2509 Park Dr 02-73 com int remodelPERMIT ADDRESS ar�oq P,�, 1 c'
CONTRACTOR �j 1
ADDRESS
p - &-'K !��) s I
,(Y�r Pcar►� FL 3,-)�ct3
PHONE NUMBER L4 (-) q - 93 07 - ,S ), LA D
PROPERTY OWNER CCl Cc u J e. E &.J a(65 TZ
ADDRESS LIS sin [V cacaos Pyve-
FL
PHONE.NUMBER q 7) -- 3-�-c;- �O o
ELECTRICAL CONTRACTOR /
MECHANICAL CONTRACTOR
PLUMBING CONTRACTOR
MISCELLANEOUS CONTRACTOR
PERMIT NUMBER FEE
MISCELLANEOUS CONTRACTOR
PERMIT NUMBER
FEE
SUBDIVISION
PERMIT # 02- DATE
PERMIT DESCRIPTION
PERMIT VALUATION V v CD T
SQUARE FOOTAGE u
ch
ol
CITY OF SANFORD PERMIT APPLICATION
a
S
Y9
Permit No.: �� - Date:
Job -Address: 2-5 erg S P^vztC 5A'Vr'.),e D r-L— 3 z -7 -7 3
Permit Type: Y'*" Building Electrical Mechanical Plumbing Fire AlarwlSpriakler
'Description of Work
.i
/ Additional Information for Electrical & Plumbing Permits
Electrical: ✓ Addition/Alteration _Change of Service Temporary Pole _New AMP Service of AMPS )
Plumbing/Residential: - Addition/Alteration New Construction (One Closet Plus Additional)
Plumbing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines
Occupancy Type: _Residential ✓Commercial _ Industrial Total Sq Ftg: O_ (D`—t (. Value of Workk S
Type of Construction: Flood Zone: Number of Stories:_ Number of Dwelling Ualts:
Parcel No.
(Attach Proof of Ownership & Legal Description)
Owner/Address/Phone: CA- A u D E rZ , D" Are DS 7 2 DD S 4J7
Contractor/Address/Phone: 1-1 UI ID & r L-0 r� 5 ' 1 N e - ,ePO 6ox 5-751 W) i47t-rz .o+wc P-` 3 7.793
15�l41c y ✓C SevN PP rd- 3 T7 1 State License Number: C47 cA 3 2-935
Contact Person: DEk`^j LE--m- Phone & Fax Number. 4-�7 K3 2 524
Title Holder (If other than Owner):
Address:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer
Address:
Phone No.:
Fax No..
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. 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 go%v mental eruities 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.
Signature of Owner/Agent Date Signature of Contractor
Print er/Agent's Name Print Contractor/Agent's
Signs a of Notary -State of Florida Date Signature oWotary-StAtc of Florida to
Stephen M HMNOCk Margie Pevehouse
*�,�nG`f*my Commission CC77OW *J-W*My Commission CC731312 ZOOZ ' l l dew se�idx� , ,,
Expires September20,2002 %;.y t£t
Expires May 11. 2002 Z£LOO u01841"Uo'.1 AWi *
esnoyened eiBieVY
Ow=r/Agentis VPersonally Known to Me or
Produced ID
Contractor/Agent is Personally Knoixi to Mo or
l/ Produced ID�-
APPLICATION APPROVED BY: � �s S �o"�- Date:
Special Conditions: &4* %.
CITY OF SANFORD FIRE DEPARTMENT
FEES FOR SERVICES
j PHONE # 407-302-1091 * FAX #: 407-330-5677
DATE: C� p G PERMIT #: "� —
BUSINESS NAME / PROJECT: �'` r G.J S
ADDRESS: ! j�A-
PHONE NO. )q3Q,
,�;?\AX NO.( Q%
CONST. INSP. [ ] C / O INSP.:[ ] REINSPECTION [ ]
F. A. [ ] F.S. [ ] HOOD [ ] PAINT BOOTH
_ R [] OTHER[]—
TENT PERMIT J TANK PE
PLANS REVIEW
[ ] BURN PERMIT [ ]
TOTAL FEES: $ c ` (PER UNIT SEE BELOW)
Address / Bldg. # / Unit # Square Footage Fees per Bldg. / Unit
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, FI. 32771 Phone # -407-
330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take
place. I certify that the above is true and correct and that I
will comply with all applicable codes and ordinances
of the City of Sanford, Florida.
