HomeMy WebLinkAboutRoof AffidavitNOTICE OF COMMENCEMENT
Permit No. Tax Folio No."'n) � �y/ v /� �uyv 5�
State of Florida County of St. Lucie
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida St.
the following information is provided in this Notice of Commencement.
Le gal Description of Property: (aPd street: address if available):
General description of improvement:
Owner information or Lessee
Name ID
for the improvement:
Address "
Interest in property
Name and address of fee simple title} 04g (if different from Owner listed above):
Contractor's Name: v 1W A1
Contractor Address: i Phone Number.
Surety (if applicable, a copy of the and is attached): Amount of bond-. $
Name and address: Phone number:
Lender Name:
Phone Number:
Lender's address:
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 Phone Number.
Address:
In addition to himself or herself, Owner designates
—to receive a copy of the
Lienor's Notice as provided in Section 713.13(1)(b), Florida S)4tuig.
Phone number of person or entity designated by owner.
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 AFTERTHE EXPIRATION OF THE NOTICE Of COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEM
uR
MUST BE RECORDED AND POSTED ON
E JOB SITE
FORE THE
IN
SPECTION, IF YOU INTENDPROPERTY. OBTAIN NOTICE
1lOdGCONSULT t COMMENCEMENT OLR ENDER OR AN ATTORNEY BEFORE COMMEN COMMENCINGWORK OR RST
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 know)edPend belief.
(Signature of Owner or Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manage,
W
(Signatory's Tltle/Office) (� I / CC
The foregoing instrument was acknowledged before me this 1 - I day of k U uIJ ! 20 2Q
1 1) I(.�I C� as OWiil,f — for�u�f�i(� bo -en o K� � is
B1l - Type of authority (e.g.officer,trustee) Party or, behalf of whom instrument was executied
Name of Person
„l( Personally known or produced identification
(Signature of of y Public -State of Florida) Vagm l" Type ofldentification produced �`—
(Print, Type, 4r S mp Commissioned Name of Notarypip
State of Pmft�
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Planning & Development Services
Building & Code Regulation Division
COUNTY 1 2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # 2006) o2 CV1
I, L_ID�J(A C.OYASWnt, licensed as a(n ontracto /Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection.
On or about ► 0 121 12 02 0 , 1 did personally inspect the roof deck nailing=.
(Date)
work at: `4003 AVe 9 Et. PieI'(-C, Fl_3yo1�-l-(
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 708 or the product approval submitted (whichever
is rnost stkentLi /i
Signature and Seal
STATE OF FLORIDA
COUNTY OF St.LU&I e
C.C,C 1321226
License #
Sworn to and subscribed before me this 2St l day of 0 C Toper 202q
by LJO�JCJ COn-S1010- Who is personal) known or who has produced
as identification.
Notary Public, State of F C a
Signature of Notary:
Commission Number: 7
En
(Seal)
;•.•``""�.; ASHLEY DEAN
Notary Public -State of Florida
s+�
•= Commission # GG 978378
'o;�ra, •�.' My Commission Expires
""'�"• April 14, 2024