Loading...
HomeMy WebLinkAboutSUBMITTED PAPERSQFWl ., g,'QDABU: PLAN REVIEW FEE: _ pg}- RECEIPT NO.: J ��. CONCURRENCY FEE: RECEIPT NO.: PERMIT NUMBER: Uo ( I CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT SCARW,PING & CODE REGULATIONS DIVISION BY 2300 Virginia Avenue Ft. Pierce, FL 34982 5652 fit' �IdCit ®1-�ht�i 772462-1553 4de � lb APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITYMONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: .:S 3 Sc 2. PROJECT NAME: SITE PLAN NAME: 3. PROPERTY TAX ID #: •( LI 1 q `1 o 1 O Q-%Q 2 4. LEGAL DESCRIPTION (attach extra sheets ifnecessary): U Loft A 5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. S. LOT NO. 9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: O �l� r S �-'- l�.i d7 c� �� c\Q•Q u.7a 11 �_� -�1,_ S�cf`, nr�� �(. i��cl {� n �' 11. SETBACKS (ACTUAL) FRONT: BACK. RIGHTS E: LEFT SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate boxes). [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL OTHER (SPECIFY) (-?,q (a cd t-Czw-\c 13. DESCRIPTION OF PROPOSED USE: 14. SQ. FT OF CONSTRUCTION: 15. SF. FT Ist FLOOR: 16. VALUE OF CONSTRUCTION: $ 3 ? 6 6 The value of construction is used to determine the amount of permit fees to be assessed St Lucie County reserves the right to question and/or modify the indicated value of construction if it is demonstrated that the submitted figures are not consistent with similar types ofconstmction activities. Uthe value is $2500 or morn, a RECORD® Notice of Commencement most be sabmitted wiffift application. SLCCDV Form No.: 001-02 UPDATED 6/25109 OWNER INFORMATION NAME: � a `j :,A ADDRESS: CITY: F-t- STATE: FL ZIP: 34 q�f 9. Q, �. r c� . PHONE (DAYTIME): S 9 s =9 3 i 1 Email: IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DRTERENTfROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: PHONE (DAYTIME): (_) STATE: ZIP: CONTRACTOR INFORMATION ST. of FL REG.CERT #: CAC- y c " 1 q a I ST. LUCIE COUNTY CERT #: BUSINESS NAME: �°iQa su c'Q Cnas 1 Mc �� �✓� c Z�� QUALIFIERS NAME: ADDRESS: 9,`1 3 CITY: STATE: L- ZIP: fit{ 9S3 PHONE(DAYTIME): 22 FAXNO. 62.1--C60(4 Email: Caw f-� Uak-00. cU-A ARCHITIENGINEER: Pau 1 W¢ I c-L LN)c- ADDRESS: 19 S 4 s,,,) CITY: Q e.r r S �- Ly c c STATE: P L ZIP: 3e-4 9 PHONE (DAYTIME): 7-77�s -9 88 BONDING COMPANY: ADDRESS, CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: 21P: STATE: ZIP: DVORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification it will be voided and returned to you by mail CERTMCATION: t 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, BEATERS, TANKS, AND AIR CONDITIONERS, FENCES, ETC., not otherwise included with this building permit application. St. Lucie County makes no representation that its granting of a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Homeowner Association rules, bylaws or any covenants that may restrict or prohibit such structure. Please consult with your. Homeowner's Association and review your deed for any restrictions which may apply. 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: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IlKPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOBSITE BEFORE TBE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT.TO ATTACHMENT: AS A CONDITION OF ISSUANCE OF THIS PERMIT, YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF TBE CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. kr 'Q OWN_Er�)CTOR SIGNATURE CO TOR SIGNATURE �g2a c�c 2v_ o �i • STATE OF FLORIDA - STATE OF FLORID COUNTY OF JT . J6, C le- `� W COUNTY OF �P p cp oc Q�M The foregoing instrument was acknowledged before N o The foregoing Instrument was acknowledged before me this day of 20- me this day o t 20, Is le by i �?o9i1•..