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HomeMy WebLinkAboutSUBMITTED PAPERSt OFFICE _.USE. ON Y: _ DATE FILED.Aq g PLAN REVIEW EE: I RECEIPT NO.: PERMIT NUMBER: CONCURRENCY FEE: RECEIPT NO.: CERT. CAP, NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue s Ft. Pierce, FL 34982-5652 C 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE ®f CAPACITY/ZONING COMPLL&NCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: 9 13 3 c22�h, /Dh 4QaZ ZZ /liter fL 3 y S 2. PROJECT NAME: /'�/h. �ts�Gf/�H 5C SITE PLAN NAME:/ 3. PROPERTY TAX ID #: 13.3 9- 1i31 " d d0 3 - d0e9/ 9 ,, 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 3 y 3 y S 7 '�i'b++, /�/E a/' / S lX O/ 9. PARCEL SIZE (ACRES/SQ FT.): 0 / ,7,gW, LOT DIMENSIONS: 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: 11. SETBACKS (ACTUAL) FRONT:- BACK: ---I RIGHT SIDE: LEFT 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: 1< ���1 14. SQ, FT OF CONSTRUCTION: 15. SR FT 1 st FLOOR: Z 16, VALUE OF CONSTRUCTION: $ 7ODO �v 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. SLCCIDV Form No.: 001-02 UPDKfED 6/25/09 a V{ NAME: ADDRESS: CITY: /-- < /"i erot . STATE: ZIP: 3 y915-I PHONE (DAYTIME): CM ,2 /6 - / 3 a? 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: sa','e 05 o 60le ADDRESS: CITY: STATE: PHONE (DAYTIME): L� ZIP: CONTRACTOR UNEFORMATION , ST. of FL REG.CERT #: C �� ^ /57? 9,2-�- ST. LUC_I/E COUNTY CERT #: BUSINESS NAME: i^� a •� /T t A osa S. QUALIFIERS NAME: ADDRESS: z La., e CITY: lC, r' ��� STATE: ZIP: PHONE (DAYTIME): (M z /6 - A 3 O ? FAX NO. 7;U - y66- 317S-Email: ARCHIT/ENGINEER: If do�' �N4rGY Wtc-4. ADDRESS: ,506 Cl4tve[^° CITY: Ila � STATE: /��- ZIP: yIS� PHONE (DAYTIME): (7A BONDING COMPANY: done ADDRESS: CITY: STATE: -------- ZIP: MORTGAGE LENDER- lion! e 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. { i i 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 taws 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. or OWNER OR CONTRACTOR SIGNATURE STATE OF FLORID QQ COUNTY OF D ,1 U_ The foregoing instrument was acknowledged before me this day o -1 D- 20 I byZ>t'IW, Sin is personally known or has produced 2.5 O to l 2 100 O as identification. Signature of Notary SIGNATURE STATE OF FLORID —A. COUNTY OF The foregoing instrument was acknowledged before me this AR —day of 2013, by JWa4L who is personally known or has produced T CK../ 41o as identification. Signature of Notary Commission No. (Seal) ,,`" IRVIE E SAUJoMorlda 2�ti,RY PUB(C� i Notary Public - StMy Comm. ExpiresP % IRVIE E SAUNDERS Ya� •NOTE: AIQ+d1Si4RE.EACH SIGNAT 2�G FOR TIqRBUILDER, THE O - O SIGN T IS A L C O STED ON THE FRO ( Af�4ilal Notuy Assn. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR For specific inptructions see appropriate permit checklist, } OFFICE USE ONLY SECTION TOWNSHIP RANGE ZONING LAND USE -TVC_ LOT CVG % FLOOD ZONE FIRM MAP # I.ST FLR ELV CONST TYPE OCCUP TYPE MAX OCCUP WATER SEWER SPRINKLERS LOT OFREC Before 1/1990 LOT OF REC After 1/1990 LOT SPLIT REQUIRED MAP NO. TAZ NO. MAX HGT # OF FLRS STORMWATER LOT SPLIT APPROVED REPORT HABITABLE RADON PERMIT CODE AREA FEE FEE (RADON) LIBRARY PUBLIC BLD PUBIC BLD PARKS IMPACT MPACT IMPACT FEE IMP IMPACT [FEE CORRECTION EE FEE GENERAL ,:SCHOOLC CREDIT Y N LAW ENF 'IMPACT IMPACT IMPACT FEE FEE FEE FIRE/EMS DRIVEWAY N DRIVEWAY ADMINISTRATIVE "ACT REQUIRED . FEE VARIANCE FEE FEE SPECIFY SUBS. MECHANIC ROOF ELECTRIC I GAS NON -CONFORMING LOT OF RECORD MISCELLANEOUS FEES REQUIRED PLUMBING FEES DATE SENT TO ADDRESSING: REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE CO RFVIEW REVIEW REVIEW RE REVIEW REVIEW DATE RECEIVED �bl I T)ATR e ZZC C_ M G x Plant: Begin Loading: I To Job---T Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: Customer Code: Customer Name: ,=,,o F:i 14 mA'1 !-iEt.el 00EMt'if..'L_ t:llN j- - f•.hr ;NC Project Code: Project Name: Ticket Date: Delivery Address: Delivery Instructions: Customer Job Number: Project P.O. Number: Order Code / Date: Order P.O. Number: Map Page: Map/Row/Column: Dispatcher: Ticket Number: Due On Job: Slump: Truck Number: Driver Number: Driver Name: End Use: tl� uC_!j v.)e '_1v <' A'.,�5�"L+. I..l ,_t �l Gl LI-)..l f..:. 