HomeMy WebLinkAboutSUBMITTED PAPERS6V--�ffC
F,
PLAN REVIEW FT:�1E_. .00 RECEIPTNO.:'
CONCURRENCY EE�� RECEIPTNO.:
PERMITNUMBER:' 1169--015V
CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Avenue
SCANNED Ft. Pierce, FL 34982-5652
BY 772-462-1553 nt
St. Lucie County
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
I . LOCATION/SITE ADDRESS: & 70 / 5 ayw? D r 10
2. PROJECT NAME: Itea-l-Ur-8 (707 4- SITE PLAN NAME:
3. PROPERTY TAX ID #: 41,5-1 ON',�_- 000
f- 1
4. LEGAL DESCRIPTION (attach extra sheets if necessary):
vv,n4-� t)(1-1- P-� I'Malt'al? /V
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO.
9. PARCEL SIZE (ACRES/SQ FT.):3-/(.r 4 0,?t?LOTD13�1ENSIONS: 27,00o-
10. CONTLETE DES CRIPTTON OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
over Jeirl eon -ere- 7r ro makp, 69(lel
w &
11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE:
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
NEW CONSTRUCTION EXPANSION/ADDITION INTERIOR RENOVATION
RESIDENTIAL COMNMRCIAL INDUSTRIAL
OTBER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: 100ur 0 yez- t�aI4,e��e_-7-0
14. SQ. FT OF CONSTRUCTION: '100 15. SF. FT I st FLOOR
16. VALUE OF CONSTRUCTION:$ 1,,r
ao
The value of construction is used to determine the amount of permit fees to be assessed. St Iucic 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 of construction activities. If the value is $2500 or more, a
RECORDED Notice of Commencement must be submitted with this application.
SLC!CDV Form No.: 001-02
UPDATED �12�i09
OWNER INFORMATION
NAME: (3 tf.S-a(6z /I LI(IfIfl .56tllcy '(Al I
ADDRESS: 78 arove- :5-7- f
CITY: /I STATE: t ZIP:
�%6 s& '??72
PHONE (DAYTIME): (___) Email:
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TrrLEHOLDER:-
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME):
CONTRACTOR INFORMATION
e
,12&
ST. of FL REG.CERT #:
BUSINESSNAME: 16
QUALIFIERS NAME: 131 C'
ADDRESS:
CITY: STATE:
PHONE (DAYTRAE): C__) 201 �2� I— FAXNO
ARCI-HT/ENGINEER--
ADDRESS:
CITY:
PHONE(DAYTIME):C__)
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER.
ADDRESS:
CITY:
STATE:
STATE:
STATE:
ST. LUCIE COUNTY CERT #: /&—,/
Email:
ZIP:
ZIP:
ZIP:
091
IWORTANT 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.
OFTICE USE ONLY3 op A"
qN TOWNSHIP
I
RANGE
MAPNO.
-ZONING. -LAm uSE
CvG%
TAZ NO.
_FL - OOD ZONE
IT FLR ELV
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-CONST-TYPE�= _OCCU]?._TWE_._
--WATER
PRINIU�M
-STORWA�
-LOT OF REC LOT OF REC
:�Bcrora_-111990
LOT SPLIT
_-R.FQ
LOT SPLIT
APPROVED
-REPORT
CODE
qil�
-HABITABLE
AREA
__RADON.
...PEnff
L113RMY
BRACT
FEE
PUBLICBILD
RRACT FEE
CORRECTION
PUBIC BW
BRACT
PAM
BRACT
FEE
SCHOOL
BRACT
ROAD
CREDIT
y
N
LAWENF
BRACT
FEE-
FRE/EMS
BRACT
E I,
DRIVEWAY
REQUIRED
y
N
DRIVEWAY
FEE
ADVIINISTRATIVE
VARIANCE FEE
[F
SPECFY
._"S
REQURUD
NECE"C. ROOF
RECIRIC GAS
PLUMBING
NON-CONIFORMING
LOTOFRECORD
FEES.
