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HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE ONLY: DATE FILED: C PLAN REVIEW FEE: RECEIPT NO.: ���--x�PERMIT NUMBER: CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED - PLANNING & DEVELOPMENT SERVICES DEPAR BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue ppef Ft. Pierce, FL 34982-5652 F♦T �', ' ' 'Y_` 'coSe772462-1553 r APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLUN PROJECT INFORMATION 11� — \ J ` z 1. LOCATION/SITE ADDRESS: b (C ( J-Nj,ter\ Dr-,1 d-e 2. PROJECT NAME: F-� A reA k4o�GC SITE PLAN NAME: E Ur c 3. PROPERTY TAX ID #: )O ( Y-6 6)061 o ao SCANNED 4. LEGAL DESCRIPTION (attach extra sheets if necessary): BY _ — E. Lucie Count, 5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. _ 8. LOOT NO. C. 9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: ,2 100 X j S _ _U L�(-� 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: e p rZcei 11. SETBACKS (ACTUAL) FRONT: ,$ I BACK:' I'180.7 t RIGHT SIDE: OS, I I 1 LEFT SIDE: , 1 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [xj NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [?� RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) I 13. DESCRIPTION OF PROPOSED USE: C r0. i O a 14. SQ. FT OF CONSTRUCTION: �;as.`rI �' 15. SF. FT 1st FLOOR 3 I,% �r 1 SF 16. VALUE OF CONSTRUCTION: $ S-® �3 r m� 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 UPDATED 6/25/09 OWNIER INFORMATION NAME:© ADDRESS: _ (� G C'OLc2t\ CITY: Cke +1 ,' It \R 1'aA 1q e- STATE: Vz coo r K ZIP: 0 Q 13 PHONE (DAYTIME): � �% S - b (6 Email: rc c1S5�tbeca�a� �'eY-,'�ea'L4on cam• IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: PHONE (DAYTIME): STATE: CONTRACTOR INFORMATION ST. of FL REG. CERT #: C G C_ 0116;2. R Y ST BUSINESS NAME: /" P �+ i C a � A ?, ul I A ; n . r. ZIP: COUNTY CERT C: QUALIFIERS NAME: ADDRESS:__�--- CITY: �n i- ��i -CA-C t e STATE: 4-1ZIP: -3 -!1 Y -�_ PHONE (DAYTIME): 772 87 c1 -.2 y�(0 FAX NO. �- 7 7 •- o i l O Email:6e,l �L ��(sd—l� , t� �t ARCHITMNGINEER: ?P�C.Orl 41 Le-0-1 Il s ADDRESS:::), I a A Se�c-c�tA— CITY: F©r -� P i c-rCe STATE: r t , _ ZIP: PHONE (DAYTIME): 7 Z .6 0 -- t, O8 5 BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: STATE: ZIP: 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. r / A 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 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 SUBJECT TO ATTACHMENT. OWNER OR CONTRACTOR §WRATURE STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this S�N day of 20 \O , by �c1o�� r�sS�c�S who is personally known or has produced CONTRAC OR GNATURE STATE OF FLORIDA COUNTY OF aN \.,, •, The foregoing instrument.was acknowledged before me this L&hday of by who is personally known ✓ or has produced as identification. as identification. Signature of Notary :w S• ture of Notary SAIL CARRUTN6R= commission No. '_ GAi1L CARRUTI ��lo` •r{ 1l�OMMISSION # DDTW1130 ommission No. ��`` t: A$�IMISSION # 0 • EXPIRES June 09, 2012 %��,.. EXPIRES June 09, (407)388-0153 FlorldallolaryServimoom �� (407)398A153 Floridallola Service. 