HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE ONLY:/.
DATE FILED: —L
PLAN REVIEW FEE:
CONCURRENCY FEE:
. RECEIl'T NO.: PERMIT NUMBER:
�a-
RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
CA N N F- 2300 Virginia Avenue D C
B Ft. Pierce, FL 34982-5652
St. Lucie County 772-462-1553
a rvi
APPLICATION for BUILDING PERMIT /-p
CERTIFICATE of CAPACITY/ZONING COMPLIANCE "OP &f"m
PROJECT INFORMATION
I. #LOCATION/SITE ADDRESS: % ' _
2. , PROJECT NAME: p SITE PLAN NAME:
3. ,' PROPERTY TAX ID #: s60cya'
4. LEGAL DESCRIPTION (attach extra sheets if necessary): L triP (,iA,f 41 6 k 29, 4arr dQ
�
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 9 8. LOT NO. 2
9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: D C
b fl8
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
.t��, �/ c � v dt e; ,1 f ��.1 � — c�1�c c f t c .�[.�/ b, K
11. "P SMACKS(A TUA ONT: BACK: RIGHT SIDE: LEFT SIDE:
W
12. E OF CO CTI Mel ap ropnate xes�
[ NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INFERIOR RENOVATION
[ ] RESIDENTIAL [ ] �OMMEIj cAL [ ] INDUSTRIAL
OTHER (SPECIFY) C� a e— J/ f
13. DESCRIPTION OF PROPOSED USE:
14. SQ. FT OF CONSTRUCTION: • sic. 15. SF. FT 1st FLOOR
16. VALUE OF CONSTRUCTION: $ :S q00
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/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 difmore, a
RECORDED Notice of Commencement must be submitted with this application
"NLCCDV Form No.: 001-02
UPDATED 6/25/09
OWNER INFORMATION
NAME: 1 a(-1er iC s
ADDRESS:S 6,fdj/
L
CITY: Pf�� STATE: f-L z>P: 3cE?S!
PHONE (DAYTIME): L79 4CUL i 0 i Email:
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY 0WNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER:
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME): �)
CONTRACTOR INFORMATION
ST. of FL REG.CERT #: C 4 G if 07167 8
BUSINESS NAME: f s
QUALIFIERS NAME: t
ADDRESS: -died
CITY: U lf0 QOR4 STATE:
PHONE (DAYTD IE): ag :219- "12 FAX NO.
ARCHIT/ENGINEER:
ADDRESS:
CITY:
PHONE (DAYTIME): �)
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE:
STATE:
STATE:
ST. LUCIE COUNTY CERT #: 2 o
ZIP: c] Q 6 -3
Email: ,Gia.td k Ij.G. S ,off
ZIP:
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
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.
OW R OR COM11fteNOR SIGNATURE'
STATE OFF )(iv
COUNTY OF�
The foregoing instrument was acknowledged before
me this-i�)day of 20 C ,
by Cal
wh s personally own or has produced
as idea cation.
Signature of lotry
Commission No. (Seal)
SIGNATURE
STATE OF A
COUNTY OF
The foregoing instrument was acknowledged before
me this �"ay of 20 I .
by �� q Y1
who is ovally own or has produced
as i tiIIcation.
Signature o otary
Commission No.
(Seal)
NOTE: D. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILDING PERMIT AS AN OWNER/BUMDER, 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.
I
OFFICE USE ONL' BP #:
SECTION
TOWNSHIP
RANGE
MAP NO.
l \
ZONING
LAND USE
(`
/
LOT CVG %
TAZ NO.