MECE11ANEOUS
FMS
DATE SENT To ADDRESSING:
REVIEWS
FRONT-
COUNTER
ZON]NG.
REVIEW
SUPERVISOR.
REVIEW
PLANS
REVIEW
VEGEUTION
REVIEW
SEA TURTLE
REVIEW&
-MANGROVE
REVIEW
DATE
RECEIVED
DATE
-c-ol"mr-D
.
INIIULS
1 1
r__1
CERTIEFICATION:
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 certit(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, PLUMING, 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 IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOBSITE BEFORE THE
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 THE CONSTRUCTION LIEN LAW NOTICE TO
THE PERSON WHOSE PROPERTY IS SLT13JECT TO ATTACHMENT.
OWARORCONTAACTORSPIATURE
STATE OF FLORIDA
COUNTY OF a Z
The foregoing instrument was acknowledged before
me this /V day of 120//
by 114,-,4P k Z e, 3 /d / � e 6
/or
who is personally known // or has produced
, as identification.
Signature of Notary
,�,Vky %,
Commission N& KATHLEEN VA '61�
!ISSION # EPS386
EXPIRES: February 17, 2015
Bonded Thru Budget Notary SerVices
CONTRACTOR SIG ATURE /100",
STATE OF FLORIDA
COUNTY OF Lo
The foregoing instrument was acknowledged before
me this 10 day of 7,20//9
by Za /<6 C,
who is personally known o/has produced
as identification.
Signature of Notary
Com V1111 11X�IWKI EN EE
OOMM18SION
�t_0�4�0" 4 'S �IRES' Febr
44a W Ttw BuW Now, w
V60
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE A(WST BE NOTARIZED. IF "PLYING FOR
THIS BUILDING PERAUT AS AN OWNERMUILDER, THE OWNER NWST PERSONALLY "PEAR TO SIGN
THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION.
OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNEWBUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.
Property Appraiser - St.Lucie County, F
Page I of I
Gerald K Dunn Record: I of I
Property Identification
Site Address:
10701 S OCEAN DR 862
Sec/Town/Range:
I I :37S .41 E
Map ID:
45/11 B
Zoning:
HIRD
Ownership and Mailing
Owner:
Gerald K Dunn Sally W Dunn
Address:
78 Grove St
Clinton CT 06413
Sales Information
Date Price Code Deed
1/17/2002
60000 00 WD
8/29/2001
55000 00 WD
10130/1992
100 01 QC
3/1/1973
13000 00 CV
Exterior Features
PROPERTY RECORD CARD
—Prev Next >> Spec.Assmnt Taxes Exemptions Permits Home Print
ParcelID: 4511-510-0063-COD-6
Account#: 123769
Land Use: Mob Homes
City/Crity: St Lucie County
Legal Description
VENTURE OUT AT INDIAN RIVER INC LOT 862 (OR 1482-723)
Assessment 2010 Final Total Land and Building
Book/Page 2010 Final: 107700 Land Value: 102000 Acres: 0.05
1482/0723 Assessed: 107700 Building Value: 5700
1436/1941 Aq.Credit: 0 Finished Area: 676 SqFt
081810448 Exempt:
021512941 Taxable:
Taxes: 2238.45
BUILDING INFORMATION
View:
RoofCaver:
-
RoofStruct: -
ExtType:
MHH - MHH
YearBlt:
1976
Frame: -
Grade:
MHTT - MHTT
EffYrBlt:
1981
PrimeWall: -
Storyl-Ight:
0010 - 1 Story
No.Units:
I
SecWall: -
Interior Features
BedRooms:
0
Electric:
PrmintWall:
FullBath:
0
HeatType:
FHA- FrcdHotAir
AvgHt/Fl:
1/213ath:
0
HeatFuel:
ELEC - Electric
Prm.Flors: -
%A/C:
100
%Heated:
100
%Sprinkled: 0
Special Features and Yard Items
Land Information
Type YIS
Qty. Units Qua].
Cond. YrBlt.
No. Land Use
Type Measure
I 0200-Mob Homes
167 -Site 1
THIS INFORMATION
IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED.
