HomeMy WebLinkAboutSUBMITTED PAPPERSBP M
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SECTION: 1 1 TOWNSHIP: - S RANGE: J� E MAP NO.:/I z4 N
1
ZONING:
LAND USE:
LOT CVG %:
TAZ NO
FLOOD ZONE
FIRM MAP #:.
1ST FLR ELV:
MAX HGP
CST TYPE
OCCP TYPE
MAX OCCP:
-
# OF R..RS:
WATER_
SEWER:
SPRINKLERS
STORMINATE
R
LOT OF REC (befr 1190)
LOT OF REC (aftr 1190)
_
"LOT SPLIT
LOT SPLIT
REOD -
APPRV'D
' DECAL
LIBRARY
PARKS
PERMIT
NUMBER
IMPACTFEE
IMPACTFEE
FEE
I REPORT
PUBLIC BLDG
HABITABALE
RADON FEE
1 CODE
-IMPACTFEE
-
AREA
'
.
(RADON)
ROAD
GROSS ROAD
CREDITTOTAL
ROAD
IMPACT ZONE
IMPACTFEE
IMPACTFEE
DUE
MEWHIM
SCHOOL-
-
CREDIT .
=% - - - -
;TOTAL
r-I
IMPACT FEE:>u''..'>r-r_;°�.:^;c
SCHOOL
'x:IMPACT
FEE
POLICE FEE
FIRE FEE
MISC FEES:TOTAL
POUCEIFIREI
"
MISC. FEES
-
Y"
N
ADDITIONAL
SPECIFY:
TOTAL ALL
PERMITS
-
FEES
RE(YO
REVIEWS
ZONING
ZONING
PLANS..
' VEGETATION
SEA
MANGROVEt -
REVIEWED BY
EXAMINING
TURTLE
-
DATE
COMPLETE
INITIALS
'
DATE FILED: - 1 �l 1
PLAN REVIEW FEE: RECEIPT NO.: U(o C3 PERMIT NUMBER: Q -! 0 - n, V O 1
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
� ALL INFO MUST BE COMPLETE U FILLED IN TO BE ACCEPTED -
ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
2300 VIRGINIA AVENUE SCANNED
�OR10a FORT PIERCE, FL 34982-5652
772462-1553 BY
St. Lucie Countv.
APPLICATION for BUILDING PERIVIIT
CERTIFICATE of CAPACITYIZONING COMPLIANCE
i PROJECT INFORMATION
1. LOCATIONISITEADDRESS: NCO T1Cps RCC'd
2. SID NAME: SITE PLAN NAME:
3. PROPERTY. TAX ID #: a:!) iA • aw. OOOO , gzgL4 cc__--
4. LEGAL DESCRIPTION (atlach extra sheets if necessary): �1 1�iSe 6fC . A I 1
�eacy)ed
5. PLAT. 6. PAGE- - 7. BLOCK -8- LOT
BOOK NO. NO. NO.
9. PARCEL SIZE: CRES Q FT.3� 'i'i l �kXC5 LOT DIMENSIONS
10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY,LfY ax �S x 12
S1CGb (rwd 'trt5i [1 145 KW Generator C �ASOgptT on diPs�_tj J\j 40nK.
11. SETBACKS (ACTUAL) FRONT-5BACK: �t� RIGHT 20 LEFT 2- +
SIDE SIDE:
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
[)q NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [)Q COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: E M2.'(O YIC'-U '- oW eY'
14. Sq. FLICONSTRUCTION: .15.. ' Sq. Ft 1st Roor.
16. VALUE OF CONSTRUCTION: $`'t' 1, Ooo
The value of consiruction Is used to determine the amount of permit fees to be assessed. SL Lude County reserves the right to question and/or modify 0te
64cated value of'construcfion i►itis demonstrated that the submitted figures are not caIgistentwith similar types of construction adNities.-If the value is $2WO
or more, a RECORDED Notice of Commencement must be submitted with this application.
SLCCDV Form No.: 001-02
OWNER INFORMATION:.
NAME: - - v1Yi IVE��II OiL •i C7TL �- �7'• L-.IP l EY -G(�i Iy
ADDRESS: l D-M-M nmIf'f 1tAv) IJIVd • �` 7
CITY: .
Icallfalxe STATE: l- ZIP J2
PHONE (DAYTIME): 1 1
-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): f 1
CONTRACTOR INFORMATION
ST. of FL REGJCERT 0:: ( i �'^�,., '� ` ,1 ST. LUCIE COUNTY CERT U:'
BUSINESS NAME: a. Woe' Cou ITV - OL rey- C.2J .1 I Ider
QUALIFIERS NAME:
ADDRESS:
CITY:
PHONE (DAYTIME): .
ARCHITIENGINEER:
ADDRESS:
CITY:
PHONE (DAYTIME):
BONDING COMPANY:
ADDRESS: -
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY:
Zt 41v2- 143z 1LOeVFAX NO. ` ���Z� U2-- I`WA
r
'. •STATE - , 1 ` .ZIP
STATE: ZIP
STATE:
ZIP
34gca
IMPOkTANT..NOTICE: When a permit is issued and it is not picked up within- 60 dazes_
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 certthcate 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, ETC., not otherwiseincluded with this building permit application.
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: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN.
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT.
NOTICE TO APPLICANT:' AS THE APPLICANT FOR THIS BUILDING PERMIT, IF IT IS NOT YOUR RIGHT, TITLE, AND
INTEREST THAT IS SUBJECT TO ATTACHMENT: AS A CONDITION OF THIS PERMIT YOU .
PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED CONSTRUCTION LIEN
LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT.
OWNER'S AFFIDAVIT:
I certify that all the foregoing information is accurate and that all work will be done in compliance
with all applicable laws regulating construction and zoning_
The foregoing" instrument was acknowledged
before me this -a- day of 2byV
who is personanwnlame-or who -
has car used as. identification.
Signature of Notary o
y O N c
Type or Print Name of Notary s
Notary Public Title o x
C U w m
Commission Number $
(seal)
CONTRACTOR SIGNATURE
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this _ day of . 20 , by
who is personalty known to me
or who has produced as identification.
Signature of Notary
Type of Print Name of Notary
Notary Public Title
Commission Number
(seal)_
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED.
IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNERlBUILDER, THE OWNER MUST PERSONALLY APPEAR
TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION.
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4CLIANCE
ST.LUCIr'INGDIVISION
REVIEWE
XEVIEN6 EDATEP!.A.N NT BE KEPT ONJOB
OP2 NO INSPECTION WILL BE MADE.
� FILE COPY
Code Compliance Division
2300 Virginia Avenue
Ft Pierce, FL 34982
Phone: (772) 462-1553 Fax: (772) 462-2522
http:lls0ucieco.govice
Date: 01 February 2007
Job Address: 8400 PICOS RD
Received By: counselb
Paid With: FW
Paid By: ST LUCIE COUNTY- RAY WAZNY
n
Building
Receipt
Receipt M 0000050663
'emit Number: SLC- 0702-0011
Amount: 5540.00
�redit Card Number:
Check Number:
Sign:
c
Barbara Counsellor - Re: 8400 Picos J Page 1
From: Raymond Wazny
To: Counsellor, Barbara
Date: 2/1/2007 4:58:04 PM
Subject: Re: 8400 Picos Rd
It is, thanks Barbara.
>>> Barbara Counsellor 2/1/2007 3:36 PM >>>
Hello Mr Wazny,
I received a permit for a concrete slab with a generator diesel tank for emergency power at the address
8400 Picos Rd. Please I need you to confirm your signature here on these forms so that I can Notarize
them.
Thank you,
Barbara Counsellor
Permitting Building Tech II
ext. 1559
roperty Appraiser - St.Lucie Coi-iv, FL Page 1 of
rr Int Imp Trust Fund
Record: 1 of 12
Property Identification
Site Address:
8400 PICOS RD
Sec/rown/Range:
14 :35S :39E
Map ID:
23/14N
Zoning:
AG-1
Ownership and Mailing
Owner:
Address:
%DEP
Sales Information
Date Price
1/1/1900 0
PROPERTY RECORD CARD
<<Prev Next»
Spec.Assmnt Taxes
ParceliD:
2314-200-0000-000-4
Account #:
13843
Land Use:
STATE
City/Cnty:
ST. LUCIE COUNTY
Tr Int Imp Trust Fund Univ of FI-Agri Exper Station
3900 Commonwealth Blvd
Tallahassee FL 32399-3000
Code Deed Book/Page
Exemptions Permits Home Prim
Legal Description
14 35 39 NW 1/4-LESS S 251.20 FT OF NE 1/4 OF BE 1/4 OF NW 1/4 AND BE 1/4
OF SE 114 OF NW 114 OF SEC
More...
Assessment Final
Total Land and Building
2006 Val: 17281900
Land Value: 16411400 Acres: 356.77
Assessed: 17281900
Building Value: 870500
Ag.Credit: 0
Finished Area: 32706 SgFt
Exempt: 17281900
Taxable: 0
TotaiTax: 0
BUILDING INFORMATION
-Extarior Features
-
View:
-
RoofCover:
-
RoofStmct: -
ExtType:
LE+ - LE+
YearBlt:
1964
Frame: -
Grade:
E+ -E+
EfYrBlt:
1977
PrimeWall: -
StoryHght:
0010 - 1 Story
No.Units:
SecWall: -
nterior Features
3edRooms:
0
Electric:
-
PrmintWall: -
-ullBath:
0
HeatType:
-
AvgHUFI: STD
I/2Bath:
0
HeatFuel:
-
Prm.Flors: -
AA/C:
0
%Heated:
0
% Sprinkled: 0
Special Features
and Yard Items
Land Information
type Y/S
Qty. Units Qual.
Cond.
YrBIL No. Land Use
Type Measure Depth
1 8700-STATE
575 -Acres 356.77
THIS INFORMATION IS BELIEVED
TO BE CORRECT
AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED.
ttp://www.pasle.org/prc.asp?prolid=231420000000004 1/30/200
�E C
G
St. Lucie County
"
Building & Zoning
.'P10R104'
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
S+ . Lucie Cot IC4 will be using the following sub -contractors for the
(Company/Individual Name)
project located' at
(Street address or Property
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
&.LUCie CcurON
2—:t) iWCylnlp, A-4e—
�txF i�i�e, e Ini • 34982
Plumbing
HVAC/
Mechanical
Roofing
Gas
OFFICE USE ONLY:
PERMIT I I ISSUE DATE:
ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
��ORI�P
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida �C+ertification Number (If appt9cable):
LI i l jnY � - cpn mY ryl P-, have agreed to be the
E I ec yi Cal sub -contractor for &. I uo lC CCilnly
(Type of Trade) (Primary Contractor) I .
for the project located at s4co PC, f?,d �ci7��[{ ate. �(x�o• OOc�/g)
(Project Street 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
d
/i
7
SIGNA RE PRINT AME DAtE
Business ame:
Address:
City/State/Zip:
Phone:
OFFICE USE ONLY:
email:
0��e co
�y, St. Lucie.County Building & Zoning
"' y -� 2300 Virginia Avenue Ft. Pierce, FL 34982-5652
` '' Tel. 772-462-1553
'`�QR10
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 yourproperty, 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 $25,000. 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 ownerlbuilder exemption shall be reported by the
Community Development Director to the Florida State Department of Professional Regulation. Signed and
acknowledged on this day of , 20
STATE OF FLORIDA
COUNTY OF 3-�A L _G_P
The foregoing instrument was acknowledged before me this a day of �:0 , 208 3--9 by
Q�ahy , who is per onallq nown to me or who has produced
as ' ntifieation. -
SIGNATURE OF NOTARY
Title: Notary Public
6C4 r'6C11 r ti Ct'i7sell6
Type or Print Name of Notary
Commission Number
St. Lucie County Owner Builder Affidavit -Electrical Contracting
(Seal)
'"•"y'••
a:�• by
`
BARBARA A COUNSELLOR
MYCOMMISSION#DO436835
EXPIRES:June2,2009
.......
"%�,°(,h°.Q"�•
Bonded Tryn, Notary P&icunde,,Re,a
St. Lucie County
Building & Zoning Department
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 $25,000.00. 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. 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.
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. 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 related 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 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
day of of 20
Owner dder Si tur
STATE OF FLORID
COUNTY OF _S
he foregoing instrument was acknowledged before me t` oZ day of 20' by
KAY Wa 7 n t/ who is p sonally known t e or who has produced
as identification. /�
J661ADa c c Cv 4 mt . I I tN-
Signature of Notary Type or Print Name of Notary (Seal)
Title: Notary Public Commission Number
'^',�"fi, BARBARAA.COUNSELLOR
MY COMMISSION9DO435835
?`• `�= EXPIRES: June 2, 2009
B0d0dncu No1aryNbIICUr&mrhem
cOti
ST. LUCIE COUNTY
\JL�E
BUILDING & ZONING
2300 VlRGINLAAVENUE
e
FORT PIERCE, FL 34982-SM
<ORIOp'•
501.462-1553
FILLED LANDS AFFIDAVIT
1, the undersigned, am the owner of the following described property:
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 7.04.01(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. 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.
Property Owner Name
STATE OF FLORIDA. COUNTY OF _�-� I�
-ACKNOWLEDGED BEFORE ME THIS_-4;3_DAY OF f"C_T.l .20(�
BY PA4 0 )Qnl/ WHO �E OR WHO HAS PRODUCED
ASIDENTIFICATION.
SIGNATURE OF NOTARY
NOTARYPUBLIC TITLE
ey', A)a rz, Ccxj rv, I3�r
TYPE OR PRINT NAME OF NOTARY
(SEAL)
COMMISSION NUMBER
,PY. BARB ARAA.000NSELLOR
!'=
MY COMMISSION N OD 436835
y. o= EXPIRES: June2,20N
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