FIRM MAP #
I sT FLR ELV
MAX HGT
FLOOD ZONE
CONST TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF REC
Before 111990
LOT OF REC
After I/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
00
HABITABLE
AREA
RADON
FEE
PERMIT
FEE
LIBRARY
IMPACT
FEE
PUBLIC BLD
IMPACT FEE
CORRECTION
PUBIC BID
IMPACT
FEE
GENERAL
PARKS
IMPACT
FEE
SCHOOL
IMPACT
FEE
ROAD
IMPACT
FEE
CREDIT
Y
N
LAW ENF
IMPACT
FEE
FIRE/EMS
IMPACT
FEE
DRIVEWAY
REQUIRED
Y
N
DRIVEWAY
FEE
ADMINISTRATIVE
VARIANCE FEE
SPECIFY
SUBS
REQUIRED
MECHANIC ROOF
ELECTRIC GAS
PLUMBING
NON -CONFORMING
LOT OF RECORD
FEES
MISCELLANEOUS
FEES
DATE SENT TO ADDRESSING: / /
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
'
I b
DATE
COMPLETED
INITIALS
�QU NTY``
F L D R I D A -
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,
t 3016oh1a0C 3aano EARGS I=f - 1-2;r"Rc F 'NRcr /c/
(Parcel Id#/Legal description/ ) 34 57 5
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 immediate
community.
Property Owner Name (Please Print)
n
Property Owner Signature
STATE OF FLORIDA, COUNTY OF % 0 T • do�& e
i,,4 1 /4-o?�l►(
Date
ACKNOWLEDGED BEFORE ME THIS / y DAY OF — JO'C 4 , 20 11
BY _,D&J�'1 19 h P— SPX-1 WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED - . AS IDENTIFICATION.
-04- Ak &60 . /� 0 - 6,v- ?C��
SIGNATURE O NODRY PUBLIC TYPE OR T NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 08/24/2010
ial
AUDREY B. HUMPHREY
3 EXPIR&,' v1er.:i
Bonded Thru D4otr, rue,.
E l 0 w �-R-
v
- - s4 o-s-
rm
J,
-+15k,k1�
ft44 ac,\
Cl J ,i i . r\
OFFICE of VITAL STATISTICS
�s�f. CERTIFIED COPY
(VPF N
PFAYNEM LOCAL FILE NO.
dA(X hat
FLORIDA CERTIFICATE OF DEATH
1. DECEDENTS NAME (F*IK Mdta, L" Swer) 2. SEX
Virginia C. Supank Female
3. DATE OF BIRTH (AAta1, Dry, YWO
N. AGE-Lul BMlttley
R
6. DATE OF DEATH (Almm. W Year)
"
Aw�aa
July 24, 1932
Y.w.) 78
February 15, 2011
a. SOCIAL SECURITY NUMBER
7 BIRTHPLACE (Cary ad S" � F-w Cowmy) 8.
COUNTY OF DEATH
265 42-1305
Miami, Florida
Saint Lude
D. PLACE OF DEATH HOSMAL I1paw" Erarperay cbpnglapepeM Dead - Antvw
Y _
(Ch-ar wdy o ) -
NowaovRAL Heapkm Facility _ Nutnp HWwtl p Term Care FW*y _ Decadam's Horne _ Ot1w (SP WN.r
to, FACILITY NAME (M not mmuoa DAa afnat add eae) 11
a. CT', TOWN, OR LOCATION OF DEATH
11b. INSIDE CITY LIMITS?
Treasure Coast Hospice
Fort Pierce
Yee 4 No
I2 MARITAL STATUS (SP-YY)
13. SURVIVING SPOUSE'S NAME (it hNa. Q11e maiden
_ Marn d _ Marrbd, bm Separated IL Widowed _ DNwad - Navar Mar ieo
IAa. RESIDENCE - STATE
1l COUNTY
)k. CITY, rOwN, OR LOCATION
Florida
Saint Lucie
Fort Pierce
14d. STREET ADDRESS i
14e. APT. NO.
141. ZIP CODE
tA¢ INSIDE CITY LIMITS?