Depth
http://www.paslc.org/prc.asp?prclid=451151000630006 7/12/2011
---ICOUNTY
1 F L 0 RL I D A
PLANNING & DEVELOPWNT SERVICES DEPARTWNT
BUMDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIF.RCF- R. 34982Z652
(7721462-1553
".,%, At"IDAVIT
1, the undersigned, am the owner of the fdHowing described property,
q,51(-
,51( , _0_ - o-��3 - -,-,,UD 0
(Parcel W/Legal description/Address)
for which I have applied to St. Lucie Co-un-tv for. a. Final Development. Permit. In -
accepting this Final Development Permit, BP Number 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 rmonsible forassur g
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in grantmg this permit for the development of this property,*
St. Lucie Countv is, neither obliged nor liable to provide for, or maintain in anv form,
adequate drainage off my property which will not adversely affect the immediate
community.
Property Owner Name (Please Print)
cis -'a !�:&) -
Prq—veiWO�We—r Si ature Date
� 1 91
Oonevee'-Hct) f
STATE OF4;6@PMWCCOUNTY OF MaA)
ACKNOWLEMED BEFORE ME THIS -aO- DAYOF-
BY -Sa (-a k w Y\.r-x WHO IS PERSONALLY I&OWN TO ME ORJ�
LTION.
-CONWISSIONNUMBER
MICHELLrz ANN MONGILLO (SEAL)
NOTARY PUBLIC
MY COMW§WN EXPIRES NOV. 30,2013
SLIC P-nSD Revi-e!4 QW-4aQI0
Continental Florida Materials Inc. 7 Pr
zonTmEnTr& 13450 W. Sunrise Blvd., Suite 430 2
Sunrise, FL 33323
Tel: (954) 858-0780 CAUTIONH Freshly mixed cement, mortar, UNLOADING Drivers are prohibited
HEIDELBERGICEMENTGroup concrete or grout may cause skin i njury. Avoid from delivering concrete except under the
co ntact with eyes where possible and wash truck's own power, and where site conditions
exposed skin areas promptly with water. If any permit the safe and proper operation of his
m'mediately equipment. Drivers are not permitted to,
:A
cement mixtures get into eyes, rinse i
and repeatedly with water and get prompt medical add water to the mix nor to go beyond the
treatment. Sawing, or grinding of concrete curb line, except upon the authorization of
masonry units may result in the release of dust the Purchaser/Purchaser's Agent and his
-t6' PIN!
particles which, without the use of proper eye or acceptance of risk for any loss or damage.
respiratory protection, could cause eye or nose I acknowledge that i have received and
12� irritation. The Material Safety Data Sheets for accepted the materials listed on this ticket. -
the products sold by Continental Florida I understand and agree to the terms on -
Curb line crossed at Purchaser/Purchaser's Agent request. Initials of Purchaser/Purchaser's Materials Inc. are available upon request. both the front and back of this ticket
Ag2nt TOTAL
WATER
Initials of Purchaser/Purchaser's Agent acknowledging addition of water at Purchaser/Purchaser's YARDS ON TRUCK/GALS OFWATER ADDED ADDED
Agent request. 10 9 a 7 6 5 1 4 1 3 1 2 1 1
,f%,- I','
ARRIVAL TIME START POUR TIME FINISH POUR TIME LEAVE JOB TIME 12 1 1 " "
PURCHASERIPUR CHASER S AGENT P.O. NUMBER/ ORDERED BY
SOLDTO
QUANTITY QUANTITY QUANTITY PRODUCT
THIS LOAD ORDERED DELIVERED CODE
'A
Truck # Plant If Slump
CalciOrrl! Air Entrain Super Plas.
