HomeMy WebLinkAboutOwner Builder AffidavitOwner Builder Affidavit JOSEPH E . SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4779147 OR BOOK 4506 PAGE 1653, Recorded 11/12/2020 11:15:22 AM
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NOTICE OF COMMENCEMENT
TO BE COMPLETED WHEN CONSTRUCTION VALUE EXCEEDS$2,500.00 OR
WHEN HEATING OR AIR CONDITIONING REPAIR OR REPLACEMENT EXCEEDS$7,S00.00
Permit#: TaxFoliam 2421-331-0005-000-1
State of Florida,County of Indian River, 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. Legal description of the property(and complete street address if available):
2135 40 E 1/2 OF W 1/2 OF NE 1/4 OF SW 114 OF SW 1/4-LESS S 25 FT FOR RD R/W-(2.43 AC)(OR 904-546:1069-1066)
2. General description of improvement:
Replace existing windows with impact windows
3. 00wner information or OLessee information(if the Lessee contracted for the improvement):
a. Name: Kim T Bolin
b. Address: 2110 W Boothe Dr Fort Pierce,FL 34982
(street address) - (complete city name) (state) (zip code)
c. Interest in property: Owner
d. Name&complete address of fee simple titleholder(if different from Owner listed above):
4. Contractor:
a. Name: Storm Tight Windows
b. Address: 500 SW 12th Ave Deerfield Beach FI 33442
(street address) (complete city name) (state) (zip code) .
c. Phone number: 561420-0271
5. Surety Company(if applicable,a copy of the payment bond is attached):
a. Name&complete street address: N/A
b. Phone number: Bond amount:
6. Lender/Mortgage Company:
a. Name&complete street address: N/A
b. Lender's phone number:
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&complete street address:_uy
b. Phone number: Fax number:
8. In addition to himself or herself,
a. Owner designates t�f1,4 of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes.
b. Phone number:
9. Expiration date of notice of commencement:
(the expiration dote will be 1 year from the date of recording unless a different date is specified).
WARNING TO OWNER:
ANY PAYMENTS MADE BYTHE OWNER AFTERTHE 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 FIRSTINSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
COMMENCEME
(Signatur of Owner or Lessee,or Owner's or Lessee's Authorized Ofncer/Director/Partner/Manager) (Signatory's Title/Office)
The foregoing instrument was acknowledged before me this�ay of AQclC Yi {l 20,-D.
By: (printed name of person signing above), / r-7-7 �,1�1
As: /10. e r For
(type of authority,e.g.officer,trustee,attorney in fact) . (name of party on behalf of whom instrumentwas executed)
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