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Home My WebLink AboutSUBMITTED PAPERSOFFICE USE ONLY BP #: f / SECTION TOWNSHIP Ll RANGE D MAP NO. •J ZONING 1 -r p f�-�-�V/ LAND USE `M I LOT CVG % / TAZ NO. FLOOD ZONE FIRM MAP # Q 1Y r�l L5 c 1' FLR ELV MAX HOT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS I WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC ' LOT SPLIT LOT SPLIT Before 111990 After 111990 REQUIRED APPROVED REPORT HABITABLE RADON PERMIT CODE AREA FEE FEE D (RADON) LIBRARY _ PUBLIC BLD PUBIC BLD IMPACT IMPACT FEE IMPACT IMPACT T FEE CORRECTION FEE FEE GENERAL SCHOOL - ROAD IT Y N LAW ENF IMPACT IMPACT IMPACT FEE FEE FEE FIRE/EMS DRNEW _ Y N DRIVEWAY ADMINISTRATIVE IMPACT RE D FEE VARIANCE FEE FEE _ SPECIFY ME C _ ROOF NON -CONFORMING - MISCELLANEOUS SUBS CTRIC GAS LOT OF RECORD FEES REQUIRE PLUMBING _ FEES DATE SENT TO ADDRESSING: REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE rf RECEIVED DATE O UI3o� 5 tl COMPLETED INITIALS DATE FILED: PLAN REVIEW FEE: RECEIPT NO.: Oct CONCURRENCY FEE: RECEIPT NO.: PERMIT NUMBER: CERT. CAP. NO.: _ D O •635T, ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEP D e��G' CIS / lie St. Lucie Count Building and Zoning Y g g /CZro� �� i 2300 Virginia Avenue �F<OR119p FL Pierce, FL 34982-5652 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION SCANNED BY 1. LOCATION/SITE ADDRESS: 2-"10p A ,q, St. Lucie Co m f 2. PROTECT NAME"S oP Il SITE PLAN NAME: 3. PROPERTY TAX ID #: Igzs (pOCe w00 000 /O 4. LEGAL DESCRIPTION (attach extra sheets if necessary): (JCS-r1 &&Chef 5. PLAT BOOK 6. PAGE NO. _� 7. BLOCK NO. 8. LOT NO 9. PARCEL SIZE (ACRES/SQ FT.):a—q9 r OT DIMENSIONS: Sr -7,--� A Q2 10. COMPLETEStc� ESN OF F CONS TRUCtTIO PRO�O J� ✓Ge ACTIVITY: 11J L G� (LEFT 11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: SIDE: - 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ]COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: W9'Vy 2 14. FZT)NSTAUCT F �3 FT 1st FLOOR: VALUE / ¢j155.. QSF. lilt 16. OF CONSTRUCTION: $ �f ��S1�G.1 fad 6 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 OWNER INFORMATION NAME: 3b)'O" 60, --IrFif Q(O� cg��'"i0 ADDRESS: �DO /J A � A' / CITY: f 1 • P-lEi1 L STATE: ZIP: PHONE (DAYTIME): Email: IF THE FEE SBvIPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: PHONE (DAYTEvIE): ( ) STATE: M3 CONTRACTOR INFORMATION ST. of FL REG.CERT #: ( 6 C oC2o 2375 ST. LUCIE COUNTY CERT BUSINESS NAME: QUALIFIERS NAME: �'�' vJ-•-�lw w t t - CITY:46rto `c; JC — STATE: ZIP: . >7 c9 (O PHONE (DAYTIME): a_I� __?0`� (7,) FAXNO. � �� Email: 1Dqjr.7 Q�(ti�f@Ga/ITiI/�C'1L�i�E� C ARCHIT/ENGINEER: pE M C ADDRESS: .O �� I D ' 6A v t V� ".' CITY: \I (. a gitrY•i-c� — STATE: PHONE (DAYTIME)•. n ) S;TL (e 6% BONDING COMPANY: -3 ADDRESS: CITY: �\\ MORTGAGE LENDER:. 4v / ADDRESS: CITY: STATE: STATE: ZIP: 70 ZIP: E%IPORTANT 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, 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: PAB URE 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: ertify that all the foregoing information is accurate and that all work ill be one in compliance w th Il applicable laws regular ons zoning. ' OWNER OR CONT-R CTOR S GNATURE CONTR1''4,ACT.OR SIGNATURE STATE OF • o• , COUNTY OF' The foregoiin(gg instrument w, as�,acknowledged before me this o/ O day of ( fd 0 2009. by STATE OF FLOR COUNTY OF CL�, The foregoing instrument was acknowledged before me this �day of b,,, 20� by YJi 1f/ % !f) �i+� Q �/ %%— who is personally known or has produced S w�hho/is^personally known �r has produced 0/1tf-�'n. •�<D•D V,9Vl�iP•/e/a, as identification. �'/,1r,• IIJY •L / (1, as tdenti tcahon. � Signature oa.):== — �-- --- - - -- -- --- MISSION p-DD 633G` '-r OMMISSI NkDD 633047 EXPIRES: March 6, 201 t �' 'a• ,'y. EXPIRES: March 6, 2011 "'S,os11n,4,•`� 6mdedtlw NMy,, yubteUMemnters Bded Thm Notary pbk Unds,,*e NO TWO. 2 ,GHATUIFES 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. 