BCP2016-05714, �
LL
° C e rwater
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PROJECT
LOCATION
City of Clearwater
Pianning & Development Department
100 S. Myrtle Avenue, Suite 210
Clearwater, FL 33756
Phone: (727) 562-4567
Building Permit Application WWW myclearwarer.com
PROJECT/JOB NAME � /-��'
PROJECT ADDRESS � � l ZIY� 1 �� 7�J
BUSINESS NAME r"—"" PHONE
PARCELNUMBER �f� / �� / �.� /`1�7��/��/�� I�
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NATURE ❑ BUILDING � ELECTRIC � PLUMBING
OF WORK ❑MECHANICAI � GAS � FIRE
(CHKK ❑ ROOFING ❑ ENGINEERING ❑ LAND RESOURCES
�' �T ❑ LANDSCAPING ❑ UTIIITIES ❑ PLN/ZON
APPLY)
❑TRAFFIC OPERATIONS �CLEARING 8� GRUBBING �}tSfHER
TYPE Of WORK: ❑NEW �ADDITION �REMODEL�REPAIR �DEMOLITION �OTHER
VALUAiION: $...2 �� V 1( // (iHIS MUST BE FILLED IN, PLEASE PRINT CLEARIIn
(LABOR & MAiERIAL5INCLUDING ANY CUSTOMER SUPPIJED PRODUCT)
PROPERTY
OWNER
(MUST HAVE
PHONE
NUMBER)
CONTRACTOR
(PLEASE
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c�art��
PROPERTY OWNER
C ITY
STATE� �
PHONE �0��'�CQ`�,�� � *EMAIL
NAME OF C
ZIP ����5
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LIC. HOLDER �v�L�l�-i�l �1 �7� PHONE �G�� �I o��-�
ADDRE t�""1 �� � I. Cj T� V� ��'
CITY %�� . STATE ZIP �� ??
STATE LICENSE # °-"�~ PCCLB #�--����
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PLEASE ENTER P RTY ADDRESS HERE:
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ARCHITECT/
ENGINEER
GENERAL
PROPERTY
INFORMATION
ADDRESS
CIN
PHONE
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EXISTING BUILDING USE
NUMBER OF STORIES
SQUARE FOOTAGE: LIVING
STATF "^
907 EARLHAM DR
BCP2016-05714
INSTALL FOOTERS FOR SLAB; INSTALL PAVERS
PAPPAS, MONICA qtlas#: 281B
Zoning:
PROPOSED BUILDING USE _
BUILDING HEIGHT NUMBE
GARAGE/CARPORT OTHER
COMME
�
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Anyone planning to do excavation work, must notify the one-caN "CALL SUNSHINE" Notification Center at 1-800-432-4770 prior f'c'
excavation work being done, in order to prevent underground damage. Federal D.O.T. Regulation Part 192, Sections 192.614 and
Application is hereby made to obtain o permit to do the work and installation 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 the standards of all laws regulating construction in this jurisdiction.
CERTIFICATION:
1 HAVE COMPLIED WITH ALL iHE FEDERAL STATE AND LOCAL ASBESTOS REGUlAT10NS CONCERNING NOTIFICATION OF THE
PROPER AUTHORIIIES OF THE PROPOSED DEMOLITION AND RENOVAi10N PROJECTS.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT NIAY RESULT IN YOUR PAYING iWICE FOR
IMPROVEMENTS TO YOUR PROPERTY.
IF 70U INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ATfORNEY BEFORE RECORDING 70UR N0710E OF
CONINIENCEMENT.
I am aware of Florida and Federal Accessibility Codes, and I certify that I have met the requirements of both.
I certify that, this application together with any plans submitted is accurate and represents all work being done at this time. All work will be done
in compliance with all applicable laws regulating construction and zoning qnd if not I reolize I am responsible For the removal of any construction
in violation of these laws or regulations. Any deviation from information submiBed, unless approved by the Building Official will render this permit
null and void.