1-K i'1•[r I WIiIi LOAD CUMULATIVE ORDERED QUANTITY QUANTITY QUANTITY MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT a r _I ,BEE c: _:i= , 1 9 EN') Cash Check # /Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect Without Standby Charges: Check Charge Comments: WATER ADDED: V ' GAL YARDS IN DRUM: WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: q / f7 SIGNATURE i t{ ! ❑ LOAD WAS TESTED BY: Notice: Our drivers will make every effort to place materials where the cus oCeridesignates, but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job, concrete strength Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material terms of sale and delivery. and accepts concrete as is. Due to imp�ytant factors yhich are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for important control after delivery, this Company will not accept any responsibiliMor the finished results. No credit for safety handling information, and to the mate" al,safety data sheets far additional information. returned concrete. Buyers exceptions and claims shall be deerped waived unless made to us in writing AUTHORIZED SIGNATURE /q within one business day after the receipt of materials. / O , 1/ 68UNIVERSAL-F�r'I,) '('y;��.>�.'�ltl'fJ INVOICE This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's ,Standard Terms and Conditions, Seller's Quotatio any, and Seller's Order Confirmation (fir ing limitations of warranties), as if fully set forth on this Delivery Ticket ("Agree `). Seller will provide the Standard Terry _ d Conditions upon request. Buyer agrees that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to pay in accordance with the Agreement. /i�il�!'l�t� �lh`'�� � DlLlle�llTtf �L�';I�LKilll[�l a 31f r �'ii :t�lIlil�.�+1/ Fib 1! I Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. Cement products 'include Portland cement, masonry, pozzolan (Type iP), roof tile, and stucco. Concrete products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin'and eye burns and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cutting.and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of arnmo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or burns of the nose, throat and lungs. See physician. Health risk depends on duration and level of exposure. Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection. First Aid: In case of eye contact, immediately flush eyes with flowing water for 1.5 mi rt►tes. If dust is inhaled, move to fresh air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists. CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combined Houston. Texas 77024 02/12 For more information please visit www.cerrrexusa.com. Este ticket de entrega incluye corn referencia at comprador (ya previamente ejecutada en su aplicaci6n de credito); cualquier —=ter-mino estandar,'condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveera los terminos estandares y condiciones detal- lados en caso de asf ser requeridos. Con este documento, el comprador acepta los ,mismos ya antes mencionados y que las cantidades y materiales fueron entregados como se expresa en el mismo. Acepta pagan el monto de acuerdo al contacto; a] menos que se identi- fique con una nota at frente de este documento. AGREGADOS / CEMENTG / PRODUCTOS DE CGNCRETO / CENIZAS VOLANTES -Los productos de agregados son. materiales naturaley como piedra caliza, dolomita, granito, coca volcanica, arena. Brava y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito, rocs volcanica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la coal puede contener ma's de 0.025% de silicio cristalino. Peligros: Mezela de cemento fresco y/o cenizas volantes pueden cat►sar irritaci6n en los Ojos, quemaduras en piel y ojos, y reacciones alergicas en la piel. Concreto seco y polvo de agregados, pueden causar irritacidn en los ojos, piel