.'��=.r... .
Sanford Fire PrevenfiviK Division pp icant's Signature 4------
CITY OF SANFORD ELECTRICAL PERMIT APPLICATION
Permit Number: 02--f73 Date: 7 .
The undersigned hereby applies for a permit to install the following electrical:
Owners Name: I-� r'� . L,�- n L J� r� r=1� `> >4 .
Address of Job:
Electrical Contractor: ,� c' i ��= -i . �E c_ 5 C i X'
t '
Residential: Non -Residential:
-
Number
Amount
Addition, Alteration, Repair Residential & Non -Residential
/
New Residential:
AMP Service
New Commercial:
AMP Service
Change of Service:
From AMP Service to AMP Service
Manufactured Building
Other.
Description of Work: / -�� - ' / , �•'Tr/.�-�c . i3,�, ,�, �t� L 4 -< <
Application Fee:
$10.00
TOTAL DUE:
By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code.
Applicant's Signature
State License Number
JOANN JOHNSON - Re: 2509 Park Dr. - Dr. Claude Edwards. Page 1
From: RUSSELL GIBSON
To: JOANN JOHNSON
Date: 10/10/01 1:50PM
Subject: Re: 2509 Park Dr. - Dr. Claude Edwards.
I went by the site during lunch; it appears contractors are already working on the building.
Given the existing status of the site, I would RECOMMEND to the owner that certain site
improvements be made for saftey purposes, i.e. traffic controls (stop signs/stop bars) and
handicap parking and signage per Ord.No. 3211. Perhaps the landscaping could be upgraded
too.
Otherwise, if the Utility Dept is reviewing already, they will determine if backflow devices, etc. are
required.
Thank you.
>>> JOANN JOHNSON 10110 11:57 AM >>>
We have a permit for an interior remodel on this address. I was under the impression that this property
had been vacant for some time. We have completed the building plan review,( it does still need to be
reviewed by utility dept.) but I was wondering if there are any site issues that need to be addressed. It
doesn't appear to be a change of use, but if it was vacant for an extended period would that indicate site
renovation?
Jo -Ann
CC: BOB WALTER
fa �allF4 M �r euSS
1a-il-ol L s oK � / ss
M1�
reSdJ�d. M
-� L� � S ► !1 cal', C c� � n � �'�� E. � P C � h� rn e� c� c��`� (�S
LA
i
CITY OF SANFORD PLUMBING PERMIT APPLICATION
Permit Number: o2 ` 79
Date: /0 /- _zO0 /
The undersigned hereby applies for a permit to install the following plumbing:
Owners Name: G �, Ayi�C- Zib �✓�?A� ,
Address of Job: '��t �/ F'/9� /C 19yz-
Plumbing Contractor: /�h<<=/� /"G iIA8 ZivG
Residential: Non-Residential::::�'j'--
Number
Amount
Addition, Alteration, Repair (Residential & Non -Residential)
New Residential:
One Water Closet
Additional Water Closet
Commercial: Minimum Permit Fee $25.00
Fixtures, Floor Drain, Trap
Sewer Piping
Water Piping
Gas Piping
Manufactured Building
Description of Work: L Ct•v
— i--
Application Fee:
S10.00
TOTAL DUE:
By Signing this application I am stating that I am in compliance with City of Sanford Plumbing Code.
Applicant's Signature
State License Number
C. R. ET-MARDS, Jr., D. D. S.
245 SAN MARCOS AVE.
SANFORD, FLA. 32771
TctcDhooe 32z•6o52
Cityof Sanford Building Dept.
Sanford, Florida 32771
Re: Building Pgrmit - 2509 S. Park Ave.
This is a follow up to the request dated 10/12/01 for reconsideration of impact fec.
1. The previow; owner was a dentist with 6 treatment areas, so the use of the facilir.• 1> t:n,:han-,eat.
2. We are not adding any bathrooms - there were originally 3
3. The number of dental units for the chairs is identical to the previous owner.
4. We have deleted the eastern treatment room along Park Ave, leaving 6 trearmew .tr :;ts identical to
previous owner.
