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Home My WebLink AboutSUBMITTED PAPPERS 2FL— OFFICE-USE:ONLY- DATE FILED: PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER:� CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: i BE COMPLETE 8t FILLED IN TO BE ACCEPTED ST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT 2300 VIRGINIA AVENUE p� FORT PIERCE, FL 34982-5652 - SCANNED 561-462-1553 B11 St. Lucie County APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION LOCATION/SITE ADDRESS: S I VI ?-low-rpF A I A FT, P 2cig, Ft. 2. SID NAME: SITE PLAN NAME: Cr-FAM I1DIc—iii 3. PROPERTY TAX ID#: _1411 - %e`] - oo4Z - Ooo-7 L�3� 4. LEGAL DESCRIPTION (attach extra sheets if necessary): `SC G , n i t hC M rLD ,L (�i ilL �G5UZ.49 I o n/ 5�, ,PLAT 6. PAGE 7. BLOCK; t,. •�i 8<, I LOT BOOK NO. NO. NO. 9. PARCEL SIZE: ACRES/SQ FT. 2,71 AL LOT DIMENSIONS VA(LI V-S 10. DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: DAIS t Au-}?Tto-I o F ,i !� n-w'�r�ytPa l'�1 t11 iL�f% J�t�GJ-j'i2 f%F( �jCISTtM` f7111 L7j7 a1 C��ol`Te tJ 11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT LEFT SIDE SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] RESIDENTIAL [ ] OTHER (SPECIFY) EXPANSION/ADDITION [ ] INTERIOR RENOVATION ['] COMMERCIAL [ ] INDUSTRIAL 13. DESCRIPTION OF PROPOSED USE: AgTrNgA, , D� 2t;S t n FxTi�s t 13o t �n ta+t- 14. Sq. Ft:/CONSTRUCTION. 15. \ WE.OF-CONSTRUCTIowj 75000 Ptruetion is used to determine the amount of permit fees to be asse wnstruction if it is demonstrated that the submitted figures are not cc Sq. Ft. 1st Floor:�A St Lucie County reserves the right to question and/or modify the I with similar types of construction activities. If the value is $2500 SLCCDV Form No.: 001-02 THE AVERAGE PROCESSING TIME FOR MOST BUILDING PERMITS IS TEN (10) WORKING DAYS OWNER INFORMATION: NAME: C^FRr- HRz- rZ� J R, Aan c-i f4'j ?oN I ADDRESS: �,(A `DTI-} •i� I -A CITY: Q-^ STATE: •FL ZIP 34 G Li PHONE (DAYTIME): a II C/L,(2 IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. ` FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: STATE: ZIP PHONE (DAYTIME): I 1 CONTRACTOR INFORMATION , : • . ' ST. of FL REGJCERT 0: C-(n Go Sq'f 69 ,�T- (E=COUNT RT , BUSINESSNAME: eiritri-�2g-Q LNG. QUALIFIERS NAME: • 'qA-M LLiriz ADDRESS: 181A C99f-0QAT1;, _D4 ✓; CITY: Re V_Tt f & lid..! g STATE: rill ZIP 3 27 PHONE (DAYTIME): _(54 ( 1 't• a '1-7-2-:1 FAX NO. S&I 7Yy .. 77 r T N NEER: ADDRESS: CITY: . PHONFi(DAYj MI E BONDING COMPANY: ADDRESS: CITY: v L!'I.1. c:1.. ' .. , t35S; R(oO-14GLI MORTGAGE LENDER: _ ADDRESS: CITY: STATE: STATE: ZIP ZIP _ IMPORTANT NOTICE: When a permit is issued and it is not picked up within after notification it will be voided and returned to you by CERTIFICATION: This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity, if applicable, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AND AIR CONDITIONERS, ETC., not otherwise included with this building permit application. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non- residential use. NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE TO APPLICANT: AS THE APPLICANT FOR THIS BUILDING PERMIT, IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT TO ATTACHMENT; AS A CONDITION OF THIS PERMIT YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance Q with all applicable laws regulating construction and /zoning. qtN—NSNCONTRACTOR SIGNATURE 6OOATRAC:T ` 'SIGNATUgE STATE OF FLORIDA COUNTY OF SL L v Lr s The foregoing instrument was acknowledged befor me this _�L day of 10-et 20$ , by�+nC who is personally known to me or who has roduced , as identification. Type or Print Name of Notary Notary Public Title C T 3LauntS3tlld%S00Z (Seal) S09U0 N SJH STATE OF ELORIDA, COUNTY OF The foregoing instrument was acknowledged before me this day of 20 0i b who s ersonal_ Iv Im to me or who has produced as identification. Dabbra J Muff My Commission CC727520 Expires March 24. 