notice of commencement 631 AmberjackState of Florida
County of Duval
To Whom It May Concern:
NOTICE OF COMMENCEMENT
Tax Folio No.
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713
of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: 30-060 17 -2S -29E Royal Palms Unit 1 Lot 2 Block 5 OIR BK 3027-827
Address of property being improved: 631 Ambedack Lane Atlantic Beach FLorida 32233
General description of improvements: Interior Home Repairs replacing drywall, floorinq, bathroom remodel
Owner: Charles Upchurch Address: 631 Ambedack Lane Atlantic Beach FL 32233
Owner's interest in site of the improvement: 100%
Fee Simple Titleholder (if other than owner):. _
Name: _
Contractor: Beaches Habitat for Humanity
Address: 797 Mayport Road Atlantic Beach FI 32233
Telephone No.: (904) 241-1222 Fax No:
Surety (if any)
Address: _ _ Amount of Bond $ _
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may
be served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2) (b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER �y
Doc # 2023185834, OR BK 24802 Page 15B6, Signed: Date: !
Number Pages: 1 Before me this • day o i in the County of Duval, State
Recorded 09,-08!2423 01:27 PM, Of Florida, has personally appeared
JODY PHILLIPS CLERK CIRCUIT COURT DIJVAL Notary Public at Large, State of Florida, County of D
COUNTY ty0y�res: ; "Y J
RECORDING $10.00 OYCE MARIE FREEMAN
Personally Known: r „�'.. Notary u c tate o W 00"2 it da
IS
Produced Identification: e 22 025
8orcecthrough National Notary Assn.