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HomeMy WebLinkAboutSUBMITTED PAPERSr Date: I " lD " I U I Fee Due:/l ,,—n U 1 Receipt# 7*7 VU / I Permit # I 1 I( ! — (7U � s �- Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing LSHVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 44700 2. Parcel ID Number: a? TR/ — / of — Oil 0' 40n9 3. C SCANNED St Lc, Cle County Township Range Map Page Zoning Land Use Initials Section Only 4. Owners Information 5. Contractors Information Name: 4,ef FL Reg/Cert Address: eff iA%r)A. J `e,14.41ej County Cert#: t�;;,21 / 0 City: F77 Pjg!-4c,Fj State: 1— Business Name: �/� Tli1& Zip: 3 7 Phone: t`XJ ' )� U Phone: '7# 'jyPax.L a2 • 7C�7 6. Value of Construction: $ B� OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done in �� / / compliance with all applicable laws regulating construction and zoning. ��l✓id AAV(J� PRINT OWNER OR CO>TRAC' OR NAME SIGNATURE OF OR CONTRACTOR STATE OF FLORIDA, COUNTY OF NI A K-m >J ACKNOWLEDGED BEFORE ME THIS DAY OF SANJ!k" ,20 ii BY 1 /+tyip H,q./iJu�i WHO S ALLY KNOWN TO ME OR WHO HAS PRODUCED Fla ... dq R v6lt5 +cr'+�SL A DE F AT 7 l Notary Public S'tme of Florida SI ATURE OF NOTARY TYPE OR PRINT NAME O OTARY Chri llmmato My commission #DDM228 COMMISSION NUMBER expires 09/071MI2 NOTICE TO OWNER FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAVING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00 Revised 04/26/2010 Dec 14 10 07:25p Easton Insurance 5617451820 p.28 CERTIFICATE OF LIABILITY INSURANCE 12/14/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION EASTON INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE POB 2025 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tupiter, FL 33468-2025 561) 746-1244 INSURERS AFFORDING COVERAGE NAIC# INSURED HAYDEN AIR, INC. — — INSUREER A MAX SPECIALTY INS CO -- 2740 SW MARTIN DOWNS BLVD.STE 241 INSURERS NATIONAL GROUP INS. CO. PALM CITY, FL. 34990 INSURER:. INSURER D. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR BRAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH • •� .. -v�vC occn RGUVIir•,or r-'�l�—l[l l.—Ci-�YrY—I.�. IAriR 0'L LTR i R I TYPE F INS N .F - ICY EFFECTNE POLICY NUMBER f DATE MMJDONY PODGY EXPIRATION DATE EXPI LIMITS JGENERAL LIABILITY I I EACH OCCURRENCE I g 1,000,000 X COMMERCIALGENERAL UABILITY II PREMISES FErm� r� S Y 100,000 CLAIMStWDE UOCCUR MEDEXP(Anyonopwwn) $ 5,000 A X EACH OCC. 09-0005341125-4 5/13/10 5/13/11 PERSONAL& ADV INJURY a 1,000,000 1 _X PRIMARY E 2,000,000 1 GENERAL AGGREGATE { r GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -comptOPAGG E 2 , 000 , 000 POLICY F7 JEC LCC AUTOMOBILE LIABILITY ANYAUTO j COMBINED SINGLE LIMIT (Ea accidenq 5 1,000,000 X ALLOVVNEDAUTOS I BODILY INJURY 5 X SCHEDULED AUTOS (Per person) I B X HIRED AUTOS 102A000170500 7/15/10 7/15/11 I ( l X .NON-OVVNEDAUTOS BODILYNJURY ' (Peracclderd) $ $ 4 ,PROPERTY DAMAGE (ParacrideM) GARAGE LIABILITY ANYAUTO AUTO ONLY-EAACCIDENT $ EA ACC $ I OTHER THAN 3 AUTO ONLY AGG EXCESS(UMBRELLA LIABILITY : EACH OCCURRENCE $ OCCUR C GLAIMMMADE AGGREGATE $ --_-- $ t { DL I)DGTIBLE _ - +� 1 RETENTION $-- WORKERSGOMPENSATIONAND 'N TATU- TH- TORYUMRS ER EMPLOYERS' LWB ILI TY EL EACH ACC CENT _ $ ANY PROPRIETOR/PARTN_PgDKZCUTrVE CFRCSRIMrUWA EXCLUDED? If yes, ftscribeUnder EL DISEASE - EA EMPLOYEf S E.L. DISEASE - POLICY LIMIIT S SPECIAL PROVISIONS tL ow OTHER 1 i DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES; EXCLUSIONS ADDED BY EN DORSEMENT /SPECIAL PROVISIONS TIE HOLDER ST LUCIE COUNTY BUILDING & ZONING 2300 VIRGIN.IA AVE. FT. PIERCE, FL. 34982 FAX: (772) 462-1148 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL=0 BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO iVA30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY FOND UPON THE WSURER, ITS AGENTS OR R0 25 (2001108) ©ACORD CORPORATION 1988 l 0 DATE(MINDDIYYM ,acoKo CERTIFICATE OF LIABILITY INSURANCE 5/18/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poiley(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements . PRODUCER NAME: Gina Vilaire COMPUPAY INSURANCE SERVICES, INC. PHONE 800)362-9519 x7626 � A/C No END;(305)591-9589 xt - 3450 Lakeside Drive, Suite 400 AODREss:ginavilaire®com u a . com Miramar, FL 33027 PRODUCER CUSTOMERI INSURER($) AFFORDING COVERAGE NAICY INSURED Hayden Air, Inc. INSURER A: Technology Insurance Co. INSURER B : 2740 SW Martin Downs Blvd., Suite 241 INSURERC: Palm City, FL 34990 INSURER0: (772) 54 6 -443 1 Fax: (772) 220-8532 INSURER E: INSURER F OMAClrlhl All 16ARGR- v THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ICY LTR TYPE OF INSURANCE N e POLICY NUMBER M POLICY D EXP MAW LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADEID OCCUR E 4CH OCCURRENCE $ PREMISES Ea oaurrence s MED EXP (Any one person) S PERSONAL 8 ADV INJURY S GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO• LOC POLICY F1 PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) S BODILY INJURY (Per accident) 5 PROPERTY DAMAGE (Per accident) S t S UMBRELLA LIAR EXCESS LtAB OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE $ DEDUCTIBLE RETENTION S $ $ A WORKERS COMPENSATIONWC AND EMPLOYER& LIABILITY ANY PROPRIETORIPARTNERAMXECVTIVE YIN OFFICEPMEM6ER EXCLUDED? tMandstory to NN) It es,descrtbaunder DESCRIPTION OF OPERATIONS below N!A TWC3 2 4 3 9 8 8 5/ 13 / 10 5/ 13 / 1 ATU- OTH. x T RYLIMITS ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYE $ 100,000 E.L. DISEASE - POLICY LIMB S 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101. Additional Rermr%s Schedule, if more space Is required) St. Lucie County Attn: Building Zoning 2300 Virginia Avenue Fort Pierce, FL 34982 Fax:(772)462-1148 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE n ACORD25(2009109) The ACORD name and logo are registered marks of ACORD All rights reserved, Property Appraiser - St.Lucie Coun 'L Page 1 of 1 Timothy A Lea Record: 1 of 1 Property Identification Site Address: 2907 SHERWOOD LN Sec/Town/Range: 21 :35S :40E Map ID: 24/21S Zoning: RS-4 Ownership and Mailing Owner: Address: Timothy A Lei Alicia S Lei 2907 Sherwood Ln Fort Pierce FL 34982-6164 PROPERTY RECORD CARD <<Prev Next>> Spec.Assmnt Taxes Exemptions Permits Horne Print ��UCIECO ParcellD: 2421-701-0020-000-7 