� m: who is personal ro or has produced who is persanall own or has produced a as identification. as identification. 2 55 o CM, -mG Signature of N ry Q Signnture of N Commission No. Sea a � Commission No. (Seal) .(Seal) NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNERBUILDER APPLICANTS. For specific instructions see appropriate permit checklist. } USE ONLY _ _ B:. _ _. `:. �( O l�_..1 1 TOWNSHIP `/ 7�4 RANGE MAPNO. N"If fFLWD LAND USE LOT CVG % TAZ NO. FIRM MAP # 1sTFLR ELV MAXHGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FM WATER SEWER SPRINKLERS STORMWATER LOT OF REC Before 1/1990 OF REC After 111990 .LOT SPLIT REQUIRED LOT SPLIT APPROVED REPORT CODE �� q TFABLERADON AREA m PERMIT FEE LIBRARY IMPACT FEE PUBLIC BID IMPACTFEE CORRECTION PUBIC BID BRACT FEE GENERAL PARKS IMPACT FEE SCHOOL IMPACT FEE ROAD IMPACT FEE CREDIT Y N LAW ENF BRACT FEE FIREMMS IMPACT FEE DRIVEWAY REQUIRED Y N DRIVEWAY FEE ADMINISTRATIVE VARIANCE FEE SPECIFY -MECHANIC SUBS REQUIRED ROOF ELECTRIC GAS PLUMBING NON -CONFORMING LOT OF RECORD FEES MISCELLANEOUS FEES DATE SENT TO ADDRESSING: REVIEWS FRONT COUNTER. ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEATURTLE_ REVIEW MANGROVE REVIEW . RECEIVED DATE COMPLETEDol 2L 2 nvrrrALs l lao�-10 3 5- C081L 0 PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772)462-1553 FILLED LANDS AFFIDAVIT I, the undersigned, am the owner of the following described property, J►l-Iq -1 O( D ac) 4 ©dgz, S 0r A Lot - (Parcel Id#/Legal description/Address) for which I have applied to St. Lucie County for a Final Development Permit. In accepting this Final Development Permit, BP Number 1206-0135, I acknowledge that as owner of the above described property, and in accordance with Section 7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring adequate drainage so that the immediate community WILL NOT be adversely affected. I further acknowledge that in granting this permit for the development of this property, St. Lucie County is neither obliged nor liable to provide for, or maintain in any form, adequate drainage off my property which will not adversely affect the immediate community. Prope weer Name (Please int) Property Owner Signature Date STATE OF FLORIDA, COUNTY OF ---/— /O A- A R ACKNOWLEDGED BEFORE ME THIS V DAY OF =, J5- 20� BY /---)/II d / b L - c� M i I h WHO IS PERSONALLY KNOWN TOME OR WHO HAS NOTARY PUBLIC NUMBER SLCPDSD Revised 08/24/2010 AS IDENTIFICATION. TYPE OR PRINT NOTARY (SEAL) ale MARGIEBRONNER MY OOMMISSIW #DD955508 EXPIRES: JAW 25,2014 Boodod through 1 st State Insur=8 or - PAUL WELCH INC. Mechanical * Electrical * Civil Engineering 1984 S.W. Biltmore St. Suite#114 Port Saint Lucie, FL 34984 Phone (772) 785 - 9888 Fax (772) 785-9933 RE: KNEEWALL REPLACEMENT 33 SOVEREIGN WAY FORT PIERCE, FL SCOPE OF WORK - REMOVE -EXISTING 20 LF OF FRAME KNEEWALL LOCATED AT THE REAR OF THE EXISTING SCREEN ENCLOSURE. - CONSTRUCT NEW 20 LF OF KNEEWALL LOCATED AT THE REAR OF THE EXISTING SCREEN ENCLOSURE PER DETAIL. o SHORE UP EXISTING SCREEN ENCLOSURE DURRING CONSTRUCTION. o