__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
________________________________________________________ ____________________________________________________
AFTER RECORDING – RETURN TO:
PERMIT NUMBER: _________________________
NOTICE OF COMMENCEMENT
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
. DESCRIPTION OF PROPERTY (Legal description of the property & street address, if available) TAX FOLIO NO.: ____________________
SUBDIVISION
_______________________________BLOCK_________TRACT_________LOT________BLDG_______UNIT_______
2
. GENERAL DESCRIPTION OF IMPROVEMENT:
3
. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
a. Name and address: __________________________________________________________________________________________________________________
b. Interest in property: __________________________________________________________________________________________________________________
c. Name and address of fee simple titleholder (if different from Owner listed above): ________________________________________________________________
4
. a. CONTRACTOR’S NAME: __________________________________________________________________________________
Contractor’s address: _____________________________________________________________________ b. Phone number: ____________________________
5
. SURETY (if applicable, a copy of the payment bond is attached):
a. Name and address: ___________________________________________________________________________________________________________________
b. Phone number: _______________________________________________________ c. Amount of bond: $_____________________________________________
6
. a. LENDER’S NAME: _____________________________________________________________________________________________________________
Lender’s 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 and address: __________________________________________________________________________________________________________________
b. Phone numbers of designated persons: ___________________________________________________________________________________________________
8. a. In addition to himself or herself, Owner designates ___________________________of ________________________________
to receive a copy of the Lienor’s Notice as provided in Section 713.13 (1) (b), Florida Statutes.
b. Phone number of person or entity designated by Owner: _____________________________________________________________________________________
9. Expiration date of notice of commencement (the expiration date will be 1 year from the date of recording unless a different date is
specified):______________, 20____
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.
(Signature of Owner or Lessee, or Owner’s or Lessee’s (Print Name and Provide Signatory’s Title/Office)
Authorized Officer/Director/Partner/Manager)
State of ___________________
County of _________________
The foregoing instrument was acknowledged before me this __________ day of _______________, 20______________________
by ___________________________________________________, as ________________________________________________
(name of person) (type of authority,…e.g. officer, trustee, attorney in fact)
for __________________________________________________.
(name of party on behalf of whom instrument was executed)
Personally Known _____ or Produced Identification______ Type of Identification Produced _____________________________
Notary _______________________________________________
(Signature of Notary Public)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Rev. 10-15-12
BE SURE TO PRINT THIS ENTIRE FORM.
When printing, be sure the page scaling option is set to
"Fit to Printable Area."
City of Edgewater
Building Department.
104 N. Riverside Drive.
Edgewater, Florida 32132
