HomeMy WebLinkAboutBuilding Permit packet i-�- ppr-- c-r... r
OFFICE USE ONLY: �
DATE FILED: 1
PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER: dv� 7
CONCURRENCY FEE: RECEIPT NO.: CERT.CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTY BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Avenue ?Ueda
oc,
Ft.Pierce,FL 34982-5652
772462-1553 7L�C.rLS
PPLICATION for BUILDING PERMIT
CERTI ICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
K
1. LOCATION/SITE ADDRESS: 1 001 S. CCfAlN-) bP r4tlz -?4RS7
2. PROJECT NAMEAckwaos- Fdgnamc SITE PLAN NAME:
3. PROPERTY TAX ID#: `ill - gOS- Old 33 - 'Db0 - 2
4. LEGAL DESCRIPTION(attach extra sheets if necessary): ��jJ?y2E L1U7-- .<EC'71 Q-) C
Lai- ly e"of 326/- Moto)
to
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO.
9. PARCEL SIZE ACRE SQ FT.): LOT DIMENSIONS: l(c u x. .
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
S ? v
11. SETBACKS(ACTUAL) FRONT: 140 _ BACK: RIGHT SIDE: y o, LEFT SIDE:_ A
12. TYPE OF CONSTRUCTION(Check all appropriate boxes)
[v� NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[y� RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER(SPECIFY)
13. DESCRIPTION OF PROPOSED USE:
14. SQ.FT OF CONSTRUCTION:- �f z4P 15. SF.FT 1st FLOOR:-4e
16. VALUE OF CONSTRUCTION: $_ 2 2� d� prJ
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/or 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$2500 or more,a
RECORDED Notice of Commencement must be submitted with this application.
SLCCDV Form No.:001-02
U 5
y�/
UPDATED 6/25/09
I
V
OWNER INFORMATION
NAME: M I C-�ArA— 12 .
ADDRESS: 11 O 1 S. it')car4i be. # (04 3
CITY: Sal Bex,& STATE: ZIP:
PHONE(DAYT ME): cqa 40 - 4JEW Email: l�IIGE. IQIGNx1 RAS� g��I�LLe. �"'T
IF THE FEE SIMPLE TITLEHOLDER(PROPERTY OWNER)IS DIFFERENT FROM THE OWNER LISTED ABOVE,PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER: W Ar
ADDRESS:
CITY: STATE: ZIP:
PHONE(DAYTIME): L_)
CONTRACTOR INFORMATION
ST.of FL REG.CERT#: 29C04-7.r-Z 7 ST.LUCIE COUNTY CERT
BUSINESS NAME: E poi pia) "c - -
QUALIFIERS NAME:
ADDRESS:9OZo KA-QUA-I►J(.uC�'�i� C i: . Ab pj;r- A2
CITY: (ZVIEDo STATE: AL ZIP: _9!27(pS--
PHONE(DAYTIME): $-D/F FAX NO.�yF7 7� �jL-401YO Email:
7i� yr'�oQi�l�-CAM
ARCHIT/ENGINEER: _ ' P MCCAfT�y
ADDRESS: /� dSGEOL ST
CITY: STATE: ZIP:
PHONE(DAYTIME):
BONDING COMPANY:
ADDRESS:
CITY: STATE: ZIP:
MORTGAGE LENDER: '-,F
ADDRESS: 144S+�� 67.
CITY:LJ/„�L Jf/P.f�✓CfS STATE: ZIP:
IMPORTANT NOTICE: When a permit is issued and it is not picked up within 6060 days after notification
it will be voided and returned to you by mail.
Oct. 28, 2013 2: 25PM No' 0868 P• 2
1, JOSEPH E,SMITP QY F THE CIRCUIT COURT
SAINT LUCID CC
FILE 0 389125910/e4)2013 HI 0101 PM
OR BOOK 3573 PAGE 78,78 DoC T
AFTYRMCORDING•RETURNIV: RECGROING; $10,00 )Pe:NC
AA�Cmt,d 4 W IIc
Auwd ate•, 0 o)g
dvi t-D o,r-t- 174(R S� <u13
PFRA[rr[.fU>,1HER� L
NOTICE OR COMMENCEMENT
T11c undersigned hereby given no(Ice(hat Improvement wilt he made to certnln real property,and In nceordanee with Chapter 713,
Plodda statutes the following Inforaintlon Is provided in the Notice of commencemeot,
1.D)+SCRIPTION OF PROPRWff(Legal description and street address)TAX FOLIO Jr`UNMER:
SUBDMSION BLACK TRACT LOT —OL UNIT
Ib701 S, 04erm,`LIZ- x#1132
2.GE NBftAL DESCRB?TION OF INlPROVR?vfENT:
3.OIYNCR INFORMATION: a.Name r
b.Addross f ool S.dG�" 1,2,. ' a�D 7en.�t¢.L)Q 3,r 9S�c.inlerost in property I@A�$IMA+C
d•Name and address of fee slmple titleholder(If other(hart owner)
A,CONTRACTOR'S NAAW,ADDRESS AND PHONE NUMBER;
OVODO
?�
5,SURETY'S NAW,ADD SAND P1HfONE NYJMBBR AND BOND IOUNTr
6.LEWER'S NAAIF,ADDRESS AND PFIONE NiJ?fMER:lA�?-Ig ERGO QA•tJk.
