRES MARCH Is% 2012
**Ask us how you can earn up to $500.00 and more with our insulation, window, and solar products!
Respectfully Submitted: J. Douglas Lanier, Collis Roofing
The above prices and scope of work are satisfactory and Collis Roofing, Inc. is hereby authorized to do the work as set forth above
and in accordance with the terms and conditions attached hereto; payments will be made as outlined.
As President, Collis Roofing, Inc.
Date: / %Z �Z Approved B.I.
ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713.37, FLORIDA STATUTES),
THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND ARE NOT PAID IN FULL HAVE A
RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. IF YOUR CONTRACTOR
OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB -SUBCONTRACTORS, OR MATERIAL
SUPPLIERS, THE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN
IF YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR,
YOUR CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED
YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS, OR OTHER
SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO PAY. TO PROTECT
YOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY PAYMENT IS MADE, YOUR
CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASE OF LIEN FROM ANY PERSON
OR COMPANY THAT HAS PROVIDED TO YOU A "NOTICE TO OWNER." FLORIDA'S CONSTRUCTION LIEN
LAW IS COMPLEX AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY.
Initial
POWER OF ATTORNEY
I J. Douglas Lanier, the "principal," of COLLIS ROOFING
INC., P.O. BOX 520668 Longwood, FL 32771, herewith appoints Ray
Henderson as their attorney in fact, to act in place and stead and
described herein; THIS IS A DURABLE POWER OF ATTORNEY
THE RIGHTS HEREIN SHALL CONTINUE DESPITE THE
INCAPACITY OR DISABILITY OF THE PRINCIPAL
To act for me in the regard to the following:
OBTAIN PERMITS AT THE BUILDING DEPARTMENTS
Job address: 268 Live Oak Blvd Sanford, FL 32773
This power of attorney shall be in effect from 1/1/12 through 12/31/12
J. Douglas Lanier, As Principal
STATE OF: FLORIDA
COUNTY OF: Seminole
The foregoing instrument was acknowledged this 25th day of January
2012, by J. Douglas Lanier_, who is personally known to me or has
produced (type of identification) as identification.
••..........W Np-STAATS•••••••••••�
,•�������,,, Comma DD0751560
Signature of tary Public State of Florida =E,tpiros 3/1612012
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FloridaNotary Assn.. Inc
ti•.••.•••.••••u• •••.•.••.•••e
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Print, Type, or Stamp Commissioned Name of Notary Public
1/10112 li53 AM OMB No. 2502-0265
SUBSTITUTE FORM 1099 SELLER STATEMENT - The IntOmnation owtsined In Slodu E. G, H and I and an taro 401 (or, a Ike 401 Is asterisked, tales 403 and 404),408,407 and
403.412 (applicable part or buyers real estate tan ep 112W to the IRS) is Important tax Information and Is bek0 fumished to the klanel Revenue Service. If you aro repulred to rde a
mhwn. a negilgdroe penallyan
or o0w sanction will be imposed on you 0 this Item Is required to be reported and the IRS determines that It has not been reported.
SELLER INSTRUCTION - 0 cos real astale was your pKndple resldenw, ale form 2119. Salo or Exdlerpe of PnndpW ResWerioe, for any gid, wtIh your Inarne lax reborn: roe color
banaac0ale, mmplete the appacabie parts of form 4797. Form 6252 and/or Schedule 0 (Form 1040).
70U aro MgU9110 ay IaW m pOVOe 1-1131 AOVarrlepe I Mia V$fU* a (40!) 91140W WO VOW 00"M VOW& err MentIlleaaon n tXn W.
If you do not provide FbriAdvantago TWe Pobw (401) 977.2600 with your coo. taxpayer MwW aeon number. you may be'vAo.d to civil or otmbw pe obm
A. U.S. Department of Housing
and Urban Development
FINAL
Settlement Statement
B. Type of Loan
I.[ ) FHA 2.11 FMHA 3.1 ) Conv. Wins.
4. VA 5. 11 COW.lm.
S. File Number
A4013
7. Loan Number
e. Mortgage Ins. Case No.
C. Note; -This form Is furnished to give you a statement of actual settlement costs. Amounts paid to and by the seltlerq•1)
agent are shown. Items marked ('POC') were paid outside the closing: they are shown here for Information
purposes and are not included in the totals.
