ANX2015-09024; ANX2015-09025�
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2425 N MCMULLEN BOOTH
ANX2015-09025
2425 McMullen Booth - ALF
Zoning: Institutional Atlas #: 234A
- '�...,r. "�,...,.i°"w-..,-°' ��,.,/��/"°•..�
�`::����:��� a..�..%� % 0 MCMULLEN BOOTH RD
ALL APPLICATIONS ARE TO BE FILLEd OUT COMPLETELY AND CORRI ANX2015-09024
DELIVERIESj TO THE PLANNING & DEVELOPMENT DEPAR7MENT BY '
PAGES WIiHIN MUST BE SIGNED BY ALL PROPERTY OWNERS LISTED O� 0 McMullen Booth Road - ALF
Zoning: Institutional Atlas #: 234A
A TOTAL OF 6 COMPLETE SETS OF APPLICATION AND SUPPLEMENTA� marERia�S (1 oRIGINAL AN� 5 COPIES) AS
REQUlRED WITHlN ARE TO BE SUBMITTED FOR REVIEW BY THE DEVELOPMENT REVIEW COIVYMITTEE. ,APPL.ICATIONS
AND SUPPLEMENTAL MATERIALS ARE REQUIRED TO BE COLLATED AND STAPLED IR1T0 SETS.
IT IS INCUMBENT UPOIV THE APPLICANT TO SUBMfT COMPLETE AND CORRECT INFORMATIt7N. ANY MISLEADING,
DECEPTIVE, INCOMPLETE OR INCORRECT INFORMATION MAY INVALIDATE YOUR APPLICATION.
THE APPLICANT, BY FILING THIS APPLICATION, AGREES TO �OMPLY WITH ALL APPLICABLE REQUIREMENiS OF THE
COMMUNITY DEVEIOPMENT CODE.
APPLICATIUN FEE: S�
IMPACT FEE/ASSES51�lIERIi FEE: TBD Information on /mpact Fees orAssessmenf Fe�s is available from
fhe City of Clearwafer Engineering Department (552-4747).
To Be Completed By City of C/ear�rrater:
TYPEOFANNEXATlON: X CONTIGUOUS
NONCONTIGUOUS (TYPE A ENCLAVE)
To Be Completed By Property Owner:
PROP�RTY OWiVER (PER DEED�; KIM A PREEDOM TRUST, KIM A PREEDOM TRE, RANDALL R PREEDOM TRUST, RANDALL
R PREEDOM TRE _______________
MAILING ADDRESS: P.O. BOX 279, SAN ANTONIO, FLORIDA 33576 _____`_ ________ __
PHONE NUMBER: 813-293-3719
EMAIL: ClaireC�hrtampabay.com, Claire@landandsand.com
AGENT OR REPRESEN7ATIVE: HR TAMPA BAY LLC, Claire Ciements
MAILING ADDRESS: 9804 West Park Village Drive, Tampa, FI. 33626
PHONE NUMBER: 813-293-3719
EMAIL: ClaireC�hrtampabay.com, Ciaire@landandsand.com
ADDRESS OF SUBJECT Z425 North McMullen Booth Rcad, Clearwater, Florida
PR�JPER71f:
PARCEL NU�ABER(5): 33-28-16-00000-220-0100, 33_28-16-U0000-0160
LEGAL QESCRIPI'lON: See attached
CUKRENT UTYSERVlC�'S:
REQUESTED CITYSERVlCES: X
(select all that dpp/y)
SANITARY Stib'VER
SANITARY SEWER
SOLID WASTE x
x SOLID WASTE
WATER
Planning & Development Department, 100 S. Myrtie Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 72T-562-4865
Page 1 of 10 Revised 04115
Planning 8 Development Department, 100 S. Myrtle Avenue, Clearvvater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 2 of 10 Revised 04115
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Planning & Development Department
Petition for Annexation
Data Sheet
PLEASE ENSURE �'HAT THE FOLLOWING INFORMATION IS FILLED OUT, IN ITS ENTIRETY. FAiLURE TO COMPLETE THIS
FORM WILL RESULT IN YOUR APPLICATION BEING FOUND INCOMPLETE AND POSSIBLY DEFERRED UNTIL THE FOLLOWING
APPLICATION CYCLE.
FUTURE LAND USE PLAN DESIGNATION
PRESENT (COUNTY): RL (COUNTY) RLM (COUNTY WIDE PLAN)
REQUESTED (CITY): INSTITUTIONAL
ZONING DISTRICT
PRESENT (COUNTY): AE (COUN7Y)
REQUESTED (CITY): P/SP — PUBLIC SEMI PUBLIC
SITE AREA: 6.43
SIZE OF DEVELOPMENT :
Existing: 1 RES
Proposed: 241 BEDS
(e.g., number of uniis, hotel rooms or
non- residentio! square fooiaqe)
acres
USE OF PROPERTY:
Existing (currently on site): VACANT AND ONE HOUSE
Proposed (new use, if any;
CONGREGATE CARE, SENIOR
plus existing if to remain): HOUSING
If residential use, is unit(s) NOT REMAIN
rental?
ARE THERE ANY ACTIVE/OPEN PERMITS FOR THE PROPERTY WITHIN PINELLAS COUNTY? YES ❑
IF YES, PLEASE LIST/EXPLAIN:
NO X❑
STATE OF FLORIDA, COUNTf OF PINELLAS
I(we), the undersigned, acknowledge that all representations made in this application are true and accurate to the best of my
knowledge and authorize City representatives to visit and photograph the property described in this applica ion.
Swor to and subscribed before me this �� � day of
V f/ oZ � c�" , by
_�% a. ,'�• �'ti'�'`� who is personafly known/has
/ _ i produced '—� ___ as identification.
Signature of property owner or representative
Signature of property owner or representative
C�.-
otary public,
My commission expires:
r �..., ��, �.,,, ,". � . , ,.,....