7.Persons within(lie Slate of Florida dcslgnakcl by Owncr upon wham nolices or olllcr docunwits moy be served As pnovldtd by
Section 713.13(1)(a)7.,Florida Stalutts: 1 I/
NANfR,ADDPJ;SS A?4D PHONII Mr11ID1 rt,
8,In addition to hluiaclf ar herself,Owncr designates the following to rtetiva a copy oFlho Lienor's Nolico as provided in Section
713,13(1)(b),Florida Slalules: ,,
tANIE,ADDRESS AND PRONE NUhSDER� 0 J�
r
9.13xpiradon dale of notice of oommencemenl(the explsallon date is I ytar from the dnte of recording unless a ditTerent date is
specified) ,20
0 2: Y TILD OWNER APrSR THE EXPIRATION OP THE NOTICE OF COMhmN E IENT
ARE CONSIDERED TWEAVERA-AXWENTS UNDE9 CMPTER 713,PAP
T I SEMON 71-113.FLORIDA STATUTV, CM US LT
CE MIPRO BA(ENTS TO YOUR PROPER NOTIG80F?COMbvMN 1Et4T MUST TiR R1�CORDB4 A14t]
COMA[PNCL�\VQfiK OR RECORDIt,10
/Y fl OP/' h
Signwtureof Onner or PTlnl Nnme mud Provide Signniary's Title/Office
Owner's Aulhorized OMeer/Dlrector/PartuerAiRnaBer
Stme of Florldn �Q-
County of_071-191n C-r0ANOe— J -j-
The foregang instnuutnl was acknowledged befom me this / S day of
By. as
(Name of risen) d 5 / Crypo of amhorlty...e.g.Owner,officer,lrustce,n(torney in fact)
Par ►l A r _ Cr( 1AE'L- \�//'
(Name of party on behnlf of whom tnstnlmen(was executed) Personally Known_ -or produced tho following type of ID:
/7� KATHY S SANFORD
r" ) MY COMMISSION#FF052858
1 HU�J �-�J�or.� c�l� }• f�
(Printed Nan e bf Notary Public) (Signattlro of NoI(uy Publio) U 0;,;, °?or,N EXPIRES September 23,z017
(4VI398-01ss FloudnNolayservlce.eom
Under pennhlcs of pcdury,1 deckme ibnt I have read the foregoing and that the facts In it rue Iruc to the bast of my knowlcdgo and
hellef(section 92.525,PloridaStnttues).
Stgunture(s)of Owuer(a)or Otener(s)'Autliortzed OflloerlDltre(ar/PRrmerfilmlRger who signed nbovel
Dy; Dy
R e r.00rra12007(Rnwdar)
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.
OWNS ONTRACT ATURE CONTRA OR SIGNATURE
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ��-I/�/aC>; COUNTY OF L.E
The foregoing instrument was acknowledged before The foregoing instrument was acknowledged before
me this day of TL- 20 r/ me this day of QGTUU/f�h ,20_A_,
by L, or,- �✓ by Caw/A�oqaj
who is personally known V/ or has produced who is personally known-A/—or has produced
as identification. as identification.
Signature of Notary Signatu �ry_. ._.
CELENI MOJICA B CELENI MO�JgIeeC�,,,1A�,��
Commission No. ;�; MY COA y"O1`.,#DD749785 Commis ion 1'v'o. 19SI0N#`DU 785
EXPIRES January 17,2012 cXP?RF^January 17,2012
(407)3A8-0153 Ft, a- r
v '
.�P:c.a-Service.com
NOTE: TWO(2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILDING PERMIT AS AN OWNER/BUILDER,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 OWNEWBUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.
f
1
OFFICE USE ONLY BP -p". -p abl
SECTION I' TOWNSHIP RANGE I MAP NO. ��
ZONING rcl LAND USE LOT CVG% /�1 ' TAZ NO.
T '
FLOOD ZONE E6 FIRM MAP# ] 1ST FLR ELV N HGT
CONST TYPE OCCUP TYPE ` MAX OCCUP #OF FLRS
WATER SEWER SPRINKLERS STORMWATER
LOT OF REC LOT OF REC LOT SPLIT LOT SPLIT
Before 1/1990 After 1/1990 REQUIRED APPROVED
REPORT HABITABLE RADON PERMIT
CODE t �I AREA FEE FEE
(RADON)
LIBRARY PUBLIC BID PUBIC BLD PARKS
IMPACT IMPACT FEE ImE IMPACT
FEE CORRECTION E FEE
GENERAL
SCHOOL D CREDIT Y N LAW ENF
IMPACT IMPACT IMPACT
• FEE FEE FEE
r
FIRE/EMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE
IMPACT REQUIRED FEE VARIANCE FEE
FEE
SPECIFY MECHANIC ROOF NON-CONFORMING MISCELLANEOUS
SUBS ELECTRIC —tp' GAS LOT OF RECORD FEES
REQUIRED PLUMBING FEES
DATE SENT TO ADDRESSING:/-2E/-12—
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTEW REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED !tz
INITIALS
PPPP—
FORM#101 TO BE USED FOR
VENTURE HARBOUR INC.