2002 Type of Print Name of Notary Notary Public Title (seal) Commission Number NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNERIBUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. BP#: -R OFFICE IM'O ONLY . . . . ... . . ....... . ..... . ... . .. ... . .. ........... . . .... . . . . . . . .. .. .... . . SECTION: TOWNSHIP: -3y RANGE: MAP NO.: 10 ZONING: LAND USE: LOT CVG %: TAZ NO.: FLOOD ZONE: FIRM MAP 1ST FUR ELV: MAX HGT: CST TYPE: yy OCCPTYPE: ��cp-. # OF FURS: WATER: SEWE SPRINKLERS STORMWATE R LOT OF REC (befr 1/90) LOT OF REC (aftr 1/90) LOT SPLIT LOT SPLIT REQ'D APPRV`D -2S-03 DECAL NUMBER LIBRARY IMPACT FEE PARKS PERMIT IMPACT FEE FEE REPORT PUBLIC BLDG HABITABALE ILDON FEE CODE. IMPACT FEE AREA (RADON) �c ROAD GROSS ROAD TOTAL ROAD IMPACT ZONE IMPACT FEE IMPACT FEE DUE N SCHOOL CREDIT TOTAL IMPACT FEE SCHOOL IMPACT FEE POLICE FEE FIRE FEE MISC FEES: TOTAL 913tr v- A POLICEIFIRE/ F MISC.EES Y N ADDITIONAL SPECIFY: TOT:ALL PERMITS FEES REQ'D REVIEWS ZONING ZONING PLANS VEGETATION I - SEA MANGROVE REVIEWED BY EXAMINING TURTLE DATE 112-EaO COMPLETE INITIALS 4 ..; iYt:afu., .•. •a :. !' ":!p' 9' v� r0t.S n 1'! •' ll' '13,i11(•i� fi ! I Il j'r .l �3a `;••9y •. !• AM:. !! " G7 :.l. is 3 K • _ - 0' 1 C:C •, Ol Y .: !._.! It LY.`• Ci ! i 10 `{^.Mill lc\ id �1 i1 � Yi ap7:: '.I `!at7 lil 9J •M3 is L'� 7.10d i( ,+ ti `+7 •9 :1 "9il 9' :d.Yl !'!1 `i ?' ;1 "I3' 31 !'�-ei' 1:13f ', 0i� 3:�R"d' d-G. Y" 'P. YS •Y ^3 iY•. s[ Z. 13- ram 7•too 3' a" • •. :' :,. l::7 'N ZI •"�: "/�.Y 73�1 ..0 4 • : 7,Y. • •:1 1 •3: Y�Mi,! • 1 aaF.� i' :+iii'<•{y {f 1a$` •C v _ !:1 6y'?0►• �1 ! 3Y! li .;<:! _!D �! _ •'G I ' i C. L ?:f'.I. r ^y3Di .G i i.i 0 ' •i i 0 OR BOOK 1485 PAGE 2518 OCEANIL&RDOUR CONDOMMUM "E" 4-Lit)-4 !- aj '60" Cis *I A PARCEL (IF 4AM BEING A PORTION OF GOVERNMENT'LOT I AND:LOT 6 IN SECTIONSZO AND: 11- TOWNSUP 34'SOUM.KANGE'; 40- FAST,-= LUCIE COUNTY..FLOMA ii&G WESTERLY -OF STALE ROAD Art -A;. SAID PARCEL BEINGMOIMPARWCMARLYDESCMWASFOLUMS; .I, Iu [4kQ(cw.If!&j;Im IN if m I NWA ot owl. All io- ni MW. 101 ',7A 111101 ldltllff� IWA 9 p :5 us•I oil" :1 '0)401 AIN lots •lot .............. 4 2 IF fal low ........a :or. . . . . . . . .$a, 61 INC. Is I I a MIN OR BOOK 1485 PAGE 2519 Ft- 9ys8o - rNvlela 5A0 rr+ 51+ aL:r (L(L REQUEST FOR 30-IRAY TEMPORARY POWER RELEASE DATE: ST. LUCIE COUNTY BLDG. & ZONING Iaia.(, lot 2300 VIRGINIA AVE FORT PIERCE, FL 34952-5652 PERMIT NUMBER: Ph. (561) 462-2165 of l a )b ?3 FAX (561) 462-1148 PROPERTY ADDRESS: 51 G7 AloArp A I A THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN PREPARATION FOR FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS: 1. This temporary power release in requested for the above stated purpose only, and there will be no occupancy of any type, other than that permitted by construction during this time period. 2. As witness by our signatures, we hereby agree to abide by all terms and conditions of this agreement, including Building Division Policy, which is incorporated herein by reference. 