5405 Fort Pierce Bouleyard
34951
- Yee NO
15. DECEDENTS USUAL OCCUPATION (fntAaty type of work dn- Ou V most of W"hv PM.)
1W KIND OF SUSINESSANOUSTRY
D. not uea *PA*.d'
Business Manager
Telephone Company
16. DECEDENTS RACE (Sp-1y tW rac.T- In bdar. af.1 M-WIt -*dorW fwrtaae7.rseM b be M- elan tale near may be Vealed.)
�( Whae -. Black or A81can A hark- -. American Indian w Ataekw Nellie f*.I#y Alba)
_ Asian Indian _ CNneae _ Fllpirb _ Jepa- _ Kwean _ Vbb.n.ae _ Other AAlen (Sp-ty)
_ Ned. Haw- _ G-nanIan or Ci a naro _ Senroan _ Oihw Pw tb Isi. (Specify) _ Ott- (50-dy)
a 17, DECEDENT OF HISPANIC OR HAMAN ORIGIN7 _ Yea (n Yea, N. _ Mewan _ Puerb Riau _ CubW -Ce I aVSdAfi Ah--In
(Spedy a deadwd was of Wsps- a Na/tlen Oni h.)
_ 0IIte1 Hwww (SPedfy) Haden
• 18. DECEDENTS EDUCATION (Spedly the deaadenYs /iywl degree a lore: of W woi wthplated at fin. of devth.)
1 D. WAS DECEDENT EVER IN
U.S. ARMED FORCES7
_ elh a I- -_ Hlph whorl Gun no doh the _ H g h adnod doorha m GED
a L C." bid m d.V- College d"- (Spa-y) _ Aaenaate _ lTaa.la'a _ MealKe _ Dotlorata
-yea No
20. FATHER'S NAME fFkst ANd1e, Lear. Sbft)
21, MOTHER'S NAME (Fitt AapMe. Mahan Surrwna)
J.L. Coker
Clara Harris
22a. INFORMANT'S NAME
22b, RELATIONSHIP TO DECEDENT
23aINFORMANTS MMUNG - STATE
Darlene Sassi
Health Care Surrogate
Florida
2M CITY OR TOWN
23c. STREET ADDRESS
231- ZIP CODE
Fort Pierce
7602 Roberts Road
34951
24. PLACE OF DISPOSITION (Nwna d -napery, o ne0y, a n6 w Pace) 25a:
LOCATION - STATE 25b
LOCATION - CITY OR TOWN
Hillcrest Memorial Gardens & Mausoleum
Florida
Fort Pierce
26e METHOD OF OWPO.WTION BIaIu _ Enbnnnwlf _ Crwr.Gcn _ Donatw RNrw Iwrn State D6w (SPady)
2eb. IF CREMATION, DONATION OR BURWL AT SEA,
27a. LICENSE NIMIBER fdlxMtebe)
27b. SIG RVIOfi NSEE OR PERSON ACTING AS SUCH
vp vALc;RA R _Y- _lie
F051196
►
2�. NAME OF FUNERAL FACILITY
. F 'S UNG - STATE
Haisley Funeral & Cremation Service
Florida
290. CITY oa TOWN
2Dc sTREEr ADDRESS
zDa. DP CODE
Fort Pierce
3015 Okeechobee Road
34947
30. CERTIFIER: _][ Caetllylrtp PhyekW . To the Wei of my krtoWadpa, death onxumd R d. tkne, data enXl place, and due b I. cwee(s) and rnare.r etwed
(GraGF one) - on the b66U d aWnatatdh, alhd'or MeaGp bon, et my op w, death oaund of ft. bR., dMa and place, due b the auaWa) and mertrw etMad.
31 a, antl d
31b.
TE B
ED InvMAYyyyy)
32. TIME OF DEATH (2a M.)
M. MEdCAL EXAMINERS CASE NUMBER
► P A NATURE
72QI 1
2330
31a. LICENSE ER (d CwNA.rJ 310.
CE FIER'S NAME 35.