'`_��Il;� 41Y COMMISSION t FF 093294
�['� * EXPIRES: febmary 16, 201e
Planning 8 Developmerrt Department,100 S. Myrtle Avenue, Clearwater, FL 33T56, Tel: 72T-562-4567; Fax: 72T-562-4865
Page 3 of 10 Revised 04/15
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Submittal Pac
Planning & Development Department
Petition for Annexation
e Instructions & Checklist
IN ADDITION TO THE COMPLETED ANNEXATION PETITION FORM, ALL PETITION FOR ANNEXATION PACKAGES SHALL
lNCLUDE A SUBMITTAL PACKAGE THAT INCLUDES THE FOLLOWING:
D Signed and sworn (notarized) disclosure of in:erest statement (form attached).
❑ If the property is not a p{atted lot of record, a current survey identifying the dimensions, area and location of the
property having been prepared, signed and sealed by a land surveyor currently registered in the State of Florida within
the most recent 12 months. [Note: Submit two copies only]
❑ If development is to be initiated prior to submission of an annexation petition and/or prior to the effective date of the
annexation, requisite site plans, plat, and engineering plans. City staff will review proposed plans to determine their
compliance with the City's Community Development Code.
❑ Terms of a proposed Agreement to Annex, if any.
❑ If the proposed annexation requires a thange in the land use classifieation and zoning category assigned to the
property, a justification for such change rnust be submitted in writing. If the requested zoning is not consistent with the
Future Land Use Map of the City of Clearwater Comprehensive Plon, the applicant will be required to file a companion
application to amend the map.
❑ Proof of ownership (e.g., copy of deed, title insurance poiicy, or other instrument demonstrating ownership). [Note:
Submit two copies only]
❑ If connection to city services is desired prior to the effective date of the annexation, applicant must provide notarized
Petition for Annexation Supplemental Statement (form attached). [Note: Submit original onlyJ
❑ If applicant is designating an agent/representative to work with City, applicant must provide notarized Affidavit to
Authorize Agent/Representative (form attached). [Note: Submit original only]
INFORMATION REQUIRED TO COMPLETE THE PETITION F�DR ANNEXATION APPLICATION AND DATA SHEET CAN BE
FOUND ON THE FOLLOWING DOCUMENTS AND/OR ONLINE AT THE FOLLOWING WEBSITES. IF THE APPLICANT IS
UNCERTAIN WHERE TO LOCATE THIS INFORMATION OR NEEDS ADDITIONAL ASSISTANCE, PLEASE CONTACT THE
PLANNING AND DEVELOPMENT DEPARTMENT, LONG RANGE PLANNING DIVISION AT 727-562-4567.
❑ PARCEL NUMBER (Parcel I.D. Number) can be found on the Warranty Deed. It can also be found by searching the
Pinellas County Property Appraiser's Office website at www.pcpao.or� (search database by address).
0 LEGAL DESCRIPTION can be found on the Warrantv Deed. It can also be found by viewing the property record online at
the Pinellas County Property Appraiser's Office website at www.pcpao.org.
C] FUTURE LAND USE PLAN DESIGNATION (COUNTY) can be found by viewing a Property Report using Pinellas Count�s
Public GIS Viewer available online at http://�is.pinellascountv.or�/public is . Search by property address or Parcel I.D.
Number and report will appear.
❑ FUTURE LAND USE PLAN DESIGNATION (CITY) is typically the same as the land use designation in Pinellas County, unless
applicant is proposing a change (see submittal package requirements for more information).
❑ ZONING DISTRICT (COUNTY) can be found by viewing a Property Report using Pinellas County's Public GIS Viewer
available online at http://�is.pinellascounty.or�/public �is/.
0 ZONING DISTRICT (CITY} can be found by contacting the Planning and Development Department or viewing the City's
Zoning Atlas, available online at
http://www.myclearwater.com/gov/depts/pwa/enpin/publir.ations/en�;atlas/atlas.asp.
❑ SITE AREA (ACRES) can be found by viewing a Property Report using Pinellas Count�s Public GIS Viewer available online
at http;//p,is.pinellascounty.or�/public �is/.
Planning 8 Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 72T-582-4567; Fax: 727-562-4865
Page 4 of 10 Revised 04/15
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ATTENDANCE AT PUBLIC HEARINGS
Planning & Development Department
Petition for Annexation
Information for Applicants
The app�icant or applicant's representative is encouraged to attend City Council public hearings unless the annexation
pertains to a property developed or to be developed with one single family dwelling.
STANDARDS FOR ANNEXATION
In determining whether to annex a property, the City shall consider the extent to which:
❑ The proposed annexation will impact public services (e.g., water, sewe�, police, parks, etc.).
❑ The proposed annexation is consistent with the City of Clean,vater Comprehensive Plan.
❑ The proposed annexation requires a change in the future land use and zoning classifications assigned to the
property as well as the jurisdiction for said change.
❑ Existing or proposed development is consistent with City regulations.
❑ Terms of a proposed Annexation Agreement, if any, promotes the City of Clearwater Comprehensive Plan.
PROPERTY OWNER AGREEMENT
Please be advised that, in consideration of the annexation, the property owners do hereby agree that:
❑ All structures and improvements which are erected upon said property subsequent to the date of this petition for
annexation shall comply with all applicable City of Clearwater regulations and ordinances as set forth in the City
Community Development Code;
❑ All residential rental units, including single-family residences must comply with the requirements in the city's
residential rental ordinance, which requires the property owner to obtain a Business Tax Receipt upon annexation
into the city;
❑ If development is to be initiated prior to submission of an annexation petition and/or prior to the effective date of
the annexation, requisite site plans, plat, and engineering plans shall be submitted to ensure compliance with the
city's Community Development Code (see Submittal Package Instructions Checklist). It is recommended that the
applicant meet with Planning and Development Department staff to review plans and/or discuss the applicable city
regulations;
J All annexations of residential dwellings of eight dwelling units or more shall convey such recreation facilities fees
and recreation land dedication and/or fees in the amount and manner prescribed by Chapter 54, Article II of
Clearwater Code of Ordinances; and
❑ When any substandard abutting street or utilities are subsequently upgraded by the City to meet City Standards,
said improvement(s) will be done on an assessment basis, consistent with City procedures therefore.