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. �_% .OFFICE USE ONLY BP #: 1012-MQ5 SECTION 01 TOWNSHIP Z 6 RANGE I io MAP NO. Naas- ZONING9;9- LAND USE LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # 1ST FLR ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # 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 RADON PERMIT CODE ?,2$ AREA FEE FEE (RADON) LIBRARY PUBLIC BLD PUBIC BLD PARKS IMPACT IMPACT FEE IMPACT IMPACT FEE CORRECTION FEE FEE NERAL SCHOOL ROAD' CREDIT Y N LAW ENF IMPACT IMPA IMPACT FEE FEE FIRE/EMS 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 2 COMPLETED 2 INITIALS Ll I pp I 08/05/2011 09:27 FAX 7724896758 GALE INSULATION IM 001/007 89L9-68p (ZLL) Xd3 ° L9t8-C8Z (ZLL) iuvnis e t L91-699 (ZLL) HOV38 Oli3A ^ 1616-99t, (91L) 30UAId 13 M, ,. w.__._..... ,5b6b£-i-1d '30H31d •ld ° AVM>i8vd s(1VoussoH0 d-4o9£ 1} :'ic jr;'i:.S...,`; z,ii': f^.e�.' q ✓'.i`4y iz-•a �' -__ EPu jjJo alms `Ot{qnd X1EIUN AZ _. -...._......_........_..._..__....._..; pz ":ram jo iEp STC{l ow asojaq poquosgns puE of utomS aW 01. NMON}I A-jTVN0S'd9d SI TSBT-i "M Tnud `ZNVIJ-[V gH.L 6LIZTSIJ;» #asuao"I antlEu2tS sioloPiluo0 uoilElnsul amluu,9tS lopling/aoloanuoD IBIDUOD 3o an{EA '_ZI„ uE play IIIM _i ofutpr000E gotgM `sagouT 10 ssauxotgl e of lluq ssB{n.Tagi3 E gltm palETnsul uaaq suq aouds DuTA1, pauotltpuoo of luoov[pu sllu.Ak uoil!vvd a�TiulvO '{; - �o anluA UP plalX TITAN of 2ulp.r000E igotgm `sagaul-- jo ssou){otT.Il u oI 111TA1 palBIT1SUT uaaq s-eq si[EM aau}l .I0i.I01uI —3o anluA «2I,- Ur- PJWJJ IPm of 0uTpi000olgA`sagov— 3o ssuIotETI (pa;In�A} s�utla�gTEuq s 3U an{En UP pIDIX IITM j V ( of BulpJ000B T3a1T4m s3T.IoU] -! jo ssou;lollp E of gl{m poluInsul uaagyszgt;npU) sgulllaD 'Z ---- 10 anIEA «?J„ uE plat,( III.M of utp T000E gotgM `sagoTrl -3o ssauptgl E 01 gllm a Elnsul uaaq set{ slium ami nj ao[ ma 1.10 f o t`nlEn � of gurptoaae ,_ .,t l E of gltM p11nsut uaq sEt{ lEn ggD soaxg' lgotgm `sagout 10 O"S,0�t[T :sMollod su Xluadotd paquosap anoqu ag1 ul pallulsui uaaq suq uotlulnsut lugl satlll.Tao Agwaq p uT 3ts.tapun agZ �17 , ,T izvjxaa NTOISIAI(Igf1S uoijuinsul ap3E) 'wslLili, IN'1Asco Contractor Y'3 Services Gale insulation CERTIFICATE OF CORE FIEF JOB ADDRESS: 10 l of 3 • �7d ia.,-i RVX,0- (Y. BUILD:ING PERMIIT# % 0/,) DOSS* This letter is to certify that Gale Insulation has installed , �,�� _ square fleet of Core Fill in accordance with Florida Building Code, &f. wi. a)kl(j INSULATION CC # CGC1512179 Gale Insulation CERTIFICATION DATE: T HF. AFFL-i.NT, d?Uyt (Gt1• (- ' IS P ERSONALL-' I{NOWli TO ME . :I ` Sworn to and subscribed before me this av'- day of �:.�.;� g5 20 i £ Notary Public, State of Florida ............... ....... .... ....... ......_.,... ........... { I........._ f 3601-A CROSSROADS PARKWAY = FT. PIERCE, FL 34945 FT. 