y/o en ]a zona respirato.ria. Polvo del manejo en el trituramiento, pulido, corte y/o perforaci;6n puede contener materiales silicon, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse en temperatura calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco. Seguridad: La humedad puede causar la hberaci6n del amoniaco. La inhalacion del amoniaco puede causar toser, irritaci6n o quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente at medico. El riesgo en la salud depende en la duraci6n y et nivel de la exposici6n. Seguridad: Evite el contacto corgi ojos y contacto prolongado con ]a pi.el. Use guantes, proteccion en los ojos y ropa Primeros adecuada para proteccion. Lavese las mans con jab6n suave y agua despues del manejo de materiales. Evite inhalar auxilios• polvos. Si se expone a polvos mas de los limites recomendados, use proteccion respiratoria. Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la parte afectada por 1.5 trinutos. Si se inhala polvo, exp6ngase a afire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fondo con agua. Acuda a atenci6n medica inmediatamente si la irritaci6n continua. CEMEX. Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combinado Houston, Texas 77024 02/1.2 Para mds informacion visita www.ce PLANNING & DEVELOPMENT SERVICES DIVISION BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Ave Fort Pierce, FL 34982 BUILDING PERMIT SUB -CONTRACTOR SUMMARY �/YQG• G/j6 3`A G.ess! JAC will be using the following sub -contractors for the (Company/Individual Name) ,,� q project located at oZZ 3.3 �a,4 fr ie� /t � /&w- /2 L3%/.Sl (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 4:�� Plumbing HVAC/ Mechanical Roofing Gas OFFICE USE ONLY: PERMIT I 'L `©1 _ (DO W ISSUE DATE: NUMBER: " 1 PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division - - - BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: 9 3V State of Florida Certification Number (If applicable): Gr Al Lv�.e c have agreed to be the (Company Name/Individual Name) Sub -contractor for &j W4 415-e- 14 �e s (Type of Trade) (Primary Contractor) for the project located at 02/3U 1,1:11,/5L 3y9s/ (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 filing a Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: City/State/Zip: cj�GC —L el r _ Phone: email: fe-5 17--1 l� I �3 SIGNATURE PRINT NAME DATE STATE OF FLORIDA, COUNTY OF F Lac c,2 THE FOREGOING OO 1R/�EGOIN` G INSTRUMENT WAS SIGNED BEFORE ME THIS 1_1+ DAY OF _�m � Ge6e , 20 BY _l �►' t Gtr 1 e S L W-e - WHO IS ONALLY KN N OR HAS PRODUCED SIGNATURE OF NOTARY PUBLIC SLCPDS: 12/16/2013 AS IDENTIFICATION. PRINT NAME OF NOTARY PUBLIC 201*30,ANIF" A R HELSETN * MY COMMISSION A EE 200139 * EXPIRES: September 21, 2016 �r\oe SoMedTluuBudpelNotarySeMw PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 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, (Parcel Id#/Legal description/Address) 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 I jjcie Coti-ty Land Development Code, 1 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. Propertf Owner Name (Please Print) X-011 Owner Signature Date STATE OF FLORIDA, COUNTY OFF r e ACKNOWLEDGED BEFORE ME THIS _ DAY OF _/t�GeN'L �' .20 L.3' BY l �►'�l CrQ nn WH IS PERSONALLY KNO ME OR WHO HAS PRODUCED AS IDENTIFICATION. SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY 6� Zao13 f COMMISSION NUMBER SLCPDSD Revised 08/24/2010 ANGEJ.A P. HEMM # * MY CO MSS)ON # EE 200139 EXPIRES: September 21, 20% &WedTW8udgatNotarySe*ft r, Permit No. NOTICE OF COMMENCEMENT Tax Folio No N State of Florida County of St. Lucie The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 4 Al Vk General description of improvement: /Fe',6vi�l! q'¢rr., w•.