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HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE ONL �� r DATE FILED: PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER: CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: 1. 2. 3. 4. 5. 9. 10 ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT SCAWDING & CODE REGULATIONS DIVISION I ED 2300 Virginia Avenue a Ft. Pierce, FL 34982-5652 ' St. L14cjp (r1,0Uf1ty 772-462-1553 �6u APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE LOCATION/SITE ADDRESS: PROJECT INFORMATION 12 u�otet� PROJECT NAME: la- -e ''iy"y',+ SITE PLAN NAME: PROPERTY TAX ID #: '3H X7 - I 11- 0 0 0 a— 0 0 0- 5 LEGAL DESCRIPTION (attach extra sheets if necessary): a-7 ': (P4_D p" l I I-hO—+ PLAT BOOK 6. PAGE NO. 7. BLOCK NO. S. LOT NO. PARCEL SIZE (ACRES/SQ FT.): COMPLETE DE 11. SETBACKS 12. 13 14. LOT DIMENSIONS: PROJECT OR WORK ACTIVITY: FRONT: g BACK: RIGHT SIDE: OZ O LEFT SIDE: TYPE OF CONSTRUCTION (Check all appropriate boxes) [4'NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] OTHER (SPECIFY) DESCRIPTION OF PROPOSED USE: [ ] INTERIOR RENOVATION [ ] INDUSTRiAL SQ. FT OF CONSTRUCTION: ! q I(4715. SF. FT 1st FLOOR: 16. VALUE OF CONSTRUCTION: $ 55X CV ® 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 of construction activities. If the value is $2500 or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 e UPDATED 6/25/09 OWNER INFORMATION NAME: ADDRESS: a CITY: STATE: ZIP: PHONE (DAYTRvIE): 3 Email: 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: STATE: ZIP:CITY: a PHONE (DAYTIME): `- CONTRACTOR INFORMATION ST. of FL REG.CERT #: � 3� BUSINESS NAME:M&rW__WS QUALIFIERSN ADDRESS: CITY: PHONE (DAYTIME) �� ®'� (( � FAX NO7 ARCHIT/ENGINEER. r L ADDRESS: v ` CITY: STATE: PHONE (DAYTIlbIE): ST. LUCIE COUNTY CE,.RT #: ZIP: .J C . I Co n. BONDING COMPANY: ADDRESS: CITY: STATE: ZIP: MORTGAGE LENDER: -ADDRESS: CITY: STATE: ZIP: IMPORTANT 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 OFFICE USE ONLY BP #: SECTION TOWNSHIP RANGE )kZ) MAP NO.1%j f% ZONING 10 LAND USE p LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # J�� r o 11T FLR ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP 9 OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC LOT SPLIT LOT SPLIT Before 1/1990 After 1/1990 REQUIRED APPROVED REPORT HABITABLE PERMIT CODE AREA FEE LIBRARY PUBLIC BLD PUBIC BID PARKS IMPACT. IMPACT FEE IMPACT IMPACT FEE CORRECTION FEE FEE GENERAL SCHOOL ROAD CREDIT Y N LAW, ENF IMPACT IMP IMPACT, FEE F FEE FIREIEMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE IMPACT REQUIRED FEE' VARIANCE FEE. FEE SPECIFY MECHANIC ROOF NON -CONFORMING MISCELLANEOUS SUBS ELECTRIC GAS LOT OF RECORD FEES: REQUIRED PLUMBING FEES DATE SENT TO ADDRESSING: REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE. RECEIVED DATE cy COMPLETED D // INITIALS �-?� 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, 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 structures (all types), swimming pools, fences, residential use. I YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR RAPROVEMENTS TO YOUR PROPERTY. A NOTICE OF CONIlbIENCEMENT 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 OWNER: exempt from undergoing a full concurrency review: room additions, accessory walls, signs, screen rooms, utility substations & accessory uses to another non - 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 SUBJECT TO ATTACHMENT. OWN R R CONTRACTOR SIGNATURE STATE OF FLO A COUNTY OF - �� C�1 P, The foregoing instrument was Aacknowledged before we this day of by 11TuL b , �-: W Lrd who is personally known ✓ or has produced identification. Signature of Notary W n5s Notary Public State of Florida Commission No. _° `', Catherin(6"ur e : c My Commission EEQ39385 Expires11/0212014 CO CTOR SIGNATURE STATE OF FLORIDA ` COUNTY OF :5T The foregoing instrument was acknowledged before me this q'I—day of by u l l C- K. � i" d who is personally known 1 or has produced Signature Commission No. as identification. Notary (fieal�tate of Florida' Catherine Mazur My Commission EE039385 Expires 11/0212014 e _ 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 OWNER/BUILDER APPLICANTS. For specific instructions see appropriate permit checklist. //-05.—�2 4.1 E NO11O3dSN 1 O N uo vsanw aNvi31 tlG ke a3M3A3k M31ASH NOISIIG DNIGlIn9O 31On'1 "S H031 ONz G' HV3S S30IS 8NO S �1 Smis 1NOUA ,70.16 9 r oz a 47 z-- Adei ' .—S A 1, o,7 ,�tm rn0 t •' ORMIT NUMBER k ! - Installer 3GI Address of home V �E[jp 4jr being installed Z y f 14 Manufaciurer Length x width X A9 NOTE; 'it home Is a single wide fill out one half of the blocking plan If home /s a triple or quad wide sketch In remainder of home I understand Lateral Arm Systems cannot be used on any home (new or us ) Mere the sidewall ties exceed 5 ft 4 in: Installer's initials Typical pU � 7 5spa:��' inI2 '_[r"' lateral PERMIT WORKSHEET I page 1 of 2 I New Home ❑ Used Home , Home installed to the Manufacturer's Installation Manual ❑ Home is Installed in accordance with Rule 15-0 Single wide ❑ Wind Zone II (' Wind Zone 111 ❑ Double idle �( Installation Decal # (CA 7(� Trip ❑ Serial # 1 CING TABLE FOR USED HOMES 4 Lcad bearing capacity Footer size (sq In) 16' x 1 1/2' x 18 1/2' (256) (342) 20'.x 20' (400) 22' x 22' (484)' 24' X 24' (576)' 26' x 26' (676) 10DD s 3 OD ps 6 6 8 000 psf 6T B 8 81 2,500 pst 8 g '3000 pSj. 8 8 B 3b00 pst k 8.B PIER PAD SIZES , I-beam pier pad size tt r2 ZY; Perimeter pier pad size f ' C ZZY2- Other pier pad sizes Yz Y Wz_ (required by the mfg.) MIDraw the approximate locations of marriage wall openings 4 foot or greater. Use this symbol to show the piers. List all marriage wall openings greater than 4 foot and.their.pier pad sizes below. Opening Pier pad: size doonal's UJI C`7 Y2_ Y 2.2Y`Z POPULAR PAD 51ZES ANCKORS= 4 ft .5.it FRAME TIES within 2' of! end of hQme�/ spaced at Al 4" oc is..