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HomeMy WebLinkAboutBuilding Permit ApplicationOFFICE USE ONLY: DATE FILED _ 'f' 1 PLAN REVIEW FEE. Grp RECEIPT NO.: PERMIT NUMBER: tZ� O � CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INFO UST BE COMP ETE_& FILLED IN TO BE ACCEPTED� PLANNAfe i C - IN & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION L LOCATION/SITE ADDRESS: 23co Vimtnic.. #toe• . Ot?i PA PROJECT NAME: ranee. 17-e.rr o64 SITE PLAN NAME: Wl E CNArdN ` ck Mi rt i gfroj;a 1 3. PROPERTY TAX ID #: *2A[ t - 504 - 0-43o - 0008 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 'Fleas. sm odd 5. PLAT BOOK 6. PAGE NO. 9. PARCEL SIZE (ACRES/SQ FT.): W by 7. BLOCK NO. 8. LOT NO. LOT DIMENSIONS: N /A 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:.:r4eriOr �rlc�VUhon ^C e--TR,n c-rre & 4r, irNAt trlq ,olPrlvit-e%l nli ,,A SETBACKS (ACTUAL) FRONT: W/ra BACK: CIA RIGHT SIDE: m/i, LEFT SIDE: rs/q TYPE OF CONSTRUCTION (Check all appropriate boxes) NEW CONSTRUCTION RESIDENTIAL OTHER (SPECIFY) [ ] EXPANSION/ADDITION AC] INTERIOR RENOVATION [ ] COMMERCIAL [ ] INDUSTRIAL DESCRIPTION OF PROPOSED USE: 1a )u40kC1 acgcr- mpQcr— jb tpahmann SQ. FT OF CONSTRUCTION: 1100 VALUE OF CONSTRUCTION: $ 10 jCD00. 00 15. SF. FT 1 st FLOOR: N�A 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 UPDATED 6/25/09 OWNER INFORMATION '' NAME: '%. Eger e COL InN ADDRESS@� %roc niQ. P CITY: 4 •m icrc-c STATE: ZIP: 34982- �t� PHONE (DAYTIME): (}� 4U-1.143Z- Jerr nn , Email: -'!nn Si luGteCJCi. 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): C__) CONTRACTOR INFORMATION ST. of FL REG.CERT #: ST. LUCIE COUNTY CERT #: BUSINESS NAME: ou3n(tr %tit hnlcy' Lode Cbun}v QUALIFIERS NAME: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): C__) FAX NO. Email: ARCHIT/ENGINEER: VN/'& ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): BONDING COMPANY: N/A ADDRESS: CITY: STATE: ZIP: MORTGAGE LENDER: NIA 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. PLANNING & DEVELOPMENT SERVICES BUILDING & CODE COMPLIANCE DIVISION BUILDING PERMIT SUB -CONTRACTOR SUMMARY S4. Lu6r_ GoLtnN - O WW/bu; ►dc-r will be using the following sub -contractors for the (Company/Individual Name) ` project located at 2--5c)o Vira(1'11Q. (Street address or Property Tax ID #) It is understood that if there is any change of status regarding the participation of any of the sub -contractors listed below, I will immediately advise the Building and Zoning Department of St. Lucie County. Trade Name of Company/Contractor St. Lucie County/ State of Florida License Number Electrical N.Wdr. Cbu owrnev-/ LaLlder Plumbing C-*. Lude &Lln owrleY /bu,t ldcr- HVAC/ s%. Liz Goon. Mechanical C wrWzy-10w ldcr Roofing Gas II NUMBER: ISSUE DATE: 1 11 PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: N/A State of Florida Certification Number (If applicable): R moray / buiI dear' have agreed to be the (Company Name/Individual Name) &C%1C sub -contractor for &. LUG,_ CCU* — 0L,0aW (pu�ick� (Type of Trade) (Primary Contractor) for the project located at 2350 Vi co', -ICL &C tor+?ky-c (Project Stfeet Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED SIGNATURE PRINT NAME DATE Business Name: S. LIxlc. COW* Address: 2-300 Vi rt %el(o" Ave- City/State/Zip: 1�'•�Pi¢rCG , R- 3�4982 Phone: (4r4i)-4U7 14 a email: Armn a 5huckc,o•Or9 OFFICE USE ONLY: PERMIT # ISSUE DATE OFFICE USE ONLY SECTION I f , I TOWNSHIP ZONING I I LAND USE BP #: s S I RANGE Ildoc I MAP NO. LOT CVG % I I TAZ Ni FLOOD ZONE FIRM MAP # I ST FLR ELV MAX HGT CONST TYPE OCCUP TYPE CCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC Before 1/1990 OT OF REC After 1/1990 LOT SPLIT REQUIRED LOT SPLIT APPROVED REPORT CODE NJ 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 REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED ..�Q DATE COMPLETED L INITIALS Ci PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERNUT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number:W/A State of Florida Certification Number (If applicable): N/A OWner/►.xtjlderr have agreed to be the (Company Name/Individual Name) RI UMV1r5) sub -contractor for CounN-Owrw_r&Lku Idle (Typ of Trade) (Primary Contractor) for the project located at 2-.W Virnitnia.We.. Fad} i�ier� (Project 43treet Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED 311S43 SIGNATURE PRINT NAME DATE Business Name: S+• Wcie.. CDun Address: 2-5-1-00 VI r 410 ia. N(z City/State/Zip: 34'ct82 Phone: C y 2' 1432 email: %0fJg a 511U6eCQ .orq .�crnj Lynn j OFFICE USE ONLY: PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number:141A State of Florida Certification Number (If applicable): C�WI'�x�builder have agreed to be the ( ompany Name/Individual Name) RVAC. (Type of Trade) sub -contractor for&.LuGeCou Vy-Otncr bulldc.- (Primary Contractor) for the project located at 2' 4iro�inio. /ate.. E or} (Project Street Address or Property Tax ID 4) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED SIGNATURE PRINT NAME DATE Business Name: Address: City/State/Zip: Phone: ,: • Lyc C- Cou 2-;5 o Vi!Gtrtia A c 7 - 1432 email J� riynn , pf rc rrI'llr4a 5 r OFFICE USE ONLY: PERMIT # ISSUE DATE 5k106is co . o ra Planning & Development Services Department Building & Code Regulations Division 2300 Virginia Ave Fort Pierce, FL 34982 772-462-1553 Owner Builder Affidavit — Electrical Contracting DISCLOSURE STATEMENT F.S. 489.503 (6) EXEMPTIONS State law requires electrical contracting to be done by licensed electrical 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 electrical contractor even though you do not have a license. You may install electrical wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under $75,000. The home or building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourself within 1 year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your electrical contractor. Your construction shall be done according to building codes and zoning regulations. 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. Failure to do so may result in a liability for you! To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application. 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 Community Development Director to the Fl rida State Department of Professional Regulation. Signed and acknowledged on this �� day of , VZot e!.- , 20Z. OWNER/BUILDER SIGNATURE STATE OF FLORI r COUNTY OF The foregoing instrument was acknowledged before me this day of by who is personally know5e to me or 60, J. ature of a Print name of Notary PELTON �'?�' =•. .k: Commission # EE 024685 a Expires October 31, 2014 Bonded bfu Troy Fein msurinc= Title: Notary Public Commission Number euo•aaeao,s SLCPDSD Revised 7/23/2010 St. Lucie County Owner Builder Affidavit -Electrical Contracting Planning & Development Services Department Building & Code Regulations 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 or a commercial building at a cost of under $75,000.00. The building or residence must be for your own occupancy. It may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved your self within one year after the construction is complete, the law will presume that you built or substantially improved it 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. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable 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 how to meet the minimum code. Imtia I understand that as an owner -builder that any contract disputes with sub -contractors and I mus be handled in a civil court with the'advice of an attorney. This department will not mitigate any contract disputes. Initial 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 liable for the cost of the license. Initiak�/ I understand that if any person that is unlicensed and uninsured gets injured on my construction pro�ect- 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 To qualify for this exemption under this subsection, an owner must personally appear and sign a 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 Deparqent to the F orida State Department of Professional Regulation. Signed and acknowledged on this Z. day of of 20 Z Owner/Builder Signature STATE OF FLO r COUNTY OF The fo oing instru t was acknowledged before me thi�c7S day of by who is personally known pro ce as idef l _ i --� Title: Notary Public SLCPDSD Revised 07/22/2010 Type or Print Name Commission Numbe d.=-, 20� to me, or who has D0RIS J.-P_dLTO Gcmmission # EE 024686 soXMF ber 31, 2014 roy Fain Insulpme 8004,14.1019 Property Appraiser - St.Lucie G^ ��ty, FL Page 1 of 1 St Lucie County Record: 2 of 3 Property Identification Site Address: 2300 VIRGINIA AV Sec/Town/Range: 16 :35S :40E Map ID: 24/16S Zoning: C1 Ownership and Mailing Owner: Address: 2300 Virginia Ave Sales Information . Date Price 6/1 /1988 100 PROPERTY RECORD CARD <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print ParcellD: 2416-504-0770-000-8 ���UCIE CpG,y Account* 25850 y� < Use Type: COUNTIES City/Cnty: St Lucie County �! Legal Description St Lucie County LAWNWOOD ADDN ALL THAT PART OF VACATED BLKS 110, 133, %Management &Budget 134 AND 159 BOUNDED ON N BY SLY R/W RHODE ISLA Fort Pierce FL 34982-5632 . More... Assessment 2012 Total Land and Building Code Deed Book/Page 2012 Final: 19181700, Land Value: 3713900 Acres: 24.36 01 CV 0598 / 1832 Assessed: 19181700 Building Value: 15467800 Ag.Credit: 0 Finished Area: 147739 SgFt Exempt: 19181700 Taxable: 0 Taxes: 0 BUILDING INFORMATION m i0 couxrtwxve,uo (mN) Exterior Features View: - RoofCover: GY - Gypsum RoofStruct: TP - Steel Conc ExtType: HROF - OFFICE YearBlt: 1988 Frame: - Grade: S+ - S+ EffYrBlt: 1988 PdmeWall: EN - Enam/Pfb Mtl StoryHght: 0030 - 3 Story No.Units: 1 SecWall: - Interior Features BedRooms: 0 Electric: MX - MAXIMUM PrmintWall: DW -Drywall FullBath: 0 HeatType: FHA - FrcdHotAir AvgHt/FI: 1/213ath: 0 HeatFuel: ELEC - Electric Prm.Flors: CU - Carpet %A/C: 100 %Heated: 100 %Sprinkled: 100 Special Features and Yard Items Land Information Type Y/S Qty. Units Qual. Cond. YrBlt: No. Use Type Type Measure Depth 1 8600-COUNTIES 320 -Sq Feet . 1061122 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED http://www.paslc.org/paslc/PRC.asp?move=next&card=l&prclid=241650407700008 3/12/2013 1 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. OWNER OR CONTRACTOR SIGNATURE STATE OF FLORID COUNTY OF '�lP-, The foregoing instrument was acknowledged before me this & day of 20 L.3 , by� who is personally known or has produced identification. of CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this day of by who is personally known Signature of Notary 20 , or has produced as identification. Commission Nt DX (Se DORIS J. PELTO o n No. (Seal) Pie`,, Commissiun # EE 024685 r,e` Expires October 3t 2014 %F„oF nQr` Bouded Th. Tmy "ram In,,, a e 8W-385.7018 NOTE: TWO (2) SIGNATURES ARE RE A ST 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. 1 ST U I VIE C 0 U N 7 Y F.-IN . EVLEW EILDG- DATE: ELEC;7 DATE: -) PLUMB: DATE: 3 MECH: DATE: �- 3 0 O IT UE AogFg Po %?\f,5 �-3a© V12q1N11-,4-'1ql1?5 Lo -/� rl q � e '5- l � � �� �'�� � '� 4 �_% - � -_ � n� � a n y' �� � s � ' :�_� r � �� t�;�Ft � i � `�, � F I i _ �.. � r � ... �� L �� _ n � t t.. . ;�., ti.