HomeMy WebLinkAboutSUBMITTED PAPERSAll • MUST BE COMPLETEE1,_,A• • BE ACCEPTED
,
•
Permit•' a
SCANNED
BY
St. Lucie County
In
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Building Permit Application
Planning and Development
Building and Code RegulationDivision
/I Virginia Avenue, Fort!•
• • • •2-1578 Commerc ial Residential
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Legal Description: h,2,1 YAY
Property • 'i I r 0i0 Lot No.
Site Plan. Name: Block No.
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Setbacks Front 35 Back: Right Side: 1& 1.5 Left Side: 15
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Total Sq. Ft of Construction: Sq. Ft. of First.Floor:
Cost Of • • +_Septic•
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If of • • • 1 or .re, a RECORDED Noticeof • • .
f
ER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I. certify that no work or installation has commenced prior. to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING 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,lender or an attorney before
commencing work or recording vour Notice of Commencement. IJ—
Signature of wner/,Wg& / Lessee
Sig License Holder
STATE OF FLORVA��'"pry:
STATE OF FLORID
COUNTY O
'''
COUNTY OF
by
y-
The fo oing instru gent was acknowledP� d befor
this day
The for ing instr nt was acknowledged befor
of . 2d by
o o
this day of 201Vby
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a
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�33CA
c
p�
�,u�i�
(Name of person acknowledging)
o
(Name of person acknowledging)
rn -a
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A
[O
Signature of btotary Public- State of Florida)
Signature of N44 Public- State of Florida )
Personally Known O d ced IdentificalJon
/
Personally Known O uced Ide tificatiorl
Type of Identification Produced
Type of Identification Produced
Commission No. (Seal)
Commission No. '(Seal)
'
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE.,' .
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW.:
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. //LU14
M/
1
ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
FORT PIERCE, FL.34982-5652
772-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
Y`12�-�oZ-d6�2-dam- �
(Tax ID/Legal description/ ddress
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.
le, �" le:�2 /21
2614� - -a*— azglc� - 61
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF n t
ACKNOWLEDGED BEFORE ME THISy� DAY OF CCU 0e& 20 ' t•
BY V?cyC k « V-PA I—'\ WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
SIGNATURE OF N TARY TYPE OR PRINT NAME OF NOTARY
(SEAL)
NOTARY PUBLIC TITLE COMMISSION NUMBER
O�PpV PUB('''
SHIRLEY A. SAUNIER
Notary Public State of Florida
My Comm. Expires Jan 31. 2017
p= Commission # EE 861169
���'':p, Bonded Through National Notary Assn.
_ .�-- a•�� 5 RceA0.
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e a •�. i � °f �'�^� i cE'S» �ID � � Yes d
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its
to s'
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tta6
ITT, LUCIE COUNTY
UUI RING EVIEVIIELII®N
FOR COO
I FL B
REVIEWED BY
DATE
PLANS AND PER IT
MUST BE KEPT ON JOB OR
NO INSPECTION WILL BE MADE
&c.k Pa f., o
�ERMI�ETR
�-'�
St Lucie County Inspei'. ins
2300 Virginia Avenue
Ft Pierce, FL 34982
(772) 462-2172
CERTIFICATE OY TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT # /Yl 0 _0-(QZ O JOB ADDRES
4f
PEST CONTROL CONTRACTOR7-%� 6�p'% O to
r
v 1' lOdJ � i� S Lr C/e_
PEST CONTROL -LICENSE #
We, the undersigned, hereby certify that we have 0retreated the above -described construction for
subterranean termites In accordance with the standards of the National Pest Control Association. `
� 0
Square feet of area treated: �� f Chemicals used: ��' '�
r
Percentage of solution:
Date of treatment: [ / `ye
1
Footing
Ur 1st Treatment
❑ Re -treat
4-Slab
I& 1st Treatment
❑ Re -treat
❑ Driveway
❑ 1st Treatment
❑ Re -treat
❑ Pools
❑ 1 st Treatment
❑ Re -treat
❑ Other
❑ 1st Treatment
❑ Re -treat
Total gallons used:
Time of 'Treatment:
FBC104.2.6 Certificate of Protective Treatment for prevention of tetvnites.
A weathar.reslstant fobsite posting board shall be provided to receive
duplicate. Treatment Certificates as each required protective treatment is
completed, providing a copy for the person the permit Is Issued to and
another copy for.' the building permit files. The Treatment Certificate shall
provide the product used, identity of the applicator, time and date of the
treatment, site location, area treated, chemical used, percent concentration
and number. 'of gallons used, to establish a verifiable record of protective
treatment.. Lf the soil chemical barrier method for termite prevention is used,
final exterior treatment shall be completed prior to final building approval.
St Lucie County requires for the final Inspection for CO, a Permanent
Sticker to• be placed on the electrical panel box cover, listing all the
treatments and dates of applications.
❑ Perimeter for Final Inspection
NOTE:
n
Signature o exterminator
There must be a completed form for each required treatment or re -treatment and this form must be on
the job site to be picked up by the inspector at time of each inspection or the scheduled lnspection will
Replied 6/I3192 dmg fail and a re -inspection fee charged.
745764
I
RECEIVED MER 05 IM
I RECEIVFO F" 05 TnTliP
1142 Water Tower Road, Lake Park, FL 33403
Phone (561) 848-9112 Fax (561) 844-7102
www.maschmeyer.com
10404
14-COD / GENERAL PROJECT-2014
-z
Remit t6' schmeyer Concrete Company of Florida
Drawer #1887, P.O. Box 5935
Troy, MI 48007-5935
CUSTOMER PHONE
CUSTOMER FAX
TEST - FAX
COD/ Jake Crouch
DATE 12/22/14 INVOICENO 303221
CUSTOMER NO 300 JOB NO
PAGE NUMBER 1 ORDER NO 158
USIMEPIN AbbRESS
PURCHASE ORDER NUMBER • _
1828 SW Buttonbush Circle ***WHITE C
DATE
QUANTITY
MATERIAL
PLANT
DELIVERED
TICKET
UNIT
TAXABLE
NON TAXABLE
SHIPPED
NUMBER
PRICE
EXTENSION
EXTENSION
.12/22
3.00
305 3000 PRPM
103
851894
$280.00
$840.00
12/22
1.00
SHORT LOAD 1
103
851894
$200.00
$200.00
12/22
1.00
ENVIRO ENVIRONMENTA
103
851894
$15.00
$15.00
12/22
1.00
FUEL SURCHAR
103
851894
$21.75
$21.75
PPY HOLID
YS FROM MASCHMEYER CONCREFE
!
Pre
ax Subtotal:
$1,076.75
TOTAL SALES TAX
TOTAL YARDS
1,141.36
. 00
structure must meet
Fninlimum setbacks
hil,4, SEMACK PEO.
SIDES
CNR SIDES
REAR-2)
ZNG.
777-77
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TERMITE TREATMENT REQUIRED
-SURVEYOMS-1 OFRTI-Ef'CA "
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