D. Name of Borrower: DUNFERMLINE PROPERTIES. I.I.C. 1805 MEADOWBEND DRIVE, LONGWOOD. FL
E. Name of Seller. CLAUDIA E. LIGHTFOOT, 570 W. SPRINGTREE WAY, LAKE MARY, FL 347+6
F. Name of lender. CASH
G. Property Location: Lot 40, HIDDEN LAKE VILLAS PHASE 4
268 LIVE OAK BLVD., SANFORD, FL 32773
H. Settlement Agent: First Advantage Title Partners (407) 977.2800
Place of Settlement 1750 W. Broadway. St., Ste 104, Oviedo, FL 32765
TIN: 711045047
1. Settlement Date: 1 /1 012 01 2
Promilon Date: 1/1012012
` 0?7404.
100.
Gross amount due from borrower.
ross amount due to seller:101.
Contract sales Ace
ontract sales ice
40,00000
102.
Personal e '
ersonal property103.
Settlement chs es to borrower ine 1400
104.
105.
Escrow Deposit Trot yet cleared by bank
3,000.00 405.
a-WRINA&I
Mg 1-2
R
106:
City/town taxes
40e.
City/town as
107.
County taxes
407.
County taxes
108.
Assessments 1/10/2012 to 1/112013
233.52 408.
Assessments '11110P2012 to 1/1/2013
233.52
109.
409.
110.
1410.
111.
411.
112.
412.
120.
Gross amount due from borrower:
43,578.52 +20.
Gross amount due to seller:
40,233.52
201.
Deposit or earnest money
3,000.00 501.
Excess deposit see instructions
202.
Principal amount of new loan(s)
$02.
Settlement charges to seller line 1400)
4,178.41
203.
Existing bans taken subject to
$03.
Exists loans taken subject to
204.
504.
Payoff of first mortgage loan 099007442291LIGHTF
38,328.89
205.
505.
Pqoff of second mortgage loan
206.
505.
207.
507.
208.
608.
209.
509.
,.Q
210.
C' flown taxes
610.
C' /town taxes
211.
County lazes 1/1/2012 to 1/1012012
10.58 611.
County taxes 11112012' to 1/10020/2•
10.58
212.
Assessments
612.
Assessments
213.
513.
214.
514.
215.
515.
216:
616.
217.
517.
21e.
$18.
219.
619..
220..
Total paid bylfor borrower.
3,010.58 620.
Total reduction in amount due seller:
42,517.118
N
301.
Gross amount due from borrower Pine 120
43,578.52 601.
Gross amount due to seller ifine 420
40,233.52
302
Less amount paid b lfor borrower (line 220)
3,010.58 602.
Less total reductiori in amount due sella Ilne 520
42,517.88
303.
CASH (X)FROM'()TO BORROWER
40,567,94 1603.
CASH (X)FROM ()TO SELLER
2,284.38
SUBSTITUTE FORM 1099 SELLER STATEMENT - The IntOmnation owtsined In Slodu E. G, H and I and an taro 401 (or, a Ike 401 Is asterisked, tales 403 and 404),408,407 and
403.412 (applicable part or buyers real estate tan ep 112W to the IRS) is Important tax Information and Is bek0 fumished to the klanel Revenue Service. If you aro repulred to rde a
mhwn. a negilgdroe penallyan
or o0w sanction will be imposed on you 0 this Item Is required to be reported and the IRS determines that It has not been reported.
SELLER INSTRUCTION - 0 cos real astale was your pKndple resldenw, ale form 2119. Salo or Exdlerpe of PnndpW ResWerioe, for any gid, wtIh your Inarne lax reborn: roe color
banaac0ale, mmplete the appacabie parts of form 4797. Form 6252 and/or Schedule 0 (Form 1040).
70U aro MgU9110 ay IaW m pOVOe 1-1131 AOVarrlepe I Mia V$fU* a (40!) 91140W WO VOW 00"M VOW& err MentIlleaaon n tXn W.
If you do not provide FbriAdvantago TWe Pobw (401) 977.2600 with your coo. taxpayer MwW aeon number. you may be'vAo.d to civil or otmbw pe obm
`1'117 '- , *�' Ili Cil� Ails W
77-7 7-7-77', EFEEF N �- 61�W -
700.
7011.
702.
Total liviteslbroker commission based on: 1140.000.00 a 6 0010056 = $2.400 00
Division of commission pine 700) as follows:
$11.200.00 to KELLER WILLIAMS ADVANTAGE III REALTY
$1,200.00 to PROFITABLE PROPERTIES
Paid From Paid From
Borrowers selws
Funds at Funds at
Settlement settlement
703.
Commission paid at settlement $2.400 00
2.400.00
704.
705.
BROKERAGE FEE to KELLER WILLIAMS ADVANTAGE III REALTY
395.00
77-T7 03"(7i'vRA?d+,
-
801.
Loan oftinsition fee
$02.
Loan discount
803.
Appraisal fee
$04.
Credit report
$05.
Lenders inspection fee
4106.
Mortgage insurance application fee
$07.