NAME OF ATTENOINO PHYSICIAN (N other ton CwllAw)
C� c
3tla. CERTIFIERS - STATE
36b. CITY OR TOWN 31 c,
STREET ADDRESS
36d ZIP CODE
Florida
Fort Pierce 5090
Dunn Road
981
37. SUBREGISTRAR - Slpulcee and an
and
LOCAL REGISTRAR - S"t,,,e
38b.'DATE FILED BY REGISTRAR (W.. OaY. Yr)
►
►
RAISED
SPAL
of tN� sr�T
C fLr do , t`l . �JZ ueo bA p 2/21 /1 1 FLORIDA DEPARTMENT OF
�J THIS DOCUMENT IS PRINTED OR PHOTOCOPIED ON SECURITY PAPER WITH A WATERMARK OF THE GREAT HEALT
WARNING: SEAL OF THE STATE OF FLORIDA. DO NOT ACCEPT WITHOUT VERIFYING THE PRESENCE OF THE WATERMARK.
THE DOCUMENT FACE CONTAINS A MULTI -COLORED BACKGROUND AND GOLD EMBOSSED SEAL. THE BACK-
. - CONTAINS SPECIAL LINES WITH TEXT AND SEALS IN THERMOCHROMIC INK. P
- �"" • DH FORM 1947 (08104)
37383613
i
. I II II III I IIII IIIII IIII IIIII I II illli ll 111
conTinen"l
Continental Florida Materials Inc.
50
1705095
�
13450 W. Sunrise Blvd.,
Suite 430
•✓
Sunrise, FL 33323
HEIDELBERGCEMENTGroup
Tel: (954) 858-0780
CAUTION!! Freshly mixed cement, mortar,
concrete or grout may cause skin injury. Avoid
UNLOADING Drivers are prohibited
from delivering concrete except under the
contact with eyes where possible and wash
truck's own power, and where site conditions
ppFF
I! &41tllizilti
p i y
ifilpii oiiy#11#1lilt
exposed skin areas promptly with water. If any
permit the safe and proper operation o1 his
cement mixtures get into eyes. rinse immediately
equipment. Drivers are not permitted to
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
( i t +Ji]"RIF-] t I•Y_.f-ANT
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
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.
Agent
TOTAL
WATER
Initials of Purchaser/Purchaser's Agent acknowledging addition of water at
Purchaser/Purchaser's
YARDS ON TRUCK / GALS OF WATER ADDED ADDED
Agent request.
SAGENT P.O. NUMBER/ORDERED BY
1112.-O�
I SOLD TO
QUANTITY QUANTITY QUANTITY PRODUCT
THIS LOAD ORDERED DELIVERED CODE
Truck # Plant # Slump
Calcium Air Entrain Super Plas.
10 9 8 7 6 S 4 3 S 1
PURCHASER/
PURCHASER'S AGENT
ZONE JOB NUMBER
DELIVER TO
PRODUCT DESCRIPTION
Due at Job Use of Concrete
Drivers Name _
CONCRETE TESTED
TIME TICKETED DATE
Concrete Disposal:
UNIT OF UNIT
MEASURE PRICE
FEE
ry
St•
-SUBTOTAL
TAX
TAX
—
--
TOTAL
TICKET
yds
EXTENDED
PRICE
Delivery Instructions
Ct 1ST0MFR
1. W,ARB ANTY: The materials sold by Continental Fl Oaterials Inc. (hereinafter "Continental") are warranted foi it from the date of delivery to be free from defects1"
material. This warranty is exclusive and is in lieu o. _... _.her warranties (whether written, oral or implied). including aartanty or merchantability or fitirlrvss for any particular
purpose. Continental's liability under any circumstances will not be greater than the purchase price of the materials supplied, the purchaser must examine the material upMi delivery
and before installation to discover any defects, latent or otherwise, anti Continental will not be liable for and other damages including, but net 'limited to incidental, indirect.
consequential, special or delay damages, loss of profits or any other damages arising out of the breach of any obligations under this agreement. Purchaser further agrees that
no claims may be filed under this wan<anty unless and until any indebtedness to Continental is paid in full.
