HomeMy WebLinkAboutSUBMITTED PAPERSDate;
Fee Due:
Permit #
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553
SPECIALTY PERMIT APPLICATION
❑ Electrical ❑ Plumbing ❑ HvAC ❑ Fence
❑ Shed ❑ Demolition ❑ Gas ❑ Siding
See page 2 f��o//r instructions and additio`nnal paperwork required for specialty permits
1. Location/Site Address: J-6 6 a ALI ,T ,4b ®�,l 0,i.n
2. Parcel ID Number: 13 / ®� ._
13LI-FT)
Office Use
Only
Section
Township
Range
Map Page
Zoning
Land Use
Initials
3. Complete Description of Project or Work:
17110
4. Owners Information a .5. Contractors Information
Name: O)?.f FL Reg/Cert #:
� 4
Address: ® a PA� 11 f A
f�
City: � 1, .lY41- ,P State: -
Zip: Phone-,-7 o - 7/
6. Value of Construction: $ C
with all applicable laws
E09
County Cert#:
�U,
Business Name: c C
Phone �- az• ' 2 � 3 �� ,F-9 /
20 BY
A&EDENTIFICAITON.
N�Auk -5iv D/TW ;? r`'M�".,' ,I) MMMULLER•WARGO
OTARYp// TYPE OR PRINT N OF NOTARY MY COMMISSION / FF Of38408
COMMISSION NUMBER f9 6 0 7( � EXPIRES Dec ember 17, 2D 7
Rt;•`Bonded Thru NotaryNOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENTMAY 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.
EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00
Revised 04/26/2010
JOSEPH E . SMITH, ^' "RK OF THE CIRCUIT COURT - SAT — LUCIE COUNTY
FILE # 3986847 0 OOK 3664 PAGE 175, Recorded '20/2014 at 01:09 )
NOTICE OF COMMENCEMENT
Permk No. Tax Follo No. 8 / 3' 411a — - g
State of Florida
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.
Owner Ind a n ar teas on lf the Lessee contracted for the Improvement:
Name G
Address
Interest In property:
Name and address of fee simple titleholder (if different from Owner listed above):
Contractor's Name: OAldi JJn t C�
Contractor Address C7E i- � '�YSf�cgPhoneNumber.:/71— —
Surety (If applicable, a copy of the payment bond Is attached): Amount of bond: $
Name and address: Phone number:
Lander Name: Phone Number.
Lenders address:
Parsons within the Stab of Florida designated byOwner upon whom notion or other documents may be served as provided by Section
711LIJIL) (n)7 Florida Statutes:
Name: Phone Number:
Address:
In addition to himself or herself, Owner designates of
Uenors Notice as provided In Section 713.13(1) (b), Florida Statutes.
Phone number of person or entity designated by owner:
to receive a copy of the
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 1, 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 108 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 kn edge bellef.
( ure of Owne Lessee, or Owne s or Lessee's Authorized Officer/Director/Partner/Manager
(SI ry'snde/offlce) The fo1 gofrig Instrument was acknowledged before methis I day of-93IL
, 21/21
By 1►IL _ _ ��� as for
Name of Person Type of authority (e.g. officer, trustee) Party on behalf of whom Instrument was executed
I � known_ or produced Identification_
gnatureofN ryPubik-Stateofflora .ARHI�lERMAR30p{
(Pdnt,Type, or Stamp Commissioned Name of Notary Pub �IRENCO 11"fw l ntfflwtlon produced
padre iron N:nr PJaa nlrurf n
STATE OF FLORIDA
ST. LUC E CO Ty
THIS I`T CERTIFYTHA THI IS
TRUE Ali CORRECY4 CO Y 0 T
D81.w AUG 0 2014
ML`�(
LOT 409 F
6' wF "T" LOT 543
(OCCUPIED) (o.s'N,O.s'E) (OCCUPIED) (, 4N�W / (0.6'N.O.5'W) LOT 542
FIR 90' 0'0 " E 1 ' (OCCUPIED)
FIRS 05�13
n I i m of 50.00, (0.2'N)
6' WF °' i PAVER oni
(7.4'S,0.5'E) ^ i BRICK METAL 1! FIR
915.2' PATIO i SHED
------ 4.0
18.0 1t 2B, 34.7 12.2' )(
LOT 544 sg
N ONE—STORY
4
U RESIDENCE
(OCCUPIED)
go
`^ COVERED
o
21.4' ENTRY
-
O
,
O
Z
N C
C
O�
-t p
00
CONCRETE'
DRIVEWAY
Z
, Q/
FlRC M1FIRC R
CATCH
BASIN
, o
of i6
Mi �O O i'�
I EP I
.CL. (Ba
��1.99, RHO.
00' \ C
±CENTER
SWALE
EP
JULY 21, 2014
Date of Signature WIWAM`B:'BENNEIT
Professional Surveyor & Mapper
Florida Certificate No. 6353
LB No. 7608
' Giol,"Ctu.')
r
Lakowaod 4r,
�.
Park z 4; v
r'
:a�'b C• .\'fir .
i� 'Qi,• ReUnnxor
Vicinity Map
(Not To Scale)
LOT 545
(OCCUPIED)
LEGAL DESCRIPTION:
LOT 544, HOLIDAY PINES PHASE 111, according
to the mop or plat thereof,
W ,., _
as recorded in Plat Book 20, at Page 9 ("A" through
Records of St. Lucie County, Florida.
