HomeMy WebLinkAboutPermit App, Checklist, Sub, HOA Approval, NocBOARDOF
COUNTY
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Application completely filled out with Notarized Signatures ............................ Yes No N/A
Owner / Builder Affidavit (signed in office) ................................................. Yes No N/A
Filled Land Affidavit (prior to issuance)..... *&Goes* sooestoo slb*6 sees 0 0 Yes.No N/A
Recorded Warranty Deed, if applicable... o*ss0000t*oo of ****two sees 66 as we o toeyes No N/A
Recorded Notice of Commencement (prior to issuance or inspection) ................. Yes No N/A
Utility Agreement or Payment Receipt (prior to issuance),..., 4 0 *694068 5444144 $Dot*.. ,,,,YesNo N/AmNL
Vegetation Removal Application with copy of survey. . yesNo N/A
Plans, Calculations �4i Attach ants ( c®pies co ercial, 2 copies residential)
Complete set of plans with Engineer / Architect Raised Seal. 1 0 6 6 2 0 9 Yes No N/A
Truss Plans reviewed and approved by Engineer / Architect................,... Yes No N/A
Landscaping and Parking plan (under 6,000 sgft)......................................... Yes No N/A
ApprovedSite Plans... I ***boo@ 0 1 sot**#% ago ON wools too@ oaq*D 0 sees o9setts too 000 &N600440 toostoo got Yes No N/A
Sealed Survey with Dimensions, Finished floor......... 4 60 *@*off 4 0$40004 so 66640 ,,,,,, Yes No N/A
Elevationsand Setbacks.............................................................. Yes No N/A
Plot plan with Setbacks... fosoto to of sQ*Vq**GoQ to Soo&* 040 wooteov 96*6**s be 40 sees 0 Yes No ®NIA
Health Department approval stamped on survey and floor plan, . * & 0 4 6 6 a 0 0 6 a t 0 4 & 4 6 6 & 0 0 . Yes No N/A
Health Department Food Establishment Permit stamped on floor plan. . Yes No N/A
Manual "J" or Manual "N" Calculations.................................................... Yes No N/AV
Sealed Wind Load Compliance Certification.. . got 00 to 40 *&get Yes No N/A
Product Review Affidavit..................................................................... Yes No N/A
Site all showing 25®fOot(minimum) set back from all property boundaries, size, Yes® No® N/A
shape, location and quantities of proposed excavation and fill areas
Health Department Permit Paperwork .......................................................Yes No N/A
CD for Fire Department if commercial or multi®family. ................................... Yes No N/A
DEP, SFWMD or Army Corp of Engineers (dock, seawall, SF on beach)............ Yes VNo.N1A.
Pool Barrier Affidavit.. 046 *#tog to 0 8 660404*9 002*V494 6 6066464004 *060 ***go 4 6" of Wo Yes No N/A
Ground Sign Landscape Affidavit (signs) ................................................... Yes No N/A
Burn Rate for Sign Cabinets......... ... 666660604*0 0060 too 4868046to 94464666 6 so@ goog go to so of 00 Yes®No N/A
AlV and Mobile Home Tie -Down MU(2 eopies)
Permit Worksheet (Tie -Down Diagram).....".. moo tannage go Ban BOB logo Yes o N/A
Manufacture Set -Up and Installation Manual... woo 949444 9#9 49104*0 1 as 006 00 1 0090 Yes No N/A V
Manufacture Blocking Documents... 00664 616649901 *Oat of YesNo N/AV
Signed Penetrometer Test (1 copy)......................................................... Yes No N/A
V.
StairDetails................................................................................... o Yes No N/A
Mobile Home Inspection Report for Relocation (used only) ........................... Yes No N/A
Copy of Title for Relocation (used only) ........................................... . ... . ... Yes No N/A
Class "N' Approval ' o
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
- Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 109 QUEENS RD. FORT PIERCE
Legal Description: QUEENS COVE -UNIT THREE - BLK 25 LOT 8
Property Tax ID #: 1423-602-0008-000-6
Site Plan Name: DAVID
Project Name: DAVID -DOCK /SEAWALL
Setbacks Front Back: Right Side: Left Side:
DETAfLED DESCRIPTION OF WORK:
Lot No.
Block No.
1. REPLACE EXISTING 100 L. FT. SEAWALL WITHIN 18" WATERWARD OF THE EXISTING
SEAWALL / INSTALLING BATTER PILES FOR STABILIZATION.