IS HISIAPPLICATION T RESULT OF A ST P WORK ORDER OR NOTICE OF VIOLATION? YES NO
1 � , �/� �
�2�c� %�
Signawre of license Holder OR Authorized
/
Please Print Nome Here / Title in Firm or Homeowner
Date
REV. 10-28
Permit Number
Parcel ID Number o�-2s•is-ss�s�-000-o1i�
NOTICE O� COMMENCEMENT
KEN BURKE, CLERK OF COURT
AND COMPTROLLER PINELLAS COUNTY, FL
INST# 2016160267 05/26/2016 at 11:42 AM
OFF REC BK: 19206 PG: 1445-1445
DocType:NOT COM RECORDING: 510.00
State of Florida
County of Pinellas
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 713.13 of the
�lorida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of property (legal description):vARSITY ESTATES LOT 11
------- -- _. - __ _ _. _ __ ---
_------ _____ ____ _.--_--
----- -__ _ _ --- __
8) Stfeet (job) AddresS: 907 Earlham Dr, Clearwater, FL 33765
— _�._.- ----------_ _----------------- -----------_____--- ---------
2.General description of improvements: Cut 8' off existing slab to install new 70' of 8" x 8' footer with 1#5 rebar. Install thin pavers 19' x 32'
_.. _______ _.__._ __--- ------__ ___.__-- __.--__._—___
_- -- _ ----- ------- -- _ _
existinq slab to remain.
3.Owner Information or Lessee information if the Lessee
a) Name and address: ��_�����,,_ _-r'�'
b) Name and address of fee simple titleholder (if different
c) Interest in property: _
- _ -- - _
4.Contractor Information
a) Name and address: PERKINS CONCRETE INC. 6692 119TH AVENUE NORTH LARGO,
-_ -- - . --
_ _ __ --- - ----- - --
b) Telephone No.: 727 531 2545 _ ___ __ Fax No.: (optional)
5.Surety (if applicable, a copy of the payment bond is attached)
a) Name and address:
-- ----------
b) Telephone No.:
__ __
__._...- __ _ ___ _. _
c) Amount of Bond: $
__ __- --- ______ __--- - -----_--- -----------
--
6. Lender
a} ►vame and address: _N C��0�1 Wr i� 2_��j(,� �1�(�__ _`�(
b) Telephone No.: � QQ_ LOCVS P� V.
� �- - - - - '� s+� �_p e�_fi 7�c.xt _-- __��
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7. Persons within the State of Florida designated by Owner upon whom notices or other documents may b'e served as provided by Section
713.13 (1) (aj 7., Florida Statutes:
a) Name and address:
------------------- -----___--- ----------------- 907 EARLHAM DR
b) Telephone No.: Fa�
8.a.ln addition to himself or herself, Owner designates __ BCP2�� 6-05714
to receive a copy of the Lienar's Notice as provided in Section 713.13 (1) (b), Flo INSTALL FOOTERS FOR SLAB; INSTALL PAVERS
PAPPAS, MONICA qtlas #: 281 B
b)Phone Number of Person or entity designated by Owner. _ Zoning:
9. Expiration date of notice of commencement (the expiration date may not be bei
�_�j.....��� av L11G
__ contractor, but will be_1 year from the date of recordin�unless a different date is �ecifiedZ __ 20
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPtRAT10N OF THE NOTICE OF COMMENCEMENT ARE j
CONSIpERED {MPROPER PAYMENTS UNDER CHApTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR I
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON I
THE JQB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN I
ATTORNEY BEFORE COMMENCING WORK OR RECORDING YQUR NOTICE OF COMMENCEMENT. !
_ ___- --_ _ .--- _ -- -- — --- ____ --_-- ----- -----_ _ __------- __ __ .
_. .
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my
knowledge and belief.
� __ __ __ _ .�--------- _ _ ___---_- --°�'���t_� ��3. _
— _-----------
(Signature of Owner or Lessee, or ners o L ssee's (Authorized OfficedDirectodPartnedMarrager) (Print Name and Provide Signatory's TiUe 0 i� �
The fore oing instrument was acknowledged before me this ��_ _ _ _ _ day of _ Q"��� _ _ _ _ _ __ _ , 201� _
--
bY (�1��� ___��� a+_._ ____ as .��112( __. ____ l�Ype of authonty, e.g. officer, trustee. attomey m fact)
for �s�.._�_ --�. � , as
_ -i�a�kr_-
--- __ _ _. ------ ----- --
--- --- _ __ __----- ------_ _. __.
( ame of Person) (type of authonty,... e.g. o�cer, trustee, attorney in fact)
for �,�n; �,. _� �s _ (name of party on behalf of whom instrument was executed).
Personally Known � �� Produced ID
C�— _ �T �an�e
Type of ID � _ � L . - .___ __ . Notary Signature -- �� _ _� p•�''"'-' -"�'� ----Stat_e_ot FlOnd�---
Print name c/J, -T�--�1�1� :"Z i. W Mlului�4inN � FC ��
Eupires: June 5, 2018
6onded t�ru CNA Surety
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BCP2016-05714
INSTALL FOOTERS FOR SLAB; INSTALL PAVERS
PAPPAS, MONICA
Zoning: Atlas #: 281 B
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