✓' TIEDOWN COMPONENTS OTHER TIES Longliudlnal_ sidewall 1 zl lc Number ' v l Manufacturer UJ! ALongitudinal Longitudinal Stabllizing Device w/Lai rat Arms Marriage wall Manufacturer Shearwall .... ,:... >'.. : PERMIT WORKSHEET page 2 of 2 :PERMIT NUMBER�I POCKET PENETROMETER TES The pbcket penetrometerlasts are roun down to psf or check hereto declare 1000 lb. soil without testing. X X X POCKET PENETROMETER TESTING METHOD 1. Test the perimeter of the home at 6 locations. 2. Take the reading at the depth of the tooter. S. Upinq 500 lb. increments, take the lowest reading and round down to that increment. X X X TORQUE PROB TEST The results of the torque probe test Is ?2r_ inch pounds or check here if you are declaring 5' anchors without testing . A test showing 275 inch pounds or less will require 5 foot anchors. Note: A state approved lateral arm system is being used and 4 ft. anchors are allowed'at•the sidewall locations. i understand 5 ft anchors are required at all centerlinefle points where the torque test reading is 275• or less an where tWmobile home manufacturer may requires anchors with 40 0I inq capacity. �t rrYY Installer's initials ALL TESTS MUST Installer Name Date Tested BY A UCENSErl INSTALLER lonnect electrical conductors between multi -wide units, but not to the mal . ower ource. This -Includes the bonding wire between mult-wide units. Pg. onneot all sewer drains to an existing sewer tap or septic tank Pg. onnect all potable water supply piping to an exi 'fig water meter, water tap, or othe (dependent water supply systems. Pp. Site Preparation Debris and organic material removed G,"- Water drainage: Natural Swale Pad g_Other__T, jr Floor. Type Fastener. tQLA Length ' (0.11 Spacing: 1 Walls: Type Fastener. Lengt Spacing: Roof: Type Fastener. Length Spacing: For used homes a . 30 gauge, 8 wide, galvanized meta strlF will be centered over the peak of the roof and fastened with galv. roofing nails at 2" on center on both sides of Me, ­11 Gasket (we therpioofing "ulrernent) I understand a properly Installed gasket Is a requirement of all new and used homes and that condensation, mold, meldew and buckled marriage walls are a result of a poorly installed or no gasket being installed. I understand a strip of tape will not serve as a gasket. n Installer's initials Type gasket 1 Installed: Pg. Between Floors Yes Between Walls Yes Bottom of ridgebeam Yes Weatherproofing The bcttomboard will be repaired and/or taped. Yes Pq.A Siding on units is installed to manufacturer's specifloatIons. Yes r/ Fireplace chimney installed so as not to allow intrusion of rain water. Yes Skirting to be installed. Yes V_ No / Dryer vent installed outside of skirting. Yes �iL N/A Range downflow vent installed' outside of skirting. �Yes %GWA Drain lines supported at'4 foot intervals. Y Electrical crossovers protected. Yes / Other: ler verifies all information given with this pe is accurate end true based 'on the ufacturer's ltfiktallatinn instrtfr_tin•ne nnri nr. G Installer Signature Date V, I V% •' PER1uflT NUMBER Installer ^ License 9 Address of home _YV 10 being installed Manufacturer Length x width 1_Y07F; 'If home Is a single wide fill out one half of the blocking plan If home Is a triple or quad wide sketch in remainder of home I understand Lateral Arm Systems cannot be used on any home (new or used) where the sidewall ties exceed 5 ft 4 in. Installer's initials Typical pier spacing • � 2' ice/ Iaeral Show locations of Longitudinal and Lateral Systems ienitudlnal (use dark lines to show these locations) marriage wall pier: within Z of and of home per Rule 150 PER•10IT WtjRKSHEET Page i of 2• New Home ❑ Used Home ❑ Home installed to the Manufacturer's Installation Manual ❑ ' Home is installed in accordance with Rule 15-0 ❑ Single wide ❑ Wind Zone II Wind Zone III ❑ Double wide Installation Decal tt Triple/Quad❑ Serial T PIER SPACING TABLE FOR USED HOMES Load bearing capacity Foze ter siz (sq in) 16,X16, (255) 181/2' x i 8 112' (342) 20' x20' (400) 22' x22' (484)' 24' X 24' (576)' 26' x 26' (676) 1000 ost 3' 4 1500 pst 4 6 6 8 000 pst 8 2500 s 6' 8 8 3D00 Dsl 8 8 8 8' 3500 ps 8" 8 8 interpolated from Buie 15G1 pier spacing laDle. PIER PAD SIZES I-beam pier pad size Perimeter pier pad size Other pier pad sizes (required by the mfg.) IRDraw the approximate locations of marriage wall openings 4 foot or greater. Use this symbol to show the piers. List all marriage wall openings greater than 4 foot and -heir pier pad sizes below. ANCHORs Opening Pier pad:size 4 ft '5• it FRAME TIES within 2' of end of home spaced at 5' 4" oc TIEDOWN COMPONENTS OTHER TIES Number ,Longitudinal Stabilizing Device (LSD) Sidewall Manufacturer Longitudinal ,Longltudlnal Stabilizing Device w/Lateral Arms Marriage wall Manufacturer Sheawall POPULAR PAD SIZES St Lucie County Building &Zoning 2300 Virginia Avenue Ft Pierce FL 34982 Mobile Home Inspection Report All requests for permits to place or replace used Mobile / Manufactured homes must be accompanied by this completed Inspection Report and copies of both sides of the Title to the home. All used Mobile homes must be Wind Zone II certified. Owner: MATT \AIYM — Date: ! (Print or type) / Address: /7 V rf 1— T PIER(, 00, 5 P LAKE C. C , M H O (hysical Location of Home) Ta�3 ► ss'� ! A r4A U9 e $ q Year / Manufacturer 1953 1-�Ef Dr MkN erial# Td(o3 /SS"!I j5 HUD Plate#ri.Aaag88S Width ` Length l Single p ' / 9 Double V Wind Zone C = In Compliance N = Not in Compliance Fire Safety / Electrical r _ 1. Smoke Detector: Installed ✓. Missing _ FILE fliop G 2. Electrical System Checked: Exposed Wiring Other 3. Distribution Panel: Missing Loose Main Missing Breaker Missing Unplugged Opening Other G 4. Electrical Fixtures: Missing Installed Improperly Improperly Wired Loose Wire 61 GFCI receptacles not where required 5. Electrical Ground: Chassis Main Panel Gas Pipe Roviscd 3/9105 Page 1 of 3 Construction G 1. Exit Doors Operable: Front Back Other 2. Exit Door Locks: Missing Inoperable C 3. Egress windows: Missing Inoperable C 4. Windows: Broken Glass Inoperable 5. Screens: Missing Damaged G 6. Floor System: Joist Decking Area Damaged C 7. Interior Paneling: Missing Loose Damaged f✓ 8. Rodent Proofing: Bottom Board Pipe openings Other C 9. Leaks Apparent: Ceiling Doors Floor Roof 10. Vertical tie -down straps: Missing PShortDamaged 11. Structural modifications since manufactured: YES_ NO­%e!!!