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"•• wwnp apydhy r d+�r Ha 83 A X 4l NU MN I £rTUM" 17 / 1 %iffu t� a f 0 ""Q! '°0 -• o V4 'n 0NI eaQ:LOU;H LN03 @lWl Wlnft , Jrb-m7* SL "q , �ga{aAe�� � :preal�fYq�'I.W� :�aotulY3aa76 c4nP�++W►f 4 X:-)IW b0 39VJ 9NIQlIWWG3I.9I1M130 OTTOSLW 99:ET TTR7/9T/QA 0 05/16/2011 13:56 7AK790110 CERTIFIED PAGE 05 ZZM.-MEX N rWck� Qln La�dk1 : I TO JOb: Arrive Job: S�d:14n�onelt 75 c,,, FPEp•`BUT'LbYN€3 coNTRACTDRS•+INC' c Xo,;L4 •1��.: RD EAST -TO! INDIAN RIVER. Di1 THEN -SOUTH TO JOS 53378766 LeavaJab: I Rgwrnpi4nL, r 04/;R1/11 ad��!I�w;KAY'iiw : �W£X.14aursoa .�0814 1.00 L247'818• •FUeL SURCHARGE - 2i p'r: L 1. 00 IE02749 ENVIRONMENTAL CHARIBE r 1001368 MINIMUM LURD CHARGE,U'iU 10 cafh Ctrs/>wdnoode �Np�siMit�nrod4erjDeraiArp NMC saalv►e�c od; To6Nl000V «AMOM9rCWMd Cho* W��wNxt W NtlbJ C1a vuw WAT£R ADDED:&Z GAL YARDS IN 6RUM: �r _ gild YVJ co ycurr oivi:o %; 0aa WHEN ADDED, ':'9:' •--•: h , .. ....'• . IY�:'Si18t Aliit'k�? tiwae GURU LIME CROSSED AT OWNER-SlA4gNt'S REQUEST: oandKons to G;���:.�/J,�7S3�r�Glvp�•�'r awe (3 LO AD'WAS TEPTED BY: N$OUCde Oor ddvans W makn Mh.Y @%a b oAmm woweAlo MhMNI eMN depow 4##M n*k &g !iY d1'QCWLL r1AN81Na; �Wy 1wdM WQW i d. , wrr�YdL Mwlrh 4tvd ue e��aea .SnPplh ro Nar dMao* a* bd o.b p DrppMtY {NYi Cutl�rwapnr. t M b m WnD0 10 MNd. WAANINk P,m�ot maY'�uw.kin rKlbr.y� IhYrtlon. CAdrtNWfi A oww %do WO �'W OdAa p �i. dIM b, INK %*M Mtkft M W or We' My be hA� b )ok, m&N auo #*Wb, Pkw mh, in a* t I -Ntim of nb mw W M.p+ftr4 tanwN ww a wws.,�. .r.�+oc+N+e AlryNsepeer0lq�Ax M» /Hi.►ad ernr.. w.w.eklbr MOM hrfld.no mom■nm...nd to n+r +�.ry aw uia.w tur.a�imp kk:nwrUsr• u+N� au burYwoy gd�ilwd.o ►raMW � nrE.�� b° dr�n�d +wk�N u�AYn nyd. W w h wr�MO IUNr31.WULro li p!: ��•. �0[1N:IYEft31�L ORIGINAL KSM1 KELLER, SCHLEICHER & MacWILLIAM ENGINEERING AND TESTING, INC. MARTIN (772) 337-7755 P.O. BOX 78-1377 SEBASTIAN FL 32978-1377 SEBASTIAN (772) 589-0712 PALM BEACH (561) 845-7445 www.ksmengineering.net MELBOURNE (321) 768-8488 FAX (561) 845-8876 E-Mail: KSM@KSMENGINEERING.NET ST. LUCIE (772) 229-9093 C.A.: 5693 FAX (772) 589-6469 April 7, 2011 Revised: May 3, 2011 Certified Building Contractors, Inc. 747 SW South Macedo Blvd Port St. Lucie, FL 34983 Re: Asselberg Residence 6101 South Indian River Drive Fort Pierce, Florida Permit #: 1012-0034 -Garage Permit #: 1012-0035 - Studio KSM Project #: 110277-3d Dear Sir: Enclosed, please find the nuclear density test results performed on the compacted foundation fill for the studio pad and garage pad at the above referenced project. `xxxo\N S I I I I I i E IV Rest' f ny questions, please feel free to call. M L rffP1IiII Fax to: St. Lucie County Building Department Fax to: 772-879-0110 JEK:km Ronald G. Keller, P.E.: 37293 / SI Lic. No.: 860 / Julie E. Keller, P.E.: 68366 KSM KELLER, SCHLEICHER & MacWILLIAM ENGINEERING AND TESTING, INC. MARTIN (772) 337-7755 PO, BOX 78-1377, SEBASTIAN, FL 32978-1377 SEBASTIAN (772) 589-0712 PALM BEACH (561) 845-7445 www.ksmengineering.net MELBOURNE (321) 768-8488 FAX (561) 845-8876 E-Mail: KSM@KSMENGINEERING.NET ST. LUCIE (772) 229-9093 C.A.: 5693 FAX (772) 589-6469 SOIL COMPACTION REPORT ASTM D 1557 and ASTM D 2922 DATE TESTED: April 6 through 11, 2011 KSM JOB #: 110277-3d/ES/km Revised: May 3, 2011 PERMIT #: 1012-0034 — Garage 1012-0036 - Studio CONTRACTOR: Certified Building Contractors JOB LOCATION: Asselberg Residence 6101 South Indian River Drive Fort Pierce, Florida MATERIAL: Brown Sand, Slightly Clayed ITEM TESTED: Compacted Foundation Fill for Studio Pad and Garage Pad --------------------------------------------------------------------- TEST LOCATION DEPTH MOTS- PEN DRY MAX. DRY PERCENT OF SAMPLE TURE READ DENSITY PROCTOR COMPACTION ---------------------------------------------------------------- VALUE Studio Pad 1. East 0" —12" 7.5 44 109.1 113.5 96.1 2. West 8.7 38 108.4 95.5 Garage Pad 3. N.E. 0" — 12" 7.6 44 110.7 113.5 97.5 4. N.W. 7.6 40 107.9 95.1 5. S.W. 4.4 42 108.7 95.8 6. S.E. 5.8 43 109.3 96.3 Ronald G. Keller, P.E.: 37293 / SI Lic. No.: 860 / Julie E. Keller, P.E.: 68366 KSM KELLER, SCHLEICHER & MacWILLIAM ENGINEERING AND TESTING, INC. MARTIN (772) 337-7755 PO, BOX 78-1377, SEBASTIAN, FL 32978-1377 SEBASTIAN (772) 589-0712 PALM BEACH (561) 845-7445 www.ksmengineering.net MELBOURNE (321) 768-8488 FAX (561) 845-8876 E-Mail: KSM@KSMENGINEERING.NET ST. LUCIE (772) 229-9093 C.A.: 5693 FAX (772) 589-6469 MOISTURE -DENSITY RELATIONSHIP MODIFIED PROCTOR (ASTM D 1557) DATE TESTED: April 6, 2011 KSM JOB #: 110277-3p PERMIT #: 1012-0034 — Garage Pad 1012-0035 — Studio Pad CONTRACTOR: Certified Building Contractors JOB LOCATION: Asselberg Residence 6101 South Indian River Drive Fort Pierce, Florida 114-I--- -------I---I---r--T -r---1 I I I I I I I I I I I I I I I I I I I I I I I I I I 1134---+--4---I---I— —I---+--F---I ci 112�---1--1--J——I-----1-- --J a I I I I I I I I I LU = I I I I I I I I 111-r--T--�— ,---1---r--T---r--, I I I I I I I I I I I I I I I I I I I I I I I I I I 1104---+— 4— 4---I-----+--4---I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1094---4---�---�---�----�---� 6 7 8 9 10 11 12 13 14 Moisture - Percent of Dry Weight Soil Description: Brown Sand, Slightly Clayed Max. Dry Density: 113.5 P.C.F. Optimum Moisture: 11.4 Percent Julie E. Keller, P.E. Ronald G. Keller, P.E.: 37293 / SI Lic. No.: 860 / Julie E. Keller, P.E.: 68366 Fort Pierce, FL 34982 772-462-2172 Fax 772-462-6443 CERTIFICATE OF TERMITE TREATMENT CONSTRUCTION SOIL TREATMENT PERMIT ADDRESS. BUILDER/C NTRACTOR: PEST CONTROL CONTRACTOR: -g '� e k PEST CONTROL LICENSE #: 1-TWO We, the undersigned, hereby certify that we have pretreated the above described construction for subterranean termites in accordance with the standards of the National Pest Control Association. Square feet if area treated:z_i Percentage of solution: r Date of Treatment; 1/~/'�/" oting reatment Re -Treat Driveway 1st Treatment e Re -Treat Other 1�t Treatment Re -Treat Note. There must be a completed form