VENTURE OUT at INDIAN RIVER INC.
VENTURE OUT at ST. LUCK INC.
r-------------------------------------------------------------------------- ._-----_-----.---_-------___-_------
NOTICE:
This form must be attached and made part of all drawings or plans regarding the installation, construction,
remodeling, setting or resetting of any permanent structure, concrete work, or any other type of worts that
may be effiected by the rules,regulations and bylaws of any of the above associations
This form shall also serve as notice to the owner or owners of Lot 11(4'34at the owner or owners or their
agents of Lot#k L Zsball solely or jointly be responsible for the proper setting and corxrpliance of all niles,
regulations and bylaws of any of the above associations, and the Codes, Laws, Rules and Regulations
pertaining to said work as set forth by St. Lucie County.
The owner,owner;,or their agents by signing this form sball hold harmless any ofthe above associations,
its officers, directors and committee personnel as pertains to its and their duties and
responsibilities as the administration of said work.
Said work is approved as per dimensions shown on attached plan or drawing this,
Date J—A� - Z
Scope of work AlaMr G'yo�rST/�'vrs7�i'✓
Association Building Committee
By: f
By:
By:
_(��-ZLG Association
4 er, ei f •Lot# 02:>
,� ----
Date:
By:
1 •
By:
AI)D►ENDUM.-Confinctor agi ees to attaelred btdermtification Agreement,and also agues to
linvocably indemnify,save harnilm and lay to any adjacent Owner hi any of the alcove
associations against any loss,cost,damage or liability arising dirvedy or indirectly out oftivork or
-corishuctiott by the Builder for the owners of the above lot;
_(Builder) (Witness)
1105M
FORM#101 TO BE USED FOR
VENTURE HARBOUR INC.
VEi NTURE OUT at MIAN RIVE,R INC.
VENTURE OUT at ST. LUCI ' INC.
---------------------------------------------------------"____._--------------------------"............
NOTICE:
This foim must be attached and made part of all drawings or plans regarding the installation,construction,
remodeling,setting or resetting of any permanent structure, concrete work, or any other type of work that
may be effected by the rules,regulations and bylaws of any of the above associations
This form shall also serve as notice to the owner or owners of Lot It&3&t the owner or owners or their
agents of Lot#k7ishall solely or jointly be responsible for the proper setting and compliance of all rules,
regulations and bylaws of any of the above associations, and the Codes, Laws, Rules and Regulations
pertaining to said work as set forth by St.Lucie County. F
The owner,owners,or their agents by sig ling this form shall hold haunless any ofthe above associations,
its officers,directors and committee personnel as pertains to its and their duties and
responsibilities as the administration of said work.
Said work is approved as per dimensions shown on attached plan or drawing this,
Date 7-/6 -yr/ Z
Scope of work I?VIW GyNST1C&,;0 /✓ MIX ,S�sv Z A
Assoniation Building Committee l0 70/ .5, DGL---Z N P/C .
By:
By''.
By: P2Gv�vS� 2cs�r.� c�
ZzG Association
0 er; e f Lot# 32-
Date:
By:
By:
ADDENDUM:Coniiactor agrees to attached Indemnification Agreement,an(]also agrees in
irrevocably indemnify,save hannkss and pay to any adjacent Owner in any of the above
j%%ociations against any lass,cost,damage or liability arising directly or indirectly out of work or
construction by the Builder for the owners of the above lot.
(Builder) (Witness)
11105108
� _ a
�COUNTY
PLANNING&DEVELOPMENT SERVICES DEPARTMENT
BUILDING&CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34992-S652
(772)02-IS53
FILLED LANDS AFFIDAVIT
1,the undersigned,am the owner of the following described property,
l-,'u- �bG -GO13 -coo - 2 0 �N.
(Parcel Id#/Legal description/Address) FL.149 r 7
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number:SLQ 12.o2 -VZC'j 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.
1 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.
P,ropat� Ow a ,P ems int)
Propefty Owner ignature Date
STATE OF FLORIDA,COUNTY OF �
ACKNOWLEDGED
^^BEFORE
L ME THIS�_DAY OF 20/.J
BY L7Ctla� n zS _p WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRQDUCED !� 3 S O �+7Q AS IDENTIFICATION
• nn
AeAz 4
SIGNATURE OF NOTAR UBLIC TYPE OR PRINT NOTARY
a'&M9 COMMISSION NUMBER
M
EY 6608272017 7019wm BW385-
SLCPDSD Revised 08n412010