HomeMy WebLinkAboutInspection Docs Public Works DepartmenRECEIVED
t
St " Code Compliance Division FEB 0 8 2017
, COUNTY2300 Virginia Avenue PER-UlITTING
St. Lucie County, cL
IF L • R I • A Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT
Re: Permit# c) C)(p
I, A4 0C-Z�V Zze,,/C,0-z. , licensed as a(n Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Bui ing Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
on or about i=—' 00l zal7 . I did personally inspect th roof deck nailing a d or
(Date) pply)
secondary water barrier work at: l �y�� �� 5� L v 111:2-5L 6
(Job site address)
Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
Signature and Seal License#
STATE OF FLORI A
COUNTY OF �i
Sworn to and subscribed before me this Z� day of 204
by a rnQA-Im� Who is personally known to me or who has produced
as identification.
Nota of FI n q
Signatur , , ✓����
Commission Number: (Seal)
En 09/17/09
KAREN S. NIELS
EN
:= Commission# FF 115637
2. •c
- My Commission Expires
o�
"':'E June 12, 2018
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 4275342 OR BOOK 3961 PAGE 1664, Recorded 02/06/2017 01 :43:48 PM
C iEfl m
NOTICE OF COMMENCEMENT FEB 0 8 2017
Permit No. 170 Tax Folio No. PERMITTING
State of Florida County of St.Lucie St. Lucie COLM4,. 17L
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.
Legal Dgsalption Property:(and streetaddr ss if av lable):
�WAZ .-gZu., ' ` �a Coy' A9 5W29 5W28 U) on- t 3 9 3� -/2 9 3
-
General description of improvement:_ _
Owner Information or Lessee Information if the Lessee contracted far the Improvement:
Name /GS _
Address ST '3(/,9 g _
Interest in property:
Name and address of fee simple titleholder(If different from Owner 4isted above):
Contractor's Name: 1
Contractor Address: !/ /�/jTL� Phone Number:
oS G._ F+C_ '�-V a-3 c-a CA m
Surety(if applicable,a copy of the payment bond is attached):Amount of bond:$ —4--t
Name and address: Phone number: in m N c m
�;rw CD
rA Lender Name:_ Phone Number: v—�C,
Lender's address: T c-ro
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section C34m n
713.13(1)(a)7.,Florida Statutes: n
--4CIO �
Name: Phone Number: 2
Address: F-2 Ir
C -<-4
In addition to himself or herself,Owner designates of to receive a copy of the v C�l
denor's Notice as provided In Section 713.13(1)(b),Florida Statutes.
Phone number of person or entity designated by owner: m y
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)
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.
(Sign a of Owner or Lessee,or Owner's or Lessee's Authorized Officer/Director/Partner/Manager
(Signatory's Title/Office)
The foregoing Instrument was acknowiedged before me this day of Fee , 20 1+7
By /�,0.e.,E L. 13 t 05 C-A, as for
Name of Person Type of authority(e.g,officer,trustee) Party on behalf of whom instrument was executed
CEEE3�
or produced Identification
(Sig otary Public-State of Florida) wr
(Print,Type,or Stamp Commissioned Name of Notary PUhi U.'..�t MARIELAMOOREType of Identification produced
4Y COMMMION 8 FF 941981
* EXPIRES:January 3,2D20
Bonded Thru Budgei N013rySenke5
t