Planning 8 Development Department, 100 S. Myrtle Avenue, Clearwater, Fl 33756, Tel: 72T-562-4567; Fax: 727-562-4865
Page 5 of 10 Revised 04J15
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Planning & Development Department
Petition for Annexation
Disclosure Statement
PROPERN OWNER (PER DEED): KIM A PREEDOM TRUST, KIM A PREEDOM TRE, RANDALL R PREEDOM TRUST, RANDALL R
PREEDOM TRE
MAILING ADDRESS: P.O. BOX 279, SAN ANTONIO, FL. 33576
PHONE NUMBER: 813-293-3719
EMAII: Claire(a�hrtampabay.com, Clair�landandsand.com
AGENT OR REPRESENTATIVE: HR TAMPA BAY ILC, Claire Clements
MAILING ADDRE55: 9804 West Park Village Drive, Tampa, FI. 33626
PHONE NUMBER: 813-293-3719
EMAIL: Claire@hrtampabay.com, Claire@landandsand.com
OTHER PERSONS HAVING ANY OWNERSHIP INTEREST IN THE SUBJECT PROPERTY:
NAME: none
INTEREST IS:
SPECIFIC INTEREST HELD:
DOES A CONTRACT EXIST FOR SALE OF THE SUBJECT PROPERTY? x YES
CONTRACT I5: With HR TAMPA BAY LLC FOR PURCHASE
NO
PARTIES INVOLVED — NAME: HR TAMPA BAY LLC, CLAIRE CLEMENTS PHONE NUMBER: 813-293-3719
NAME: PHONE NUMBER:
ARE THERE ANY OPTIONS TO PURCHASE THE SUBJECT PROPERTY?
PARTIES INVOLVED — NAME:
NAME:
ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY?
PARTIES INVOLVED — NAME:
NAME:
YES x NO
PHONE NUMBER:
PHONE NUMBER:
YES
PHONE NUMBER:
PHONE NUMBER:
x NO
STATE OF FLORIDA, COUN'CY OF PINELLAS
I(we), the undersigned, acknowledge that al) representations made in this application are true and accurate to the best of my
knowledge and authorize City representatives to visit and photograph the property described in this application.�,[,�
Swor to and subscribed before me this � Q/ v� day of
V S f"' ol 0 J by
> �l. r L �/I'1'1 who is personally known/has
� produced �—' as identification.
Signa property owner or representative /�' /
Nota�y public,
My commission expires:
:"&�, KAREN F. HOKE
MY CCiMMISSiON N FF 093294
1.� * _.__...�� .. �. ___..n rv��e
lorbldi�ru AuC�t Nottry 5lrvices
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: T27-562-4567; Fax: 727-562-4865
Page 6 of 10 Revised 04115
Signature of property owner or representative
Planning 8 Developmer�t Depariment, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-48fi5
Page 7 of 10
Revised 04/15
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Planning & Development Department
Petition for Annexation
Aff d '
1 avit to Authorize
Provide names of ali property owners on deed – PRINT ful) names:
KIM A PREEDOM TRUST, KIM A PREEDOM TRE,
RANDALL R PREEDOM TRUST, RANDALL R
PREEDOM TRE
ent/Representative
2. That (i am/we are) the owner(s) and record title holder(s) of the following described property:
2425 N. MCMULLEN BOOTH ROAD, CLEARWATER, FL.
That this property constitutes the property for which a request for (describe request):
ANNEXATION TO THE CITY OF CLEARWATER TO OBTAIN UTILITIES
4. That the undersigned (has/have) appointed and (does/do) appoint:
HR TAMPA BAY LLC, CLAIRE CLEMENTS
6.
7.
as (his/their) agent(s) to execute any petitions or other documents necessary to affect such petition;
That this affidavit has been executed to induce the City of Clearwater, Florida to consider and act on the above
described property; 2425 N. MCMULLEN BOOTH ROAD, CLEARWATER, FL.
That site visits to the property are necessary by City representatives in order to process this appiication and t
owner authorizes City representatives to visit and photograph the property described in this application; he
Tha I/ ), t un er ig d u rity, hereby certify that the foregoing is true and correct.
d
P e Owner
Property Owner
Property Owner
BEFORE ME THE UNDERSIGNED,
THIS � DAY OF
Q � � �./ ( /
Property Owner
STATE OF FLORIDA, COUNTY OF PINELLAS
DULY COMMISSIONED BY THE IAWS OF THE STATE OF FLORIDA, ON
v s �' �n
" "" ��_ PER50NALLY APpEARED
n _
—' WHO HAVING BEEN FIRST DULY SWORN
DEPOSED AND SAYS THAT HE/SHE FULLY UNDERSTANDS THE CONTENTS OF THE AFFIDAVlT T T HE/SHE SIGNED.
Notary Publj� Signature �
otary Seal/Stamp �°��a •`;'�% KAREN F. HOKE
MyCommissionExpires: * � * MYCOMMISSION�FF093294
Planning 8, Development Department, 100 S. Myrtle Avenue, Clearvvater, FL 33756, Tel: 727-562-4567; Fax: 727.562-4865
Page 8 of 10
Revised 04N5
LL �
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rwater . .
� Petition for Annexation
Supplemental Statement
PROPERTY OWNER (PER DEED): K�M A PREEDOM TRUST, KIM A PREEDOME TRE, RANDALL R PREEDOM TRUST, RANDALL
R PREEOOM TRE
MAILING ADDRESS: P.O. BOX 279, SAN ANTONIO, FL. 33576
CITY OF CLEARWATER CASE
NUMBER:
I/we, _KIM A PREEDOM TRUST, KIM A PREEDOM TRE, RANDALL R PREEDOM TRUST, RANDALL R PREEDOM TRE
names of all property ownersJ, having �led a Petition for Annexation regarding the above property/case number[Igra t
consent, agree and acknowledge that the City of Clearwater may immediately or at a later time process the application to
completion, including adoption and recordation of related Ordinances, without the necessity to further notice me/us. This
Supplemental Statement shall supersede any provision in any Agreement to Annex executed by me/us or my/our
predecessors in interest.
Select One Option Below Which Applies to This Petition for Annexation:
X❑ Annexation of Contiguous Parcel(s): I/we further agree and acknowledge that I/we shall not rescind the Petition for
Annexation or execute any documents attempting such rescission, and that any attempted rescission shall be of no force
and effect.
