HomeMy WebLinkAboutBuilding Permit Application (2) •
All APPLICABLE INFO MUST BE C•PLETED FOR APPLICATION TO BE ACCEP•D
Date: Permit Number: J( ' 5 • 03'77
. "� RECEIVED
COLI T Y
F L 0 R I DALMAr .1., 8
Building Permit Application
� .. Perrnitting pe
Planning and Development Services St,Lucie r.ean meat
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:
•
I?R®POSE®:tqf) ®VEME:NT LOCATION
Address: ` (AC) i a drPY�;7��n e t 1Lcar..
Legal Description: N ICtd-eh Ci ill. S F s{4,A 5 I 1-6A- ii ( l.D Ike\ (pig. yo-rico)
Property Tax ID#: Z'3 2-3-7 of- boa- p-' • Lot No. 11
Site Plan Name: - Block No. A
Project Name:
Setbacks Front • Back:_ Right Side: Left Side:
., Y
DETAILED DESCRIPTION WORK � aV
• «,..._ �..^.._., e •,� ,..._..�a r.� ....�,,�x. ., �x—.,��: _., ...fav .�..,,. �...,_,...�.w.. _•
\\)t ��( ft.? Lek r^ epi(.5 ; (2.-z,\r‘ce_ ,a 4, (,,y kIc 1 rep(c2ccV''e[t-
a.4A. e 11 x l?, pck `(o •
• Additional work to be performed under this permit—check all that apply:
_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: $ (_0 r)ere) Utilities: _Sewer _Septic Building Height:
®U4"CNiERJLE=�SSEE�
Name F itct�
�J nq. jc --11 Name:
Address: &o f(�t�-el\ re rr\Z5 1c4 Company:
City: ft v(tt State: Address:
Zip Code: 3 guts Fax: City: State:
Phone No.T12 Lf(g(p 2t OrD Zip Code: Fax:
E-Mail: lC rYlpnik-Oti J Q M i) y al p0.Lc h Phone No
Fill in fee simple title Holdel•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.
SUPPLEMENTAL CTI ON LIEN LAW INF®RMATI®N �' `
a{8yw £.V �.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not 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 recording your Notice of Commencement.
)710 )14 .
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 64- X.A3c.%e COUNTY OF
The forgoing instrument was acknowledge before me The forgoing instrument was acknowledged before me
this%6 day of t e4 l ,2CA% by this day of , 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu ic-State of Florida) (Signature of Notary Public-State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced mac. (\ L Produced
MARIE GIVENS
Commission No. %U8-''v. + UEt)A#GG022023 Commission No. (Seal)
5 a MY GOMR 2020
S:December 16,
i* U EP bE Public Undenvrite�
b 111 tory
REVIEWS FR - `v NING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW ,REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ley. 7/2014
1 • •
PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
COUNTY FLORIDA 2300 VIRGINIA AVENUE
-10 FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
(Parcel 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.O1(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.
pa lq-r o ti) ';
Property Owner Name(Please Print)
66101a-itt en0A1-1J-1-019-A-1-:, 4.ce
•
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OSS \ c s.
ACKNOWLEDGED BEFORE ME THIS DAY OF YIN d►'1 ,20 VI ,
BY 'l W•A-.- Vftw 4 WHO IS PERSONALLY KNOWN TO ME(E)OR WHO HAS
PRODUCED . t L AS IDENTIFICATION.
SIGNATURE OF NOTY PUBLIC TYPE OR PRINT NOTARY
tS� w/COMMISSION NUMBER
;! :;P,;;� RE.;;J�,yy4f2lEGIVEMS ��'
nR
Vii' r
AY COMR�1,9i3;0`"!4 CG 0'2C7
w
SLCPDSD Revised 04/11/2011 � 4�Yy l LL
S T Lac
C I E' Planning&Development Services Department
• CC/(1 N T Y .... Building&Code Regulations
F p"fR JI',p pr _ 2300 Virginia Avenue •
Fort Pierce,Florida 34982
(772)462-1553
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
F.S.489.103(7)EXEMPTIONS
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you,as the owner of your property,to act as your own contractor even
though you do not have a license. You must provide direct,on-site supervision of the construction yourself. You
may build or improve farm outbuildings, a one-family or two-family residence for your use and occupancy. You
may also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for your own
use or occupancy.You may not build or improve said structures for the purposes of selling or leasing that building.
If you sell or lease a building you have built or improved within one year after construction is complete, then a
presumption is created that it was built or improved for sale or lease,which is a violation of this exemption. You
may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is
your responsibility to make sure that people employed by you have licenses required by state law and by county or
municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed
contractor who is not licensed to perform the work being done. Your construction must comply with all[laa'�,,plic�able
laws,ordinances,building codes,and zoning regulations. Initial
I understand that the building official and inspectors are not there to design or give advice on h t meet
the minimum code. Initial (
: I understand that as an owner-builder that any contract disputes with sub-contractors and I must be handled
in a civil court with the advice of an attorney. This department will not mitigate any contract disputes.
Initia�
I understand that if I compensate any person or company for work performed they are required to be
licensed in this jurisdiction. If for some reason they do not possess a license,I may be responsible and lia le for the
cost of the license. Initial
I understand that if any person that is unlicensed and uninsured gets injured on my construction project-
they may be entitled to workmen's compensation. I could be held liable for all doctor,lawyer and relat d medical.
cost,which could include loss of wages during recovery from their injury. Initial , in
To qualify for this exemption under this subsection,an owner must personally appear and sign the building
permit application and initial the above.