5. The previous owner had 13 sinks unrelated to the bathrooms. We are putting in I i, -Joks unrelated to the
bathrooms.
6. The total water usage for our facility will be considerably lower than the previow, nor, because %ve.
arc
installing a wateless suction pump system, and the have a much smaller patient I';;%. than aii m1hodomic
practice.
7. We are installing a main utility shut off which should prevent an accidental wain Ican when the building
is unoccupi�!d.
In surnmary, the use of the facility is not changing. We will have lower water usage Iiiar. the previous
owner. We are adding 3 more sinlus however, and I would not object to paying the standard impact fee for
the 3 additional sinks.
I am very sorry for all the trouble over this, and I thank you for your time and pat wut -. with us.
Sincerely,
CA. Edwards, Jr.
Z0 39VJ SGaV G3 JIH;D �IQ 6909-ZZE-L0b 99:bI Z00Z/9Z/0Z
SANFORD FIRE DEPARTMENT
FIRE PREVENTION DIVISION
300 N. Park Ave., Sanford, Fl. 32771 / P. O. Box 1788, Sanford, FL 32772
(407 302-1022 / FAX (407) 330-5677
Pager (407) 918-0388
Plans Review Sheet
Date: October 8, 2001 Business Address: 2509 S. Park Drive Occ. Ch. 26
Business Name: Claude R. Edwards Dental Ph. O
Contractor: Avid Builders, Inc. Ph. (407) 832-5240
FAX (407) 832-5240
Reviewed [ ] Reviewed with comment [X J Rejected []
Reviewed by: Timothy Robles, Fire Protection Inspector GiY
Comment: Plans reviewed as Business Occupancy. FD reserves right to require applicable code
requirements if occupancy use changes.
1.1 Application — Interior remodel for dental office.
1.2 Mixed — N/A
1.3 Special Definitions — N/N
1.4 Classification of Occupancy — Business
1.5 Classification of Hazard of Contents — Ordinary
1.6 Minimum Construction — N/R
2.2 Means of Egress Components - O.K. Three (3)
2.3 Capacity of Egress — O.K. 3'
2.4 Number of Exits — O.K. Three (3')
2.5 Arrangement of Egress — O.K., will field verify
2.6 Travel Distance — O.K.
2.7 Discharge from Exits — O.K., will field verify
2.8 Illumination of Means of Egress — O.K.; will field verify
2.9 Emergency Lighting — O.K.; will field verify
2.10 Marking of Means of Egress — O.K.; will field verify
SANFORD FIRE DEPARTMENT
FIRE PREVENTION DIVISION
300 N. Park Ave., Sanford, FI. 32771 / P. O. Box 1788, Sanford, Fl. 32772
(407 302-1022 / FAX (407) 330-5677
Pager (407) 918-0388
2.11 Special Features — O.K.
3.1 Protection of Vertical Openings — N/N
3.2 Protection from Hazards — N/N
3.3 Interior Finish — Class "B" or "A"
3.4 Detection, Alarm and Communications Systems
3.5 Extinguishing Requirements - as per NFPA 10, Provide 2ABC and (or) a 3ABC
Fire Extinguisher every 75 "
3.6 Corridors — N/A
- 4 Special Provisions
- 5 Building Services
5.1 Utilities — as per LSC 7-1
5.2 HVAC — as per LSC 7-2
5.3 Elevators, Escalators, Conveyors (4A-47) — N/A
5.4 Rubbish Chutes, Incinerators, and Laundry Chutes — N/A
Sanford City Code — Chapter 9
Fire Sprinklers:
Monitoring:
Other: NFPA 1
3-5.1 Fire Lanes —
3-6.1 Key Box —
3-7.1 Bldg. Address Number Posted and Legible — Required; will field verify, LARGE
NUMBERS VISABLE FROM ROAD.
2
C2�v1s-e��
DEVELOPMENT FEE WORKSHEET
CITY OF SANFORD
UTILITY - ADMIN.