Delivery Instructions
PURCHASER/
PURCHASER'S AGENT
ZONE JOB NUMBER TIMETICKETED DATE
14-c
DELIVERTO Ism
Concrete Disposal:
PRODUCT DESCRIPTION UNIT OF UNIT
MEASURE PRICE
Due at Job Use of Concrete
Drivers Name
C3 CONCRETE TESTED
SUBTOTAL
TAX
TOTAL
TICKET
ydsl�
EXTENDED
PRICE
CUSTOMER
I . NVARBANly: The materials sold by,Coritincfital F Materials Inc. (hereinafter "Continerbl") are warranted f ear from the date of delivery to be free from detects in
material. This warranty is exclusive an , of 'is in'tiou , )tl-lCr v.lananfues (wl, other -written, orai or implied), includir warranty or merchantability or fitness for any particular
purpose. Continental's liability underany 6�cl.�-,Mtarlces will not be g,eaterthan 'he purchase pi,re ofthe materials supplied, the purchaser must examine the material upon delivery
and before installation to discover any defo�s, latent or othe"mse-, and Contl!:antal will not'be liable for and other clarnages including, but not limited to incidental, indirect,
consequential, special or delay damages, IA of proilts, or any other darnages ansing out of t�ie breach of any obligations under this agreement. Purchaser further agrees that
no claims may be filed under this warranty uhloss and until any indebtedness to Corfinenial i,�, paid in full.
2. EXCLUSIVE REMEDY: Purchaser further arraes, that 'L� exclusive iemedy against C-�ntinenlall in the event the goods, materials or services
supplied by Continental are alleged to be dc�cctrve and/or are alleged to have caused PANchasor to suffer personal injury, loss of life, property, damage or economic losses as a
result of breach by Continental of any and Wi of the foregoing express or itriptied warranties, or�as a result of any negi.-jence, strict liability, or othertortious conduct or statutory
violation by Continental, shall be limited to ond shifli not exc<,�,,d the purchase price of the goodf;, materials, or services purchased from Continental by purchaser and purchaser
agrees that Continental shall not be liable ld,ougrhaser for any other damages including, but nodilriited to, lost profits, lost wages, indirect, incidental, coilsequential, compensatory,
special, delay, Punitive or arly other darnagob, incli.rding damages for pain and suffcvtl�,6rrrental disease, medical or funeral expenses, any other similar damages, or any attorney
fees or costs incurred by the'purchaser in cAinection with pursuing any claim, dernanq1, or I cause I pf action against Continental for breach of any obligations under this agreement,
breach of the express or implied warranle�.-, delineated above, negligence, strict liability or ol.h�!r tortious conduct committed by Continental in connection with its sale to the
purchaser's use of goods, materials or so�Vices sold by Continental.
3, _DUE I
-Q&T-E: Payment for a I credit sales is ol�ie by the I Oth of the month following the purchase d The Purchaser agrees that all past due accounts will accrue interest at 1 .5%
per month.
4. COLLECTION COSTS: Purchaser agree&t6pay attorneys' fees and costs of collection, inCUrred by Continental prior to judgment, in obtaining judgment, or appeal, for bankruptcy
. ... .......
arid for post -judgment collection procedures. Venue of any action between the Purchaser and Continental shall be Broward County, Florida.
5, MIX C0DE1_LQQATtQNEj: The purchaser agiees to order the mix needed by product code and accepts full responsibility to determine the location for the readymix concrete.
6. 5E:1:1VERY SITE CONDITIONS: Continental reserves the right to determitie whether the site; for dclivery requested by the Purchaser is suitable for such delivery and Continental
may refuse to deliver to a site if Continental is of the opinion that delivery Would be unsuitable or uisafe. The Purchaser shall be responsible for all costs and damages incurred
where adequate access for delivery cannot be obtained,
7. UNA7ENDIED DELLVERY SITE: Where dclivery of produ='s to be to all unattended site. �ontineri,ql will not,be liable for any loss or damage to products. property or for unsigned
, delivery tickets. I
8, Q_EL)WS: Continental shall riot be lii�ble for any delay in delivery or non -delivery �esulflng from any cause beyond its control including but not limited to plant and delivery equipment
breakdowns, industrial stoppages or shorlages of raw rnateriaLs� If Continental is unable to complete delivery, of any part of an order, the Purchasershall accept such part of the
order as Continental is able to deliver and the Purchaser shall pay for the part delivered pro rats at-it'n sarne rates as the whole of the order agreed to be sold and the same terms
of payment.