�lr o�/�osrJ C.nr/� Owner informs ion o Lessee information if the Lessee contracted for the improvement: - Nan Address 7.133 a ,$"' Interest in property: Name and address of fee simple titleholder (if different from Owir listed above): �tw 5—erS' 4' 79ep S< Contractor's Name: Contractor Address: Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $ Name and address: Phone Number: 71oG aZ/b — number: Lender Name: i?6►/l P Phone Number: Lender's address: Persons within the State of Florida designated by Owner upon whom notices or other docu ., Florida Statutes: Name: `!oh a Phone Number: A4,iracc- In addition to himself or herself, Owner designates of Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number of person or entity designated by owner: D O U ca a � �� LL °O o O U � N U ~ N N Two N 0izve6 N�co�4n UL0u'O LLI cn i=°12,0 a p�[=.acu -�0U_Oo_ to receive a copy of the Expiration date of notice of commencement: (the expiration date -may not be before the completion of construction and final payment to the contractor, but will be 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENTARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. I Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowledge and belief. (Signature of Owneror Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manager (Signatory's Title/Office) The foregoing instrument was acknowledged before me this � —day of , 2013 By r' rlww- as /OCCA/1 Q111— for N me of Person Type of authority (e.g.office r,trustee) Party on behalf of whom instrument was executied ��p'`% Personally known_Yor produced Identification (Signa�ota�ryPublic- State of Florida) (Print, Type, or Stamp Commissioned Name of Notary Public) Type of Identification produced W ft ANGELA FL HUM * * MY COMMISSION t EE 200139 s EXPIRES: September 21, 2016 l ,V OF FILO*'p Bonded Thm budget Notary sr4cea Property Appraiser - St.Lude County, FL r 12/17/13 5:45 PM PROPERTY RECORD CARD Tyler Crum Record: I oft <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification Site Address: 2133 JOHNSTON RD ParcelID: 1334-431-0003-000 4- Sec/Town/Range: 34 :34S :39E Account #: 5591 :c N-fap ID: 13/34S Use Type: SF Res Zoning: AG-1 City/Cnty: Saint Lucie County Ownership and Malling Legal Description Owner: Tyler Crum 34 34 39 FROM NE COR OF S 1/2 OFN 1/2 OF SW 1/4 OF SE 1/4 RUN WLY 40 Address: 2133 Johnston Rd FT TO POB, TH CONT WLY 281FT, T Fort Pierce FL 349514102 More... Sales Information Assessment 2013 Total Land and Building Date Price Code Deed Book/Page 2013 Final: 83700 Land Value: 17500 Acres: 0.97 5/1/2013 90000 0112 SP 3517 / 1345 Assessed: 83700 Building Value: 66200 3/20/2013 100 0112 CT 3498 / 0617 Ag.Credit: 0 Finished Area: 2064 SgFt 11/15/2005 209900 00 WD 2422 / 0592 Exempt: 12/18/1997 100 01 QC 1116 / 1696 Taxable: 4/22/1997 40100 01 TD 1072/ 1815 Taxes: 1695.1 0. c+� BUILDING INFORMATION Exterior Features View: - RoofCover: FS - Fibrglss Shg RoofStruct GA - Gable ExtType: HC- - HC- YearBlt: 1970 Frame: - Grade: C- - C- EffYrBlt: 1970 PrimeWall: BP - Cone Block StoryHght: 0010 - 1 Story No.Units: 1 Sec%ll: - Interior Features BedRooms: 3 Electric: MX - MAXIMUM PrmIntWall: DW - Drywall FullBath: 2 HeatType: FHA-FrcdHotAir AvgHt/FI: 1/2Bath: 0 HeatFuel: ELEC - Electric Prm.Flors: CU - Carpet %A/C: 100 %Heated: 100 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qual. Cond. Y rBlt. No. Use Type Type Measure Depth SNVAV - RES POOL AVG Y 1 450 AV AV 1980 1 0100-SF Res 200 -Acres 0.97 PA01 - POOL DK-AVG Y 1 522 AV AV 1980 ENC2 - POOL ENC-AVG Y 1 W2 AV AV 1980 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?prclid=133443100030004 Page 1 of 1 12/17/13 5:45 PM Detdi15Paresl Ili. 1.3,113-431-00013-000-4 Card Vutninr. 1 Account ------------------------ 42 '21 () (04) (40) C.d. Am Perimeter Description APSA - Alu®nitm Patio 288 82 (Semen) Avenge BAS- BASE 1848 204 AREA BAS- BASE 216 60 AREA t4VSE- Scrm E.cl— for Sketch 972 144 Only (vahndin SFYD OPAA- OP- Porch 64 40 Atached Avenge OPAA - open Porch 48 32 Attached Avenge Utility Rcom 120 44 Attached Average http://www•paslc.org/paslc/basearea.asp?sketch=\5000\591001.jpg&account=5591&card=l&parcel=1334-431-0003-000-4 Page 1 of 1 PLANNING 2 DEVE.;LOPMENT SERVWES DEPARTMENT ReslldentW / C6mmerelnl Building Ormit Checklist 1..