Account #: 29363 Land Use: City/Cnty: SF Res St Lucie CountyAU00 Legal Description SHERWOOD ACRES UNIT 1 LOT 20 (0.25 AC) (OR 851-2428) Sales Information Assessment 2010 Final Total Land and Building Date Price Code Deed Book/Page 2010 Final: 50800 Land Value: 12500 Acres: 0.25 7/22/1993 62000 00 WD 0851 / 2428 Assessed: 50800 Building Value: 38300 2/22/1991 58000 00 WD 0727 / 2422 Ag.Credit: 0 Finished Area: 1204 SgFt 10/1/1986 55900 00 CV 0516 / 1715 Exempt: 25800 6/1/1978 37500 00 CV 0289 / 0164 Taxable: 25000 7/1/1973 3900 00 CV 0217 / 1593 Taxes: 526.16 zz :a Exterior Features zs .a View: RoofCover: SA - Asph Shingle RoofStruct: GA - Gable ExtType: HD+ - HD+ YearBit: 1973 Frame: Grade: D+ - D+ EffYrBlt: 1973 PrimeWali: BS - CB Stucco StoryHght: 0010 - 1 Story No.Units: 1 SecWali: Interior Features BedRooms: 3 Electric: MX - MAXIMUM PrmintWaii: DW - Drywall FuilBath: 2 HeatType: FHA - FrcdHotAir AvgHt/FI: STD 1/2Bath: 0 HeatFuel: ELEC - Electric Prm.Flors: CU - Carpet %A/C: 100 %Heated: 100 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qual. Cond. YrBlt. No. Land Use Type Measure 3CHT - 3CHT S 1 1 AV AV 1977 1 0100-SF Res 220 -Front Ft 77 SDSF - SITE DEV S-F Y 1 1 AV AV 2001 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED Depth 123.8 http://www.paslc.org/prc.asp?prclid=242170100200007 1 /5/2011 Property Appraiser - St.Lucie County_ F1, Page 1 of 1 Timothy A Lei Record: 1 of 1 Property Identification Site Address: 2907 SHERWOOD LN Sec/Town/Range: 21 :35S :40E Map ID: 24/21S Zoning. RS-4 PROPERTY RECORD CARD <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print �v\3CIE CO ParcellD: 2421-701-0020-000-7 29363 yes _L 1r2� 7`R,'CiT._ Account #: Land Use: SF Res CitylCnty, St Lucie County Ownership and Mailing Legal Description Owner Timothy A Lei amwagumiom SHERWOOD ACRES UNIT 1 LOT 20 (0.25 AC) (OR 851-2428) Address 2907 Sherwood Ln Fort Pierce FL 34982-6164 Sales Information Assessment 2010 Final Total Land and Building Date Price Code Deed Book/Page 2010 Final 50800 Land Value 12500 Acres. 0.25 7/22/1993 62000 00 WD 0851 / 2428 Assessed: 50800 Building Value 38300 2/22/1991 58000 00 WD 0727 / 2422 Ag.Credit. 0 Finished Area 1204 SgFt 10/1/1986 55900 00 CV 0516 / 1715 Exempt: 25800 6/1/1978 37500 00 CV 0289 / 0164 Taxable: 25000 7/1/1973 3900 00 CV 0217 / 1593 Taxes: 526.16 BUILDING INFORMATION r'tri� t.. r Exterior Features View: RoofCover ExtType: HD+ - HD+ YearBlt Grade D+ -D+ EffYrBlt StoryHght 0010 - 1 Story No.Units. Interior Features BedRooms: 3 Electric: FullBath: 2 HeatType: 1/2Bath. 0 HeatFuel. %A/C: 100 %Heated: Special Features and Yard Items Type Y/S Qty Units Qual Cond YrBlt 3CHT - 3CHT S 1 1 AV AV 1977 SDSF - SITE DEV S-F Y 1 1 AV AV 2001 SA - Asph Shingle GA - Gable RoofStruct: 1973 Frame 1973 PrimeWall: BS - CB Stucco 1 SecWall MX - MAXIMUM PrmintWall: DW - Drywall FHA - FrcdHotAir AvgHt/FI: STD ELEC - Electric Prm Flors: CU - Carpet 100 %Sprinkled: 0 Land Information No Land Use Type Measure 1 0100-SF Res 220 -Front Ft 77 Depth 123.8 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=242170100200007 1 /6/2011