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Home My WebLink AboutBuilding Permit Application All APPLICABLI INFO MUIT BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date. Permit Number: 1 as C I E _grill wl` v' klc'-.. `'-„':•yg Ep„ ^two C [I 1��;tapg Ii<rrFd Building Permit Application MAR 2 2017 Planning and Development Services P E f St. Lucia Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR:PROPOSED IN`PR®URMEJNT LOCAii, N. Address: �/�� 2 ��C✓Oyn7�S �� l�e �� lS�� Legal Description: Property Tax ID#: "?Y30 // 3 b66 / Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D'ETAI'LED DXE1S60I i INT1ION /7z°'inoG�7��s r odd ' `��G✓�"Zc/i✓�i JECROWITRUCTIOIV NFOR+MATIO'N: Additional work to be pertormed under this permit-check. a that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ v2606 Utilities: —Sewer _Septic Building Height: 0 529 Name CONTR CTOR: Name Name:Address: Company: la �lzi7! S �0�57/�vt�i4nJ City: State��-- Address: 3e�x Zip.Code: 3Fax: City: '-57z,,14 Z State?`- Phone tateFLPhone No. Zip Code: ,,;2mq Fax: E-Mail: Phone No 7 7-2 - yG,, Stela' Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPP'LEMENTAL CONS"TRjUCTI®'N L1E�N LAUV I�N�FOR�fUTATI:ON• DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: t Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ' Wt Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING 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 lender or an attorney before commencing work or recorcring your Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/L! I Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF (i,R –, COUNTY OF The forgoing instrument w acknowled ed efore me The for oing instrument wa acknowledged before me this day of ri� 201 by this day of�n��20/ by 4 (Name of perssonn acknowleciging (Name of person acknowledging (Signature of otary Public-State of lorida} (Signature of Notar�Public-State of Florida} Personally Known OR Produced Identification V/ Personally Known OR Produced Identification ►r Type of Identification Type of Identifi�tio Produced i Produced { , ' t tlllJt �.� Commission No. I '� ;=o�' a�KAREN S. NiELa sion N0. —�— 1 �P (Seal) _• *" ommission#! FF 1 " My Commission a" ssion Ex F�FFt00.''� June 12, 201 ``�\gip T PttB li �^. NIE SEN "� (n-"" `%7ggs.511 nKARLITS•� 7REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATI A =TyE COUNTER REVIEW REVIEW REVIEW REVIEW -;qrF a; ;€VIJU1e 12 Rel{�W DATE RECEIVED DATE COMPLETED :Fe—V. PERMIT #:56-SF-1708792 c APPLICATION #:AP1281878 STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: ' ONSITE SEWAGE TREATMENT AND DISPOSAL ! n� E PAID: SYSTEM .i , RECEIPT #: yfi. MAR 2 9 2017DOCUMENT #:PR1054718 CONSTRUCTION PERMIT FOR: OSTDS Abandonment PERF 1"l'AG St. Lucie Goi111ty. L APPLICANT: Lorraine Harris PROPERTY ADDRESS.: 4442 Edwards Rd Fort Pierce, FL 34.981 LOT: BLOCK: SUBDIVISION: PROPERTY ID #: 2430-113-0001-000-1 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX 'ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ ] GALLONS / GPD Septic existing CAPACITY A [ ] GALLONS / GPD CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ ]. SQUARE FEET SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ ] [ / ] [ ABOVE/BELOW]BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ ] [ / ] [ABOVE/BELOW]BENCHMARK/REFERENCE POINT L D FILL REQUIRED.: [ 0-00] INCHES EXCAVATION REQUIRED: [ ] INCHES Have the tank,abandoned in accordance with the following procedures:(a)The tank shall be pumped out.(b)The bottom of O the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water,and(c)The T tank shall be filled with clean sand or other suitable material,and completely covered with soil.Have the system inspected H by the health department after it has been pumped and ruptured but before it is filled with sand and covered. E R SPECIFICATIONS BY: Brian J Ingram TITLE: Environmental Specialist II APPROVED BY: 049ZTITLE: Environmental Specialist II St.Lucie CHD Brian J Irngram DATE ISSUED: 03/23/2017 EXPIRATION DATE: 06/21/2017 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 V 1.1.4 AP1281876 SE-1 Planning&Development Services ASBESTOS NOTICE Building&Code Regulation Division 2306 Virginia Avenue Fork Pierce,FL. 34982 Phone:(772)462.2172 Fax:(772)462.6443 MAR 2- P i_it at 177,: (( ;.. t. Lu c. ^- Asbestos Notice to Contractor March 23, 2017 FACILITIES CONSTRUCTION ONE LLC SCOTT A MILLER P.O. BOX 12208 FORT PIERCE, FL 34979 RE: Building Permit Number 1703-0501 It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal law. L--- '° Signature .ate 3/23/2017 1:11:03 PM