3. All conditions and requirements listed in the attached document entitled 'Requirements for 30 Day Power for Testing' have been fulfilled and the premises is ready for compliance inspection. WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM ALL LIABILFI IES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT OF THIS TRANSACTION, INCLUDING ANY DAMAGES WHICH MAY BE INCURRED DUE TO THE DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF IBIS AGREEMENT. 1 BOARD OF COUNTY COMMISSIONERS November 30, 2001 Mr. Gerald Freeman Nextel South Corp. 6700 N. Andrews Avenue, Ste. 700 Ft. Lauderdale, FL 33309 JL�E CMG COMMUNITY DEVELOPMENT ' DIRECTOR F�OR1�P Subject: Nextel Antennas - Minor Adjustment to a Major Site Plan Ocean Harbor North, South Hutchinson Island, St. Lucie County Dear Mr. Freeman: The St. Lucie County Development Review Committee has reviewed your application for a minor adjustment to the above referenced project and has determined it to meet the minimum technical requirements of Section 11.02.04(C) and Section 7.10.23(H), St. Lucie County Land Development Code. This site plan approval becomes effective immediately. The purpose of this adjustment is for the installation of nine (9) wireless communication antennas (three (3) antennas to be located on the north side of the condominium, three (3) antennas to be located on the east side of the condominium and three (3) antennas to be located on the west side of the condominium) and a 230 square foot rooftop equipment shed on the roof of the Ocean Harbor N. Condominium. This approval does not in any way constitute authorization to begin construction. Prior to the commencement of any construction on this property, an application for specific building permits must be obtained from this department. Building permit applications maybe submitted at anytime following the receipt of this notice. For specific information on the composition of these submissions, including applicable fees, please contact the St. Lucie County Public Works Department - Building and Zoning Division at 462-1553. Please contact me at 561/462-1960 if you have any questions. Sincerely, l uwY0,0 � ANwo Dennis J. Murph V'' 6 �S Community Development Director DJM/cs WprojectANeztel-Ocean Harbor Mapproval-ltr. cc: County Attorney County Enginneer County Surveyor Road & Bridge Acquisitions Building & Zoning Allison Megrath (Urban Concepts) File JOHN D. DRUHN. District No. 1 • DOUG COWARD. District No. 2 • PAULA A. LEWIS. District No. J • FRANNIE HUTCHINSON. District No. 4 • CLIFF BARNES. District No. 5 County Administrator - Douglas M. Anderson 2300 Virginia Avenue • Fort Pierce, FL 34982-5652 Administration: (561) 462-1590 • Planning: (561) 462-2822 GIS/lechnical Services: (561) 462-1553 Economic Development: (561) 462-1550 Fox: (561) 462-1581 Tourist/Convention: (561) 462-1529 • Fox: (561) 462-2132 TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY FARMINGTON CASUALTY COMPANY r Hartford, Connecticut 06183-9062 POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford, County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these presents make, constitute and appoint: Shannon R. Keane, Alexandria N. Gardner, David C. Moylan, Julia B. Taylor, Susan B. Willett, of Washington, DC, their true and lawful Attomey(s)-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, the following instrument(s): by his/her sole signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Companies, and all the acts of said Attomey(s)-in-Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are now in full force and effect: VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attomeys-in-Fact