2. EXCLUSIVE REMEDY: Purchaser further agrees that its exclusive remedy against Continental in the event the goods, materials or services
supplied by Continental are alleged to be defective and/or are alleged to have caused purchaser to suffer personal injury, loss of life, property, damage or economic losses as a
result of breach by Continental of any and all of the foregoing express or implied warranties, or as a result of any negligence, strict liability, or other tOrtiolrS conduct or statutory
violation by Continental, shall be limited to, and shall not exceed the purchase price of the goods, materials, or services purchased from Continental by purchaser and purchaser
agrees that Continental $hail not be liable to purchaser for any other damages including, but not limited to, lost profits. lost wages, indirect, incidental, consequential, compensatory,
special, delay, punitive or any other damages. including damages for pain and suffering, mental disease, medical or funeral expenses, any other similar damages, or any attorney
fees or costs incurred by the purchaser in connection with pursuing any claim, demand or cause of action against Continental for breach of any obligations under this agreement.
breach of the express or implied warranties delineated above, negligence, strict liability or other tortious conduct committed by Continental in connection with its sale to the
purchaser's use of goods, materials or services sold by Continental.
3, DUE QATE: Payment for all credit sales is due by the 10th of the month following the purchase date. The Purchaser agrees that all past due accounts will accrue interest at 1.5%
per month.
4. G,O...LL.EGDQN._GQST$: Purchaser agrees to pay attorneys' fees and costs of collection incurred by Continental prior to judgment, in obtaining judgment, or appeal, for bankruptcy
and for post -judgment collection procedures. Venire of any action between the Purchaser and Continental shall be Broward County, Florida.
5, MIX,G,QDE/LQCATI.ONS: The purchaser agrees to order the mix needed by product code and accepts full responsibility to determine the location for the readymix concrete. i
6. PE -LIVERY S1T..E_CQNDITIONS: Continental reserves the right to determine whether the site; for delivery 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 unsafe. The Purchaser shall be responsible for all costs and damages incurred
where adequate access for delivery cannot be obtained.
7. LLM TTENQED DELIyERY SITE: Where delivery of products is to be to an unattended site. Continental will not be liable for any loss or damage to products, property or for unsigned
delivery tickets.
8. DELAYS: Continental shall not be liable for any delay in delivery or non-delivory resulting front any cause beyond its control including but not limited to plant and delivery equipment
breakdowns, industriai stoppages or shortages of raw materials. if Continental is unable to complete delivery; of any part of an order, the Purchaser shall accept such part of the
order as Continental is able to deliver and the Purchaser shall pay tot the part delivered pro rata at the same rates as the whole of the order agreed to be sold and the same terms
of payment. <
g W.ANTiTi�S: This typo and quantity of products delivered and detailed on fhe delivery ticket must be cheFked-by th'e buyer at,the time of delivery for compliance with the
Purchaser's order. Variations between actual quantities delivered and those 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 quantities of products shown to be supplied as per the delivery ticket. Any claim for alleged short delivery of products must be made in writing
within seven (7) days of delivery: otherwise it will be accepted by Purchaser and 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,MI,,IyIMkaM.-.LQAQ..Gi.L�ARGE: 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 pours exceeding ton yards.
11.WAITING TIME: A maximum of sixty minutes per 10 yard load will be allowed at no charge. After sixty minutes there will be a charge of $1,50 per min,
12.EN) ONMENTAL-CHARGE: A $5.00 per load environmental charge will be assessed.
11SPECIFICATION: Unless specially ordered. Continental concrete is manufactured according to the provisions 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. Continental 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, admixture or additive or where the Purchaser has mishandled the concrete
after delivery.