❑ Annexation of Noncontiguous Parcel(s): I/we understand that this annexation is voluntary, and that I/we may withdraw
this Petition for Annexation prior to final action on this Petition by the City of Ciearwater. I/we further agree and
acknowledge, however, that receipt of all sewer, solid waste or other city service is contingent upon completion of the
Petition for Annexation process, and that any withdrawal of this Petltion prior to final action by the City, may result in a
discontinuance and termination of all City-provided services.
STATE OF FLORIDA, COUNTY OF PINELLAS
I(we), the undersigned, acknowledge that all representations made in this application are true and accurate to the best of my
knowledge and authorize City representatives to visit and photograph the property described in this application.
Swor to and subscribed before me this _� O�.-
5 L day of
t � � �- ao��--b
`� v
�'�� s who is personally knownLhas
Signature of property owner (individu I or authorized produced '—
�— as identification.
representative of corporation, partner hip or other � ��� _
antityj
ry public,
My commission expires: *
KAREN F. HOKE
* MY COMMISSION A FF 093294
'�'*y�Etia�' �?ndeq Thrv A�9� Nnwry Strvices -
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727_5g2.�qgg5
Page 9 of 10
Revised 04/1 S
Signature of co-property owner
Planning & Development Department,100 S. Myrtie Avenue, Gtearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 10 of 10 Revised 04/15
LAND OWNERS:
For ANNEXATION, ZONING, and LAND USE CHANGE
at 2425 N. McMullen Booth Road, Clearwater, Pinellas
� County, Florida
1. 33-28-16-00000-220-0100
KIM A PREEDOM TRUST
KIM A PREEDOM TRE
RANDALL R PREEDOM TRUST
RANDALL R PREEDOM TRE
P.O. Box 279
San Antonio, Fl. 33576
2. 33-28-16-00000-220-0160
KIM A. PREEDOM TRUST
KIM PREEDOM TRE
RANDALL R PREEDOM TRUST
RANDALL R PREEDOM TRE
P.O. Box 279
San Antonio, Fl. 33576
AUTHORIZATION LETTER
To Whom It May Concern:
KIM A. PREEDOM TRUST, KIM A. PREEDOM TRUSTEE, RANDALL
R. PREEDOM TRUST, RANDALL R. PREEDOM TRUSTEE the owners
of the property described as "Exhibit A" of Parcel Number 33-28-16-
00000-220-0100 and 33-28-16-00000-220-0160 attached hereto and made
a part hereof (the "Property"). Seller has entered into a contract to sell
the Property to HR TAMPA BAY LLC, Claire Clements or Assigns (the
"Buyer"). In conjunction with and consistent with the Contract to Sell,
Seller hereby authorizes Buyer or its agents to apply for obtain zoning
amendmeats, land use amendments, site plan approvals, plat approvals,
building permits, concurrency or level of service determinations or
certificates utility commitments or reservations, curb cuts, variances,
wetlands, flagging and delineation, and any other permits and approvals
which related to the Buyer's proposed residential and or commercial and or
office development of the Property as previously disclosed to Seller.
"Owner" KIM . PRE M T T, KIM A. PREEDOM TRUSTEE
By: -
A. P ED M
RANDALL R. PREEDOM TRUST, RANDALL R. PREEDOM TRUSTEE
B. �
RANDALL R. PREEDOM
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH
The foregoing instrument was acknowle
, 2014, by
personally known ta me ve produced
identification.
ACKNOWLEDGMENT
State of l�'1 c � �`'
County of - ' �sb.� i n
Oot6is�_dayo(�la.i�/,20�,Xi.+� f�Jbzr��1'ce�r�t
personaliy appeared betore me,
w6o e persooaify i�owo to mq
✓hose idendty t verified oo the basis o( F 1. DL
_whose idenNty ( verified on the oath/affirma6on ot
a credible wifiess,
to be the signer of ' g daument, e that
he/s6e signed i
N ta Si7�nature
My Commission Ezpires: �C.� Y1 e a�i �� i 7
me this
day of
She & he are
for
RONDW AAOlNd1FORp
PIORARY PUBIlC �at 1t�
• SEAI � 9�s af MaMaw
Reddrp d edpib�, Mi
�a r�' c°mrwalo" E�iw
J�x�e 20, 2p17
STATE OF FL RIDA
COUNTY OF � y��s
Th fo e oing instrume t was a�
9 2014, by ��1��
personal known to me or have
identification.
/�`�
� ` S
(print or type or stamp name )
this day of
� She & he are
�- .------- .
Signature of Notary Public
My Commission Expires � �- ( �
tiic:""'� PAULA FAKIOLAS
:�' �;� Commission # FF 117554
:�� Expires May 22, 2018
.
'�R ,�''� e�a.enwrmrF.hinN..p.eoo.aes.�o�t
Z01S FLORlDA LiMtTEn r �ewr rrv r_nivaeNV eeyNUAL REPORT
D�CUMENT# Li000005387Q
Etrtity Name: HR TAMPA BAY LLC
CurreM Principai Piace of Buslness:
9604 WEST PARK VILLAGE DRNE
TAMPq, FL 3362g
Cutrent Maillnp Address:
98�4 WEST PARK VILLAGE DRtVE
TAAAPA, FL 33626
FQ Number: 47-1534919
Name and Address of Cument Registered Agent
Cx.EMENTS, CLAIRE H
9804 WEST PARK VILtJ1CiE ORNE
TAMPA, FL 33g26 US
FfLED
Aug �16, 2095
Secretary of State
CC8095892979
Certlflcate of Status Desir+ed: No
Thr sbovs raemed aitry aubmta lh/a a�e[�merklorihe pupoae d dtrpB�O A'a �eD6�ied aAR.�e or rep�Ee�sd a�e,►� arddh h fhs Stats d Ab+ida.
SIGNATURE:
EJectraNc Sigrtat�re of Registered AgeM Date
AuthoMzed Peraon(s) Detail :
Ttde Mt3R
N�e CLEMENTS, CLA�tE H
Add►eas� 9604 WEST PARK VlLLAGE OR1VE
C�Stato-Tip: TAMPA FL 33828
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SiGNATURE: CLAIRE Cl.EMENTS MGR OS/16/2415
Ekctrn►�c Slgneluro ot Sf�rin0 At�ra�ized Person(si �i
Date
I�: 2010026663 SK: 16817 PG: 88�, O1/29/2010 at 01:17 PM, T2ECORDING 3 PAGE$
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✓JCOLJNTY, FL HY ,DEPUTY CI.�RR: CLKDU48 .