and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her. VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary. VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary, or (b) duly executed (under seal, if required) by one or more Attomeys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority. This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed) under and by authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, which Resolution is now in full force and effect: VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attomeys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. (11-00 Standard) Bond No.53SB103700943 SITE RESTORATION BOND Nextel South Corp., d/b/a Nextel Communications, as Principal, and Travelers Casualty and Surety Company of America of Hartford, CT, as Surety, are held and firmly bound unto St. Lucie County, 2300 Virginia Avenue, Ft. Pierce, FL 34982, as Obligee, in the penal sum of One Thousand and 00/100 Dollars ($1,000.00) the payment of which we bind ourselves, our heirs, executors and assigns fmmly by these presents. The nature of this obligation is such that the Principal has been issued a permit from the Obligee located at Nextel Site No. FL4580B-Indrio South, 5167 North AIA, Ft. Pierce, FL 34946 and intends on malting changes, additions and alterations to the leased premises. Now therefore, if the Principal removes the telecommunications tower or antenna (St. Lucie County Permit ) upon abandonment by Section 7.10.23 of the St. Lucie County Land Development Code then this bond is void, otherwise to remain in full force and effect. The total amount payable under this bond, in the aggregate, shall be the penal sum referenced above, regardless of the number of years this bond remains in force. This bond is a continuous obligation and shall remain in force until canceled. The Surety may cancel this bond at any time by giving the Obligee written notice thirty (30) days prior to the effective date of the cancellation. Upon the cancellation effective date, future exposure to the Surety under this bond shall terminate. However, the Surety shall remain liable for any exposure under this bond resulting from the Principal's failure to fulfill its site restoration obligations during the time this bond was in force. Cancellation by the Surety does not need to be accepted by the Obligee to be effective. The Obligee may terminate this bond at any time. Effective Date of Bond: October 15, 2001. Signed and sealed this: October 15, 2001. Nextel South Corp., d/b/a Nextel Communications Principal By 114A-L"—) {1 _ Christie Hill, Corporate Secretary Travelers Casualty and Surety Company of America Sur B S B. Willett, ttomey-in-fact Co ntersigne�dJBy: /,� � �� Q uli A. Russell, Florida Resident Agent SWM-SWEXML�Sm yWextol South Cotp'Sne Ranomion aondt10370094311.doc CA a ST. LUCIE COUNTY PUBLIC WORKS BUnbm & ZONING DEPARTMENT BUILDING PERMIT SUB -CONTRACTOR SUMMARY EN" '-QZF2> Nyifthl Mf T< lac SAM Vlc"(Z will be using the (comPanyfftw ual name) l J ( r6(Qd{o 50wT7+ 5t��ren- following sub -contractors for the project located at 5 16� 11 Vxna 4 / 4 It is understood that if there is any change of status regarding e n the participator property tmxl of any of the sub -contractors listed below, I will immediately advise the Building and Zoning Department of St. Lucie County. Name of CamPary/Contraeeor St. Web County/ Stab of Rodda uemoe Number FE y'a�r'9 �rJl/<oM/�iY�j f.