Assumpbon fee
5011.
Tax Service Fee
aft.
Flood Com Fee
$10.
Underwriting Fee
111111.'
Processing Fee
512.
813.
014.
Yield Spread Premium
815.
901.
Interest from
902.Mortgage
insurance premium for
903.
Hazard insurance premium for
904.
905.
VA Funding Fee
10 R 6M 6p i'd ipWkIjt0 M4 I h. Wn
10011.
Hazard Insurance
1001
Mortgage insurance
1003.
City property taxes
1004.
County property taxes
11005-
Annual assessments (m9ink.)
1006.
1007.
1008.
1009.
Aggregate Adjustmaril
1101.
Settle III cc dosing lea to First Advantage Title Partners
250.00 51000
1102.
Abstract or title seativiv to STEWART TITLE GUARANTY COMPANY
99.00
1103.
Tilt examination
1104.
Title insurance binder
1105.
Document preparation
11106.
Notary fees
1107.
Attornefs fees to
&MW*3 Ob" ile'"S no:
1110e.
'Title insurance to STEWART TITLE GUARANTY COMPANY
230.00
frictudes above
1109.
Lenders coverage
111110.
Owners coverage 140.00000 $23000
11111.
END. a I
1111112.
FL FORM 9
111113.
F-7
7201.
Recording Ift,: Deed M.00
I0.00
1202.
CI /court tax/slarripw.
Im.
State laxistanw, Deed $280 00
280.00
1204.
1205.
1206.
? 771.
1301.
Survey HOLD HARMLESS AFFIDAVIT
11302.
Pest inspection
11303.
CD 9 ARCHIVE FEE to PIONEER RECORDS MANAGEMENT
3500
11304,
2011 PROPERTY TAX to SEMINOLE COUNTY TAX COLLECTOR DOCS 412.96
1305.
HOA TRANSFER FEE to SANFORD HIDDEN LAKE VILLAS
5000
1306.
HOA ESTOPPEL FEE to JS PROPERTY MANAGEMENT
2500
1307.
2012 ANNUAL HOA DUES to SANFORD HIDDEN LAKE VILLAS
239 4-1
1400.
Total settlement charges (entered on lines 103. section J and 502. section K)
345.00 4,1711.411
CERTIFICATION: I have cafe" reviewed the HUD.I Settlement Statement and to the best of my knowledge and belief. d Is a tnre and &=rate statement of a0
reee4b ane msWAMnents ntade on my account or by me in offs transaction. I ranter certify that I live received a Copy of HUIYt Settlement Satemem
DUNFERMLINE PROPERTIES, LLC, a Florida Limited
Liability Company
BY: IAN D. CRAWFORD
ITS: MANAGING MEMBER
To the best olmy l , -- oge, the HUD -1 Settlement Statemani which I have prepared is a Into and — leacc ounl of the Imtds which were reoelve0 and have
been or will be disbursed by the undersigned as part of the settlement of this transaction. • .
JAN 10 2012
First Advantage TiO Partners (407) 977.2800 Date
WARNING: h N a crime to knowingly make false staNwnena to the United States on this a any other s!mitar form. Penalties upon catvklbn Can ir1rAr0e a me
and knpriaavnent For dsWle see: Title IS: U.S. Code Section 1001 and Section 1010.
I 'r
SCPA Parcel View: 11-20-30-509-0000-0400
4m4dJohrna.CFA Parcel. 11-20-30-509-0000-0400
POor�ROPERTY Owner: DUNFERMLINE PROPERTIES LLC
APPRAISER Property Address: 268 LIVE OAK BLVD SANFORD, FL 32773
SEMINOLt3 COUNTY. FLOFGDA
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Parcel: 11-20-30-509-0000.0400 I Value Summary
Property Address: 268 LIVE OAK BLVD
Owner. DUNFERMLINE PROPERTIES LLC
Mailing: 1805 MEADOWBEND DR
LONGWOOD, FL 32750
Subdivision Name: HIDDEN LAKE VILLAS PH 4
Tax District S1-SANFORD
Exemptions: 00 -HOMESTEAD (1998)
DOR Use Code: 0103-TOWNHOME
TRACT
v eve 00 e►-`�° '" p, ..