2. REPLACE EXISTING 324 +/- SQ FT DOCK IN THE SAME LOCATION &CONFIGURATION
CONSTRUCTION INFORMATION:
m
itionai work to aje�errormea unaer tnis permit — cnecK aipja l apply:
�HVAC L _I Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 57,000.00
S Ft. of First Floor:
_
Utilities:�Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MICHAEL DAVID
Name: ROBERT WILLIAMS
Address: 109 QUEENS RD
Company: WILCO CONSTRUCTION INC
City: FORT PIERCE State: FL
Zip Code: 34949 Fax: N/A
Phone No. 661-713-9509
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772460-6929
Phone No. 772460-6928
E-Mail: SLAMDAVID@EARTHLINK.NET
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: WILCOINC@BELLSOUTH.NET
State or County License: SCC131151026 29115
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applica
Name: DANIELPAULMCI HERFORD
Address: 1402 HARTMAN RD
City: FORT PIERCE
Zip: 34947
n P h oe : 772-224-
9626
State: FL
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address.
City:
Zip: Phone: _
MORTGAGE COMPANY: X Not Applicable
Name: _
Address:
City:
Phone:
State:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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 inspect . If you intend to obtain financing, consult with I nder or an attorney before
commencing workorrecjbrding your Notice of Cojpmremement.
qK
v
f s
Signature of Owner
as Agent
Holder
STATE OF FLORIDA
COUNTY OF
The for ng inst
this day of _
(Name of person ackn
acknowledge fore me
20 by
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/1
DAWI�i�I`ilrGt=lZ!\LD
r '���; ';, MY COMMISSION fr Grp 162348
L'onded'ihni Notary PuL�lic tlndeivniters
The forgQoininstru
g
this yboo+�
of
was acknowledge fore me
20 by
(Name of person acknowledging )
(Signature of Notary'Publ/ic-State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No.
�,' �;, ', MY CUMMI SION # GG '161348
F�onded'fhni Notary Public Underxrilzrs
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
PERMIT # ISSUE I�AT�
i
(Company
tkte ELECTRICAL
(x'ype of Trade)
PLAN�G & ��V�X.r4PIV�N'T S�IE2,'V'XCES
Suildfing 8z Code Compliance Division
Nt+me)
BUILDING PERMIT
SUB-CON'I'RA,CTOIZ A.CI��MCIVT
have agreed to be
Sub�co>atractor for WILCO CONSTRUCTION IN
(Primary Contractor)
For the project located at 109 QUEENS RD 1423-602-OOOS-000-6
(Project Street Address or Pi'opet'ty Tax XI] #)
It is undcrstvod that, iI'there is any change of status regarding our participation with the above mentioned
project, the Building and Cade }Zegu4ation Division of St. )_.ucie County will be advised pursuant to the
filing of a Change of Sub�contfactor notice,
CONTRACTOR g[GNk\TUt��, (Qunp
ROBERT WILLfAMS
PRRVT NAMI's
29115
COUNTY CERTIhICATION NUMSLK
Slnteofi'[nr[dn,Caunryor.ST, LUCIE
The foregoing instrmuent wns siyncd before me this � day of
zu�hy � � ^ �'lS
who is personally l<nowu _or has produced a
as identiLcntion.
s;gnuturc of Notary Public
f �,2tL�-
rint Nnmc of Notary Public
"�4�;•, DAWN FI7ZGERALD
�'�• �� ' h1Y COMMISSION ik GG 162348
l:iPu :�-
:,.,.-��k�;,; EXPIRES; December 17, 2021
` °,F,t:;° Bonded Thnr Notary Public Undervrriters
NA'rUR>; (Qualifier)
PItjN7' NAME
a?a 9�`
::OuN7•Y C6:FiTC};ctCA'1`I N NUN11al;R
Stntc of171orfctn, Carney nr�_��5�f
'Ciro forcguiug iustrmncnt wns SigrAed before me lhid � dny of
by � � {'YL-Q.D ,��
who is personally known �r has produced n
qg Idenli(icntinn,
STAMP
Signnhn•c o Notary uh rc
Pr ntNam or Notary Public
;� DAWN FI IZGcRALD
,= MY COMMISSION # GG 162348
`��`"�' EXPIRES: December 17, 2021
• '• Fronded Thnr Notary Public Undenrcriters
STAMP
i000/T000 �
'IS 08TZbOZZGL XF�d IQd00 � ZT OZOZ/ZO/60
Marine Construction and Hold -harmless Agreement
The undersigned Property Owner desires to construct a facility on the submerged land owned by the
Queens Cove Property Owners Association in the adjacent waterway of the Owners Property utilizing
the undersigned Contractor. Both the Owner and Contractor wish to perform this construction as
specified in the permits obtained by the Property Owner from the Association.