�[.2�T2/CaL %FLffl/oLo�FdS •F4 LLG ECG°oo931 WVACUedoodcM Roaft Gn �, ,. :/ F .. ' - � t' l J t. .. �.i � , f .. � ST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number. State of Florida Certification Number (If applicable): 1q�q9 C-CA 6o643r r� -r5 no l nlQrtic 5e ofG SNEt=+� �Kca m �Ss F�Lrr c ra I c A t� 'f'att•f AA Lag t es_�L L.l-Chas agreed to be (mmpanylndividual name) the A,L- sub-contractorfor GAlG1Na&cltTzoiinSyirzoNantEu,-1uC (type of construction trade) (name of the prime contractor) for the project located at _S/ 6 7 /Yo2 m 41 A It is understood that, (street address or property tax ID #) if there is any change of status regarding our participation with the above mentioned project; I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor Form (SLCCDV FORM NO.004-00). BUSINESS OU 1FIER (original signatures required): s�djl" It sign a Priff name Date business name: 19LF-67 Ir A--. %eC9A/9LaRtes-r-L.LLC address: 3� S . (! 13 7)4Z. city,state,zip: CL 33rf',42. phone: 95-�4 - 'f 27 - -n W 5 DFFICEVSE ONLY: SLCCDV FORM NO.: 002 PERMIT 0 ISSUE DATE 00 Permit # 6P 11 a I I nl fOsr a Desired date of issuance St Lucie County Permit Submittal Form Poss,l Date Received i2 f 2t 1 o I Location/Site Address51(v-4 ,,�, . A, , c-�� , �- 3 "q 4 4 Owner's Name ,0,,2 afl--;,A Phone # %-ALtASc,,-- Contractors Name 6 -,c.Phone # 5(o I - 2,3 � g Engineer's Name .ApE G co,,s,_., �-�.4,�s . Phone # .Page? p'l��l�� 01 /30/2002 FL4580- Indrio South Notice: of Commencement State of Florida County of St. Lucie �i Permit No: _Tax Folio No. (PID): 1410-501-0016-01018 The undersigned hereby gives notice that improvement will bg made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. Description of Property (Legal description of the property and street address): See Attached Legal Description (a/k/a Building E, Ocean Harbor, Condominium, 5167 North A1A, Ft. Pierce, FL 34946) General Description of Improvement: Installation of equipment shelter for wireless communication antennas on existing building rooftop. Owner Information: Name and address: I` etc.) d/b/a NextefCommunications. FL 33309 (c/o Jim Fee Simple Title Holder ( if other than owner ): Ocean Harbour Condominium Association, Inc., a Florida non-profit corporation, 5167 North A1A, Unit 408E, Ft. Pierce, FL 34946 (c/o Gerald Freeman) CONTRACTOR: Name and address: Engineered Environments, Inc. 1829 Corporate Drive, Boynton Beach, FL 33426 Surety (Bonding Company):J. Name and address: N/A i Amount of Bond: N/A Lender: Name and address: N/A .Tl—nc- ED r- = 0 rD 0 M z Persons within the state of Florida designated by Owner, up whom notice or other documents' may be M _ served as provided by Section 713.13(1)(a)7.,Florida Statutesi CD Name and address: LIJ L, a 0 CD z \Ems] V oon In addition to himself, Owner designates — of ro N m fd'receive a copy of the Lienor's Notice as �F provided in Section 713.13(1)(b), Florida Statutes. - CD 0 0 Expiration Date of Notice of Commencement:. - o m The expiration date is 1 year from the date of recording unless a differeht_date is s ecified) F-d 4-1 W c� E Si ture of ner .Ly _ m o Sworn to and subscribed before me this 30 Day,of•.„ _, 204L. cz P] -i En ;ST_ATE Of FLORIOIA CO My Commission; iq_ B Y/f 4. & COUN v Notary Public (' =''' �o z The foregoing instrument was acknowledged before me this3� �' I YTHATT I_ H $ISHE A by ¢ q. y —+ J �b c t m .1c e�INs�er (name of person acknowledged)o erso to me or ® as produced (type of identificatioh) as identiflclion and who did/did not take an o r 'm ,. o Jo NE iOLMAN CLERK ' �� doowEte ca m ':t< y. NICOLE BAVIELLO DUSn;,�"cvuNt�fr o r: MY COMMISSION# D00019 8 z •e EXPIRES: March 15 2005 •1.,p/�;; Bonded Thm Nolory Pub% UndawflWis� i'' ' 11'Dato