P. 0. BOX 1788
SANFORD, FL 32772-1788
Project Name: Date: to ,, of
Owner/Contact Person: k pq, S Phone: 3L2.6
Address:
Type of Development:
1) RESIDENTIAL
Type of Units (single family
or multi -family):
Total Number of Units:
Type of Utility Connection
(individual connections
or central water meter &
common sewer tap):
Water Meter Size (3/4
1", 2", etc.):
REMARKS:
2) NON-RESIDENTIAL
Type of Units (commercial,
industrial, etc.):
Total Number of Buildings:
Number of Fixture Units
(each building):
Type of Utility Connection
(individual connections
or central water meter &
common sewer tap):
Water Meter Size (3/4"
1", 2", etc.)
REMARKS:
CONNECTION FEE CALCULATION:
st' t v e, UU
'TDT `a l 1 r7 /Y-1(--r F�c c 1 S 7 s( }
Name - Signature - Date.
REVISED ..3-�-2t"'b
is/9�7
I )
TABLE 709.1 -- - —
DRAINAGE FIXTURE UNITS FOR FIXTURES AND GROUPS
2)
Water System Impact Fees
Equivalent Residential Connection (ERC) -.300 Gallons Per Day (GPD)
Residential -
$650/Unit - Single family structure, or multi -family unit
containing three (3) bedrooms or more.
$487.50/Unit - Multi -family unit or Mobile Home unit containing
less than three (3) bedrooms. (This category is
based on judgement/assumption, estimation that
such family units on average require 751 - 225 GPD
of the water and sewer service of an average
single family unit.)
Commercial -
$650/ERU - Fixture unit schedule from Southern Plumbing Code
will be used. One ERU will be charged for
connection and up to twenty (2) fixture units.
For projects having more than twenty (20) fixture
units the Impact Fee will be determined by
increments of 251 based on multiples of five (5)
fixture units above the twenty (20) fixture unit
base for the first ERU. (Example: twenty-five
(25) fixture units will be rated as 1.25 eru;
twenty-six (76) fixture units will be rated as 1.5
ERU.)
Sewer System Impact Fees
Equivalent Residential Connections - 270 Gallons Per Day (GPD)
Residential -
$1700 Unit - Single family structure, or multi -family unit
containing three (3) bedrooms or more.
S1275/Unit - Multi -family unit or Mobile Home unit containing
less than three (3) bedrooms. (This category is
based on judgement/assumption/estimation that such
family units on average require 751 of water and
sewer service of an average single family unit.)
Commercial - Industrial - Institutional
$1700/ERU - Fixture unit schedule from Southern Plumbing Code
will be used. One ERU will be charged for
connection and up to twenty (20) fixture units.
For projects having more than twenty (20) fixture
units the Impact Fee will be increments of 25t
based on multiples of five (5) fixture units above
the twenty (20) fixture unit base for the first
ERU. (Example: twenty-five (25) fixture units
will be rated as 1.25 ERU; twenty-six (26) fixture
units will be rated as 1.5 ERU.)
6 v ti l-�S
FIXTURE TYPE
DRAINAGE FIXTURE UNIT VALUE
AS LOAD FACTORS
MINIMUM SIZE OF TRAP (Inches)
Automatic clothes washers, commerciala
3
2
Automatic clothes washers, residential
2
2
Bathroom group consisting of water closet, lavatory, bidet and
bathtub or shower
6
—
Bathtubb (with or without overhead shower or whirlpool
attachments)
2
11/2
Bidet
2
11/4
Combination sink and tray
2
11/2
Dental lavatory
)
11/4
Dental unit or cuspidor
)
11/4
Dishwashing machine c domestic
2
11/2
Drinking fountain
1/2
11/4
Emergency floor drain
0
2
Floor drains
2
2
Kitchen sink, domestic
2
11/2
Kitchen sink, domestic with food waste grinder and/or dishwasher
2
11/2
Laundry tray (1 or 2 compartments)
2
11/2
Lavatory
1
11/4
Shower compartment, domestic
2
2
Sink
2
11/2
Urinal
4
Footnote d
Urinal, 1 gallon per flush or less
2e
Footnote d
Wash sink (circular or multiple) each set of faucets
2
11/2
Water closet, flushometer tank, public or private
4e
Footnote d
Water closet, private installation
4
Footnote d
Water closet, public installation
6
Footnote d
For S1: 1 inch = 25.4 mm, 1 gallon = 3.785 L.
