"Notice of Commencement Form" - Florida

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Download "Notice of Commencement Form" - Florida

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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 $7,500.00
PERMIT #: _________________________________TAX FOLIO #:_____________________________________________________
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 PROPERTY (AND STREET ADDRESS IF AVAILABLE):
________________________________________________________________________________________________________
2. GENERAL DESCRIPTION OF IMPROVEMENT:
________________________________________________________________________________________________________
3.
OWNER INFORMATION or
LESSEE INFORMATION (If Lessee contracted for the improvement)
a. Name: __________________________________________________________________________________________
Address: ________________________________________________________________________________________
b. Interest in property: ______________________________________________________________________________
c. Name and address of fee simple title holder (if other than owner):
_________________________________________________________________________________________________
4. CONTRACTOR:
a. Name: __________________________________________________________________________________________
Address: ________________________________________________________________________________________
b. Phone number: ____________________________
5.
SURETY COMPANY (IF Applicable, a copy of the payment bond is attached):
a. Name & Address: __________________________________________________________________________________________
b. Phone number: ___________________________ Bond amount: _________________________________________________
6.
LENDER/MORTGAGE COMPANY:
a. Name & Address: __________________________________________________________________________________________
b. 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 & Address: __________________________________________________________________________________________
b. Phone number: ______________________________________ fax number: _________________________________________
8.
IN ADDITION TO HIMSELF OR HERSELF,
a. Owner designates _____________________________________ of ______________________________________ to receive
a copy of the lienor’s notice as provided in section 713.13(1)(b), Florida statues.
b. Phone number: _____________________________
9. EXPIRATION DATE OF NOTICE OF COMMENCEMENT: _____________________________________________________
(THE EXPIRATION DATE IS ONE (1) YEAR FROM THE DATE OF RECORDING UNLESS A DIFFERENT DATE IS SPECIFIED).
WARNING TO OWNER:
ANY PAYMENTS MADE BY THE OWNER AFTER THE 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 FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING AND THAT THE FACTS IN IT ARE TRUE TO THE BEST OF MY
KNOWLEDGE AND BELIEF (SECTION 92.525, FLORIDA STATUTES
___________________________________________________________________________
SIGNATURE OF OWNER or LESSEE or OWNER’S AUTHORIZED OFFICER/DIRECTOR/PARTNER/MANAGER
___________________________________________________________
SIGNATORY’S TITLE/OFFICE
THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME THIS _______DAY OF________________, 20____, BY:
____________________________________________________________________________________________________________
AS__________________________________________FOR___________________________________________________________
NAME OF PERSON TYPE OF AUTHORITY
NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED
PERSONALLY KNOWN
OR
PRODUCED IDENTIFICATION TYPE OF IDENTIFICATION PRODUCED________________________
_____________________________________________________________________________
NOTARY SIGNATURE
NOTARY PRINTED NAME
NOTARY SEAL
NOTICE OF COMMENCEMENT
TO BE COMPLETED WHEN CONSTRUCTION VALUE EXCEEDS $2,500.00
OR WHEN HEATING OR AIR CONDITIONING REPAIR OR REPLACEMENT EXCEEDS $7,500.00
PERMIT #: _________________________________TAX FOLIO #:_____________________________________________________
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 PROPERTY (AND STREET ADDRESS IF AVAILABLE):
________________________________________________________________________________________________________
2. GENERAL DESCRIPTION OF IMPROVEMENT:
________________________________________________________________________________________________________
3.
OWNER INFORMATION or
LESSEE INFORMATION (If Lessee contracted for the improvement)
a. Name: __________________________________________________________________________________________
Address: ________________________________________________________________________________________
b. Interest in property: ______________________________________________________________________________
c. Name and address of fee simple title holder (if other than owner):
_________________________________________________________________________________________________
4. CONTRACTOR:
a. Name: __________________________________________________________________________________________
Address: ________________________________________________________________________________________
b. Phone number: ____________________________
5.
SURETY COMPANY (IF Applicable, a copy of the payment bond is attached):
a. Name & Address: __________________________________________________________________________________________
b. Phone number: ___________________________ Bond amount: _________________________________________________
6.
LENDER/MORTGAGE COMPANY:
a. Name & Address: __________________________________________________________________________________________
b. 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 & Address: __________________________________________________________________________________________
b. Phone number: ______________________________________ fax number: _________________________________________
8.
IN ADDITION TO HIMSELF OR HERSELF,
a. Owner designates _____________________________________ of ______________________________________ to receive
a copy of the lienor’s notice as provided in section 713.13(1)(b), Florida statues.
b. Phone number: _____________________________
9. EXPIRATION DATE OF NOTICE OF COMMENCEMENT: _____________________________________________________
(THE EXPIRATION DATE IS ONE (1) YEAR FROM THE DATE OF RECORDING UNLESS A DIFFERENT DATE IS SPECIFIED).
WARNING TO OWNER:
ANY PAYMENTS MADE BY THE OWNER AFTER THE 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 FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING AND THAT THE FACTS IN IT ARE TRUE TO THE BEST OF MY
KNOWLEDGE AND BELIEF (SECTION 92.525, FLORIDA STATUTES
___________________________________________________________________________
SIGNATURE OF OWNER or LESSEE or OWNER’S AUTHORIZED OFFICER/DIRECTOR/PARTNER/MANAGER
___________________________________________________________
SIGNATORY’S TITLE/OFFICE
THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME THIS _______DAY OF________________, 20____, BY:
____________________________________________________________________________________________________________
AS__________________________________________FOR___________________________________________________________
NAME OF PERSON TYPE OF AUTHORITY
NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED
PERSONALLY KNOWN
OR
PRODUCED IDENTIFICATION TYPE OF IDENTIFICATION PRODUCED________________________
_____________________________________________________________________________
NOTARY SIGNATURE
NOTARY PRINTED NAME
NOTARY SEAL