14, FQCHNiGAL.ASSISTANCE: Continental accepts no responsibility for claims arising from technical advice or assistance provided to the Purchaser. Advice and assistance provided
by Continental is for Purchasers guidance only and Purchaser agrees to rely solely on its own architects, engineers or other technical experts.
15.5A_ EETY_D_AT_.A. The Material Safety Data Sheets for the products sold lay Continental are available upon request.
16.MDDIFICATI N OF 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 or guarantee and no such employee or agent making any such statements
shall be 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 conditions. 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 change in the legal status of Purchaser, or until the term of this quotation,
agrees to abide by these terms, regardless of any change in the legal status 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 with the terms herein.
If, at the request of the Purchaser, Continental Florida Materials Inc. enters into a written agreement or purchase order with the Purchaser to furnish materials to or on behalf of
the Purchaser for a specific project or job, all of the terms set forth herein shall be deemed to be a part of and incorporated by reference into such written agreement or purchase
order notwithstanding any term or provision in the written contract or purchase order to the contrary and, if there is a conflict with terms and/or provisions of the written contract
or purchase order, the terms herein shall prevail and be determinative.
n,nTinenT
Continental Florida Materials Inc.
13450 W. Sunrise Blvd., Suite 430
1722284
Sunrise, FL. 33323
HEID LBERGCEMENTGroup
Tel: (954) 858-0780
CAUTION!! Freshly mixed cement, mortar,
UNLOADING Drivers are prohibited
concrete or grout may cause skin injury. Avoid
from delivering concrete except under the
contact with eyes where possible and wash
truck's own power, and where site conditions
p! 7
J.4111011 011� �
exposed skin areas promptly with water. If any
permit the safe and proper operation of his
#
j
cement mixtures get into eyes, rinse immediately
equipment. Drivers are not permitted to
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
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
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.
Agent
g
TOTAL
WATER
Initials of Purchaser/Purchaser's Agent acknowledging addition of water at
Purchaser/Purchaser's
YARDS ON TRUCK / GALS OF WATER ADDED ADDED
Agent request.
10 9 8 7 6 5 4 3 S 1
PURCHASER/
PURCHASER'S AGENT
PURCHASER/PURCHASER S AGENT
P.O. NUMBER / ORDERED BY
ZONE JOB NUMBER
TIME TICKETED
DATE TICKET
SOLD TO
DELIVER TO
Concrete Disposal: yds
QUANTITY
QUANTITY
QUANTITY
PRODUCT
PRODUCT DESCRIPTION
UNIT OF UNIT EXTENDED
THIS LOAD
ORDERED
DELIVERED
CODE
MEASURE PRICE PRICE
Truck #
Plant #
Slump
Due at Job
Use of Concrete
SUB TOTAL
Calcium
Air Entrain
Super Plas.
Drivers Name
TAX
J CONCRETE TESTED
TOTAL
Delivery Instructions
CUSTOMER
1. WARRANTY: The materials sold by Continental F Materials Inc. (hereinafter "Continental") are warranted fi gar from the date of delivery to be free from defects
material. This warranty is exclusive and is in lieu of an other warranties (whether written, oral or implied). includin, _.., warranty or merchantability or f%ess for any particular
purpose. Continental's liability under any circumstances will not be greater than the purchase price of the materials supplied, the purchaser must examine the material upon delivery
and before installation to discover any defects, latent or otherwise. and Continental will not be liable for and other damages including, but not limited to incidental, indirect,
consequential, special or delay damages, loss of profits, or any other damages arising out of the breach of any obligations under this agreement. Purchaser further agrees that
no claims may be filed under this warranty unless and until any indebtedness to Continental is paid in full.