�' Ci 12. Walls: Structurally Unsound Loose Weather tight Plumbing G 1. Trap: Missing Not connected Other C 2. Plumbing fixtures: Missing Not installed Not Vented G 3. Relief Valve: Missing Inoperable Other _ 4. Drain Waste and Venting Piping: Missing Not supported Clean outs Use of fittings Not capped Heating and Air Conditioning Ci 1. Heating Appliances: Missing Not Connected Other C 2. Deleted Heating/AC system: Not installed Other G 3. Thermostat: Missing Inoperable C 4. Air registers: Missing Inoperable C 5. Ducts: Not sealed Missing Collapsed Page 2 of 3 FILE CO,, C 6. Gas furnace Water heater vent: Missing C 7. Return Air: To Furnace To A/C C 8. Range: Vent Hood Loose From rooms 9. Gas Valve: Accessible Installed improperly C 10. Gas lines: Not capped Not supported Kinked, NotbondedFILE COP Summary 1. Is subject structure found to be fifty (50%) or more damaged or deteriorated? YES NO_k_-_� 2. Will a remodeling permit be required? YES NO_� The provisions of the repair and remodeling code shall ensure safe and livable housing and shall not be more stringent than those standards required to be met in the manufacture of mobile homes. Such provisions shall include, but not be limited. to, standards for structural adequacy, plumbing, heating, electrical systems, and fire and life safety. FS 320.8232 IF ANY RENOVATIONS OR IMPROVEMENTS OVER AND ABOVE THE REQUIREMENTS OF FS 320.8232 ARE TO BE PERFORMED ON ANY MOBILE HOME WHICH WILL BE PERMITTED TO BE TIED -DOWN IN ST. LUCIE COUNTY, A SEPARATE PERMIT WITH ENGINEERING (IF APPLICABLE) WILL BE REQUIRED. ALL SEPARATE PERMITS MUST OBTAIN A FINAL INSPECTION BEFORE A FINAL INSPECTION IS OBTAINED FOR THE TIE -DOWN PERMIT. NO MOBILE HOME WILL BE ALLOWED TO BE MOVED TO ST. LUCIE COUNTY OR RE- LOCATED WITHIN ST. LUCIE COUNTY UNTIL THE REQUIRED DOCUMENTS HAVE BEEN SUBMITTED, REVIEWED, APPROVED AND THE TIE -DOWN PERMIT HAS BEEN ISSUED. A REGISTERED FLORIDA PROFESSIONAL ENGINEER MUST COMPLETE THIS DOCUMENT, SIGN AND AFFIX Date inspected: cY ! 1 Inspected By:�. License # L J U Sign ture iequifed� Phone Number: M) THEIR SEAL. r.� ��9 fit Engineers Seal Page 3 of 3 STEVEN G. WOOD, P.E. FL LICENSE 34398 9so SULTAN DR pOR.T ST LUCEE, FL .14 La ititudinal Stabilization focr `Jorida When using longitudinal stabilization only, sidewall perimeter anchors with diagonal ties and stabilizer plates �avery 5'-4" must be used on the home. Vertical tie red on homes supplied with vertical tie con- nection p ' s (per Florida egu tions). Typical Placement Single Section Double Section Triple Section Up to16' Nominal Up to 32' Nominal or Double w/tag up to 48' Nominal R� When the Xi -System is used only as Ion inal stabiliz , systems must be as evenly spaced as possible, no more than 16' from the end of the home. Maximum roof slope for single units & double section is 5/12, for triple sections is 3.5/12, for the above number of systems. Combining Longitudinal and Lateral Stabilization for Florida • Sidewall anchors with vertical ties every 5' 4" per Florida requirements n .., • Roof slope of 20 degrees or less (See chart for 5/12 roof installations). r' Single and double section homes require the same number of systems ;,� • Triple section homes and double: section homes with tag units require two addition I I ngj# JAI systems • Diagram represents single section -•up to 16' width, double section up to 32' width, and triple section homes up to 48' width. • NOTE: Older homes without vertical tie attachments, require diagonal frame ties/anchors/plates every 5'-4" per Florida regulations Xi Block System Assembly Nut & Washer Beam Clamp Bracket J-Bolt 1-112" Tube o.. 1-314" Tube � 4 1/4 x3/4„��.� •' Self Tapping Screws (2 per side) Side View ®OWN ENGINEERING y I� Xi -Steel Pier System - Effective: August, 2007 Installation Instructions FLORIDA ONLY By Tie Down Engineering Installation instructions for longitudinal and lateral stabilization of manufactured homes set to specifications of the State of Florida. • Easy installation • 3 square foot pad and Xi -system replace standard support pier and base pad • Screw;type pier adjusters... no need to use installation jacks to adjust home to system Steel Pier Systems P/N's #59321 +Xi, 12" Pier #59314 Xi, 25.5" Pier #59317 Xi, 36" Pier #59315 Xi, 5' Lateral Strut #59318 Xi, 6' Lateral Strut Block P'er Systems P/N's #59319 Xi, Lateral w/5' Strut #59320 Xi, Lateral w/6' Strut • In • FI1 • 4' to s add • Ma) adji • Ma) • Mai • Mal • msi • Inst one • Add P/N 15386 F L F- C) 0 � , r-IE r MOO" can be made in any type of soil, 4B or better = a requires 5' 4" anchor spacing for vertical ties fund anchors are used with the Xi -system in 4A and 4B soils, except at shear wall or marriage wall ons where loads exceed 3150 pounds. Florida requires that 5' anchors be used at these locations. r line or shear wall anchors, that may be required by specific manufacturers, are to be sized according I torque conditions. Follow all manufacturers instructions for anchor type and placement in on to Florida regulations. num sidewall height is a 96" projection. Higher walls may be used, when the design loads are ted accordingly. num roof eave is 16" rail spacing must be 99.5" or less num pier height of the Xi -system is 48" actions are not for use on "Exposure W homes within 1500 feet of the coastline lation instructions are based on 4200# per pad longitudinal load and 6000# per pad lateral load with iagonal tie/stabilizer. Tonal vertical anchor ties that are unique to a home's design may be required by the home facturer. These locations include shear walls, marriage line ridge beam support posts, and rim plates. REQUIREMENTS LongituL.