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256 McKay Blvd - BR18-002681 - REROOFjdgftlk CITY OF r SjkNFORD FIRE DEPARTMENT Building & Fire Prevention Division Residential Permit Card PERMIT NO. a- 3t US ( ISSUE DA' CONTRACTOR: JOB ADDRESS: TVPV.. AV WAR] 13, Post this permit in a conspicuous location outside Leave all work uncovered until inspected and approvedFApprovedplansmustbepostedwithpermitforinspectionPermitexpires6monthsfromdateofissueorlastapproved inspectio nPROTECT FROM WEATHER BUILDING ELECTRICAL MSPEC770NTYPE APPROVED REJECTED InPECTUR MSPECT70N7YPE APPROVED RVECIED INSPECTOR FOOTER INSPECTION ELECTRIC UNDERGROUND STEEL BOND STEMWALLFORMBOARDSURVEY U.G. / PRE POWER SLAB / MONO -SLAB AFOOTER/SLAB LECTRIC ROUGH LINTEL / TIE BEAM LECTRIC FINAL MECHANICAL SHEATHING - ROOF MSPEMONTrPE APPROVED REJECTED INSPECTOR SHEATHING - WALLS MECHANICAL ROUGH FRAMEINSULATION ROUGH IN MECHANICAL FINAL PLUMBING DRYWALL/SHEETROCK WSPECT70NTYPE APPROVED REJECTED MSPECTOR LATH INSPECTION FINAL STUCCO/SIDING UNDERGROUND ROUGH FIREWALL SCREW TUB SET FIREWALL FINAL SEWER INSULATION FINAL PLUMBING FINAL GAS INSPECTIONS FINAL SFR INSPECTION TYPE APPROVED REJECTED INSPECTOR ROOFGAS UNDERGROUND PIPE MSPEC1701VTYPE APPROVED REJECTED INSPECTOR ROOF DRY -IN GAS ROUGH -IN FINAL ROOF GAS FINAL MISCELLANEOUS / FINAL INSPECTIONS INSPECTION TYPE APPROVED REJECTED INSPECTOR MSPECTIONTYPE APPROVED REJECTED INSPECTOR FINAL DEMO FINAL DOOR FINAL SOLAR PANELS FINAL WINDOW FINAL POOL SCREEN FINAL SCREEN ROOM FINAL UTILITY BUILDING FINAL BUILDING OTHER MOBILE HOME TIE -DOWN MOBILE HOME FINAL WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL"I" Iry YVVK rAT11.4" 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 OFTHISCOUNTY, AND THERE MAY BE ADDITIONALPERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES OR FEDERAL AGENCIES FBCI05.3.3 Inspection Line: 407.79L"9 or855MI.2112 REVISED: 4.17 TO SCHEDULE AN INSPECTION: Dial855.541.2112 Provide the items requested during the message The type of inspection requested must be scheduled• under the appropriate permit type Follow the prompts To Schedule Fire Inspections: Please call 407.562.2786 *** PLEASE NOTE: Inspections scheduled by 3:30 p.m. will be conducted the next business day. If you experience difficulty, please call 407.688.5150 Monday - Thursday 7:30 am - 5:30 pm for assistance. AUTOMATED INSPECTION SYSTEM CODES BUILDING ELECTRICAL FOOTER 104 ELECTRIC UNDERGROUND 211 STEMWALL 102 FOOTER / SLAB STEEL BOND 221 FORMBOARD SURVEY 147 T.U.G. 216 SLAB / MONO -SLAB 103 PRE POWER FINAL 218 LINTEL / TIE BEAM 105 ELECTRIC ROUGH 212 SHEATHING - ROOF 106 ELECTRIC FINAL 213 MECHANICALSHEATHING - WALLS 115 FRAME 109 MECHANICAL ROUGH 409 INSULATION ROUGH -IN 110 MECHANICAL FINAL 410 PLUMBINGDRYWALL / SHEETROCK 131 LATH INSPECTION 132 UNDERGROUND ROUGH 322 FINAL STUCCO / SIDING 130 TUB SET 312 FIREWALL SCREW 120 SEWER 311 FIREWALL FINAL 143 PLUMBING FINAL 313 GASINSULATIONFINAL113 FINAL SFR 138 GAS PIPING UNDERGROUND GAS ROUGH -IN 328 314ROOF ROOF DRY -IN 116 GAS FINAL 315 FINAL ROOF III MISCELLANEOUS / FINAL INSPECTIONS PRE -DEMO 144 FINAL DOOR 136 FINAL DEMO 126 FINAL WINDOW 137 FINAL SOLAR PANELS 134 IRRIGATION FINAL 321 FINAL POOL SCREEN 139 FINAL SCREEN STRUCTURE 127 FINAL UTILITY BUILDING 124 FINAL BUILDING - OTHER 112 MOBILE HOME TIE -DOWN 145 MOBILE HOME BUILDING FINAL 146 Miscellaneous Notes: REVISED: OCTOBER 2014 Inspection Line: 855.541.2112 9CITY OF S.kNF0RD 1 Building & Fire Prevention Division RESIDENTIAL RE -ROOF POLICY & PROCEDURES FIRE DEPARTMENT PERMITTING REQUIREMENTS - NO PLAT REVIEW REQUIRED 11 THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE REQUIRED TO BE SU13MT17ED AS PART OF YOUR PERMIT APPLICATION. THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS OR ALL ROOF COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT. A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ON j HE JOB SITE. PROJECTS LOCATED IN TFIE SA,NFORD HISTORIC DISTRICT WILL REQUIRE PLAN REVIEW AND APPROVAL BY THE SANFORD HISTORIC PRESERVATION BOARD INSPECTION POLICY & PROCEDURES A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMIiY, TOWNHOUSE, MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE -ROOF PERMITS. THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE: PERMIT CARD, POSTED IN A CONSPICUOUS AND WEATHERPROOF LOCATION COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCI PRODUCT APPROVAL SHALL MATCH WHAT IS ON TT•IE SCOPE OF WORK) DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS IN EACH o EACH PLANE OF TI•IE ROOF, SHOWING THE UNDERLAYMENT INSTALLED o ROOF DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER) o ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWINGIIISIZE OF NAILS) o UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RU'LER) o DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER) o SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS I SKYLIGHTS (IF APPLICABLE) o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL FAILURE TO FOLLOW TTIIESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL LSPECTION. COA'TRACTOR (OR OWNER/BUILDER) SIGNATURE: fIR 6dn DATE: CITY OF S,kI40RD FIRE DEPARTMENT PERAET # Building &Fire Prevention Division RESIDENTIAL RE -ROOF SCOPE OF WORK JoBADDRESS: ""^'1 bly , JVI y1t 1' Z, / 1 STRUCTURE TYPE: ® SINGLE FAMILY RESIDENCW TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMM UM RE -ROOF TYPE: ® REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK TYPE (PLEASE SPECIFY): PLEASE NOTE. ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED** 1 ROOF VENTILATION: DOFF -RIDGE ® RIDGE OSOFFTT OPOWERED VENT OTURBINES SKYLIGHTS: O YES (M No IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: 1 MAIN ROOF AREA ROOF SLOPE: O LESS THAN 2.12 0 2:12 - 4:12 QX:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE I k.0 CauU bra FL# 'loo (p - OMETAL FL# O MODIFIED Bn uMEN FL# OTORCH DOWN i FL# i OINSULATED FL# O TILE FL# OTHER: ()A&W( W.^ pp CJY1111 S i C, FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE** ROOF SLOPE: O LESS THAN 2:12 Q 2:12 - 4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE FL# ; OMETAL FL# OMODIFIE•DBITUMEN 1 FL# OTOP CHDOwN FL# O INSULATED FL# OTILE FL# i O OTHER: FL# FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 Page 2 Application Number . . . . . 18-00002681 Date 6/13/18 Property Address . . . . . . 256 MCKAY BLVD Parcel Number . . . . . . . . 31.19.31.527-0000-0880 Application description . . . ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . SINGLE FAMILY Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1057512 Permit pin number 1057512 Required Inspections Phone Insp Seq Insp# Code Description Initials Date 1000 Ill BL03 FINAL ROOF CITY OF SANFORD ram CUSTOMER RECEIPT *+* Oper: BLANDA Type: OC Drawer: 1 Date: 6/13/18 01 Receipt no: 140828 Year Number Amount 2018 E681 256 MCKAY BLVD SANFORD, FL 32771 BP BUILDING PERMIT RECEIPTS 240.88 AC 076256 Tender detail CC CRLDIT CARD $240.88 Total tendered $240.88 Total payment $240.88 Trans date: 6/13/18 Time: 11:08:38 AGREEMENT goofing OAK CREST CONTRACTING, INC. 115 Timberlachen Cir #1013 Lake Mary, FL 32746 oakcrest.com Contractor Registration: CCC1330407 No Risk' Guarantee! REP:t--L1-`------------ SOLICITOR'S LIC: --------- —_______________ PHONE: 407-284-1738 FAX: 866-648-8193 PHONE: ------- _^:15.. <J3 - Q1440 v OWNER DATE EMAIL ADDRESS STREET CELL PHONE WORK PHONE' a.5(: 1V1CkAY —LVJ CITY 5 *t% 7 STATE 1 L ZIP 3,,)- HOME PHONE We hereby submit scope of work for. wear offer Lt_ Lam, 4 17gr-` k•, OrWof squares off__ ac r: aYl ecover roof with :r 4 c c,.:4_ Q-1of squares on ' - G v arl$ingletcolor. c X Of Protect property as needed daily Decking "SB O CDX 0 other p Underlayment 0 15 lb. 0 30 lb. I;RL Other 5r:--k- •I- OMetal edge color UrValley re 4- C,closed0 open C-TjJ4 p and Ridge [(standard 0 enhanced 0'1Y ils t /' + v.a r:- c > O open eaves CYPjpeflashing nr,: O 3/1 I Ventilation 0 box midge 0 other 0(4;- t c- O'1eal around all vents, pipes and flashings - Q,fce and water shield to local code furnish all materials, labor and necessary permits GVbelivery instructions 0 left M--K—ght O other Q,'Fiaul off construction debris 0/ year limited warranty CIRoll magnet through yard Cl-ien waivers provide upon final payment FLORIDA CONSTRUCTION LIEN. ACCORDING TO FI.ORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713-37. FLORIDA STATUTES), THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIAL AND ARE NOT PAID -IN -FULL HAVE A RIGHT TO ENFORCE 'THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION LIEN. IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAIIS TO PAY SUBCONTRACTORS, SUB - SUBCONTRACTORS OR MATERIAL SUPPLIERS OR NEGLECTS TO MAKE OTHER LEGALLY REQUIRED PAYMENTS. THE PEOPLE NVI-IO ARE OWED THE MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE PAID YOUR CONTRACTOR IN FULL IF YOU FAIL TO PAY YOUR CONTRACTOR. YOUR CONTRACTOR MAY ALSO HAVE A IJEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED, YOUR PROPERLY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR MATERIALS OR OTHER SFRvicts THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FATLED TO PAY. TO PROTECT YOURSELF. YOU SHOULD STIPULATE N 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" R=JDA)S CONSTRUCTION UEN LAW IS COMPLEX. AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNY. FLORIDA HOMEOWNERS CONSTRUCTION RECOVERY FUND. PAYMENT MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND IF YOU LOSE MONEY Ot`1 A PROJECT PERFORINIED UNDER CONTRACT, WHERE THF, LOSS RESULTS FROM SPECIFIED ViOLKnONS OF FLORIDA LAW BY A LICENSED CONTRACTOR FOR tNFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM, CONTACT THE FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD AT 1111E FOLLOWING TELEPHONE NUMBER AND ADDRESS: CIL% 1940 North Monroe St, a42. Tallahassee, FL 32399. ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJECT TO THE NO'rI E AND CURE PROVISIONS OF CHAPTER 558, FLORIDA STATUTES BUYER'S RIGHT TO CANCEL: This lca home solicitation sale, and if you do not want the goods or services, you may cancel this Agreement by providing written notice to the seller inperson, by telegram, or by mail This notice mast indicate that you do not want the goods or services and must be delivered or postmarked before midnight on the third business day afteryousignthisAgreement. If you cancel this Agreement, the seller may not keep all or part of any cash down Payment, By signing this Agreement, you agree that you have also beenprovidednoticeofthisrighttocancelorallyinadditiontothewritingcontainedherein. Customers signature below signifies acceptance ofall terns and conditions of this Agreement. including all terms on the reverm side hereof: Terms: This Agreement is contingent upon insurance company price and approval. This Agreement does not obligate the Customer or Company in any way unless it isapprovedbyCustomersinsurancecompanyandapledbyCompany. Company proposes to furnish all permits, labor and materials to complete the above replacementorrepairfortheestimatedsumoftotalcostbelowortheprtoeotherwiseagreeduponwithCustomer's insurance company (the 'Agreed Price.). Customer aullvdzesCompanytoobtainlaborendmaterialsinaccordancewiththeAgreedPriceandthespecificationssetforthhereintoaccomplishtheabovereplacementorrepair. Customer understands that Company does not work for Customer'sinsurance company and/or the Insurer for the property, and that Customer alone has the authoritytoauthorizeCompanytoperformtheabovereplacementorrepair. Customers signature on this Agreement also slgnires acceptance of all terms and conditionsofthisAgreement, including all terms on the reverse side hereof. In situations where supplements for additional work fare necessary outside of the original scopeofwork (ex additional layers or measurements). Company will seek approval from insurance company. Customers otit of pocket to not to exceed deductibleplusupgradesfornonansurancerelatedclaimitems. Payment Method: Payment Upon Completion of Each Trade Check or money order made Payable to Oak Crest. Cash will not tie an acceptable form of payment. Emergency Tarps $ x Insurance Proceeds $8-ZG. v Tc e'u.;!- Estimated Project Start Date: A 01 Cash/ Financing S Total cost (tax included $ Estimated Date of Completion: Acceptance by Owner of property y: Date: Representative Signature By: Date: FL itCITY OF SAj4FORD FIRE DEPAR7MEN! Building & Fire Prevention Division PERMIT APPLICATION 1 Application No: Documented Construction Value: $ $ * i -- R01 ;to Job Address: 256 MCKAY BLVD SANFORD, FL 32771 Historic District: YesQNoR Parcel ID: 31-19-31-527-0000-0880 Residentiala Commercial Type of Work: NewElAddition Alteration Repair Demo Change of Use Movc Description of Work: RE -ROOF. STRIP ROOF TO DECK. INSTALL NEW UNDERLAYMENT AND SHINGLES TO LOCAL CODE __AlSt,(9 U Plan Review Contact Person: BUCKY HARRIS 3 1 1_%5 o— 7 G (Q3 Title:PROJECT MANAGER Phone: 863-703-6406 Faz: 866-648-8193 Email: BUCKYHARRIS@ROOFALLY.COM l ( N 1y. (o. Property Owner Information Name PETERS, ROSEMARIE Street: 256 MCKAY BLVD City, State Zip: SANFORD, FL 32771 Phone: ( 407) 807-1832 Resident of property? . YES Contractor Information Name OAK CREST CONTRACTING Street: 115 TIMBERLACHEN CIR, STE 1013 City, State Zip: Name: Street: City, St, 'Lip: _ LAKE MARY, FL 32746 Bonding Company: Address: Phone: 407-284-1738 Fax: 866-648-814,3State License No.: C;CC1330407 Architect/ Engineer Information Phone: Fax: E- mail: Mortgage Lender. Address: 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. 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, hoilers, heaters, tanks, and air conditioners, etc. FBC 1053 Shall be Inscribed Mth the date of application and the code in effect as of that date: 6t1 Edition (2017) Florida Building Code Kevised: January I, 2018 Permit Application 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 ofFlorida Licn Law, FS 713. The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal. The actual construction value will be figured based on the current ]CC Valuation Table in effect at the tithe the permit is issued, in accordance with local ordinance. Should calculated charges figured oft' the executed contract exceed thc1actual construction value, credit will be applied to your permit fees when the permit is issued. 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. atu of OO wnei' gcn Date Sipara6f Cont to Agent Date l o w cr A c t am Print Contractor/A is Namc t ofNotary -Note ofFlo % ate .•• ND r ••. A 8}gnature o -State o on a Ir Ju it S`S • i ne r9DMf fires: `0 rOy GGITWI Owner/Agent is Personalty Knob Jl & I r t 2 •: Q*htractor/Agent is Me t Krf c so l Qr Produced 1D - TypeType of I D =L' •'•.VV L IC ••.••• 0- `Oroduced ID Type o 22.IOtt . at rAjrilll grquuna+" BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Flood Zone: Total Sq Ft of Bldg: Min. Occupancy Load: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads APPROVALS: CONING: COMMENTS: UTILITIES: ENGINEERING: FIRE: Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Revised: January 1. 2018 Permit 4pliwtion I THIS INS PRE BY: Plan*: Address• IaYj Mani 1 NOTICE OF COMMENCEMENT State of Florida County of Seminole Permit Number. Parcel M Number. 3k—, 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 ofCommencement n c g IQj,Q pItQP,F t7x;.(LPAaI S dDliotr 1b oloaeAltapdsbteel address if available) LV oo AY 1:5 tilu_ rcCF'LA , I-L ZIf Jb y7 br ytS i fF-M8V9ffWFfdZY?9MMK. INSTALL NEW UNDERLAYMENT OWNER INFORMATION: Name: PETERS, ROSEMARIE Address: 256 MCKAY BLVD SANFORD, FL 32771 Fee Simple Title Bolder (if other than owner) Name: Address: Address: (l`t> "f;mlXr'lach n lake (Tl&w Y FL 327116I Persons within the State of Florida Designated by Owner upon whom notice or other documents may 11e servedasprovidedbySection713.13(1)(b), Florida Statutes. I Name: O Address:____ _ In addition to hbuself, Owner Designates 1 of To roe" a copy of the Lierors Notice as Provided to Section 713.13(t)(b), Florida SlabAes. Expiration Date of Notice of Commencement (The expiration data Is 1 year from date of recording unless adifferentdateisspecified) 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 1, 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, ) declare that 1 have read the foregoing and that the facts stated in it are true 4toLestoff my knowled a and belief. r o mef* Rirdw Nam* Florida Stab 713.13(1)W• The ow.w must shn ft rottee ofcwaw wwM and "Done abe nor b* p&WA*d to sign 1n hfs *r Iron sfsad.' State of —1" county of Y 11/i. ,I `%p p;N:4,O,pi Ole - The foregoing Instrument was a edged before me this day of ` : N'ry e: iM. MybYud' A _ 'J T G S Who Is pehsonaty known to role O Jt lii; R r ,• OR who has produced idenbikatio of identification produced: -(L t)t- !1'_=AID • GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'S # 2018066559 BK 9150 Pg 1612; (1 pg) &RECORDED 06/12/201810:06:30 AM 10.00