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Permit Number
Parcel ID Number
NOTICE OF COMMENCEMENT
State of Florida
Count y 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
Florida Statutes, the following information is provided in this NOTICE OFCOMMENCEMENT.
T
HIS AREA IS RESERVED FOR
C
LERK OF
T
HE
C
OURT
C
ERTIFICATION
1.
Description of property (legal description):
a)
Street (job) Address:
2.
General description of improvements:
3.
Owner Information or Lessee information if the Lessee contracted for the improvement:
a)
Name and address:
b)
Name and address of fee simple titleholder (if different than Owner listed above)
c)
Interest in property:
4.
Contractor Information
a)
Name and address:
b)
Telephone No.: 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)
Name and address:
b)
Telephone No.:
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)
Telephone No.: Fax No.: (optional)
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 may not be before the completion of construction and final payment to the
contractor, but 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.
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.
(Signature of Owner or Lessee, or Owner’s or Lessee’s (Authorized Officer/Director/Partner/Manager) (Print Name and Provide Signatory’sTitle/Office)
The foregoing instrument was acknowledged before me by means of physical presence or on-line notarization, this day
of , 20
by
(type of authority, e.g. officer, trustee, attorney in fact)
for
as
, as
(Name of Person) (type of authority, e.g. officer, trustee, attorney in fact)
for
(name of party on behalf of whom instrument wasexecuted).
Personally Known Produced ID
Type of ID Notary Signature
Print name
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signature
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