RE -CONNECT SCREEN ENCLOSURE POSTS TO NEW KNEEWALL PER DETAIL. - NOTES: -THE CONTRACTOR, SUBCONTRACTOR, SUPPLIER, ECT. SHALL VERIFY ALL DIMENSIONS, CONDITIONS AT JOB SITE, PLANS, SPECIFICATIONS, ECT. -STRUCTURAL FEATURES NOT DETAILED ON THESE PLANS WILL BE ADDRESSED BY THE ENGINEER AS CONSTRUCTION PROGRESSES. -ALL WRITTEN DIMENSIONS ON THESE DRAWINGS' TAKE PRECEDENCE OVER SCALED DIMENSIONS. -ALL CONSTRUCTION TO BE IN ACCORDANCE WITH THE FBC 2010 / FRC 2010. STRUCTURAL NOTES 1) DESIGN LOADS IN ACCORDANCE WITH ASCE7-10. 2) SOIL BEARING CAPACITY: 2500 PSF (MIN.). 3) ALL STRUCTURAL CONCRETE SHALL HAVE A MRQMUM[ COMPRESSIVE STRENGTH OF 3000 PSI AT 28 DAYS. 4) SLAB / FOOTINGS TO BE CONCRETE WITH A MINIMUM 2500 PSI COMPRESSIVE STRENGTH AT 28 DAYS. SEE PLAN FOR SIZES & STEEL REQUIREMENTS. 5) MINIMUM CONCRETE PROTECTION FOR REINFORCING BARS:; FOOTINGS: 3'. BEAMS: 1 '/2" SUSPENDED SLABS: 1 '/2" b) LAP ALL REINFORCING STEEL.A M NIM[UM OF 48 BAR DIAMETERS EXCEPT AS NOTED GRADE 60 STEEL MINIMUM IN BEAMS AND COLUMNS. 7) ALL LUMBER IN CONTACT WITH CONCRETE OR MASONRY SHALL BE PRESSURE TREATED. 8) SPLITING OR CRACKING OF STRUCTURAL COMPONENTS DUE TO INSTALATION OF HARDWARE IS NOT PERMITED. ALUMINUM NOTES: 1) FOR 1X2 ATTACHMENT USE '/4" 0 X 3" LONG LAGS INTO WOOD HOST, '/4 0 X 2 ''/4" LONG CONCRETE SCREWS INTO CONCRETE OR MASONRY CONSTRUCTION AND #14 SMS X 2" LONG INTO ALUMINUM ()" EMBEDMENT TYPICAL); SPACING 24" 0. C. AND WITIEN 6" OF EACH PERPENDICULAR MEMBER 2) ALL PLANS IN ACCORDANCE WITH THE FBC 2010. 3) BOLTS AND OTHER FASTENERS SHALL BE ALUMINUM, STAINLESS STEEL, HOT -DIP OR ELECTRO-GALVANISED STEEL. DOUBLE CADMIUM PLATED STEEL BOLTS MAY ALSO BE USED. 4) DURING ERECTION, STRUCTURAL ALUMINUM SHALL BE ADEQUATELY BRACED AND FASTENENED TO RESIST DEAD, WIND AND ERECTION LOADS. 5) ALL EXPANSION BOLTS SHALL NOT BE INSTALLED LESS THAN 3" FROM THE EDGE OF CONCRETE SLAB. 6) ALL FASTENERS SHALL HAVE HEAD, OR WASHERS NOT , LESS THAN '/z" IN DIAMETER 7) NON STRUCTURAL ALUMINUM SHEETS SHALL HAVE A MINIMUM THICKNESS OF 0.032 INCHES (KICKPLATE, ETC...) 8) ALUMINUM IN CONTACT WITH CONCRETE, OR MASONRY MATERIALS SHALL BE PROTECTED WITH ALKALI -RESISTANT COATINGS. 9) ALUMINUM IN CONTACT WITH WOOD TO BE PANTED WITH TWO COATS OF HEAVY -BODIED BITUMINOUS PAINT. Submitted by: PAUL WELCH INC. 4f. Paul Welch, P.E. Reg. No 29945 PW:P.1 '�,1 0 7 2012 FI LE ,� p.°, 7. PAU L WELG.H I N G.. MECHANICAL * ELEGTR'IGQL * CIVIL ENGINEERING 1 9B4} S.W. BILTM'ORE ST. - # 1 1 4 Pq;RT, SAINT LUCIE, FL 349B4 CI� E-MAI.L FAX f (7• ,);s�I, 5-9BBB PWELCHINQ(WACL.COM (772) 7B5-9933 PAut WELCH, P.E. — FL REG. No. 29945 - - -- R i=4 n 7 20121 33 - SOVEREIGN WAY opFT. FIERCE, FL 'a C EXLSTING ALUM. SCREEN ENCLOSURE POST ' I 2" X 3" X 5/10 ANGLE X 2" LONG EACH SIDE W/(3) 014 SMS & (1) -3/8" X 2" EMBED CONC. - ANCHORS EACH ANGLE 2" X 2" X 118" ANGLE EACH SIDE W/ (3) #14 SMS & (I)-%" X 2" EMBED CONC ANCHORS EACH ANGLE 3/8" X 2" EMBED CONC. ANCHOR MAY BE SUBSTITUTED FOR'/." CONC. ANCHOR 1" X 2" ALUM OPEN BACK -FASTEN, PER -NOTE ALUMINUM NOTE #1 #5 BAR VERT IN (3000 PSI) 4 ,'F, PY -LE 8" CONTINUOUS BEAM BLOCK W/ (1)- 05 BAR IN (3000 PSI) CONCRETE CONTINUOUS CONCRETE FILLED CELL C3a 48" O.C. #5 X 12" LONG REHAR DRILLED OUT tz & EPDXIED (Qa 12" O.G. 8"X 8'q X 16" CBS WALL W/ STUCCO FINISHED . FINISHED #5 BARKON9 n EXIST CONCRETE POOL DECK • n A " II �lv �I,�,l�..