PERMIT DOCUMENTS CFN. 20160159939
AFfERRECORDINO-RETURN TO OR BK 28272 PG 1176
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RECORDED 05/04/2016 10:43:15
• Palm Beach County, Florida
•/ Sharon R. Bock,CLERK 8 CO)IPTROLLER
G
I V' I 11V Pg 1176; (1pg)
PERMIT NUMBER;
.NOTICE OF COMMENCEMENT
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The undersigned hereby gives notice that Improvement will be made to certain real property,and In accordance wish Chapter 717, •
Florida Statute,,thefollowing information U provided in this Notice ofCommutccmenc.
08 43 45 29 18 059 0380
I. OPSCRIP ION OP PROPERTY(Legal description or the property A rind address,If available)TAX POLIO NO.:
Palm1Beach Leisureville 59 38
SUBDIVISION BLOCK TRACT LOT BLDG UNIT
3.
GENERAL DBSCRIPf10NOPIMPROVEMENF: Home improvement •
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3. OWNER INFORMATION OR LESSEE INFORMATION IFTHE LESSEE CONTRACTED FOR THE IMPROVEMENT:
..Nem.end semRoger Fortin, 1000 SW 15th St., Boynton Beach, Fl 33426
b.!Mural In popery Owner
c.//smear.]Adana of reesimple lldrheldo,(IrdiTnm from Omer iiesti stove; N/A
4. a.CONTRACTOR'S NAME: Bailey's Home Services, Inc.
Gono.r,a,.raed err. • P.O. Box 476, Boynton Beach, Fl 334,?Ama..mbm: 561-738-5933 -
3. SURETY Of,WInbre,•copy or loo torment bond le Mahe*
•.Rims cod addrau: N/A
b Mom waiter I c.Amami or bend:S
6.a.LENDER'S NAME: N/A
Lmdc'a.ddrsn b.Phase minket
7. Persalt within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Seaton 717.17(I)(a)7.,Florida Statutes: _
•.Noma d address. I N/A
a
•
tt Phone number•oflelgiated puna:
8.a.In addition to himself or herself,Owner designates N/A of •
to reserve I copy of the Lienor'a Notice as provided In Section 717.17(1)(b),Florida Statutes.
b P00.e mambo erpeene amity dolorous'W Omer:
9. Expiration date of notice of commencement(the expiration date may net be before the completion of cone cJ Oend Final
payment to the nano-lifter,but will be I year from the due of recording unless a different date Is specified): �- 20 16
la e .4 C.4.1 ' I.,' e.IJ': .i, . I. . • • so- .ye - e' Its„I,.R. '�GJ
•:•t• I• : . I..MJK].0'.l ..r: 'Mss,. . Y.ala: ..n
RFSLB T N YOUR PAYING TWICE FOR IIPROVPMFNTR M YOUR PROPERTY A NOTICE OF COMMENCEMENT All ITT-g
RECORDED AND POSTED ON THF 100 SRP BggOaE THE FIRST D.'5PE6TION YOVV']MEND TO OBTAIN FINANCING CONSULT
WITH YOUR LFNDER OR AN ATTORNEY BEFORE COMM ENCNO WORK OR RPCORJOJO YOUR NOTICE OP COMMENCEMENT
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated therein we Due to
the best of my knowledge and belief
0. 7vr,-- RI/L, Fmr7nnilh
(SIAu rise ofOwnerprctor/PLana,
rt er/MaOwnenor Leuu'r (Print/game and ProvideSignatory's 71tle/Ofllu)
Authorised Oflleer/Dirtctor/Partner/Manager)
' Stele of L,(., '
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County of 8' •• ' I •
• /^� z9 20/6
.. . he forewenglnagummpwaa aclu(mwledged before me Nis,2-9 day of Y 2,—
_.T
•
by Ro z r— —Tf� -
(name of person) (type of authority,...e.g.officer,Dunce,attorney in fact)
for
(name of party onibehalf of whom instrument was executed) r,7,1 �, / /J
Personally Known or Produced identification t/ Type of IdentificationonPrrodduuced lF14—A^2 i1cc'J ` Fl
YYPrneS: 1EEaSmH 2�/��1, % Notaq
•
• •�irU• E%PIREE:DMrmMI1,4M0
• �r was Te.By9M",ariat (Signature of Notary ubllc)
- Rev.I4el-II(s,Rewdlnp mere (Prink Type,or Swap Commissioned Name of Notary Public)
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`'•"fovo•y STATE OF FLORIDA • PALM Of ABB COUNIr
;ice' Tru- '- %Y I nereby certify Thal the lolegoinp ie.a
A. IYt\: true copy of the record in my Mlles win
revs.v d any as re uvea by Tag
�% r• THIS DAr OF(�/(/�(jJ�''��� .20
'�••triapu). SMARON R, BOLR(
CLERK & COMP LLER
By