2. EXCLUSIVVREM M: Purchaser further agrees that its exclusive remedy against Continental in the event the goods, materials or services
supplied by Continental are alleged to be defective and/or are alleged to have caused purchaser to suffer personal injury, loss of life, property, damage or economic losses as a
result of breach by Continental of any and all of the foregoing express or implied warranties, or as a result of any negligence, strict liability, or other tortious conduct or statutory
violation by Continental. shall be limited to, and shall not exceed the purchase price of the goods. materials. or services purchased from Continental by purchaser and purchaser
agrees that Continental shall not be liable to purchaser for any other damages including, but not limited to, lost profits, lost wages, indirect, incidental, consequential, compensatory,
special, delay; punitive or any other damages, including damages for pain and suffering, mental disease, medical or funeral expenses, any other similar damages, or any attorney
fees or costs incurred by the purchaser in connection with pursuing any claim, demand or cause of action against Continental for breach of any obligations under this agreement,
breach of the express or implied warranties delineated above, negligence, strict liability or other tortious conduct committed by Continental in connection with its sale to the
purchaser's use of goods, materials or services sold by Continental.
3..QME_�TE: Payment for all credit sales is due by the 10th of the month following the purchase date. The Purchaser agrees that all past due accounts will accrue interest at 1.5%
per month.
4. C.Q_LLECTION COSTS: Purchaser agrees to pay attorneys' fees and costs of collection incurred by Continental prior to judgment, in obtaining judgment, or appeal, for bankruptcy
and for post -judgment collection procedures. Venue of any action between the Purchaser and Continental shall be Broward County, Florida.
5. MIX CODE/LOCATIONS: The purchaser agrees to order the mix needed by product code and accepts full responsibility to determine the location for the readymix concrete.
6. D.E..LV.E..RY.,SLT_..4.....N._.LLTION,S: Continental reserves the right to determine whether the site: for delivery 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 unsafe. The Purchaser shall be responsible for all costs and damages incurred
where adequate access for delivery cannot be obtained.
7. _UNATTENDED DEAL VERY�jITE: Where delivery of products is to be to an unattended site. Continental will not be liable for any loss or damage to products, property or for unsigr,pd
delivery tickets.
8. DELAYS: Continental shall not be liable for any delay in delivery or non -delivery resulting from any cause beyond its control including but not limited to plant and delivery equipment
breakdowns. industrial stoppages or shortages of raw materials. If Continental is unable to complete delivery, of any part of an order, the Purchaser shall accept such part of the
order as Continental is able to deliver and the Purchaser shall pay for the part delivered pro iata at the same rates as the whole of the order agreed to be sold and the same terms
of payment
9. QUANTITIES: This type and quantity of products delivered and detailed on the delivery ticket must be checked by the buyer at the time of delivery for compliance with the
Purchaser's order. Variations between actual quantities delivered and those shown on the delivery ticket must be noted on all copies of the delivery ticket signed by the Purcnao&.
Invoice charges will be based on the quantities of products shown to be supplied as per the delivery ticket. Any claim for alleged short delivery of products must be made in writing
within seven (7) days of delivery: otherwise it will be accepted by Purchaser and 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.MINIMUM LOAD CHARGE: 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 calf back
without charge will be allowed on pours exceeding ten yards.
11.WAITING TIME: A maximum of sixty minutes per 10 yard load will be allowed at n , charge. After sixty minutes there will be a charge of $1.50 per min.
12.ENVIRONMENTALC_H. AROE: A $5.00 per load environmental charge will be asse ed.
13.SPE tC FICATI,QN: Unless specially ordered. Continental concrete is manufactured ._.;cording to the provisions of ASTM C-94. Specifications for Ready Mixed Concrete, and block
is manufactured according to the provisions of ASTM C-90. Specifications for Concrete Masonry. Continental is not responsible for concrete to which the Purchaser (without the
approval of an authorized agent of Continental) has added or requested Continental to add any water, admixture or additive or where the Purchaser has mishandled the concrete
after delivery.
14.T.E,C.H.N.IGA.i ..A.SSISTA.( CIE: Continental accepts no responsibility for claims arising from technical advice or assistance provided to the Purchaser. Advice and assistance provided
by Continental is for Purchasers guidance only and Purchaser agrees to rely solely on its own architects, engineers or other technical experts.