-AITE* 'LOCATION] .:..T.E.C.H441aA Other: Health Department Permit Paperwork .......................... ........................... yes No N/A CD for Fire Departz . nent,if Commercial or Multi Family ............................. Yes E:1 No OLN/A DEPI, SFWMD or Army Corp of Engineers ............................................ ED Yes E3 No It N/A -Pool Barrier Affidavit ........................................................................ M Yes F .1 NoN/A Ground Sign- Landscape Affidavit ..................................................... yes ED No ON/A Bum Rate- for Sign Cabinets ............................................................... -yes No. N/A RV and Mobile Koine Tie-D_qwn OUh_(2 Copies Permit Workshe6t (Tie=Douw Diagram) ................. .............. .................. Yes -.El No [E N/A T X'T I lViLanulat,14U Vx VL�%Jp LL .......................................... I- I A 14-10 1 .:I L'I V Vkj _L-i1A--% Manufacturer Blocking Documents .......................................................... M Yes..M No N/A Signed Penetrometer Test (I copy ) ............. r .......................................... Yes 0 No N/A Stair Details ...... yes N/A ................................................................................ Mobile Home Inspection Report for Relocation ........................................ Yes -No N/A Copy of. Title .for Relocation .............................................................. Yes No NIA 'Class. 'W' Approval from Growth Management ....................................... 0 Yes E3 No rVi N/A Name (Printed) Page 2 of 2 signature Date Permit Checklist Resid6tgal/(ffommerdal Bu d s Y 0 ATION I�MIY. idUBdlE 'dEcO-0I� General: Application completely filled out with Notarized Signatures ........................ yes ❑ No ❑ N/A Sub Summary list with contractors' names & county & state certification numbers.. nA Yes ❑ No ❑ N/A Sub Agreements with Original Signatures ................. :............................. ( Yes ❑ No ❑ N/A Owner / Builder Affidavit ................................... Yes El No WN/A [ ( Owner /Builder Electric Affidavit ......................................................... Yes ❑ No ❑ N/A .. . Filled Land Affidavit ........................................... VYes ❑ No . ❑ N/A GEO or Recorded Warranty Deed ❑ Yes N® �'N/1� Recorded Notice of Commencement .................. :................ • .......... .. , ...._ (j Yes ❑ No El N/A Utility Agreement or Payment Receipt ........................................... ❑ Yes ❑ No [H-' N/A :..:..... ❑-Yes No N/A Vegetation Removal Permit ..:.................................................... ., Non Conforming Lot of Record ............................................... ............ ❑ �'es ❑ No EVrN/A P➢aiasa Calcaalafli®ns & Attachffiemts (3 copies commercial 2 copies �esade�a�d) Complete set of plans with Engineer / Architect Raised Seal..................... ]Y es No /A ❑N Truss Plans Reviewed and Approved by Engineer / Architect ....................... ❑ Yes ❑ No N [ /A Landscaping and Parking Plans ...................................... [] Yes ❑ No NIA. .........:.........:.::.::................:..... ❑ Ye Three (3) copies of Approved Site Plans s ❑ NoUn N/A Two (2) Sealed Surveys or Plot Plans with Dimensions, Finished Floor ........ ❑ Yes ❑ No N/A- _ ❑ Yes ❑ No [ NIA_ Elevation and Setbacks ................................................. . ............ Health Department Approval� on Stamped and Floor Plan ................ ❑ Yes ❑ No NIA Survey Health Department Food Establishment Permit Stamp on Floor Plan ............ ❑ Yes ❑ No ( N/A Manual ' ' or Manual `W' Calculations ................................................ ❑ Yes ❑ No [ N/A Signed Energy Calculations ...............•••••••••••-••••-••••••••••••• ............ ❑ Yes ❑ No' N/A Sealed Wind Load Compliance Certification ........................................... ❑ Yes ® No ( N/A Product Review Affidavit................................................................... ❑Yes ❑ No N/A Page 1 of 2