for each fe4 site to be picked up by the Inspector at time of each fee charged Chemicals used: Total gallons used: `t% d Time of Treatment:.1� C-C't'r atment Re Treat Pools for Final Signature nent S're-treatment and this form must be on the job or the scheduled inspection will fall and a re -Inspection F13C104.2.6 Certificate of Protective Treatment for preventlon of termites A weather resistant fobsite posting board shall be provided to receive duplicate Treatment Certificates as each required protective treatment Is completed, prov/ding a copy for the person the permit is issued to and another copy for the building permit files The Treatment Certificate shall provide the product used, identity of the applicator, time and date of the treatment, site location, area treated, chemlcal used, percent conoentratfon and number ofgallons used, -to establish a verifiable record of protective treatmentff the soil chemical barrier method for termite preveniron is used, final exterior treatment shall be completed prior to final building approval. St Lucie County requires for the final inspection for CO, a Permanent Sticker to be placed on November 5, 2010 Project: Asselbergs Renovations & Additions Address: 6101 South Indian River Drive, Ft. Pierce, Florida Authorized Agent To Whom It May Concern: This letter is to certify that Steve Torres and Bob McCreary of Certified Building Contractors, Inc. are hereby authorized agents to sign for and process all necessary permits for the above referenced project. Robert Asselbergs — ner Date The foregoing was acknowledged before me this y-g� of November, 2010 by Robert Asselbergs who is personally known to me or produced,! � as identification and who did not take an oath. ,a° YeLB s GAIN. CARRUTHERS Notary Seal: 'N: MY Cc7KOOISSiON # DD796130 EXPIRES June 09, 2012 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, �J1{O�-3y `DDOI—®Q'9%y 6101 S,LhA'iQnR(dP—1 (Parcel IM/Legal description/Address) F, N ePc e—( F ( . for which I have applied to St. Lucie County for a Final Development Permit. In P Ana.3� so I g acceptingthis Final Development Permit BP Numbe� 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 c//o��mmunity. Property Owner Name (Please Print) Lal �- 9!;;& , lr�-'A . 0 / 12-011 Property er Signature Imes v � � G STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE p\ ME THIS �DAY OF � e� �. . 20_\\ BY `p�.+�� a Yi VN&1 �SS``�WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED ���\— AS IDENTIFICATION. "NAOF NOTARY PUBLIC COMMISSION NUMBER TYPE OR PRINT NOTARY A m RUTHERS MY COMMISSION # DD796130 EXPIRES June 09, 2012 (407) 388.0153 FiOdallola +S6Arvioe.wm SLCPDSD Revised 08/24/2010 AFTER RECORDING -RETURN TO: y JOSEPH E. SMITH, CLrmrl OF THE CIRCUIT COURT SAINT LUCfE COUNTY FILE # 3544369 12120l2010 at 04:25 PM OR BOOK 3254 PAGE 2957 - 2957 Doc Type: NC RECORDING: $10.00 PERMIT NUMBER: • NOTICE OF GUMmENU-ENIISIv r The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida statutds the following information is provided in the Notice of commencement. 