I hereby acknowledge that I have read and understand the above disclosure statement and that I further
understand that any violation of the terms of the owner/builder exemption shall be reported by the Building and
Zoning Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this
3 p day of Ina Cr of 201 .
sit kinaakkadk
Owner/Builder Signature
STATE OF FLORIDA
COUNTY OF S•Scr• L l
The foregoing instrument was acknowledged before me this-3445 day of'r^4 c ,.20 t1 ,
by t 414',sem Wr%1 S 14.46�..�s k Z who is personally known to me,or who has
produced '.L m L_
DEANNAM/:AIEGIVENS
' �q tra G\ h1Y COMFJIISSfON t%GG D22023
Signature of Not Type or Print Name of No .i Bonded Rrus+lota0tal)unttenvnters
Title:Notary Public Commission Number
SLCPDSD Revised 05/15/2014
i
• S
SURVEYOR NOTES: • DESCRIPTION:
1. THE NORTH RIGHT-OF-WAY LINE OF HIDDEN PINES ROAD BEING ALL OF LOT 3, BLOCK B, HIDDEN PINES ESTATES
IS TAKEN TO BEAR N89'44'06'W, AND ALL OTHER BEARINGS AS SHOWN IN PLAT BOOK 17. PAGE 21, OF THE PUBUC
SHOWN HEREON ARE RELATIVE THERETO. RECORDS OF ST. LUCIE COUNTY, FLORIDA
2. NO SEARCH OF THE PUBUC RECORDS WAS MAD BY THIS
OFFICE.
3. SUB-SUFACE IMPROVEMENTS WERE NOT LOCATED AS PART OF
THIS SURVEY. •
4. LAST DATE OF FIELD SURVEY: 15 APRIL, 2018 CERTIFIED TO:
---- - KYLE MONTGOMERY •
EDIIJNA MARKOWSK!
•
FRC 5/B' —CANAL No.49= FRC 5/8'.i
UNREADABLE1 RL52391
101'RIGHT-OF-WAY
LEGEND:
P = PLAT ---- _
--.1.---- S89'44'08'E f 150.18'
C= CALCULATED
M= MEASURED 20'0 20' UTILITY EASEMENT 20.0'
ID: IDENTIFICATION 1 30.00'
�
ANC= WOOD POWER POS--- � GATE I r---
ANC= GUY ANCHOR P ESMT= EASEMENT I •
OHU=OVERHEAD UTILITY UNES • I .
CA= CHAIN UNK • I` I
®= WATER WELL WIRE FENCE I I .
(TYP) Imo; 10'x14'
"' i - ALUMINUM SHED •
A= GAS VALVE I- 5.00. L SKIDS 6'U.E 6'U.E
6'U.E-I PROPOSED,::
U.E.= UTILITY EASEMENT 30'x30'
METAL BUILDING • -
0 LOT 12 N
. 'o BLOCK A •d
m o
N
SCREEN ENCLOSED
0 POOL DECK • i
c
04 aA. ,z
LOT 13 II� •
BLOCK,A I pA� I r o
OCCUPIED j
1 WOOD FENCE ' 43.68' , •
•]] - GATE I SCALE: 1'= 30'
]]]]• esa •
;'..y. �. 1 STORTY I
..:,•,1(ur F.�{� •' FRAME&STUCCO WOOD FENCE
`i�j( No.8880 ,�+
m
4,1: r:,'^'•;, :!•.-. — o LOT 11
tnae ix,... 1:01NOeaucN� .�• �y .:..:! i:¢,.; II'. 43.95' o OCCUPIED
Aaia am/ee. a hIr '•4•"'4�,:••:i'.•'^ �, N •
ot61,6eea'' amelw�eaa ,'j� :•iCONGf @:E.ni• Q•Lmy
IxartlM ••;-..v. .• '4 pILJ 11
N :::.' ASPHAL 91.49' ,.
o �I. m NCJ .n.. •..brPj
P NJ,e1 ig &s ck;,•
. Il to n t . •.
__ 4.i
/�(\/,- ~-4.' '11'.1':•.••, - FIP 3/4 NO'I.D.
I
ir �I —— • •- Nj48g'44'08'W 150.00'` •''••i. 1
;'i; 0.00' 44Ver+ ;,�k'• 30.00'
6,.
589.44'06'E / 346.06, .\� ?'^•�'I_'.:.:::.;.:...r.< ::?r.,:::z..:.,;.,;':�.:_ :•:�.•.�':..::t +`� =;•'
,HIDDEN-PINES-ROAD '::
: ;.,:;•.: ;:.;
'�_ ::
`M 3/4'NO La ... ...... .. , .'4D...'R�GHT"•.QFr... .
WAY1 .
CIENTERLINC
CUL-DE-SAC
v
SURVEYOR AND ' SIGNATURE BOUNDARY SURVEY FOR:
1.UMW uDL1.l'J 1I I NC. 6 WED Dot o .•
Re DIFORWONAL 2.No SEAM Of 111 °1 _ E DIM KYLE MONTGOMERY
aFFI� ::
Ted E. FI£'LUips REVISIONS:5/07/18 ADDED PROPOSED BUILDING
• 102 SW Pariah Te°Deo.... •
:alae! 1 OF1 `•+�� 1'530'
Pert ST.Lucie,Florida
T.(772)350-7023 Computed: TP Mid 00o4c MISC.4 Pape: 61-62 Fled: . TP .
tod_plirrosOmSlate daLiman
m
SlaNo.LS5932 Chucked: TP Dot.. 4/26/18 FILE NO.18-013 BNDRY Project No.18-013 .