"G"), of the Public
LOT AREA: 12,117 Sq, Ft.; 0.28 Acres±
STREET ADDRESS: 4502 Poleo Pines Circle, P'Irt
St. Lucie, Florida.
UL
SURVEYORS' NOTES:
ley
1. Bearings shown hereon are based on the centerline of Pelee Pines Circle as
platted and bears N 90'00'00" E.
2. Written dimensions take precedence over scaled dimensions and distances are
not to be scaled for construction and/or design
I
purposes.
3. All distances and bearings are as field measured and are coincident with
"PLAT" and description data unless otherwise noted.
Paleo Pines Circle
(60' Right —of —Way)
Pavement Width Varies
,
LEGEND
(2)
= SANITARY MANHOLE
0
= TELEPHONE RISER
®
= SANITARY CLEANOUT
•
=_,WATER METER.._..-
-CL
--CENTERLINE RIGHT" 'OF WAY
A%C
_...,.
= AIR CONDITIONER PAD
EP
= EDGE OF PAVEMENT
o
= MAILBOX
FIRC
= FOUND 5/8"IRON ROD
WF
= WOOD FENCE
& CAP (UNNUMBERED) ,
DUE
= DRAINAGE & UTILITY EASEMENT''
Jf
- CA13LE TELEVISION RISER
D
= DELTA ANGLE
-OHE-= OVERHEAD UTILITY LINES
L
= ARC LENTH
0
= WOOD POWER POLE
R
= RADIUS
FIR
= FOUND 5/8" IRON ROD
±
= PLUS OR MINUS
4. This drawing Is not valid without the signature and original raised seal of a
Florida licensed Surveyor & Mapper.
5. This survey is based upon a description furnished by the client, there has
been no search of the public records done by this office.
6. Property Ices in Flood Zone "X" as scaled from the National Flood Insurance
Program Rate Map, Community Panel Number 12111CO070 J. with an effective
date of February 16, 2012,
7. This survey is not covered by professional Ilabiifty insurance.
S. City water & sewer are available in this area.
9. No underground utilities or Improvements were located unless otherwise shown.
CERTIFIED TO:
JOHN E. MCDANIEL
nefn nr r,.., a.:., ,., .. ny /. n /nn. .
�� e n n ett
Bennett Surveying, Inc.
8833 San Andros
Went Palm Gooch, Florida 33411
---, L tal: 772.336.4933
__ -_Boundary Survey - ---
Prepared on the order of:
John E. - McDaniel
Field: LM BB
Job No.: 14-0708
Drawn: LM
Dafe: 07/21 E014
08/27/2014 13:03 FAX 407 6540766
2001
ACOR[7® DATE (MnuDDmYYI
CERTIFICATE OF LIABILITY INSURANCE 8/26/2014
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE ROES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION is WAIVED, subject to
the terms and conditions of the policy, certain policlos may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements .
PRODUCER cO aiE r Mitzy Taylor
State Insurance Agency Inc. PHONE (772)426-9ti133 rarxc Nn1:177R1a2G-9943
1010 SW Martin DOwas Blvd AoAIL nAESS,
palm City FL 34990 INSURER A
INSURED INSURERS
Superior Fence and Rail of Brevard County Inc. INSURERC:
1730 Baldwin Street INSURER*:
INSURER e
ockledge FL 32955 INSURERF:
OVERAGES CERTIFICATE NUMBER:CY,14826024 B1 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTER BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 074ER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 6Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CIAMS.
RADDL POLICY EFr,, LIMITS
IR TYPE OF INSURANCE POLICY NUMet=R M DD,
GENERALLIABILITY EACH OCCURRENCE $
COMMERCIAL GENGRAL LIABILITY P en n $
CLAIMS -MADE OCCUR MED EXP (Any one 0er80e) $
c
LIMB APPLIES PER: ` , 1 I PFkvvUG ks • wmnvr row a
$
AUTOMOBILE LIAEIIUTYMea
BODILY INJURY (Per person) $
ANY AUTO BODILY INJURY (Peracddnnl) $
AOWNED SCHEDULED
AUTOS NON -OWNED PROP IT DAMA6 $
HIRED AUTOS H AUTO$ $
MBRELLA LUit3 I
H OCCUR U
EXCESS LIAL0 CLAIMS
A YYQRK ZS 9QMF ZA1 WIC
ANCi EMPLOYERS LIABILITY YIN E.L.E.EACH ACCIDENT $ 1 1000,00
ANY PROPRIGTORIPARTNERIEXECUTIVE
OFFICERIMEMSEREKCLUDED7 NIA p7C008795-i3 io/zl/20i31D/al; 2019 E.L.DISPASF - EA EMPLOYEd $ 1,000,00
(Nlendatory In NH)
RYyW,deecdbaunder E.LDISEASE- POLICY LIMIT 5 1,000,0
DESCRIPrIpN OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (A=0 ACORD 101, A001tlnncd Remarks Schedule, If more aPW Is mclul'90)
SHOULD ANY OF THE AISOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DNIT THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
St.Lucie County
Contracting Licensing AUTHDRmWREPREBENTATPoE
2300 Virgina Av®sue
Vt Pierce, FL 34982
Laura Vfarten/LWAFR
®19$8-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105)
li INS029r2atnast nt Thm arnQrt na.++s and I^Ad% ova -ft,c4orpA "edge r.f D.r'nion