00 ncm�' �OR10 ST. LUCIE COUNTY BUILDING & ZONING 23W %nRGINIAAVENUE FORT PIERCE, FL 34902.5652 4624653 FILLED LANDS AFFIDAVIT I, the undersigned, am the owner of the following described property: �� Sai�dsav►D�ea� C°o�galtn�utivi�u . �ssqa�«a v , lnz_, (Tax ID/Legal desuip0on/Address) 5G Z307Z 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. l 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. RfPk Property Owner Name Property STATE OF FLORIDA. COUNTY OF ' J 4 1. uC L Lei ACKNOPEDGED BEFORE ME THIS nZ Y * _DAY OF QLL BY IL/L , R P�Rn _ a)&MtHO IS PERSONALLY KNOWN TO ATURE OF NOTARY IDENTIFICATION. t/e-9la Date 2DjPj. WHO HAS PRODUCED 1CIM F 5 A. Q r' FX fiS TYPE OR PRINT NAME OF NOTARY (SEAL) NOTARY PUBLIC TITLE _ _ _ _ DSSO i COMMISSION NUMBER A a JAMESA.RE M y: .r WOOMMISSIONODD550709* EXP1RES: June 1, 2010 ''�P;j,h4` BwMe77touNdaryPuhlouad�"= AFTER RECORDmNG-RETURN TO: ' JOSEPH E. SM ;LERK OF THE CIRCUIT COURT SAINT LUCIE COON rY FILE # 3338034 04/27/2009 at 02:39 PM OR BOOK 3o83 PAGE V62 -1762 Doc Type: NC RECORDING: $10.00 PERMIT NUMBER: NOTICE OF COMMENCEMENT The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida statutes the following information is provided in the Notice of commencement. 1. DESCRIPTION OF PROPERTY (Legal description and street address) TAX FOLIO NUMBER: �Y'/✓ /�O�rP ��/O SUBDIVISION BLOCK TRACT LOT BLDG UNIT 2. GENERAL DESCRIPTION OF IMPROVEMENT: C : - flu" (I10-j( 1h m 3. OWNER INFORMATION: a. Nae.�QS�S 61� iker �� ®l`wo b. Address f.( .d 4-A if - a bf1, rc., 'i �� c. interest in property CALL d. Name and address of fee simple titleholder (if other than owner) 6N/A 4. CONTRACTOR'S NAME, ADDR S AND PHONE BER: C0,07176tt ,�-1ZOIC �j.1T- q2'I l8 � A�� sf� 0 5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT: A 6. LENDER'S NAME, ADDRESS AND PHONE NUMBER: 0/4 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (1)(a) 7., Florida Statutes: Q p, ,�, r �m,� '/,'�+ NAME, ADDRESS AND PHONE NUMBER: t li'u (� C• Y 1L� 1'I 11 42--1 (U� AdE . S� `JC1ou f L 8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in 713.13 (1)(b), Florida Statutes: NAME, ADDRESS AND 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) , ,20. WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT el -cWb --�, (-�- f%,,� ` Pa 1, 1 o ,,<m 7— Signature of O ne or Print Name and Provide Signatory's Title/Offrce Owner's Author d Oflicer/Director/Partner/Manager State of Florida County of 5'T•G.vot tS, The foregoing instrument was acknowledged before me this day of R � A t By R, f-4Pv'< lss ,as p(�'l?-slC1(1EA= (Name of person) (Type of authority... e.g. Owner, officer, trustee, attorney in fact) --- - �// (Name of party on behalf of whom instrument was executed) Personally Known= or produ d thefollowinetvueof ID: &�:'::%iy ,= JAMESAREEVES r MY COMMISSION 8 DD 550709 (� =y. °•: EXPIRES: June 1, 2010 eamem�anmanP�umamma� (Printed Name of Notary Public) ( gnamre of Notary Public) I Seait, Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are true to the best of my knowledge and belief (section 92.525, Florida Statutes). S gnature(s) r(s) r Owner(s)' Authorized Officer/Director/Partner/Manager who signed above: By: By Rev. os/30WW(RmoNing) Tuesday, Apr 28, 2009 02:03 PM