1. DESCRIPTION OF PROPERTY (Legal description and street address) TAX FOLIO NUMBER:3g61-3V't -DOo1-000-1q BLDG UNIT 2. GENERAL DESCRIPTION OF.IMPROVEMENrc., . M v-w •- IS 1e- 15acn . 6, LLPs't Hogs g, C oa6&wa.l St oVCA, A i ton VJKe&U 3. OWNER INFORMATION: a. Nam �AB5 1 nZ--:- b. Address ,6 C -ow R .&1114i C,(��s C ri �� � idCa� . tJ i., f Oy 7 7 c. interest in property fNer d. Name and address of fee simple titleholder (if other than owner) 1 f ��-r- 4. CONTRACTOR'S NAME, ADDRESS AND PHONE NUMBER: e �e t ? �� cai 1 cX t n o 6, o TLL� ']Lo eLe io ����l. for Sf �.� �� f FI 349R3 S. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT: N J A 6. LENDER'S NAME, ADDRESS AND PHONE NUMBER: •1 A 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 (1)(a) 7., Florida Statutes: NAME, ADDRESS. AND PHONE NUMBER: bJ / A 8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in Section 713.13 (1)(b), Florida Statutes: NAME, ADDRESS AND PHONE NUMBER: /A 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) , 20 or Print Name and Provide Signatory's Title/Office Owner's Authorized Officer/Director/Partner/Manager State of Florida County of Czh `yam �►. The foregoing instrument was acknowledged before me this day of \ i]�t� , .20 y By S�P_.1E�oQ.@`ES , asN . - ame of person) `\ (Type of authority ... e.g. Owner, officer, trustee, attorney in fact) For �h! (Name of party on behalf of whom instrument was executed) Personally Known or produced the following type of ID: ,gtt"Y"`•?;: GA IL CARRUTHERS MY COMMISSION # DD796130 EXPIRES June 09, 2012 (Printed Name of Notary Public) (Signature of Notary Public) (407)98 a153 FloridallotaryServico.cam 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). f Owner or Owner(s)' Authorized Officer/Director/Partner/Manager who signed above: By: By Rev. 08M ecordi PLANNING &DEVELOPMENT SERVICES DIVISION BUILDING & CODE. REGULATIONS DIVISION 2300 Virginia Ave r _ - Fort Pierce, FL 34982 BUILDING PERMIT SUB -CONTRACTOR SUMMARY i be using the following sub -contractors for the (Company/Individual Name) project located at (Street address or Property Tax ID It is understood that if there is any change of status regarding the participation of any of the sub -contractors listed below, I will immediately advise the Building and Zoning Department of St. Lucie County. Trade Name of Company/Contractor St. Lucie County/ State of Florida License Number Electrical �a[ P AC 13W3316 1179 SW B!(f xore 5+, Plumbing n �i�4,� Cvn- PI �w.bin A— I From 23�3 C nsu1I 2125 S �0.� w� A r7V 'P' SJ j Ft . 3 � S 3 HVAC/ Mechanical ,/C-fie 189W4 $ ` bas�-�-� QR $` se 60S icen2 ( , :3ZQS`� Roofing ' � d� C.anS�rc,�c��oil+Po� �'� P Z-4 oyccc O57686 -TacT LL I i' •e A ae P. S e I- " F( . 