�ll_I:�II� :' I I I`I ^,��, (- .I w 12" X 12" (2500 PSI) CONC.FOOTING III ^III= Il rf q I W/ (2)- #5 BARS CONTINUOUS GL DETAIL NTS... 33. SOVEREIGN WAY FT. PIERCE, FL PAUL WitLCH I:NG. I %ss ST. LUCIE COUNTY BUILDING DIVISION REVIEWED FOR CO CE REVIEWED BY DATE PLANS AND PERMIT MUST BE KEPT ON JOB OR NO INSPECTION WILL BE MADE MEGMANICAL ELECTRICAL* CIVIL EN13INEERINC3 1984 S.W. BILTMORE ST. - # 1. 1.4 j. PORT SAINT LuCIE, .FL 349S'4 PM,ONE Fr, -MAIL PAN ' l;i n 72012 (77� � 765-9988 Pwjgunma to @AQL.QQn (7721 ?85-9933.. PAUL WELCH, P.E.: JrL: REa, Na; 29945 l � L� Planning & Development Services Department • Building & Code Regulations Division y 2300 Virginia Avenue, Fort Pierce, FL 34982 — (772) 46iE5 _ OPY c Certification for Design Load Compliance Project Name: Mt-[" V'gee WAIL Project Address: ?7 �7 y G V r12 S % " Permit #: Occupancy Type: Construction Type: INSTRUCTIONS FOR USE; • This certificationmust be completed, signed, and sealed by the design professional of record. • Submit (2) copies for residential, (3) copies for commercial with all permit applications involving the following: o New Residences (single or multi -family) o Residential Addition o Any accessory structure requiring a building permit o Any non-residential structure. * Note: Form not required for interior renovations provided that no exterior structural elements are affected and certain minor building permits at the discretion of the local building official. Contact the # above for questions. DESIGN PARAMETERS AND ASSUMPTIONS USED: (complete all that apply) 1. DESIGN CODE: Florida tut L ip t nr tS Code 2010 Edition with 2016 Supplements using ASCE 7.10 2. Structure Designed as (check one): Enclosed Partially Enclosed e4 Open 3. Risk Category: _I II ,III IV Exposure Category: B C ,�4 D 4. Design Wind Velocity (-'0 mph 13L ASD 0,J LRFD End Zone Width: Ji ft S. Mean Roof Height id ft Roof Pitch; N :12 Parapet: _ - ft 6. Components & Cladding Design Pressures Used: (PSF; based on 10sgft @ 15'MRH, clearly label on all plan openings): Zone 1: N d Zone 2: Zone 3: Zone 4: n Zone 5: a' �A Garage: N 7. Design Loads: Floor: A- PSF Roof/Dead: PSF Roof/Live:JIA Balcony: 0 2 PSF Dock: W)PSF Deck: N �--PSF Stairs: N ` PSF Fence: 1) 1A PSF Railings: PSF 8: Were Shear Walls Considered For Structure? Yes Not Applicable Explain Why Not: 9. Is A Continuous Load Path Provided? Yes Not Applicable Explain Why Not: 10. Design Soil Bearing Pressure: 2400 PSF Soil Test Reports Submitted? Yes DESIGN PROFESSIONAL CERTIFICATION STATEMENT: I certify that, to the best of my knowledge and belief, the attached plans & specifications have been designed to comply with the applicable structural portions of the building codes currently adopted and enforced by St. Lucie County. I also certify that structural elements depicted can these plans provide adequate resistance to the design , forces specified: Print Name Cert # & Co. Cert Auth. IMN-✓' 021 ) -t Signature, 6e, and Sea( Company Name & Address SLCCDV Form # 020-12 Revised 3/25/12 (JS) Property Appraiser - St.Lucie "­inty, FL Page 1 of 1 David C Smith Record: 1 of 1 Property Identification Site Address: 33 SOVEREIGN WAY Sec/Town/Range: 14 :34S :40E Map ID: 14/14S Zoning: RS-4 PROPERTY RECORD CARD «Prey Next» Spec.Assmnt Taxes Exemptions Permits Home Print C�G2 ParcellD: 1414-701-0064-000-2 ���,CIE Account* Land Use: 7478 SF Res If City/Cnty: St Lucie County' Ownership