The Owner and Contractor have read and agree to abide by the rules, regulations, restrictions and
conditions of the permit issued to the Property Owner. Because the St. Lucie County permit for this
construction must be issued to the owner of record of the submerged land on which the facility will be
placed, the Association has agreed to seek this permit in partnership with the Property Owner,
The Owner and Contractor will hold the Association harmless from any claims or fines resulting from the
performance of the dredging operations.
Property Owner °
Name M1Cwrf' DAo'1tJ
Address t t7 Q0t4g5
Address !-�r�i' N'. 501 5 � �'�
A AM
Signature
►�r_��rx•Tr�rn .
COUNTY OF ST. LUCIE
The foregoing instrument was acknowledged
before me this >,�E day of ��U' 20 � by
q� k�°�®ei. <E , J who is personally
known to me or produced as identification
Vld
t:l , ;;?� aFUe4�,, DAWN F{TZGERtaLD
Notari�!Star, ;�_ WIYCOMMISSION#GGi623S8
EXPIRES: December 17, 2021
I ;oF„ti Bonded Thru Notary Public Unde vrriters
Notary Public,State of Florida
My Commission Expires: � .� I
Dai
For Queens Cove Property Owners Association
Contractor
Name WILCO CONSTRUCTION INC.
Address 10751 ORANGE AVE
Address FORT PIERCE, FL 34945
License No. #_ 15 02 "
Signature °
RO F T WILLIAMS
STATE OF FLORIDA
COUNTY OF ST.LUCIE
The foregoing instrument as acknowledged
before me thiL day of U 20 by
(' i�A. who is ersonally
Known to me or produced as identification
Notary Stamp
Notary Public, State of Florida
My Commission expires: IBC
r� DAWN F{TZGERr;LD
COMMISSION # GG 1623A8
EXPIRES:December 17,2021
Bonded Thru Notary Public Under+rriiats
Signature Title Date
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4738167 OR BOOK 4456 PAGE 2225, Recorded 08/05/2020 12:03:47 PM
Permit No.
State of Florida, County of St. Lucie
NOTICE OF COMMENCEMENT
Property Tax ID No. ta23 sot 000s-000 s
The Undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
Legal Description of property and address if available 109 QUEENS RD, FT PIERCE, FL
QUEENS COVE -UNIT THREE- BLK 25 LOT 8 (OR 1133-2574: 409&1916)
General description of improvements
DOCK & SEAWALL
Owner/lessee_ I ttthe
Address _ /®9 01/JZ4 )kW
Interest in property: OWNER
Fee Simple Title holder (if other than owner)
Address
Contractor WILCO CONSTRUCTION INC Phone # 772460"6928
Address 10751 ORANGE AVE, FORT PIERCE, FL 34945 Fax # 772-460-6929
Surety v Phone #
Address Fax #
Amount of Bond
Lender Phone #
Address Fax #
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13 (a) 7., Florida Statues:
Name Phone #
Address Fax #
In addition to himself, owner designates °f
Phone # Fax #
to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes. Expiration date of notice of
commencement is one year from the date of recording unless a different date is speeiCed.'ARNIPtG TO OWN]El�:
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER
PAYMENTS UNDER CKI13,13, F.S., AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK. OR RECORDING YOUR NOTICE OF
COMMENCMENT.
Acknowledged before me this , day of 11FAR
has produced
Signature of Notary Type or Print Name of Notary
j
CommissionNumber
try
(Seal)
cation.
DAWN FffZGERALD
MY COMMISSION # GG ffi2348
EXPIRES; Decembee 17, 2021
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser ve All rights reserved.
Site Address:
Parcel ID:
Account #:
Map ID:
Use Type:
Zoning:
City/County:
Ownership
Michael David
Sharon David
109 Queens RD
Hutchinson Island, FL 34949
Legal Description
QUEENS COVE -UNIT THREE- BLK 25 LOT 8
Current Values
Just/Market Value:
Assessed Value:
Exemptions:
Taxable Value:
$390,100
$332,179
$50,000
$282,179
Property Identification
Property taxes are subject to change tai�t�i�t
change of ownership.
• Past taxes are not a reliable projection of future taxes.
• The sale of a property will prompt the removal of all
exemptions, assessment caps, and special classifications.
Taxes for this parcel: SLC Tax Collector's Office ❑
Download T1tIM for this parcel: Download PDF ❑
109 QUEENS RD
1423-602-0008-000-6
8558
14/23N
0100
RS-4 Count
Saint Lucie County
Total Areas
Finished/UnderAir (SF): 1,980
Gross Sketched Area (SF): 31912
Land Size (acres): 0.26
Land Size (SF): 11$00
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
0 Copyright 2020 Saint Lucie County Property Appraiser. All rights reserved.