--.al and Lateral Stabilizati l__ `for Florida Xi Lateral Xi Longitudinal Xi Longitudinal System p Stabilizer Plate & Diagonal r"Oily" System "Only" System with Lateral Strut Combo Frame Tie j Homes Up To 52' 4 g a E> 4 MEM i� Single Up to 16' Width 2 Combo Systems 2 Lateral only 101 A: 0 NVAUM M uWO Double Section Up to 32' Width 4 Co�stems Homes Over IR', up to A: SIMO 0 M Triple Section or "Tag" Up to 48' Width 4 Combo Systems 2 Additional Longitudinal Xi Piers Single Double Sectio Triple Section or "Tag" Up to 16' Width Up to 32' th Up to 48' Width 2 Gombio Systems 4 Combo Sys s/2 Lateral Only 6 Combo Systems/2 Lateral Only 4 Lateral Only Note. (5/12 roof pitch Y7home }requires 2+Gadditional systems. ., .:._-.,�;. 5 s>_•; ..� .,:-: .. '-3. .�;:,w_.:.9J=1C"ittN+ir(il:.systeat's;:.upFt0:A5.2�•,.8,':•.latera.l;,syste.:m.s,I.�p a.4Q,:�$o'u�•*r:,v,• t•' ..v_.i:a .c.wv .. JIM— 0 C is N n O Insta.,,Aon of Longitudinal Syst..._. 4 (Figure 1) i 1.. identify the number of systems to be used on the home using the chart provided. 2. _Identify on the location where the longitudinal systems will be installed. 3. Clear all organic matter and debris from the pad site. 4. Place pad centered under beam using the centering mark imprinted on the pad. F LE COP 5. Press or drive pan into ground until level and flush with prepared surface. 6. Slide Xi -System pier feet into slots in pad so that the Xi -system pier is centered under the I-beam. 7. Raise telescoping extension post to contact the bottom of I-beam, secure with bolt provided, tighten bolt -nut. (Figure 1) 8. Turn hex nut on pier height adjuster until Xi -System pier is rigid between pad and I-beam. 9. Install Gator Beam clamps to I-beam on each side of the Xi -System pier. Do not tighten nuts at this time. (Figure 2) 10. Connect struts (open side down) to each side of the Xi -System pier using the U- bolt provided. Struts are attached to the upper hole in each pier leg and to the flanges on the beam clamps. (Figure 1) 11. Tighten all nuts and bolts on the struts and beam clamps. Installation of Lateral System (Figure 3) 1. Assemble lateral strut by sliding smaller (1-1 /2") tube into the larger (1-3/4") tube. Holes should be on the sides of the larger tube and the "flag" up on the larger tube. 2. Attach the end of the smaller tube to the inside of the pan using u-bolts and nuts provided. 3. Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the I-beam with the nut & washer provided. (Figure 4) 4. Install a minimum of four(1/4"04') self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together. (Figure 1) (Figure 2) Frame (Figure 1) - ,: Lon itudinal Height Bracket 9 Adjuster 0-3" ®' Struts Bolt ° o Pier Base o. ' ° Extension Pier Base Post Foundation Base Pad Tube Beam Clamp Bracket J-Bolt (Figu Lateral Struts 4-#12xI- °:)11� -1-112°Tube Tek Screws (2 per side) � 5trut r s ��, ; (Figure 3) All Components Hot Galvanized Coated L--f u �j r ^ i De 'artment of Flighway Safety and Motor Vehicles Division of Motor Vehicles Bureau of .Mobile Home and :Recreati6nal Vehicle Construction FLORIDA'S -AP P RO VED PRODUCTS LIST FO R T FI E INS'Y'A L.L. ,"rION OF NI ; I3I L E/NIANUFACTURED FIONIES i ( Revised 03/08) i i 1 �;B i I I i ! � INTRODUCTION Florida statutes r(quire that mobile/manufactured homes are installed safely and will meet wind loads as determined by Section 3280.306 of Code of Federal Regulations (CFR), Part 3280, Manufactured [-lousing Construction and Safety Standards established by the U.S. Department of Housing and Urban Development. Section 320.825 V, Florida Statutes requires that: "Each person or entity that engages in the Manufacture of i obi le home installation components, products, or systems must obtain a certification from the department which affirms that -such component, product, or system is approved for use in the installation of mobile homes in this state." The "department" refers to the Department of Highway Safety and Motor Vehicles. The Bureau of Mobile Home and Recreational Vehicle Construction is a',unit of this department and is the unit responsible for certifying mobile/manufactured home components, products and systems for use in Florida. This document is�the official list ofmobile/manufactured home installation components, products and systems that Dave been certified for use in Florida. If you have any questions, you may contact me at (407) 445-7407, Wayne Jordan E C sFY+'� Program Manager ' References: Section 320.8249 F.S.: Provides for the licensing and regulation of mobile/manufactured home installers. Section 320.825 L F.S.: Provides for the certification of mobile/manufactured home installation components, products and systems. Section 320.83251 F.S.: Provides for the department to adopt rules `stating forth uniform i Standards ror the installation o.fmob ile/manufactured homes. Rule Chaptcr 15(.:!-1, I.A.C.: Provides the unirorm mobile/manufactured home installation standards I ti)r Florida. Revised 03108 APPROVED PRODUCT'S r,OR THE INStAL.LATION OF MANUFACTURED HOMES MOBILE HOME SAFETY PRODUCTS continued... Dba Oliver Technologies, Ins. P.O. Box 58/467 Flohenwald, Tennessee 38462 MODEL # I.D19 IF.ICATION DESCRIPTION 1055-18L Longitudinal Stabilizing System 20" galvanized steel pad beam clip ('or longitudinal bracing system w/square'tubing in a cross "X" 1101E i 1101 Al] Steet roundation System pattern Longitudinal Stabilizing System All Steel Foundation System . Longitudinal and Lateral 110,1 V i All Steel Foundation System LongitudinalStabilizing System Stabilizing & Lateral l 101 CVW i Wet Bracket Bracing System l 101 CVD 1 101-W-C Dry Set Bracket Concrete :Full System Concrete Full System i 1101-D-CPCA Wet Set Bracket Dry Set Bracket Concrete Longitudinal System .1101-W-TACA ' Wet Set Concrete Longitudinal System 1:101-D-TACA 1055-14 .Bracket Dry Set Bracket Concrete Transverse System Concrete Transverse System 1055-10 I Plastic Foundation Pad IV x 16" 1 Q55-8 1 .Plastic Foundation .Pad 16" x 16" .Plastic Foundation .Pad 16" x 18" 1055 9 Plastic Foundation .Pad Plastic Foundation Pad IV x 18 %" (rounded)(2 sq. ft.) '/z" SPA. 264-1 ( Plastic Foundation Pad 18 x 18 %z" x 1511611 18 %" x 18 %" x 3/4" 41484 l 055-16 Plastic Foundation Pad 13 %" x 26 %" 3 x Pl/499 astic Foundation Pad 17" x 22" x 1055-2 Plastic .Fo " C 20" k 7/$" 1055-17 a ion Pad Plastic Foundation Pa 17'/Z" x 22 12 1055- 2 I 1 U55-12 Plastic Foundation Pad z z' x 1 24" x 24" i 055-20 I Plastic Foundation Pad , .., ... 1 lastic, foundation Pad c . „ 21. (3" x .2� 13 (rounded) '''W.' I 23 x 31 '/4" Revised 03108 10 • � i I APPROVEDPRODUCTS � .FOR THE INS'Ii'ALLATION OF MANUFACTURED HOMES MOBILE HOME SAFETY PRODUCTS continued... Dba Oliver Technologies, .ins. P.O. Box 58/467 }5` Hohenwald, Tennessee 384625 MAXI UM PIER LOADS IN POUNDS BASED ON SOIL VALUES Paul Area 1,000 lb. , 1,50011). 2,000 lb. 2,500 lb. 3,000 lb. Remarks Confi uration s , ft. soil soil soil soil soil Max. i 16" x 16" 1.77 1,770 2,650 3,450 4,420 5,310 5,310 16" x 16" ; 1.78 1,780 2,660 3,560. 4,430 5,340 5,320 16" x 18" 2.0 2,000 3,000 4,000 5,000 6000. 6,000 16" x 1$ ''/s" (rounded) 2.0 2,000 3,000 4,000 5,000 6,000 6,000 18'/z" x 18 %x" x 15716" 2.360 2,360 3,550 4,730 5,910 7,090 7,096 18 ''/s" x 18 %" X W 2.375 2,375 3,563 4,750 5,598 5,598 5,600 13'/4" x 26'/4" 2.4 2.375. 3,563 4,750% 5,938 6,400 6,400 17" x 22" I 2.5 2,500 3,750 5,060 6,250 7,500 7,500 2029 2.75 3.0 2,750 3,000 4,.125 4,500 5,5001 6,000 6,875 7,500 8,250. -9,000 8,250 ' 9,00o 7 %" x 22 %" (rounded) : x 3.0 3,000 4,500 6,000. 7,500 9,000 .9,000 24" x 24" 4.0 4,000 6,000 8,000 8,000 8,000 8,000 2 l .13" x 29.13" (rounded 4.0 4,000 6,000 8,000 8,000 8,000 8,000 23 %" x 31 '/." 1 1 4.698 1 4,698 17,047 8,000 8,000 81000, 8,000 PAD CONFIGURATIONS .Pail Description Pad Aria 1,000lb. 2,000 lb. 3,000 lb. (Pyramid tooter Configuration) sc . ft. ~ sojil soil soil (2) 13 14" x 26 ''/4" as a base and (1) 20" x 20" on top 4.9. 4,800 %600 N/A T r9e (3) 17" x 22" 5.0• .5,000 10,000 N/A 'Chree ,3 i 7 ''/2" x 25 '/z" 6.0.. 6,0 ____0U _ 12 U00 NIA MODEL # IDENTIFICATION DESCRIPTION U'r i C.B 1 Plastic Cap Board I " x 8" x 16" OT 1 CB2 Plastic Cap Board 2" x 8. x 16" The cap boards woke test on CMU pier (C90) with either a single or do ble stacked cap boards. Revised 03/08 t i i LE C 0 Plt� APPROVED PRODUCTS FOR THE. MN TALLATION OF MANUFACTURED HOMES 'rIE DOWN ENGINEERING 5901 Wheaton Drive Atlanta, Georgia 30336 MO )EL 1# IUE; M12EI-5/8" Gal'vanized TIMATION Auger Anchor DESCRIPTION 5/8" x 48".rod,. double head with a single 6" disc SOil Class 4a Working Load 3,150 Ultimate Load 4,725 M 121.1-3 ra vanize Auger %►" x 48" rod, double head with 4a 3,.150 4,725 Anchor a single 6" disc . M607 Galt anized Auger %" x 60" rod, double head with 4b 4,000 6,000 i Anchor a single 7" disc NiIT2 Galvalnized Patio Slab j Anchor '/a" x 10" threaded rod w/tlat Concrete a to 3, l50 4,725 washer and nut, double bolt head M1.12 Galvanized Patio Slab 5/8" x 10" rod concrete anchor Concrete 3, l50 4,725 Anchor with a double bolt head M I CS2 Galvanized Patio !nchor %z" x 3" steel expansion bolt Concrete 3,150 4,725 Bolt. ,V'Redhead Sleeve Anchor" double head MIAlt2 Galvanized Double Head Device Double head tension -device N/A 3,150 4,725 (only) w/bolt hole in the bottom_ of the yoke M I S2 Galvanized Double Double head tension device N/A 3,150 4,725 1lead ,'wivel Adapter with swivel adapter 592,35 Stabilil:er plate — steel 0alvanized steel 17 %" (width) :16 4,000 6,000 x 7" (side) x 1.3 %" x 8 gaug"e i (thick. 105" 909 degree top 59293 Stabilizer flute/ - I 8" x 24" x 1.375" tat top I I 1 plastic Revised 03103 1 15 APPROVED PRODUCT FOR THE . s F'LE IN,.. TALLATION OF MANUFACTURED HOMES nri, DOWN ENGINEERING co' atinued... 5901 Wheaton Drive Atlanta, Georgia 30336 IDE TIRCAnoy DESCR[PTFON Soil Working '"g Ultimate Ultimate te.Down Strap'ing p ASTM Standard Spec. 1 D3 953 -91 I x .035" galvanized steel N/A 3,150 0 Load Load 4,725 F4,7 2 5 strapping G.;. 120 MORB ! oof Bracket Galvanized Roof Bracket N/A N/A TD Slotted Bolt 1 2 5/8" N/A 3,150 4,725 TDE CI mping Seal 1A 10" x 2.25011 N/A 3,150 4,725 59010 [longitudinal Metal pads, bracket with N/A 7,000 10,000 Stabi,lizdtion Device hardware metal struts L2S.D .59002 iv " Strap 'tonnector 2.601.)x 4.875".v. 10 gauge N/A 3,150 4,725 W/I !/Ilw x.03511 59003 Beam!Connector for a 2.511.x 6-300" x 10 gauge beam N/A - 3,150 4,725 [-beam connector used with 59002 59004 Beam iC' O'nnector for a 2.5" x 7.300" x tO gauge beam N/A 3,150 4,725 4 1-beam connector used with 59002 59005 Adj. liea'rn Connector 2.5'* x 9,850" x 10 gauge used N/A N/A N/A Forti toa8"double. with 59002 and grade 5 bolt and I I-beam nut 59009 Lon itudinal Beam I V2" x 6 !/," x !/4" tsiiM`as pair N/ik NIAL N/A -onneetor with 59002' 59011 Longitudinal Beam 6 x63/4" x 7 gauge eraime N/A N/A N/A Clamp with. clamp w . eight grade 5 (8), bolts and nuts Revised 03/08 1 16 INS', APPROVED PRODUCTS FOR THE ['ALL.,vuON OF MANUFACTURED HOMES HE DOWN ENGINEERING continued... 5901 Wheaton Drive ILE C, OF -I" Atlanta, Georgia 30336 THE [FOLLOWING ARE KIT NUMBERS MODEL # ; iDE:NT.IFIC.ATION DESCRIPTION 59006 Lateral (Vector) Kit w/pads For concrete 17.25" x I 1", 12 gauge galvanized applications — single stacked block piers pad, part # 59277 w/mounting brackets, hardware &* parts 59276 and 59282 59008 �"ateral (Vector) .Kit w/pads for concrete `Ipplications — double stacked block piers 17.25" x 18.6", 12 gauge galvanized i pad, part # 59273 w/mounting brackets, hardware A parts 59276 and 59282 59273. Double block foundations pad for concrete 59277 Single block foundation pad for concrete 59024 Lq.teral (Vector).14ardware Kit (use w/59271) 59026 1 L4mgitudinal L2SD Hardware Kit (w/59271) 59314 i Vector Xi System 59315 I Vector Xi System Xi Concrete anti Concrete Mock System 59361 1 j Outriggers 59362 1 1 Outriggers Revised 03103 17 Use with Vector System Use with Vector System U-bolts, "U" shaped connectors & inside brackets 6" �x 6'/a"".x 7 gauge beam clips, "U" shaped'plate connector, bolts and nuts for connections Longitudinal Stabilizing System Lateral Stabilizing System Longitudinal/Lateral Stabilizing System 24" Outrigger/Diagonal Strut 24" Outrigger/Diagonal Strut Y• I I IMMOE . F=L�7rJA L.f_VEL (" UFr1.L1(:'rF� 3PH$RB 4`rY -II>�6LJOH OUARDJAIiNNO L 2� kfuIJMJ .�NL,r_ lr��ENc3T_H I I F / �_�j 9• •u1M.� i Pcr]'p 111/1MRRPNAS9 ERg UGH ARLIA 95TWER"I-FAEA AND a77, C8QR OUAROgA1L rnGADS ANO Rf9ERS MAY'VAR1' NuE9, s.rZZAY prn SIiitic. TrOu SFif!>< r C UNIR7ttN( ib L`F tDti7CJN GV/ _k, SIJi'T'T. 'l rlft?t i Wrf F.R1C A PPI.iL'AbL ijC(jy}B �'QluklA 817(LI'jpT((, (�Q tdis 5N.�t-i. pL� AK7N t RF O TO: IMECTiONS 124 Tii1+ ,• It7A7a, I� i—xC rr iamg f01,15i• fL 1007 �, EXIL,L!P'T1A T. I��v�,s r •K• t A 1 /l! tr . '',` ,,'1 ;.• �' ,� .• _��� eft � oi .f•Va�r)]li.i(71TIA-r rill U,^ 1•rrif,'i '!Jj 'i�QCJIi'Nr1fi7� Elf,' rr/�IIu,F��t r11 ' '`T771^_,'i• I lJ1.iJ,i7NAllc r4CrilUA .1.rfi%? ,f � . ' � r ..rr•nwrvm nruuM>"no.vnnrr.rm...+.v. llrrr.-ti,H et•:rr�rANN•rrv:!te>tne/�r•rr rnnrrrr..n/runenurnr.Mr•n.�lnrn!nY.Y.rrNbnrWNtrV/utNWmvrvvn.MrlWwM�aNNrrrmlr'erMursye•NNemiwnvr_rin�mrYurreaLl��/.rr4x'NtMUMurV,.weNMMNp-lM1rWrm�IMc11en0erenue9tlN ' . -TYLECREST 11 fl w.• I i r 4'in Use this full 381Y x 3811 otl -the 3B" x .4� landing wal reversible r when you r par•all'el' apr !,ME SIDE ,APPROACH i I �aa '1 ailing lrefer a roach. r Code approved in most areas 3811 x 38-11 Pictured with Deluxe Rails Note.- Side & Back Fails must be Ordered S.4parately Model# r'ti,e► Overall Landing Width Standard, Deluxe Standard (deluxe .tee+n'nu'eRe"Y lifright sleight Depth .,,r,,:,.�.1.,�.!.Nrb,RR.,r„N...M..,l..r.en„".:.�ra."r • aide Fail Sides Flail Back R611 Back Flail �. 017143838 7'! 14" 'all "38" 02138 ()29138 0238 02938 01816:3E33r3 t3";. 't t 8 1k ;38 ff '38 ! 02138 r 029138 0238 02938 017213838 I" ?'I " 38" 3l3" 02238 . 029238 0238 02938 078243838 8"' :'.d•" 38" 38" 02238 029238 0238 02938 0'17.283838 ' T r'811 38" ;381" 02838 OP-9388 0238 02938 8rrl: :32'f 381, 38 02338 02.9338 0238 02938 . -i173531433 r r ;.'.';" ::'tf3" 331, 02a38 0294387 0233 029349 019403838 8"j : 9()" 38" 38" .92413f3 C)294,18 ()238 02938 38" 38') NIA 029538 NIA 02938 '38" 48" 02138 029138. 0248 02948 . Q'l8 243843 T! I. ..,,fir! :'38 Jc 311 02238 029208' (1'7248 029,48. flt7Z8:3£3Id8 I"�' :'.tl" 18" 18" 0233E 029338 0248 02948 Jtii323f34F3 3" ;3'" 38" �1f3" 02338 ()29336 0248 0294$ 017353848 7" 1 ; ,511 13311 1F3 " 02538 02,54387 0248 02948 t;18403i348 3" i • )c)" ;1W,:r18" 02438 029438• 074.13 0^9.1Fr . ......... .. i .:,... ....,.^Sty,t wrt::rt,•.,r;n:......:�s Clrt:)nM':>ra•ar yo l.:,l�•.ul ;•I<sc,�:,, ._ .. 1 -VJ1J 1" VJVJ.J./ YU.L.L L zyw i I�WW�I STYLECRE-a Fiberglass Step ;Anchoring Guidelines - -! Concrete Instal-lation U, ,t of Con7ponents (PU1rh�sed Locally) 1 2c4ch [sus Cate I ArrhZ 2 c wc3l l/ l•" � slYYs Concrete Installation` Guidelines 1) Drill''/a" hole through step and bracket at desired position Through lower wooden frame member. 2) Install L-brackets using '/i' x 20 x 2 5/4" Bolts, washers, 4nd nuts. 3) Mark location o:('hole :in 1,-bracket on the concrete. 4) Move the step aivay from the house. Drill holes in concret6 at the desired locations, Talc in'/4" concrete anchors. 5) Replace step so hat the tops of the concrete anchors protrude through the L-bracl�ets, Secure with the;iiuts and washers, I G'rourid I"nstalaa-trim. List of Components (2) 4$4154 Anchor Asseinblies Each assembly includes: (1) 15 inch Anchor (1) 3/V x I Y2" lag screw (1) 7/1 C" X 1 '/" washer Ground Installation Guidelines 1) Set step in desired position and mark the anchor placements on the ground. Remove step. 2) Screw the anchors in the ground so that the eye of the anchor will be in the position as. shown. 3) Replace step and mark the place where the hole in the eye of the anchor meets the side of the step at the height of the lower frame member. 4) Fas ton screwy into lower frame member though ere of the anchor and washer. Fm PIT ILE'. PPY W'A"X, .N'G: Failure to anchor the step properly can result in injury. Place the step against the hou-9 . Make sure the st rBice on which the step rests is level. Style Crest,.Inc. Drawer A Fremont, Ohio 43420 man raen aausracrron m: uepr!r rngnwd:Vamcay —,n FT —Identification Number � Year T .,.,.. , �,.....�...o..�.........y, .a..W....... , Ma.__ IyT— Wr-L-BHP —r Vessel Regis. No.—F Title NumL. Registered Owner: LINDA JOHNSON ITO 2870.NEWLAND ST WHEAT RIDGE CO 80214 Mail To: LINDA JOHNSON ITO 2870 NEWLAND ST WHEAT RIDGE CO 80214 Date of Issue 05/21 Uen Release Interest in the described vehicle is hereby released Title Date INFORTANT INFORMATION 1. When ownership of the vehicle described herein is transferred, the seller MUST complete in:full the Transfer of Title by Seller section at the bottom of the certificate of title. 2. Upon sale of this vehicle, the seller must complete the notice of sale on the reverse side of this form. 3. Remove your license plate from the vehicle. 4. See the web address below for more information and the appropriate forms required for the purchaser to title and register the vehicle, mobile home or vessel: httpJ/www.hsmv.state.fl.uslhtmUtillinf.html f SASE_ i ,i f—�r -sr. oil 0 3-.- �� .� 4 N S .»u � .+� y �C5 4 " R P1 ,6t i 45 ' M I Ui " r7 it 4 STATE OF FLORIDA DE rMENT OF HIGHWAY SAFETY AND. MOTOR VEI=S DIVISION OF MOTOR VEHICLES f 2900 Apalacriee Parkway • Neil Kirkman Building - TallahasseL, _ 32399-0620 iNotice of Sale -of Motor Vehicle, Mobile Home or Vessel Section 319.22(2), Florida Statutes, requires that the seller file a Notice of Sale with the department within 30 days after the sale or transfer of the motor vehicle, vessel or mobile home. Filing this form removes any civil liability for the operation of the sold motor vehicle, vessel or mobile home. In addition to filing this form; we suggest you keep a copy of your bill of sale (we suggest it be notarized), certificate of titlePr other type of transaction document showing the vehicle was sold. Complete the information below, tear the top portion of this document at the perforation and mail to the address above or submit to your local tax collector's office or lfeense plate agency. I have this . day of transferred by assignment of and delivered Florida Certificate of Title, to: Name: Purchaser(s) / Purchaser's DUID First MI Last Address - Selling Price $ UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ'THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE. Seller's Signature Co -,Seller's Signature NOTE: THE SUBMISSION OF THIS FORM, ACCURATELY COMPLETED, TO A TAX COLLECTOR'S OFFICE, LICENSE PLATE AGENCY OR TO THE ADDRESS ABOVE WILL ALLOW THE TITLE CLERK TO UPDATE THE DMV DATABASE TO REFLECT THE TITLE RECORD AS "SOLD". HOWEVER, THE OWNERSHIP STATUS WILL NOT CHANGE UNTIL THE PURCHASER APPLIES FOR AND IS ISSUED A CERTIFICATE OF TITLE. Identification Number Year III'- Andy wr-L-BHP Vessel Regis. No. T TAIe Num' �E �2631SS I IB 1983�TWIN J 59IF 120801305"� Regist6itd'Uwner:a Date of Issue 05/21/2009 uen Release interest in the described vehicle is hereby.released LINDA JOHNSON ITO av 2870 ,NEWLAND ST .. WHEAT RIDGE CO 80214 e • Date � IWORTANT INFORMATION 1_ When ownership of the vehicle described herein is transferred, the seller MUST complete in'fuil the Transfer of Title by Seller section at the bottom of the certificate of title. Mail To: 2. Upon sale of this vehicle, the seller must complete the'notice of sale on the reverse side of this form. LINDA JOHNSON ITO 3. Remove your license plate from the vehicle. 2870 NEWLAND ST 4. See the web address below for more information and WHEAT RIDGE CO 80214 the appropriate forms required for the purchaser to title and register the vehicle, mobile home or vessel: httpl/www.hsmv.state.fl.usthtmIAitlinf.html; DIF STATE OF FLORIDA . - D1. ITMENT OF HIGHWAY SAFETY AND MOTOR VE,` _ .ES �.� DIVISION OF MOTOR VEHICLES f „ . is 2900 Apalachee Parkway • Nell Kirkman Building - Tallahassee, rL 32399-0620 . I Notice of Sale of Motor Vehicle, Mobile Home or Vessel Section 319.22(2), Florida Statutes, requires that the seller file a Notice of Sale with the department within 30 days after the sale or transfer of the motor vehicle, vessel or mobile home. Filing this form removes any civil liability for the operation of the sold motor vehicle, vessel or mobile home. In addition to filing this form, we suggest you keep a copy of your bill of sale (we suggest it be notarized), certificate of title or other type of transaction document showing the vehicle was sold. Complete the information below, tear the top portion of this document at the perforation and mail 4o the address above or submit to your local tax collector's office or license plate agency. I have this day of , transferred by assignment of and delivered Florida Certificate of Title to: I - Name: Purchasers) / Purchaser's DL/ID First MI Last . I Address - Selling Price $ UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE. Seller's Signature Co -Seller's Signature NOTE: THE SUBMISSION OF THIS FORM, ACCURATELY COMPLETED, TO A TAX COLLECTOR'S OFFICE, LICENSE PLATE AGENCY OR TO THE ADDRESS ABOVE WILL ALLOW THE TITLE CLERK TO UPDATE THE DMV DATABASE TO REFLECT THE TITLE RECORD AS "SOLD". HOWEVER, THE OWNERSHIP STATUS WILL NOT CHANGE UNTIL THE PURCHASER APPLIES FOR AND IS ISSUED A CERTIFICATE OF TITLE. Of %0%, y. 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Sigii:FttrC .t :>� .,; i -.:. �Aucfo•''Licenscldtinber.E: ::E:. Pr nt.Here. .. .. .. R Ni $F'Wng Dealer - Sellm�. Dealer s - fdX -Tax ;L[e4hseNo,°;�^ �.:i'YnMe�'�:: ::No Cotkcted I Sc N&.R 1@ ?6 Addre$s. .. . `,i). ¢ So w LT Purchaser s N7me s ;r:: ,:.., 0 (')' - Address m. .:. .. y y'--�- ...•.: : /K T W ` PI � � j� XX RE ?J`3 „ ,1 ., E S7ATE THAT TH1S 5 OR ab'?71G1 017 ZvIETFit Np REA S {NO TENTLjS)' Iv1jLI 5 SSATE AD 1 AND 1 HEREBY: :.1 .;:.. .i_ .. :' T Y H t. 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X 's,,Jiildtwa�F'is#SKns.Ttu y .,. .,.:M'..%n�.w ��. ••... w.�h, f ,�,a.a ,.^�:s;.---^ <. .✓.axarw»:.M r. r.,=sue :w':: .:.. v. �1?� ci..—�5-..�'s[ae ..7 .� 3 :..� PLANNING & DEVELOPMENT SERVICES DIVISION BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Ave Fort Pierce, FL 34982 BUILDING PERMIT SUB -CONTRACTOR SUMMARY 1 1 (, will be using the followin sub -contractors for the (Company/Individual Name) l �� Arc , project located at �� ` -- (Street address or Property Tax -16 # It is understood that if there is any change of status regarding the participation of any of the sub -contractors listed below, I will. xmnediately.advise the Building and Zoning Department of St. Lucie County. Trade Name of CompanylConfractor - --- St. Lucie County/ -"-Stre�f Florida License Number Electrical p pD9 9 Plumbing AMC M021(e hu'm rn Uveys [At Le K., Gdll- HVaalijue Mechanical a 1 o a C — CA n I p 1 5 I Roofing Gas bin PERMIT ISSUE DATE: NUMBER: ST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: 2098 State of Florida Certification Number (if applicable): ER0000122 Lawlz. -E1-ectric,Inc_ (Company Name/Individual Name) electrical (Type of Trade) for the project located.at have agreed to be the sub -contractor for (Primary Contractor) d (Project Street Address or Property Tax ID #) It is understood that, 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 notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGtiATURES ARE REQUIRED Jamea V. Law GNATURE PRINT NAME DATE BusinessNume: Law's E3:ectric,Isc. Address: 218 Beach Avenue City/State/Zip: Port St_ Lucie. FI _ 34952 Phone: 772-464-3969 email: OFFICE USE ONLY: PERMIT # ISSUE DATE _ PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: J State of Florida Certification Number (If applicable): T H I o of 5743 5 1 �(( have agreed to be the ompany Name/ (CIndividual Aam bI OCA sub -contractor for �� (Type of Trade (Primary Contractor) i nEtal'a)�fck) t� for the project located at (Project Street Address or Property Tax ID # ) It is understood that, 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 notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED �r- - Address: City/State/Zip: Phone: C)TiFTC.F. TTIRF C)NF,V: Jalle-&Lrd PRINT NAME t, C.o C 11 DAT .. 'e-s 4 ) ry J PLANNING & DEVELOPMENT SERVICES DEPARTMENT - BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: 4) D State of Florida Certification Number (ifappli We): L O ✓ I Iq } '^ z f) 1 (� have agreed to be the (Company Name/Individual e) M!C l �yl ( sub -contractor for 1 I ! C rYIDV U ii�}v Y r 1C0� (Type of Trade) (Primary Contractor) for the project located at 2 v i de (Project Street Address or Property Tax ID #) It is understood that, 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 notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGLNAL SIGNATURES ARE REQUIRED AK;� - Business Name: Address: City/State/Zip: Phone: ��] OFFICE USE ONLY: PRINT NAME DATE S(yuji, • na�- AFFER RECORDING -RETURN TO:. PERMIT NUMBER: r Tlti.s:9pace is reso-'cd lur ivcurdii4 int'i L NOTICE OF COMMENCEMENT The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida statutes the following information is provided in the Notice of commencement. 3Alq -\\\ ] . DESCRJPTIO OF PROPERTY ( al description an.d street address) TAX FOLIO NUMBER:• crTRniVISIO141 c� �C _I @ TRACT LOT _BLDG UNIT A" t — _0�m - �v , .... — 2. GENERAL DESCRIPTION OF IMPROVEMENT:. single family residence OWNER INFORMATION: ' a. Name L Tv^_ n _n_r� R u i 1 rl i• n n b.Address 8000 S. US1,. Suite 402, PSL, FL 34952 c. interest in property d. Name and address of fee simple titleholder (if other than owner) 4. CONTRACTOR'S NAME, ADDRF, SS AND PHONE NUMBER:7d-7 ��s m Anc 4 PI rear �✓_-��°C�t 8 ' �9_ iSa 5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT: 6. LENDER'S NAME, ADDRESS AND PHONE NUMBER: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (])(a) 7., Florida Statutes: Tom Lee Spanish Lakes Blvd. Ft_ Pierce,, FL. 201— NAME, ADDRESS AND PHONE NUMBER: otice as provided in Section 0590 8. In addition to himself or herself; Owner designates the following to receive a copy of the Lienor's N 713.13 (1)(b), Florida Statutes: NAME, ADDRESS AND PHONE NUMBER: 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) 1 20 . 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING CONSULT WTTH YOUR ncrnvnwr:vnTTR NnTTCF.OFCOMMENCEMENT. Matthew Lyle Wynne, Vice=president Print Name and Provide Signatory's Title/Office Signature of Owner or Owner's Authorized OtTcer/Director/Partner/Manager State of Florida County of S t T. I1 c i e- 20 The foregoing instrument was acknowledged before me this 3 day of _ g Matthew Lyle Wynne as *_L!Q� �,2�5/ E7Y9 By of person) (Type of authority ... e.g: Owner, officer, trustee, attorney in Fact) For Wynne Building Corporation / (Name of party on behalf of whom instrument was executed) Personally Known— or pr DOROTHY ANN HAFNER rorav p.`�-m Notary Public - State of Florida n My Comm. Expires Oct 2, 2012 Commis Osion # DO 827096 ; ; Bonded Through National Notary Assn. ,d`� (Printed Name of Notary Public) (Signature of Ndt Public) !_' '1. Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are true to the best of my knowledge and belief.(section 92.525, Florida Statutes). Signature Ow or Owner(s)' Aut ized Officer/Dire ctor/Partner/Manager who signed above: By JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT By: SAINT LUCI FILE tt 3599861 06/1012011 at 11:07 AM Rc 08/30R007(Rcco,ding) OR BOOK 3300 PAGE 525 - 525 Doc Type: NC RECORDING: $ O IIIIIV I�" ST. L tCIE '�.a F:,•L R � U ST. LUCIE COUNTY BUILDING & ZONING 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: (Tax 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 , 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 immedia Property Owner Name Property Owner Signature Date STATE OF FLORIDA, COUNTY OF-42+ • L Al ACKNOWLEDGED BEFORE ME THIS :7) DAY OF , 20 BY&IM—M-610 L`/C.e W YN I-e WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS IDENTIFICATION. SIGNATURE O OTARY TYPE OR PRINT NAME OF NOTARY NOTARY PUBLIC TITLE M� � UMB9RROTHY ANDN Notary Public - SMy Comm. ExpireCommission # ° Bonded Through Natio Property Appraiser - St.Lucie Coun.' - FM Page 1 of 1 Wynne Building Corp Record: 1 of 6 Property Identification Site Address: 157 Camino Del Rio Sec/Town/Range: 27 :36S :40E Map ID: 34/27N Zoning: AR-1 Ownership and Mailing Owner: Wynne Building Corp Address: 8000 S US Hwy 1 Ste 402 Port St Lucie FL 34952 PROPERTY RECORD CARD <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print l 00G.y ParcellD: 3427-111-0002-000-5 \X,`rUl Account #: 115459 !' Land Use: PRKG/MOBILE City/Cnty: St Lucie County Legal Description 27 36 40 ALL THAT PART LYING E ANDN OF ST LUCIE RIVER AND W OF US 1 (218.217 AC) (OR 254-1990, 2013) Sales Information Assessment 2010 Final Total Land and Building Date Price Code Deed Book/Page 2010 Final: 13009100 Land Value: 4620700 Acres: 218.22 1/1/1900 0 / Assessed: 13009100 Building Value: 8388400 Ag.Credit: 0 Finished Area: 19828 SgFt Exempt: Taxable: Taxes: 270383.72 BUILDING INFORMATION Exterior Features View: RoofCover: - RoofStruct: ExtType: MHPK - MH Parks YearBlt: 1983 Frame: - Grade: C - C EffYrBlt: 1983 PrimeWall: - StoryHght: 0010 - 1 Story No.Units: 610 SecWall: - Interior Features BedRooms: 730 Electric: - PrmintWall: FullBath: 0 HeatType: - AvgHt/FI: 1/2Bath: 0 HeatFuel: - Prm.Flors: - %A/C: 0 %Heated: 0 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qual. Cond. YrBlt. No. Land Use Type Measure Depth CURB - CEMENT CURB Y 1 650 GD AV 2001 1 2800- 130 -Site 610 PRKG/MOBILE ASP1 - ASP1 HIGH Y 1 277848 AV AV 1983 2800- 2 530 -Acres PRKG/MOBILE 36.5 3 2800- 500 -Acres 31.6 PRKG/MOBILE More... THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. http://www.paslc.org/prc.asp?prclid=342711100020005 7/18/2011