3 45� Gas O;F�IGE`USE-ONLY PERMIT I ��� ��� I ISSUE DATE: NUMBER: ST. LUCIE COUNTY PUBLIC WORKS y BUILDING & ZONING DEPARTMENT OR1�P BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: �Q `1 3 a a State of Florida Certification Number (If applicable): Dolg! Td s�C' have agreed to be the (Company Name/Individual Name) E) e c+g- iy_ o L sub -contractor for (Type of Trade) (Primary Contractor) for the project located at ect Street Address or Property Tax ID #) r. 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 GNATURE PRINT NAME DATE Business Name: �p,j�� 19 . = c 4 --i c oz l eq f+e� TO) � Address: 9 �� �0 ee, it � 1 4' , - 4 o' C 3 s+e A?e City/State/Zip: („ .Phone: % %Q4 9173 a 517 3 ® email: CE USE ONLY: PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: 0y C"t,-3 State of Florida Certification Number (If applicable): (!':7'0 C'i -7 L? I I n-1-:LPt�� r�SS i � � J sa t_ �:�N r>+. c , i ,v�� r Fuj r-,;K )Ak., have agreed to be the (Company Name/Individual Name) #2L.0r—r NA. sub -contractor for �` g�F Lr'i, co �• .: ��5 (Type of Trade) (Primary Contractor) for the project located at Dg I'- �f ►�► �� (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) QUALIFIER (Name of the Individual shown on the Contractor's License) INAL SIGNATURES ARE REQUIRED IQ 1 =, rPRINT NAME DATE Business Name: - -J_ S iorJ ra ,r 1-2 11,�,t—liS).�5� Address: S 5 i-1 1A n1 u ►.� z;Z-1 ,i City/State/Zip: 1'S �- , L 3 i-) C; S 3 Phone: ' 7 "7 ';Z - 3 J-/ 3. email: ._� Y M - % -- •i f?, — (d a✓ Y--6 -,,,) E t- - C. -Z. v--p OFFICE USE ONLY: PERMIT # ISSUE DATE - ST. LUCIE COUNTY PUBLIC WORKS " BUILDING & ZONING DEPARTMENT s . BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: 249004 State of Florida Certification Number (If applicable): CAC `C l O [ 1 -I 6b Arnold Aii .Conditi6ning Iris; have agreed to be the (Company Name/Individual Name) Mechanical. sub -contractor for Certified Building Contractors. (Type of Trade) (Primary Contractor) for the project located at 6101 S. Indian River Drive, FortTierce (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 QUAIFiR (Name of the Individual shown on the Contractor's License) GNATURES,.RE REQUIRED c/6 ��,ic/ Steven A. Arnold 11/23/2.010 SURE PRINT NAME DATE Business Name: Arnold Air" Co nditioning,Inc. Address: 181 Sebastian. Blvd: City/state/zip: Sebastian, Florida 32958 Phone: It 58.94063 email: arnoldairsebastian@ginai j" OFFICE USE ONLY: PERMIT # ISSUEDATE v PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMTI' SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: 92r2 1 ©- State of Florida Certification Number (if applicable): c C c (Company Name/Indivi al Name) ve agreed to be the o� C1 sub-contractorfor �°�P��s �ji•,,I�ct �n� rr��� (Type Trade) (Primary Contractor) for the project located at ` i S , T, rri ; ✓ z f r ; e. (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 SIGNA URLS ARE REQUIRED le i - V;.5 �-,���� 11 �E� G ATURE P"_R""INT/NAME DATE Business Name: F-i 1%��G� 1 • J" ��r�vT •��R!+`c L Address: 1 So5 W�• c. City/State/Zip: >� 5-j ' '� e `` 3 'Act Phone: '`?79.igo- 9 32Y email: ,� A t��ya0- "N 9tnn� OFFICE USE ONLY: PERMIT# I ISSUE DATE