For traps larger than 3 inches, use Table 709.2.
b A showerhead over a bathtub or whirlpool bathtub attachments does not increase the drainage fixture unit value.
e See Sections 709.2 through 709.4 for methods of computing unit value of fixtures not listed in Table 709.1 or for rating of devices with intermittent (lows.
d Trap size shall be consistent with the fixture outlet size.
c For the purpose of computing loads on building drains and sewers, water closets or urinals shall not be rated at a lower drainage fixture unit unless the lower values
arc confirmed by testing.
TABLE 709.2
DRAINAGE FIXTURE UNITS FOR FIXTURE DRAINS OR TRAPS
FIXTURE DRAIN OR TRAP SIZE
(inches)
DRAINAGE FIXTURE UNIT VALUE
11/4
1
11/2
2
2
3
21 /2
4
3
5
4
6
:3
Standard Plumbing Code01997
Fig S1: I inch = 25.4 nun
BP200IO3 CITY OF SANFORD
Application Inquiry - Fees
Application nbr : 02 00000073
Property • • • • : 2509 PARK DR
Fee
Class/Type/Description Trans amt Amt due
A AF 01-APPLCTN FEE -BUILDING 10.00 10.00
A F1 01-FIRE INSPECT -NEW CONST 52.94 52.94
P PF 01-PERMIT FEES 263.00 263.00
A U3 WD IMPACT:COMMERCIAL 975.00 975.00
A U6 SD IMPACT:COMMERCIAL 2550.00 2550.00
Press Enter to continue.
F3=Exit F12=Cancel
Total due : 3850.94
10/11/01
15:15:05
Struct Permit Insp
000000 BLCA00
J0 I�PGci— Fee-f
Bottom
Seminole County Property Appraiser Database Information
Pagel of 3
SEMINOLE COUNTY
APPRAtS/AL DATA
Assessed values shown are NOT certified values and therefore are subject to change before being
finalized for ad valorem tax purposes.
Parcel Id O1-20-30-501-0200-0000
Tax District
Sl-SANFORD
Owner
EDWARDS CLAUDE R JRJ
r
19-PROFESSIONAL SERVICE
Address 245 SAN MARCOS AVE
City,State,ZipCode SANFORD FL 32771
Exemptions
-
Property Address
2509 PARK AVE S
VALUE SUMMARY
Value Method Market
Number of Buildings 3
Depreciated Bldg Value $207,184
Depreciated EXFT Value $13,775
Land Value (Market) $71,755
Land Value Ag $0
Just/Market Value $292,714
Assessed Value (SOH) $292,714
Exempt Value $0
Taxable Value
$292,714
http://www. scpafl. org/pis/web/seminole_county_title?PARCEL=01203050102000000 10/11 /2001
SANFORD FIRE DEPARTMENT
FIRE PREVENTION DIVISION
300 N. Park Ave., Sanford, FI. 32771 / P. O. Box 1788, Sanford, Fl. 32772
(407 302-1022 / FAX (407) 330-5677
Pager (407) 918-0388
Plans Review Sheet
Date: October 8, 2001 Business Address: 2509 S. Park Drive Occ. Ch. 26
Business Name: Claude R. Edwards Dental Ph. ()
Contractor: Avid Builders, Inc. Ph. (407) 832-5240
FAX (407) 832-5240
Reviewed [ ] Reviewed with comment [X J Rejected []
Reviewed by: Timothy Robles, Fire Protection Inspector
Comment: Plans reviewed as Business Occupancy. FD reserves right to require applicable code
requirements if occupancy use changes.