and Mailing Owner: David C Smith Edith Widder Smith Address: 33 Sovereign Way Fort Pierce FL 34949-8360 Legal Description QUEENS COVE -UNIT 1- BLK 8 LOT A (OR 660-696) Sales information Assessment 2011 Final Total Land and Building Date Price Code Deed Book/Page 2011 Final: 262800 Land Value: 167100 Acres: 0.27 10/23/1989 245000 00 WD 0660 / 0696 Assessed: 187492 Building Value: 95700 2/3/1989 180000 00 WD 0622 / 2322 Ag.Credit: 0 Finished Area: 1802 SgFt 6/1/1978 22500 01 CV 0288 / 2236 Exempt: 50000 Taxable: 137492 Taxes: 2994.33 BUILDING INFORMATION unaboi.r 1— Exterior Features View: - RoofCover: SA - Asph Shingle RoofStruct: GA - Gable ExtType: HC - HC YearBit: 1981 Frame: Grade: C - C EffYrBlt: 1981 PrimeWall: BS - CB Stucco StoryHght: 0010 -1 Story No.Units: 1 SecWall: BW - Brk/Wd Frame Interior Features BedRooms: 3 Electric: MX - MAXIMUM PrmintWall: DW - Drywall FullBath: 2 HeatType: FHA - FrcdHotAir AvgHt/Fl: STD 1/2Bath: 0 HeatFuel: ELEC - Electric Prm.Flors: CU - Carpet %A/C: 100 %Heated: 100 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qua]. Cond. YrBlt. No. Land Use Type Measure Depth DOK2 - WOOD DOCK Y 1 144 AV AV 1976 1 0100-SF Res 240 -Front Ft 50.68 102.84 SWAY - RES POOL AVG Y 1 350 AV AV 1990 2 0100-SF Res 205 -Front Ft 61.69 102.84 ENC2 - POOL ENC-AVG Y 1 822 AV AV 1990 3CFT -3CFT S 1 1 AV AV 1981 3CFT- 3CFT S 1 1 AV AV 1981 PHTR - POOL HEATER Y 1 1 AV AV 1981 SDSF - SITE DEV S-F Y 1 1 AV AV 2001 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. http://www.paslc.org/paslc/Prc.asp?prclid=141470100640002 6/8/2012 JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY FILE # 3712631 OR 3,3" `1,3398 PAGE 1306, Recorded 06/08/201 , - 01:20 PM l Permit No. NOTICE OF COMMENCEMENT Tax Folio No. 1 414 :Jill 7UCng200;L- State of Florida County of St. Lucie The undersigned herebygives 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 l��gaI Description of Property: (and street C:)sJec�S CoUe Un'E- ( E General description of Improvement: 1. owner infQ�atkxr or Lessee Information Name ..'i S-"+k Address 3-4 .SnU_QX� an ' CVWLP—lcc fti.rE,'.�qq QAd If the Lessee contracted for the Improvement: Interest in property: Q-1c- c Name and address of fee simple titleholder (if different from Owner listed above): � SC.rc-�.'\ Comractces Name: + Contractor Address S m� Phone Number'112-(a2f-tJ60o 3y4 S3 Surety (if applicable, a copy of the payment bond 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 Llenor's 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 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. IFYOU INTENDTO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penal rjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowl g;Z:� (Signature of Owner or Lessee, or Owners or Lessee's Authorized officer/Director/Partner/Manager r.1fNEn- (Signatory's Title/Office) The foregoing instrument was acknowledged before me this 4 day of 20L; By, /AJ, 11 as n&J AJ A_ for e of Person Type of authority (e.g. officer, trustee) Parry on behalf of whom Instrument was executed Personally known_ or produced Identification_. (Signature of Public -State of Florida) (Print, Type, a .St mp Commissioned Name of o blic) =S11tsInSUMIKO R Type of Identification produced M 955506 �u 2014 BandInSUMIKO STATE OF FLORIDA ST• LUCIE COUNTY THIS ISTOCERTIFYTHAT THIS iSA ot►t tg (•� TRUE AND CORRECT COPY OFTHE ORIGINAL. By: Date: