438-Adcock Roofing~Tax Parcel'Number: ~-l~-,?0 -o~o~- o~ to
u~Address of job: /ZO 5 ~, ~c~ ~/~U~
NOTICE OF CO~ENCEME~
State of
County of
be ma~e t0 ~Certain real property, and In accordance wit~
713, Florida ~Statutes, the following information is
this Notice E of .Commencement.
1. Description of P 'operty: Eec ~ ~d~o,)va ~
2. eneral D iption f ImprQ ment: -,' ' '
3, Owner Information:
a. Name & Address: ~/ ~ n ,'
b Interest in Property: '
C.Name & Address of fee simple titleholder
than Owner ):
, 4. Contractor's Name & Address:~c~ ~~ '
5.:SUrety Information:
a. Name & Address:
[ b. Amount of Bond:
6. ~ Lender' s Name & Address: ~a~
7. Persons within tl~e State of Florida designated
Owner upon whom notices or other documents may
served as provided by Section 713,13(1)(A)7,
Statutes: '
8. In addition to himself, Owner designates
to receive a copy of the Lienor's Notice as ProVided
in Section 713.13(1) (b) , Florida Statutes.
9. Expiration da~e of Notice of Commencement (the
expiration date is one (1) year from the date of
recording unless a different date is specified):-~%~]~2
.;~
Signature O~ Owner: __
:, ,
.... ; -.