HomeMy WebLinkAboutOwner Builder Affidavit JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4213187 OR BOOK 3894 PAGE 316, Recorded 07/25/2016 01:45:38 PM
Jul. 22. 2016 1:18FM norris i No. 1242 P. 2 1
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RECEIV--D JUL 2 N1
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NOTICE OF COAONCEMENT J
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The undersigned hereby given notim that improvement will be made to certain real property,and In accordance with Chapter 713,
Florida statutes the following information is provided in the Notice of commeacewent.
1.DESCRI MON OF PROPERTY(Legal description and strw address)TAX FOLIO NUMBER!
SUBDIVISION BLOCK TRACP----LOT tf /}`?BLDG UNEP
,Alj4, E CrTH �1rAlein.rC (jtJAeed-dad -PL.rr G-'10
2.GRNERAL DESCRUgION OF BNPROVEMIENT: IZe (A C e m c T p F /o Toa 2 a o c3-oto ,4)C
3.OWNER WORMATTON: a Name Nt-fl i N; FXr1 o u S Pl Ar e XZIA. R• b S
b.Address no"1 Sa 3fLL A,)4 it Loo Fon? LA PizOlAl E e Interest in property
d.Name and addtess of fee simple titleholder(if other than owner)
4,MNTRACPOR'S NAME,ADDRESS AND PHONE NUMBER:
Sf.SI 1�3t+ Ntw^tLLe, L../ Pje_ , NAL 34SC�3 7`7�- fi-73•- Soe6
5.SURETY'S NAME,ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
6.LMER'S NAME,ADDRESS AND PHONE NUMBER.
7.Persons within the State of Florida designated by Owner upon whom notices or other documents maybe served as provided by
Section 713.13(1)(e)7.,Florida Statutes:
NAME,ADDRESS AND PHONE NIMBER:
'a.In addition to himself or herself,Owner designates the following to receive a ropy of the Lienor's Notice as provided in Section
713.13(1)(b).PloridaStatutes:
NAMIE,ADDRFSS AND PHONE NUMBER:
9.Expiration dale of AWce of rommencarn=t(Ute expiration date is I year ham the date of recording unless a different date is
specified)- —20—
WARNMqG'[DOWNER•ANYPAj?,ERIS_MADE RYUTalMAFrFRTIM 11Ml1Q4M0NOFTHE N j=OF COMMENCEMEU
aF CONSMER13D ll12pR=R PAY?,MM UNDEL CKAr'M 711 PART I tEC1TON 7131'+�ARrOA crA'rtJTES AND(�'AN 7Z>ticLn T
1N YOUR PAYING TWICE FQB tMPROVEN=Tt7 YOUR PROPERTY A NC)nCF OF COMM'LNCPMFNT MU�r B$$ [ZAID
N ORE CT CI'f TO CING CONS111 VIM YO
MOr REMBE COMMANCIRG WORK Qa RECORVINQ YOUR MOnCE OF 9Q�eMCBTFSNT
Signature(f Owner or Print Name and Provide signatory's Tiue/OILce
OwmesAuthorizedOW-r cedor/Padver/Mattager
State ofEosida
Countyof-A?A�
The foe ing instrument was acknowledged before me this day d J
By .,rk4e D/scP tx4;'- ,es
(Name Of person) (Type of authority...e.g.Owner,officer,trustee,attorney in fact)
For
(Name of party on behalf of whom instrument was executed) Personally Known__,or produced the following type of ID:_
6N ON Ndary P. SmU d Plorldn
Raymond J Powers
y.Cemmts9onE69Nr�18_
amftffit+iftR1197P11i1$e) i ban of tory c)
Under penalties of perjurry,I declare that I ave d the fore oing and at the facts in it are hue to the best of my knowledge and
belief(section 92.525,Florida Statutes).
J�e(s)ooffdwner(s)or Owner(s)'Authorized Ofilcer/D1rer2or/Partner/lyfan Ter who slgncd above:
By. ` By
ao..aarwrmm
STATE OF FLORIDA
ST. LUCIE COUNTY
THIS IS TO CERTIFY TH T THIS IS A
TRUE ND CORRECT OPY F THE "ser;
OR I L .
S E. S H, LER
b
Depu y Cle rye'
Date: Z 1