15.SAFETY DATA: Ttie Material Safety Data Sheets for the products sold lay Continental are available upon request.
16.MQDIFICATION_OF TERMS: No employee or agent of Continental has the authority, in the absence of an express writing, to make any statement. including restricting or modifying
or otherwise concerning the existence or effect of any of these terms and conditions or of any warranty or guarantee and no such employee or agent making any such statements
shall be acting on behalf of or with the consent or agreement of Continental. These conditions may only be altered or varied to writing signet by an Officer of the Company and
no other employee nor any other person has authority to alter or vary any or all of these terms and conditions. Some of Continental Divisions' terms may vary due to industry
standards but all changes must be approved by an Officer of the Company.
17.TERMI$: The Purchaser as indicated in this quotation, agrees to abide by these terms, regardless of any change in the legal status of Purchaser, or until the term of this quotation,
agrees to abide by these terms, regardless of any change in the legal status 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 with the terms herein.
If, at the request of the Purchaser. Continental Florida Materials Inc. enters inic a written agreement or purchase order with the Purchaser to furnish materials to or on behalf of
the Purchaser for a specific project or job. all of the terms set forth herein shall be deemed to be a pail of and incorporated by reference into such written agreement or purchase
order notwithstanding any term or provision in the written contract or purchase order to the contrary and, if there is a conflict with terms andlor provisions of the written contract
or purchase order, the terms herein shall prevail and be determinative.
Property Appraiser - St.Lucie County FT
Page 1 of 1
PROPERTY RECORD CARD
Virginia Supank (EST)
Record: 1 of 1
<<Prev Next » Spec.Assmnt Taxes Exemptions Permits Home Print
Property Identification
�UCfi C�G��
Site Address:
5405 Fort Pierce Blvd
ParcellD: t*,$9-604-006; -000-0
Sec/Town/Range:
11 :34S :39E
Account # 883
Map ID:
13/11S
Land Use: SF Res
Zoning:
RS-4
City/Cnty: St Lucie County
�ll�►'"
Ownership and Mailing
Legal Dc=.�;�[io
Owner.
Virginia Supank (EST)
*LAKEWOOD PARK -UNIT 4- BLK 29 LOTS 21 AND 22 AND N 1/2 OF
Address:
PO Box 3218
06LOT 23 (MAP 13/11 S)
Fort Pierce FL 34948-3218
Sales Information
Assessment 2011 Final Total Land and Building
Date Price
Code Deed
Book/Page 2011 Final: 91300 Land Value: 33800 Acres 3
1/1/1900
0
/ Assessed: 91300 Building Value: 57500
Ag.Credit: 0 Finished Area 1628 SgFt
Exempt: 50500
Taxable: 40800
Taxes: 1027.06
BUILDING INFORMATION
Exterior Features
View
RoofCover:
CE - Ceramic Tile
RoofStruct
HP - Hip
ExtType:
HD+ - HD+
YearBlt:
1960
Frame:
Grade:
D+ - D+
EffYrBlt:
1977
PrimeWall:
BS - CB Stucco
StoryHght
0010 - 1 Story
No.Units:
1
SecWall:
Interior Features
BeclRooms:
3
Electric:
MX - MAXIMUM
PrmintWall:
PF - PF
FullBath:
2
HeatType:
FHA - FrcdHotAir
AvgHUFI:
STD
1/26ath:
0
HeatFuel:
ELEC - Electric
Prm.Flors:
PQ - Parquet
%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
3CCT - 3CCT
S 1
1 AV AV
1977 1 0100-SF Res
LVC -Front Ft
160
Y 1
1 AV AV
2001 2 0100-SF Res
205 -Front Ft
40
SDSF - SITE DEV S-F
THIS INFORMATION
IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT
TO CHANGE AND IS
NOT WARRANTED.
Depth
180
180
http://www.paslc.org/prc.asp?prclld=130160400630000
12/14/2011