9, QUA. BE,5: This type and quantity of products delivered and detn;ted on the delivery ticket Ou,,,t be checked by the buyer at the time of delivery for compliance with the
Purchaser's order, Variations betweerincival quantitie,,, deliverl- d aird ' ffioscl shown on the delivery ticket must be noted on all copies of the delivery ticket signed by the Purchaser.
Invoice charges will be based on the quintities of produQts shown to be supplied as per the de!ivery ticket. Any claim for alleged short delivery of products must be made in writing
within seven (7) days of delivery: othem,�e it will be acceptedby Rurchaser arid in the absence of any claim the Purchaser shall be liable to pay for the full quantity of products
listed on the Continental delivery ticket.
10.MINIMUMLOAD HA
_g�_ _RQ : All prices quoted are based on loads of not less than five yards. There will be a short load charge on each delivery. less than five yards. One call back
without charge will be allowed on pou—, exceeding ten yards. I
111WITING TIME: A maximum of.sixty rninlutes per 10 yard load will be allowed at no charge. After sixti minutes there will be a charge of $1.50 per min.
12.ENVi_�oNMENTAL CHARGE: A S5.00 per load environmental charge will be assessed,
I&SPECIFICATION: Unless specially ordered, Continental concrete is manufactured according to the proldsions of ASTM C-94. Specifications for Ready Mixed Concrete, and block
is manufactured according to the provisions of ASTM C-90, Specifications for Concrete Masonry. Confi, i nental is not responsible for concrete to which the Purchaser (without the
approval of an authorized agent of Continental) has added or requested Continental to add any water, a . dmixture or additive or whore the Purchaser has mishandled the concrete
after delivery.
14.TE-0H_NAML&_R$laTA1iQE: Continental accepts no responsibility for clairris arising from technical advice or assistance provided to the Purchaser. Advice and assistance provided
by Continental is for Purchasers guidance only and Purch6ser agrees to rely solely on its own architects, engineers or other technical experts.
153 EF, -, Sheets for the products sold Jay Continental are available up
., IY._.p
A _Ar�: The Material Safety Datn iiln request.
16.!�CQ QF TERMS: No employee or agent of Continental has the authority, in the absence of an express writing, to make any statement, including restricting or modifying
or otherwise concerning the existence or effect of any of these terms and conditions or of any warranty orguarantee and no such employee or agent making any such statements
shall ba acting on behalf of or with the consent or agreement of Continental, These conditions may only be altered or varied to writing signed by an Officer of the Company and
no other employee nor any other person has authority to alter or vary any or all of these terms and corditions. Some of Continental Divisions' terms may vary due to industry
standards but all changes must be approved by an Officer of the Company.
'17.TERMS: The Purchaser as indicated in this quotation agrees to abide by these terms. regardless of any Q?ange in the legal status of Purchaser, or until theterm ofthis quotation,
agrees to abide by these terms, regardless of any change in the legal satus of Purchaser, or until the term of this quotation expires. These terms contained herein supersede any
and all terms previously given to Purchaser that conflict vdth the tennis herein.
If. at the request of the Purchaser, Continental Flodda Materials Inc. enters irto a written agreement or pirchase order with the Purchaser to furnish materials to or on behalf ot
the Purchaser for a specific project or job, all of the terms set forth herein shall be deemed to be a part of J;nd incorporated by reference into such written agreement or purchase
order hotwithstanding any term or provisiol in the written contract or purchase older to the contrary and. ii there is a conflict with terms aridlor provisions of the written contract
or purchase order, the terms herein shall prevail and be determinative.