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nn� by ana �� t�:
C#REdORY A. FOX
FOX & FOX, P.A.
2535 Landmark Drive, 3uite 102
Cl�a:water, P'L 33761
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lwnensuer u:«c her�i�. r/cs renres -g,n�t��n,'a «' ,gi�e�� ��1r rrre pa,rfes ro chis
inatnuitterit and Nea /�eiia legctl �nbatiues A�d'a§�rea of fiedividualar, and tlte
suooessors cved assigns of corpar���, ;;
. . , . ,.
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WiTNB�88STS: Tha�f;tdie `� `�r, � arid in consideration of the. aum
of Ten Dallars {$14.001�ui ,,j��pa d Dy, the aiaid (3rauteo, the s+ecdpt whe�r�.wf
is hereby acknowlod�;d'. do�at��reby rcmise, releasz and quit claim unto the
said C}rantee fonwa�,��ll,the ri�� tit]e, interest. claim and demand which the
said Srst par�y Jzag 3a�'e�d oo the followinQ deacribed lot, piece or parcxl of
land, •situate,��g,�;}�einB 3n the County of Pincllas, State of Florida
to-wi� � � ` � `'
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, �' ' • `� � :�8"� ATTACN�D l�lL D�88C�RD�Tl�D1V
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�.;�, 8�8JF:C'i"TC� EA8EME1�'P9 AND RE9TRICT[Ol�i9 OF RECORD.
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. .THIS IS A DEED OF CONVEIVIENCE
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T� IIAVS APiD TO HOLD, the �ame together with aIl and singular thc
appurtenas�cea thex�vnto belongi,ng or i� anywiee app�ertai�i�& and all th�e
estate, rlght, titie, iatei+eat. lien, equit�Y and clainn whateaver of the said
Qranto�, either in 1aw or equih�, bo thc onlY P�P�' use� benc�t and behalf of
the said Qreabee fonwer.
..L.A� COUNTY FL OFF. RSC. BK 1681T R� �B�J
.�� -'� •
IP WI'1'1�tE88 WHER�OF, th+e said �rantor has signed and sealed these ;',
preaenta the d�► and ycar first above writben. ;�
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Sig�ned, sealod and
delivered in our presencx:
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8TA1'$ OFFLORtDA ,�;•, .���,���_
COIIATY OF P�B'LLA� �� ., ,•;,' '•�, .
The foregoing dp�;t'imb�'�bvas a,claiawledged before me this 13�' day of
January, 2U10 by,�d,.11. �i�,F�DO�, as Ca7lrt��ib� qj t1a .�a A.
PRSaDO�[ �'R08T dGI�S�Ait6NT 3L►1�'D ltAi�C� 80, 1989 who ia �p�rsons�tiY
known oar whq�(ii�ec�a drivtrs lioeslse as id�ntiScation and who d3d not
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take an oath: � �� '. �•'
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`QQUN'?Y OF PI�PELLAB �
'•; �ie foregoing documeat was acknowledged before me this ,;� 1 day
of January� 2020 by RANDALL R.. p1t�RDO�L, as �,b.�ea qf q�t Jg�g
d. P�iSaDOY?1tvSTdliRd�K��?dDl�ilRCEl90, 2989 who ia porsonaUq
known or who pz�odueed a ddv�s lic�e�e as identiflcatioa and who did not
#ake an oath.
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Notaty Publi
,• dLI.?18 COL7NTY F'L OFP'. REC. BK 3681'7 PG 889
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Cararnanc+s ot t/�� Savthearat c+arHr o�f QM�R�AK ESTAIE.S c� �� �' pl�of
Boak 11$ pagw �7 a►►d � Rib►�fc Rler.+a�ab of Piia� Gbwv�t�c-f����Ni�+�s
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f1'a'ddor bs�i�.�id�v�a�D� d6�e�a� oi �a/lowbr
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Boak t1�:�'�-q.aid 4$ A�cd/J�c Rl�covdlr of Ppire9�oa l�au►�� � t/ra��s
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�r Gi4�br of Taok�iiQ b OA9�i3ar Rscard. Bo�ok 9�?$ 188 of ths '
A��/liaor+ds �! P�irlaiVa�r Gbrin(x f7arrtokC tAanas /e�va �a�td�aat Dora�dary /irs
;�, n�ortl� �9�Y�tT Eaa� aa,� ,saa6► So�uth aorrr,adr}t ?�a?3 /b�e� rhenc�s /eore
��: �oold �CjvCh bo�»dary' /,�t SawM► GD7f�0' 1lbra� ?f6GID � tha►a NarHy
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akafki//ei►� Baotli Ro�od o�.�o ab�ed �it Arabr of Tao�iiy �a►�d �t Oli'Rc�ta�
Ra�cardi B�air 8!?$�po�s ?8d o! ths Pr�6✓!c rdc�ar� o/ P,g� t�aur�tX f7orr�
thax�t So�ulJ� Q0�718�3" Eos! dfai9 s�a�td lii�t r�it�-oJ�-wny /+h� 2�37 16�t to
o po�t of hter�+s�c�trtai w�d!► M�s Sorrdl► b�o�w�d�y /,�is o! ths AkrEhww! l/� o!
th,s Nai►dhw�sl t/f of sadd Ss�clla� .� Mraics %s�ara �d iJbst rlyVit-oJ�-M+ay /�
of �ik'�A�/a� B�t/i' R� •MartA • av3o�iB" Ut�t a�,d aa►,g s�td sori�rr eo�ur,sa►y
of Me Narthw�.4t �/�t of the Na�thwest �/4 of Ss�ct� .�.� 609.56 1lsyt to ths
Polnt of Beg�6�in�h� �
P�a►,�✓ caito�ii� 191�,937.8 sq�ra /b�t ar A3215 �tc�.t mors ar /ass�
Lega! Descriptio�
33-28-1 Cr00000-220-0100
PART OF NW 1/4 OF NW 1/4 OF SEC 33-28-16 i�ESC FROM SVV COR OF NW 114 �F NW 1/4
OF SD SEC TH S89D50'a8"E 625FT TH NQODOI'46"E 464.95FT TH N89D55'd5"E 210.23FT
FOR POB TH N89DSS05"E �04FT TO W R/W OF MCMUL,LEN BOOTH RD TH SOOD22`55"W
2t}6.02FT TH SOOD06'43°E 11.98FT TH S89D55'05"W 4QOFT TH NOOD21'20"E 21$FT T� POB
3�-za-i�-0000aazaoiso
PART OF TTVi7 i/4 OF NW 1J4 OF SEC 33-28-26 DESC FROM SW COR OF NW 1/4 OF N'W I/4
OF SD SEC TH S89D50'08"E 625F'T FOR POB TH NOOD01'46"E 46�4.95FT T�i N89D55'OS"E
210.23F'i' TH SOOD2I'20"W 218FT TH N89D55'OS"E 400FT TO W R/QV QF MCM[n.,�,ET!
BOOTH R.D TH SOOD46'43 "E 249S7FT TH N89D50'08"W 609.56FT TO POB CONT 4.43AC(�
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COPYRIpHTm 2015 KSOArchtleols, pC
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2425 McMulien Booth Road, Ciearwat�r, Florida
Conveniently located on major north/south corridor McMullen Booth Road, Safety Harbor wilt offer Independent Living
in an "Affordable Luxury" resort-like setting. A Mediterranean villa architectural sryle is evoked with design elements
like stucco, sandstone, cast stone and clay tile roofing in a soft pastel color palette. Social interaction is enhanced
within the four-story Garden Atrium Lobby featuring a Living Room, Library, Dining Room, Bistro Bar, and Coffee &
Pastry Shop. Interior ��ght well courtyards bring natural light into the resident wings and further supports the important
community aspects of senior living. Approx. building area is 295,138 sf.
Site Key Features:
• 6.43 acre site on Safety Harbor's North/South Corridor
• Frontage on McMullen Booth Road
• Entitlements in progress
• 250 parking spaces provided
Independent Living Key Featur�es:
• 241 Assisted Living residence units
• Multiple dining venues including Dining Room,
Bistro Bar and Coffee & Pastry Shop
• Three and four story resideni towers
with courtyard light welfs
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Key Plan
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property linas ��\
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Indsp�ndant Livinp Resid�nCOl Units 12' Landawpe Bulfer
Four Stories NotAd"pcsMto Reeidential DisUici ;
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CONCEPT SITE PLAN 12� v��� �_�
Scaie: t'=30'- 0"
250 Parlong Spaces Provided
241 Total Reside�t Units
Total BuAding Approx: 295,138 Sqf.
441'
609'
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Enylna�rin9 D�Wrtm�nt
Woqraphlc T�thnoloyy Divlslon
100 S. Myrtl� Av�, CNsrwabr, FL 33758
Ph: (7R7�562�1760, Far. (737)6TBJ766
www.MyCNarwatsr.com
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izs MHP Lot Number
�� �xsas � Subdivision/Condo Number
- - - - (' - Refer to Plat)
� Block Number
� Sub-Parcel Number
� Parcel Number (M&B)
-: land Hook (Common Ownership)
— "� Platted Subdivisio� Boundary
/ Lot Ownership Line
Original Platted Lot Line
----- Trails
': Building Footprint
i Unincorporaled
City Owned Property:
� Vacant
��f Parks 8 Recreation Area
� Improved
(^'�'� Leasehold
`;�;j CRA Owned
HOUSE ATLAS
Updated: W29Q015
NW 1/4 of 33-28-16
234A
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a�ographle T�cMobqy DlNSbn
f00 5. MyN� Av�, Ckarwa�er, FL 7�166
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Proparty with Ayraamant to Annex:
-•�� �'i Other ATA - 0 Records
�' I Sanitary Only ATA - 0 Rewrds
/�i. Sanitary & WaterATA- 0 Records
� Water Only ATA - 0 Records
; Solid Wasle Only ATA- 0 Records
� ATA Outside Chain of Title - 0 Records
Unincorporaled EndaveType "A"
....ii'�. Unincorporetad EnGave Type "8"
?;, ;;f, Outside of Clearwater Service Area
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Property Appraiser General Information
Page 1 of 4
Interactive ;��lap of this narcel Sales Querv Back to Queitir Results New Search Taa t'ollector Hotne Pas;e Contact IJ; WM
Portabilitv
Calculator
33-28-16-00000-220-0100
Compact Propertv Record Card
Data Current as of R�a;��
Email Print Search
September O1, 2015
�wnership/Mailing Address Chany
Mailing Address
PREEDOM, KIM A TRUST
PREEDOM, KIM A TRE
PREEDOM, RANDALL R TRUST
PREEDOM, RANDALL R TRE
PO BOX 279
SAN ANTONIO FL 33576-0279
Site Address
2425 N MCMULLEN BOOTH RD
(Unincorporated)
ner F.S. 553.8�4
Properri„_Use: 0110 (Single Family Home} Living Units:
1
[click here to hide] Legal Description
PART OF NW 1/4 OF NW 1/4 OF SEC 33-28-16 DESC FROM SW COR OF NW 1/4 OF NW 1/4
OF SD SEC TH S89D50'08"E 625FT TH NOODOI'46"E 464.95FT TH N89D55'OS"E 210.23FT
FOR POB TH N89D55'OS"E 400FT TO W R/W OF MCMULLEN BOOTH RD TH SOOD22'S5"W
206.02FT TH SOOD06'03"E 11.98FT TH S89D55'OS"W 400FT TH NOOD21'20"E 218FT TO POB
CONT 2AC(C)
:�'Iort�a�e Letter
� Exemption �
Homestead: �
Government:
r Institutional:
Historic:
� File f�r Homestead
2015 2016
No No
No r-No �
No � o �
No �No
2015 Parcel Use
iestead Use Percentage: 0.00%
-Homestead Use Percentage: 100.00%
�.!
Parcel Information Latest Notice of Fronosed Propertv Taxes (TRI�1�I lYc�tice)
2015 Preliminarv Value Information
Year .1ustlMarket Assessed Value! Count � School M��tiicipal
Value SC)�-I Can TaYable Va(ue Taxable Va1zx: Taxable Value
2015 $275,568 $248,596 $248,596 $275,568 $248,596
http://pcpao.org/general.php?strap=162833000002200100 9/ 1 /2015
Property Appraiser General Information
Page 2 of 4
[click here to hide] Value History as Certified (yellow indicates correction on file)
Nome�tead �`�ssessed School
.Tust/Market � Cor�tltv IVfnzlici�ai
Year Value; Taxable
Exem�tion Va1ue Taxable Value Taxable Value
S{)II Cap Value
2014 No $230,267 $225,996 $225,996 $230,267 $225,996
2013 No $205,451 $205,451 $205,451 $205,451 $205,451
2012 No $253,359 $253,359 $253,359 $253,359 $253,359
2011 No $262,183 $262,183 $262,183 $262,183 $262,183
2010 No $285,574 $285,574 $285,574 $285,574 $285,574
2009 No $344,130 $344,130 $344,130 $344,130 $344,130 '
2008 No $397,300 $397,300 $397,300 $397,300 $397,3001'
2007 No $430,200 $430,200 $430,200 N/A $430,200
2006 No $411,400 $411,400 $411,400 N/A $411,400
2005 No $394,700 $394,700 $394,700 N/A $394,700
2004 No $284,900 $284,900 $284,900 N/A $284,900
2003 No $213,600 $213,600 $213,600 N/A $213,600
2002 No $182,300 $182,300 $182,300 N/A $182,300
2001 Yes $178,500 $161,400 $135,900 N/A $135,900
2000 Yes $158,000 $156,700 $131,200 N/A $131,200
1999 Yes $152,600 $152,600 $127,100 N/A $127,100
1998 Yes $155,200 $151,000 $125,500 N/A $125,500
1997 Yes $148,500 $148,500 $123,000 N/A $123,000
1996 Yes $157,700 $157,700 $132,200 N/A $132,200
2014 Tax Information
Click I�ere iot• 2014 T�aa I3ill Tax District:
Tax Collector Mails 2015 Ta�c Bills October 31 CT T'
2014 Final Millage Rate 21.8998
2014 Est Taxes w/o Cap or $5,042.80
Exemptions
A significant change in taxable value may occur
when sold due to changes in the market or the
removal of exemptians. Click here for�more
information.
Ranked Sales c��n:�►arr�nke�is:,�e,�� See all
transactioris
Sale Date Book/Page Price /U V/I
No recent sales on record
2015 Land Information
Seawall: No Frontage: None View:
Land ITse Land Size Unit Value Units Total Adiustments Adiusted Value liflethod
Single Family (O1) 218x400 125000.00 2.0000 1.0000 $250,000 AC
[click here to hide] 2015 Building 1 Structural Elements I3ack ta To�
Site Address: 2425 N MCMULLEN BOOTH RD
http://pcpao.org/general.php?strap=16283 3000002200100
9/1/2015
Property Appraiser General Information
Quality:
Average
Square
Footage:
2772.00
Foundation:
Continuous
Footing
Floor System:
Slab On Grade
Exterior Wall:
Cb Stucco/Cb
Reclad
Roof Frame:
Flat Shed
Roof Cover:
Bu Tar &
Graval Alt
Stories: 1
Living units: 1
'' Floor Finish:
' Carpet/
Vinyl/Asphalt
Interior Finish:
Drywall/Plaster
Fixtures: 6
Year Built:
1962
Effective Age:
42
Heating:
Central Duct
Cooling:
Cooling
(Central)
�
Open plot in'�ew Vliindow
Description
Screen Porch
Open Porch
C.arpc�rt
Fiase
Building 1 Sub Area Information
Livi��� Area Ftz Gross Area FtZ
0 616
0 48
0 380
1,728 1,728
Total Living SF: 1,728 Total Gross SF: 2,772
[click here to hide] 2015 Extra Features
Page 3 of 4
Coinn�
1'roner
Recort':
Card
Factor Effective :
0.25 l
0.21
0.25
1.00 1; �
Total Effective SF:1,9
http://pcpao.org/general.php?strap=162833000002200100 9/ 1 /2015
Property Appraiser General Information
Description
GARAGE
SHED
FIREPLAGE
Value/Unit Units
$7.00 648.00
$6.00 120.00
$3,000.00 1.00
Total Value as New
$4,536.00
$720.00
$3,000.00
click here to hide� Permit Data
Page 4 of 4
Depreciated Value Ye
$4,536.00 19t
$720.00 19t
$1,230.00 19t
Permit infortnation is received from the County and Cities. This data may be incomplete and may exclude permits that do not result in
field reviews (for example for water heater replacement permits). We are required to list all improvements, which may include
unpermitted construction. Any questions regarding permits, or the status of non-permitted improvements, should be directed to the
permitting office in which the structure is located.
Permit Number Descri tion Issue Date Estimated Value
No Permit Data Found
Interacti��e Map af this parcel �1�c� Sales B1ck to (Juerv '�e�v Tax Collector H�me ('ontact
Legend ue Results Search Pa�e t�s
http://pcpao.org/general.php?strap=162833000002200100 9/ 1 /2015
Pinellas County Public GIS Viewer
Property Report: � ciose w�r,dow
2425 N MCMULLEN BOOTH RD
33/28/16/00000/220/0100
v: : X;
Prooertv Ao�raiser
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Page 1 of 1
General
Municipality: UNINCORPORATED '
Subdivison: '
Tax District: �F
Census Block: 1004
Census Tract: 026813
Zipcode: 33759 ,
Acreage: 1•999
2onin and Land Use
Land Use '
RL. Residentia) Low
Zoning Acreage '
A-E, Aqricultural Estate Residential 2
Public Safe
Fire District: 05 - Clearwater '
Evacuation Level: NON-EVAC
Political
Voter Precinct: 611
District 1
At-Large District: Janet C. Long '
Single Member District: District 5 '
Karen Williams Seel
Environmental
within 330ft. of Eagles Nest: No
within 660ft. of Eagles Nest: No '
Rec clin b Ci
Curbside: null
Dropoff: null '
Pickup: null '
.
http://gis.pinellascounty.org/public_gis/web/parcel_report.cfm?TYPE=ADDRESS&OBJ_K... 9/1 /2015
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Property Appraiser General Information
Page 1 of 3
lnteractive '�4ap of tttis narcel Back to Querv Results New Search Tax Collector Home PaTe Contact (.;s WM
Portabilitv
Calculator
33-28-16-00000-220-0160
Compac# Prot�erty Record Card
Data Current as of ����� P���tRadii�s
September O1, 2015 �e����'
Ownership/Mailing Address Chanae
PREEDOM, JESSE A JR TRUST
PREEDOM, KIM TRE
PO BOX 279
SAN ANTONIO FL 33576-0279
Site Address
0 MC MULLEN BOOTH RD
(Unincorporated)
Propert�° t1se; 0000 (Vacant Residential - lot & acreage less than 5 acres)
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Living Units:
[click here to hide] Legal Description
PART OF NW 1/4 OF NW 1/4 OF SEC 33-28-16 DESC FROM SW COR OF NW 1/4 OF NW 1/4
OF SD SEC TH S89D50'08"E 625FT FOR POB TH NOODOI'46"E 464.95FT TH N89D55'OS"E
210.23FT TH SOOD21'20"W 218FT TH N89D55'OS"E 400FT TO W R/W OF MCMULLEN
BOOTH RD TH SOOD06'03"E 249.57FT TH N89D50'08"W 609.56FT TO POB CONT 4.43AC(C)
'�lorta�a,ge Letter � File for Homestead
Exemption (� 2015
Homestead: No
Government: No
Institutional: No
Historic: No
2016
No
No
No
No
2015 Parcel Use
omestead Use Percentage: 0.00%
on-Homestead Use Percentage: 100.00%
lassified A�ricultural: No
Parcel Information Latest Notice of Pronosed PropertY Taxes (TRIl�7 Notice3
2015 Preliminarv Value Information
Year �ust/Market Assessed Value/ Countv �chool Municipal
Value SO�� Ca� Tasable Valr�e Tax�ble `'al�ie Taxable Value
2015 $470,642 $366,540 $366,540 $470,642 $366,540
[click here to hide] Value History as Certified (yellow indieates correction on �le)
Year 1-1c�me5tead JustiM�rket Count�� Mtxulici��al
Exemption Value Taxable Value Taxal�l�; Value
http://pcpao. org/general.php?strap=162 83 3 000002200160
9/1/2015
Property Appraiser General Information
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
$345,486
$302,925
$351,856
$366,660
$445,499
$578,633
$765,700
$746,000
$871,200
$664,500
$553,800
$398,700
$354,400
$332,300
$288,000
$288,000
$288,000
$288,000
$288,000
.'iSSk.:iS�C}
Value,!
SON Cap
$333,218
$302,925
$351,856
$366,660
$445,499
$578,633
$765,700
$746,000
$871,200
$2,200
$2,300
$2,200
$2,200
$2,300
$2,300
$2,300
$2,300
$2,300
$2,300
2014 Tax Information
Glick I-Iere for ?014 Tax Bill Tax District:
Tax Collector Mails 2015 Ta�c Bills October 31 �. �_�`�'
2014 Final Millage Rate 21.8998
2014 Est Taxes w/o Cap or $�,566.07
Exemptions
A significant change in taxable value may occur
when sold due to changes in the market or the
removal of exemptions. Click here for mare
information.
$333,218
$302,925
$351,856
$366,660
$445,499
$578,633
$765,700
$746,000
$871,200
$2,200
$2,300
$2,200
$2,200
$2,300
$2,300
$2,300
$2,300
$2,300
$2,300
�Ci100 �
Taxable
Value
$345,486
$302,925
$351,856
$366,660
$445,499
$578,633
$765,700
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Page 2 of 3
$333,218
$302,925
$351,856
$366,660
$445,499
$578,633
$765,700
$746,000
$871,200
$2,200
$2,300
$2,200
$2,200
$2,300
$2,300
$2,300
$2,300
$2,300
$2,300',
Ranked Sales n�n�c art i�nkf��► sa��s�l �Cf; 13�1
transactions
Sale Date Book/Page Price ,(�IU �_/I
No recent sales on record
2015 Land Information
Seawall: No Frontage: None
Land Lse Land Size Unit Value Units Total Adiustments
Vacant (00) Ox0 125000.00 4.4300 1.0000
V iew:
Adiusied Value �lethod
$553,750 AC
[click here to hide] 2015 Extra Features
Description Value/Unit Units Total Value as New Depreciated Value Year
No Extra Features on Record
click here to hide Permit Data
http://pcpao.org/general.php?strap=162833000002200160 9/1/2015
Property Appraiser General Information
Page 3 of 3
tnteractive %1ap of this narcel '�lap t.,e�end Back to Ouerv ResultsNe��� Search Tax Collector Horoe Pa�re Contact L;s
http://pcpao.org/general.php?strap=162833000002200160 9/1 /2015
Pinellas County Public GIS Viewer
Property Report: � Ciose Window - -
33/28/16/00000/220/0160
<.�
Prooertv Aooraiser
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:
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Tax Collector
Page 1 of 1
General
Municipality: UNINCORPORATED ,
Subdivison: '
Tax District: CTF '
Census Block: 1004 '
Census Tract: 026813
Zipcode: 33759
Acreage: 4.523 '
Zonin and Land Use
Land Use
RL Residential Low
Zoning Acreage '
A-E, Aqricultural Estate Residential 4.525
Public Safe
Fire District: 05 - Clearwater '
Evacuation Level: NON-EVAC
Political
Voter Precinct: 611 '
At-Large District: District 1
Janet C. Long
Single Member District: District 5 '
Karen Williams Seel
Environmental
within 330ft. of Eagles Nest: No
' within 660ft. of Eagies Nest: No
Rec clin b Ci
Curbside: nuli '
Dropoff: null
' Pickup: null
http://gis.pinellascounty.org/public_gis/web/parcel_report.cfm?TYPE=ADDRESS&OBJ_K... 9/ 1 /2015
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