HomeMy WebLinkAboutPermit ApplicationOFFICE USE ONL I
DATE FILED:'r
PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER. 62
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTYBUILDING & CODE REGULATIONS DIVISION'
2300 Virginia Avenue
Ft. Pierce, FL 34982-5652
772462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
LOCATION/SITE
2. PROJECT NAME: C
3. PROPERTY TAX ID #:
01
SITE PLAN NAME:
4. LEGAL DESCRIPTION (attach extra sheets if necessary):
5
9
PLAT BOOK a0,5q 6. PAGE NO. �Sr'o 7. BLOCK NO. 8. LOT NO.
PARCEL SIZE (ACRES/SQ FT.):
'D
LOT DIMENSIONS:
10. COMPLETE DESCRIPTION OF CONSTRwm2ag
ION PROJECT OR WORK ACTIVITY:
ag 4 �, ' Q
' 8 X 4aLLJ f
1 l . SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE:
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
[NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[,f RESIDENTIAL C RCIAL q^ n INDUS L
[] OTHER (SPECIFY) Q 1 co (n f O rn l
13. DESCRIPTION OF PROPOSED USE:
14. SQ. FT OF CONSTRUCTION:
16. VALUE OF CONSTRUCTION: $ Q� T V
15. SF. FT 1 st FLOOR:
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
A
4 - i
UPDATED 6/25/09
OWNER INFORMATION(�
NAME: C �CX w ( �( C� n
ADDRESS: _ I a V -0 -A - o „
CITY: STATE: . ZIP: (
PHONE (DAYTIME): ftiO a6 3 - (,Poo Email:
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) 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 #`Z1� (Oa,S (4 PT, LUCIE COUNTY CERT #;
BUSINESS NAME: S
QUALIFIERS NAME:t( '' (
ADDRESS: 3 `� W-1'
CITY: S'- STATE: ,
PHONE (DAYTIME): (U Cj - -q(Q�� FAX NO. ��0 - UR Email:
ZIP:
ARCHIT/BNGINEER
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME):
BONDING COMPANY:
ADDRESS:
CITY: STATE: ZIP:
MORTGAGE LENDER:
ADDRESS:
CITY: STATE:
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.
The foregoing instrument was acknowledged bbefore
me this :J day of PA20 �1 ,
by
who is personally known _Zor has produced
of
Commission No. 1
h,
NANCY MIMS ARMSTJaO3G
MY COMMISSION # EE059652
�FXPIREfft*iarY 30, 2015
The foregoing instrun
me this day of
by
who is personally known
acknowledged before
�
(11
or has produced
s identifica
NVCY MIMS ARMSTRONG
IY COMMISSION # EE00ib
EXPIRES January 30, 2015
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 OWNER/BUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.
OFFICE USE ONLY BP #:
SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
im
LAND USE
V
/to
LOT CVG %
TAZ NO.
FLOOD ZONE
FIRM MAP #
1ST FLR ELV
MAX HGT
CONST TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF REC
Before 1/1990
LOT OF REC
After 1/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
HABITABLE
AREA
(RADON)
RADON
FEE
PERMIT
FEE
LIBRARY
IMPACT
FEE
PUBLIC BLD
IMPACT FEE
CORRECTION
PUBIC BLD
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
JtEVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
21
DATE
COMPLETED
1 S I y
INITIALS
ct 141402:59p Sandi
8-57-4850... _ ; t P.1
�entras Mobil domes
;07 N:E Pet Street
A U"' i.arry Gabar
Za'. mot 172 & 326-
3 i}d tlilS OWe 13dve, 4""n Death, Ft_ 34S57
(772) 229-2M
FAX r,M) ?29-990f
'with regal•:: to he above lots, I am confinning that the Fart: Model' on Lot 172 has been
pulled out and iauled out of die cammiuutq, It Was my tuidelstanding that the Screen
xown'was disassembled and all parts talir. away.
. _ :{i� �jjtC;:. ti7';_;:f '�:C.: •.C.i:.... :
c'Jt 610 tat=,,;,=u; i:j, 53 :%t:3�:a} %Z;'- f" Y:i "lieU: 1*' 1S a4L t�EIF2ra" t'rltiiS , but
instead hauled out of the community.
SlFolztd you choose to demolish ally unit in Nettles Island, NeWes Island True. A
tDl1^.i11T1:i'5:33'..:1=ill i'w- ilea a%t. Luju ie Det-' C 811d _ djot.-, nt nroner:vi w1fiCC
ii IiVe.lYiX 10 OUr 0111(* D11U1 IG WOij( CUlI2MU10111R. U1u511d11t to t)llr CODUaCUlP 1111" -411d
Y gulati0ilS ,
Tf we car. be of flrt3ier assistance, please lei ms kno-v.
S�
Gera Jones, LC AIM
Ne"fles island
inu., - Condominium
cc: Mettles Islan- Security Dept.
10/10/2014 12:08 7724621
1014 08:36a Sandi
Oct. 7. 2d14 9:22AM W%ES ISLAND 19C
s. u0-\
ST LUCIE CO IM.PArT PAGE 02/05
863-3850 p.2
No.564") P. I
Nettles Island Inc. ca COO ClUminium
996t .South Ot;eatt OrW% 4spssp Beach, r-L 34997
(772) 229-200
FAX V72i 229-9901
May 22, 2014
Central Mobile Homes
807 NE Park Street
Qkeer„hobee, FL 34972
Attii: Larry Gabar
Re: Lot 172 & 526
Dear Larry,
With r+epud to the above lots, I mn confirming that the Park Model m Lot 172 has bemi
pulled o%)t and hauled out of the community. It was my understanding that the screen
rom wn disassembled and all parts tahen away.
With regard to Lot 526, please notify Security when you enter Nettles Wandto haul the
unit out ofthe Cozrununity, so we may confirm the imit is n.ot being demolished, but
insteAd hauled out offiie community.
Should you choose to demolish any unit in NOdes Island, Fettles Island, Inc. A
Comdotniniurn, will rogou-a a St. Lucie Comity permit and adjecont pippeity notice
deJiv=d ro our office prior to work eom making, pursuant to our contractor rules and
regulations,
if we can be of fuldler assistance, please let us )mow_
Si aly,
Laura Jones, LCA,M
Mettles lsland Inc., a Condominimu
I. bs
cc: Nettles Island Security Dcpt.