PERMIT NUMBER:______________________
NOTICE OF COMMENCEMENT
The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713,
Flo
rida Statues the following information is provided in the Notice of Commencement.
1. DESCRIPTION OF PROPERTY (Legal description & street address, if available) TAX FOLIO NO.: _______________________________
SUBDIVISION
_______________________________BLOCK_________TRACT_________LOT________BLDG_______UNIT_______
__________________________________________________________________________________________________________
2. GENERAL DESCRIPTION OF IMPROVEMENT:
__________________________________________________________________________________________________________
3. OWNER INFORMATION: a. Name________________________________________________________________________________________________
b. Address________________________________________________________________________________ c. Interest in property_________________________
d. Name and address of fee simple titleholder (if
other than Owner) ______________________________________________________________________________
4. CONTRACTOR’S NAME, ADDRESS AND PHONE NUMBER:
____________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________
5. SURETY’S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
____________________________________________________________________________________________________________________________________
6. LENDER’S NAME, ADDRESS AND 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:
NAME, ADDRESS AND PHONE NUMBER:
____________________________________________________________________________________________________________________________________
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor’s Notice as provided in Section
713.13 (1) (b), Florida Statutes
:
NAME, ADDRESS AND PHONE NUMBER
:
____________________________________________________________________________________________________________________________________
9. Expiration date of notice of commencement (the expiration date is 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 Print Name and Provide Signatory’s Title/Office
Owner’s Authorized Officer/Director/Partner/Manager
State of Florida
County of Polk
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 the following type of identification: __________________________________________
Notary ___________________________________________
(Signature of Notary Public)
Unde
r Pe
nalties of
perjury,
I
declare t
h
at
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(s) of Owner(s) or Owner(s)’ Authorized Officer/ Director / Partner/Manager who signed above:
By __________________________________________________ By _______________________________________________
AFTER RECORDING - RETURN TO:
