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HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE ONLY: ry DATE FILED: / PLAN REVIEW FEE: RECEIPT NO.: CONCURRENCY FEE: RECEIPT NO.: PERMIT NUMBER CERT. CAP. NO.: 1 JW.©05 j ALL INFO MUST BE COMPLETE & FIPLED IN TO BE ACCEPTED p p t(ti•&. qJV1 C14P2-/ M _ J = _ _ PLANNING & DEVELOPMENT SERVICES DEPARTMENT 0 BUILDING & CODE REGULATIONS DIVISION r 2300 Virginia Avenue — Fl. Pierce, FL34982-5652 SCANNED 772A62-1553 BY St. Lucie County APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE I. LOCATION/SITE ADDRESS: 2. PROJECT NAME: SurgSt ical 3. PROPERTY TAX ID #: S� PROJECT INFORMATION SITE PLAN NAME: 4. LEGAL DESCRIPTION (attach extra sheets if necessary): " ry' — H- 1. locate din Sectionl5 Township36 South Range 4 as t. ucie in Pla+ Rnnb �,Dage $1—of the Public Eecords of St �ncie rauntT 5. PLAT BOOK 1 6. PAGE NO. 41 7. BLOCK NO. 4 within 8. LOT NO. 9 9. PARCEL SIZE (ACRES/SQ FT.): 2.46 Acres LOTDIMENSIONS: 232.16030.00x232.06030.00 to. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: /9 iNS'VW.'i�at1 aEto K 3421 11. SETBACKS (ACTUAL) FRONT: 97.29 BACK: 32.85 RIGHT SIDE: 44.33 LEFT SIDE: 193.00 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [X] NEW CONSTRUCTION [ ] EXPANSION/ADDITION (] INTERIOR RENOVATION [ ] RESIDENTIAL [X] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: 14. - SQ. FT OF CONSTRUCTION: w D•VV 16. VALUE OF CONSTRUCT[ - IS. SF. FT Ist FLOOR: - _ - - - - - - - . - r - - - - - 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 S2500 or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 UPDATED 625109 OWNER INFORMATION NAME: Surgical Specialties of St Lucie County. LLC ADDRESS: 4632 South 25th Street CITY: Fort Pierce STATE: Florida ZIp; 34981 PHONE (DAYTIME): (772) 464-9595 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: Same ADDRESS: CITY.. STATE: PHONE (DAYTIME): (� CONTRACTOR INFORMATION ZIP: ST. of FL REG.CERT #: CGC 019761 ST. LUCIE COUNTY CERT #: o? IQSI, BUSBJESSNAME: J. MCLauchlin & Company QUALIFIERSNAME: Ben G. MCLauchlin ADDRESS: 3019 SW 27th Avenue, Suite 102 CITY: Ocala STATE: Florida ZIP: 34471 PHONE (DAYTIME): 3( 52) 873-3900 FAX NO.(352)873-0755 Email:dblowers@mclauchlin.com can blowers ARCHIT/ENGINEER: Gordon & Associates ADDRESS: 3787 Lake Center Drive CITY: Mount Dora STATE: Florida ZIP: 32757 PHONE (DAYTIME): ( 21 383-6505 BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: STATE: ZIP; 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. J ` Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 r Permit 1 Addres4M-*; Owners) rLoto 34952JrisdictionParcelSID Block 9 FLUG Flood Maf 28OF Flood Elevation Flood Zone X Application Type I Master Permit w/subs Status Issued 1009-0139 Activity Type INew Expiration 09128/2011 Other - Specify 616 Permit Type Building Commercial Date Applied 09/14/2010 Taken By humphreya Location Mainland' Date Issued Ot/2812011 Issued By angela lat Fee Valuation Date Finaled Posted By Date Voided Please explain in Additional Comme Job Address 16SM,q lf.S:1, CONTACT•• Category Type Contractor Property Owner Name Property Owner Contractor Business Address Email Sub -Trade Permit Permit Type 1009-0139-01 _ Contractor 1009-0139-01 EP Company 1009-0139-02 PP 1009-0139-03 MEC Conlin, Owner / Buildier Electrical 23220 1 POMEROY STEPHENC POMEROY ELECTRIC INC (954) 427-0705 Sub -Trade Job Description �� Total Sq. Ft. C - —` --FCC- 32 Setbacks Job Description Additional Info txpirauun 09/28/2011 Open Contractor . Registration Phone (772) 464-9595 ext Fax ( ) - Mobile ( ) Pager ( ) jb Trade Status Taken By Date Applied Issued Issued By Finaled Finaled By Issued humphreya 09/14/2010 01/28/2011 angela Floors � Buildings # Bedrooms L�� -# Bathrooms " Min Flood Elevation Flood Map 280E Flood Zone 1- Office/Bank/Professional_ NOC Required N NOC Receivec N NOC Expiration 01/28/2012 Front 58.00 Back 32.85 7 Left Side 193.00 Right Side 44.33 - -- - l VEW CONSTRUCTION OF AN OUTPATIENT -SURGERY CENTER & ASSOCIATED SITE IMPROVEMENTS 9138 SO FT) Please include the date and your name when adding information. -n Property Appraiser - St.Lucie G-- ity, FL Page 1 of 1 PROPERTY RECORD CARD Surgical Specialists Real Estate Holdings «Prev Next» S ec.Assmnt Taxes Exemptions Permits Home Print p p LLC Record:1 oft Property Identification V11CIE0 . sr�} Site Address: 6830 S US HWY 1 Sec/Town/Range: 15:36S:40E ParcellD: 3415-800-0003-000-0 ya�Gy.,jf3,; Account#: 175206 2 Vac Com Cond }?� Map ID: 34/15S Zoning: CG Land Use: City/Cnty: St Lucie County y i Y v, Ownership and Mailing Legal Description Owner: Surgical Specialists Real Estate Holdings DEEJ COMMERCE CENTER (OR 2950-2762) UNIT 3 (OR 3148-1023) ^-+ LLC .• �_~ Address: 4632 S 25th St r. y Fort Pierce FL 34981 v Sales Information Assessment 2010 Final Total Land and Building Date Price Code Deed Book/Page 2010 Final: 351100 Land Value: 351100 Acres: 1.61 10/2/2009 440000 0001 WD 3148 / 1023 Assessed: 351100 Building Value: 0 "r:.. Ag.Credib 0 Finished Area: 0 SgFt Exempt: :i�•:`l. Taxable: Taxes: 7297.35 qyy BUILDING INFORMATION Y..> s,. No Sketch No Image h4i. f 4,7: Available Available Exterior Features View: - RoofCover: - RoofStruct: - ExtType: - YearBlt: Frame: - Grade: - EffYrBit: PrimeWall: - StoryHght: - No.Units: SecWall: - Interior Features BedRooms: 0 Electric: - PrmintWall: - FullBath: 0 HeatType: - AvgHt/FI: 1/2Bath: 0 HeatFuel: - Prm.Flors: - %A/C: 0 %Heated: 0 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qual. Cond. YrBlt. No. Land Use Type Measure Depth 1 1004-Vac Com Cond XI-Sq Feet 70219? 4 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. http://www.paslc.org/i)rc.asp?prclid=341580000030000 4/7/2011 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. 1 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 [hat may restrict or prohibit such structure. Please consul[ 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 FLORIDA COUNTY OF Marion The foregoing instrument was acknowledged before me Ihis�'day of_2Q 2010 by Ben G. McLauchlin xl1� CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF Marion The foregoing instrument was acknowledged before me IhisX�day of is 20 10 by Ben G. McLauchlin Who is personally known V or has produced who is personally known r/ or has produced as idenlification• _ as identification. SlgnaI Wr e_of Nol= A_ _ &gnature of No Commissio==Mrl DUKE$ x•', C.KDUID;S- Co to COMMISSION t100[0 UB eal) SION ®00553539 ="° a F�(PIRE : a 2073 Fehruary 13, 2013 A• ',> BOddOdlldn NatarlCUIWtlMTIaR tary PubllcUrlderm" 'I„p�n.° NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNERIBUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF TH IS APPLICATION. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALLOWNER/BUILDER APPLICANTS. For specific instructions see appropriate permit checklist. o cRUSEON _ � r._.� : l� cos. SONHIP RANGEMAPNO.ZONINGSE LOTCVG% TAZNO. FLOODZONEAP# ISTFLRELV CONST TYPETYPE MAX 0 # OP FLRS WATER SEWER SPRINKLES STORMWATER LOT OF REC Before 111990 OF REC After 111990 LOT SPLIT REQUIRED LOT SPLIT APPROVED REPORT CODE HABITABLE AREA RADON FEE LIBRARY IMPACf FEE PUBLICBLD IMPACT FEE CORRECTION PUBICBLD BRACT FEE GQIERAL PARKS — BRACT FEE SCHOOL INPAC.T FEE FRUNEMS IMPACT FEE ROAD IMPACT FEE DRIVEWAY REQUIRED Y N CREDIT DRIVEWAY FEE Y N LAWENF IMPACT FEE ADMINISTRATIVE VARIANCEFEE SPECIFY SUBS REQUMM MECHANIC_ ROOF _ ELECTRIC GAS PLUMBING _ NON -CONFORMING IATOFRECORD FEES MISCELLANEOUS FEES DATE SENT TO ADDRESSING - REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEATURTIE REVIEW MANGROVE REVIEW DATE NIDLETED—I F A. M. ENGINEERING AND TESTING, INC. N.W. MERCANTILE PLACE PORT ST. LDCIE, FLORIDA 34986 OFFICE: (772) 924-3575 FAX: (772) 924-3580 /00 � - 61V DENSITY OF SOIL IN PLACE Client: Demorest Construction Group, Inc. Report Date: May 3, 2011 800 SE Indian Street Project No.: PSL2511 F Stuart, Florida 34997 Lab No.: 2 Contractor: Client Technician: R. Ankrom Site: Virginia Avenue Medical Office, Virginia Ave. & 38th Street Page No.: 1 of 1 Fort Pierce, St. Lucie County, Florida Footings Field Test Results Proctor Compaction Eleva- Test Date Location tion Dry Probe Dry In Min Pass/ No. Tested (it) HCP H2O Density Depth Density Place Req'd Fail % (c (in) (et) % %) 1 4/28/11 5' South of Northwest Comer 0-1 60+ 6.4 103.1 . 12 105.0 98.2 95 P 2 "" 1-2 55 95+ 95 P 3 "" 2-3 50 95+ 95 P 3-4 50 95+ 95 P Remarks: • Elevations are below bottom of footing. • Field density tests were performed in general compliance with ASTM D 6938, Density of Soil in Place by Nuclear Methods. • Hand Cone Penetrometer (HCP) tests, in conjunction with information about the soil type, are empirically correlated to the relative density of the subsurface soils. • Laboratory Proctor maximum dry density was determined in accordance with ASTM D1557. Distribution: Client - 2 PCM/ah - - Reviewed by: A. M. ENGINEERING AND TESTING, INC. Paul C. Martin, P.E. Florida Registration No. 65051 MAY 0 9 2011 Publts; ':'srEa St. Lucie C::,,,--n -I Merver-amelcompanylAM Data0emorest Construction Group - Virginia Ave. Medical Office, Virginia Ave. & 38th St., Fart Pierce - PSL251IlFoundationl2 - Footings - Den.