-_�Corjtinental Florl4a MaterialS Ind
TinenTF. 1-3450 WSund
- se�,Blvd., S06,4,�d-
'Sunrise, FL 333�3.
z,
M
-Tel: (954) 858 0780, �C'
AUTION11 Freshly ixied'cement, mortar,
HEIDELBERGUMENTIG rod -m UNLOADING D"' :Are prohibited
nverg
P concrete or. grout may Cguse skin
5 ury� Avoid from delivering concrete exce
Pt. urider the
contact with eyes whe'!& 'Possible -and sh truck1s o
wit,
Tlil fl , I ", . . - , . i ' -, %1�a — Power, and where site 6ondifions
yl � �,;,i �j ,
R! 1,
wi -ea
j exposed skin ar . s proMptlk with water..If any permit the safe and proper operation of,his
cement mixturesiget into eyes, rinse i�mmediately equf ment. Drivers are hot permitted to,
1p
and repe.atedly'with'wa[ter and get PromOt medical add water to the mix nor.
to go beyond the
treatment. Sawjng��,�6�' grinding of' concrete GUrb line, except f
-upon the authorization o
ts,'may�result.in the rele se.6f dust the P
masonry uni uichaser/Pur6haser's. Agent. and his
particles which; w1thout-the use of p?6per eye or acceptance of dsk:for anyloss or�da age.
m
respiratory protectioh,--Gould cause eje or nose I acknowledge that I have received and
eets for. accepted the materials hsled on this ficket,
irritation. The Material Safety Data Sh
.Curb line crossed At Purchaser]Purchaser's'Agent- qyea t. nitials of Pu _ rchaser/P the products sold by Continental Florida I understand and agree to the
terms on -
urchaser's Materials Inc: are available upon re -back of this fi�ket
Ag�nt i6est. both the front and
--Initials of Purchase' TOTAL
r/Purchas
er's Agent�apknowledging addition of -water at Pur6ha !DS ON TRIUbK_/ 6ALS OF mm-r=o A
ser/Purchaser's . YAR WATER'.
Agent request.,
ARRIVALTIME START"POUR TIME FINISH POUR TIME� LEAVE JOB TIME
7 F
-7,
-ADDED
�6
3
2T
PURCHASER'S AGENT
%
PURCHASER/PURCHASERSAGENT
P.O.NUMBER/ORD ED By-
E -JOP NUMBER T - IMETICKETED
-
�7270
DATE
-nc.KET.� -
T
SOLD TO
DELIVER TO
Concrete Disposaf:
-,QUANTITY
THIS LOAD ORDERED
QUANTITY
DELIVERED
PRODUCT
CODE
-PRODUCTI)ESGRIp,jOpj
UNIT OF
UNIT
E)(TENDED'
MEASURE
PRICE
I
PRCE
P1
ITrdck
I
4
1-P,
Plarit
Slum
�p
D� ue At Job,
Use of Concrete
-C dro-
Ai
-Air Entfain
er P
$up Ias.
Drivers Name
SUBTOTAL
Q -CONCRETE TES TEI
TAX
beliveW-frfstructlons
Spd6ial lnstru�tions
%
TOTAL
'ZDUSTOMER
Plangn7� Development Services-k
A
Building & Code RegulAdon Division
2300 Virginia Avenue
Fort Pierce, FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Review Comments
PROPERTY INFORMATION
Address: 10701 OCEAN DR 858
City / State I Zip JENSEN BEACH FL 34957
Parcel #: 4511-510-0059-000/5 Jurisdiction: St. Lucie County
zoning: HIRD Lot # : 858 Block:
APPLICATION INFORMATION
Permit Number: 1107-0153
Activity Type: Other
Permit Type: Building (Miscellaneous)
CONTRACTOR INFORMATION
Contractor Name: LASHLEYMARKA
Business Name: MARK LASHLEY INC
Business Addr: 1562 N E MAUREEN CT
City I State I Zi[ JENSEN BEACH, FL 349!
REVIEWS AND COMMEN
Page 1
Owner(s):
Thomas M Darby
lkpplication Type: Building Permit w/o subs
Other Activity: CONCRETE
Stories: 1 Automatic Sprinkler Systern't
Fax Number 772-232-1235
Review Type Status Reviewed By Date Starte Date Complet Date Released
Front Counter Review Complete Angela Huff 0711312011
Zoning Review Incomplete Irvie Saunders 0712012011 0712012011
07/20/2011 1 Comment: Left voice mail for contractor - not permitted to pour concrete in setback area.
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