1.1 Application -Interior remodel for dental office.
1.2 Mixed — N/A
1.3 Special Definitions — N/N
1.4 Classification of Occupancy — Business
1.5 Classification of Hazard of Contents — Ordinary
1.6 Minimum Construction — N/R
2.2 Means of Egress Components - OX Three (3)
2.3 Capacity of Egress — O.K. 3'
2.4 Number of Exits — O.K. Three (3
2.5 Arrangement of Egress — O.K., will field verify
2.6 Travel Distance — O.K.
2.7 Discharge from Exits — O.K., will field verify
2.8 Illumination of Means of Egress — O.K.; will field verify
2.9 Emergency Lighting — O.K.; will field verify
2.10 Marking of Means of Egress — O.K.; will field verify
SANFORD FIRE DEPARTMENT
FIRE PREVENTION DIVISION
300 N. Park Ave., Sanford, Fl. 32771 / P. O. Box 1788, Sanford, FI. 32772
(407 302-1022 / FAX (407) 330-5677
Pager (407) 918-0388
2.11 Special Features — O.K.
3.1 Protection of Vertical Openings — N/N
3.2 Protection from Hazards — NIN
3.3 Interior Finish — Class "B" or "A"
3.4 Detection, Alarm and Communications Systems
3.5 Extinguishing Requirements - as per NFPA 10, Provide 2ABC and (or) a 3ABC
Fire Extinguisher every 75 "
3.6 Corridors — N/A
- 4 Special Provisions
- 5 Building Services
5.1 Utilities — as per LSC 7-1
5.2 HVAC — as per LSC 7-2
5.3 Elevators, Escalators, Conveyors (4A-47) — N/A
5.4 Rubbish Chutes, Incinerators, and Laundry Chutes — N/A
Sanford City Code — Chapter 9
Fire Sprinklers:
Monitoring:
Other: NFPA 1
3-5.1 Fire Lanes —
3-6.1 Key Box —
3-7.1 Bldg. Address Number Posted and Legible — Required; will field verify, LARGE
NUMBERS VISABLE'FROM ROAD.
2
Permit No.
State of Florida
County of Seminole
NOTICE OF COMMENCEMENT
Tax Folio No.
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 property: (legal description of the property and street address if available) g lable) I 0 Ck'2 y %
2-7,toO .er ( boo C c_ Pe, -1 1-t G1,C-' 2c0-4s rhiw 9/o
-1
2. General de cription of improvement: ` N 't- p-P i 0 r re wi oAe,(
3. Owner information �
a. Name and address C ,10,U &10 0 -
7
CERTIFIED COPR
b. Interest in property O LJ n R1'
c. Name and address of fee simple titleholder (if other than Owner) .¢ 0,1, 4- 60 1, �
Contractor n a. Name and address Vi V I leis _ �L ✓►C, SEP 19 200
(:)o2��
b. Phone number lyCL � 93SZt/0 Fax number' 7 8 3 Z S2 2 C�-
5. Surety
I IIII II III II 111 A 11111 III II I!1 A 111 II III II 11111 AI II111 I IIII
a. Name and address
b. Phone number
Fax nuMWNNE MORSE,
c. Amount of bond
SEMIN ULt COUNTY
6. Lender
CLERK'S # 2001749630
a. Name and address
RMORDED 0911W2001 09,36,51 GM
iiE66iia FEES 6.00 '
b. Phone number
Fax nurPAMDED BY L McKinley
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes:
a. Name and address
b Phone number _
Fax number _
8. In addition to himself or herself. Owner designates
of
to receive a
copy of the Lienor's Notice as provided in Section
713.13(l)(b), Florida Statutes.
a. Phone number
Fax number
9. Expiration date of notice of commencement (the expiration date is I year from the date of recording unless a different
date is specified)
Signature of Owngr
Sworn to (or affirmed) and subscribed before me this _ / g _ day of _SBPM v h .20 m / by
L-
Personally Known Oroduced Identification
Type of Identification Produced
THIS INS f PUNtNT FREPAMD WV,
CiavCt(� �dc,�cr�s �"
NAME
Signature Notary Public, State of Florida
ADDR. )-9 S S� ? c'-`<<JS
Commission Expires: » � v ,%StephenMHartaodc
a='0Z MWMC1 s * �" ''� * *My commission ccno2a7
AN* ''� September 20. 2002
SG �,'-� r�l �/ 32 7 7 /
J.MLL30 �!�oC) Expires
VonW W ua4da)S �''+• •`�
COURT
FI,ARIDA