—J1 C
4
Map Aerial Etoth Footprint + Extents Center
Larger Map I I Dual Map View - External
Page 1 of 2
Tax Amount without SOH: $430
2011 Tax Bill Amount S430
Tax Estimator
Save Our Homes Savings: SO
• Does NOT INCLUDE Non Ad Valorem
Assessments
Legal Description
2012 Working
2011 Certified
Values
Values
Valuation
Cost/Market
Cost/Markel
Method
Tax Details
Number of
1
1
Buildings
Depreciated
S34,337
$36,217
Bldg Value
Taxable Value
Depreciated
$374
S374
EXFT Value
S19,711
Land Value
510,000
$10,00C
(Market)
S19,711
Land Value Ag
S44,711
Just/Market
$44,711
$46,591
Value ••
$44,7111
Portability Adj
519,711
Save Our Homes
$0
$C
Adj
S19,711
Amendment 1
Adj
Sales
Assessed Valuel
$44,7111
S46,591
Tax Amount without SOH: $430
2011 Tax Bill Amount S430
Tax Estimator
Save Our Homes Savings: SO
• Does NOT INCLUDE Non Ad Valorem
Assessments
Legal Description
LEG LOT 40 HIDDEN LAKE VILLAS PH 4 PB 28 PGS 26 TO 28
Tax Details
Taxing Authority Assessment Value Exempt Values
Taxable Value
County General Fund
$44,711
$25,000
S19,711
Schools
S44,711
$25,000
S19,711
City Sanford
S44,711
$25,000
S19,711
SJWM(Saint Johns Water Management)l
$44,7111
S25,000
519,711
County Bondsl
$44,7111
$25,0001
S19,711
Sales
Deed Date Book
Page
Amount
Vac/Imp
Qualified
WARRANTY DEED 01/2012 07698
0300
• S40,000
Improved
Yes
WARRANTY DEED 10/1997 03327
1240
S50,500
Improved
Yes
WARRANTY DEED 04/1984 01539
1606
542,700
Improved
Yes
http://www.scpafl.org/ParcelDetails.aspx?PID=11-20-30-509-0000-0400
1/25/2012
SCPA Parcel View: 11-20-30-509-0000-0400
Find Comuarable Sales withib this Subdivision
Page 2 of 2
Land
Method
Frontage Depth Units
Unit Price
Land Value
LOTI
01 01 1.0001
10.000.001 510,000
Building Information
# Description
Year
Built
Fixtures
Base
Area
Total SF
Heated
SF
Ext Wall
Adj
Value
Repl
Value
Appendages
1 SINGLE
FAMILY
1984
3
1,022.00
1,296.00
1,022.00
CB/STUCCO
FINISH
$34,337
538,799
Description Area I
GARAGE FINISHED_
OPEN PORCH
FINISHED
_
250_ _
24
Permits
Permit #
Type Agency Amount
CO Date
Permit Date
Extra Features
Description Year Bit Units
Value Cost New
ALUM SCREEN PORCH W/CONC FLI
19901 1101
S3741 $935
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http://www.scpafl.org/ParceiDetails.aspx?PID=11-20-30-509-0000-0400 1/25/2012
Permit Number:
Parcel ID Number:
v c 'lo
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
IHiRME WEE, CLERK W CIRWIT MURT
SEN NGLE CMN"
Hit 07M PO 00198 UpH)
CLERK'S 0 0012009603
RECORDED 011ML1Olt 09151:09 AN
RECORDING FEES 10.00
RECORDED BY T Saith
The undersigned hereby gives notice that improvement will be made to certain real properly, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
GENERAL DESCRIPTION OF IMPROVEMENT: Z (`]
Address: /� ( _\ )r( L t K I r ) L21 Y (1 '— JX 1 M » (X rL - - -V-'- 1 1.
Fee Simple Title Holder (if other than owner) Name:
Address:
CONTRACTOR: Collis Roofing
Name: P-8. Box 520668
Address: Loppood. R 82162466iO COQv
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be se���Z�E�E MOR VRA
as provided by Section 713.13(1)(b), Florida Statutes.
Name.
5 Address:MG_`����t`�'�
r In addition to himself, Owner Designates SiMof C`tyR
To receive a copy of the Lienors Notice as Provided i G V� L 2
Section 713.13(1)(b), Florida Statutes. `t w\ 2 V
Expiration Date of Notice of Commencement (The expiration dale Is 1 year from date of recording unless a
different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A
NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalties of perjury, l declare that I have read the foregoing and that the facts stated in it are true
to the best of my knowledge and belief.
`' �1�kti �. Gn �► (✓ F -o R D
Ownees Signature Owner's Printed Name
Florida Statute 713.13(1)(g): ' The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead!
State of PLo2 IPA County of S jC-,M 1/V OC/ F _
The forego)1kV9 Instrument was acknowledged before me this day of "t �, 20
by P� + " ` C . G A ✓ �-A e, Who Is personally known to me
Name of person making statement
OR who has produced Identification ❑ type of Identification produced:
SEAL
Notary Signature
Es
'�q� Notary Pu(.ikc �itgig of:Flonda] Patricia A Jones
My Commission DD84
ri Exptres01/08/2013