HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE'ONLY:
DATE FILED:
PLAN REVIEW FEE:
CONCURRENCY FEE:
1.
2.
3.
4,
4
RECEIPT NO.:
RECEIPT NO.:
PERMIT NUMBER:
CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Avenue SCANNED
Ft. Pierce, FL 34982-5652 BY
772-462-1553 St. Lucie County
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
LOCATION/SITE ADDRESS: RIb!i Dade- 14 i7` I/ l fQrT e
PROJECT NAME: %4 V/G i SSITE PL ,NAME:
PROPERTY TAX ID #:19
'�
LEGAL I
Of 5W
PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO.
9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: :3;Y1 -7
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:11-901MA1 V"I r P�t�
sid e wa ! lL 6 jre6L 119,e!q --%oo m FrbePxa,t acre&
a4 (0•-(0113-q , ( 2-? It )s 3*5
11. SETBACKS (ACTUAL) FRONT: / YO .P' BACK: ,2DO.9'RIGHT SIDE: a 9", LEFT SIDE:
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
NEW CONSTRUCTION [K_ EXPANSION/ADDITION [ ] INTERIOR RENOVATION
RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: 51 L eyja C�-(t e nt cy 't"d Poo rea
r
14. SQ. FT OF CONSTRUCTION: 35:� 15. SF. FT 1st FLOOR:
16. VALUE OF CONSTRUCTION: $ z)3 0 4�
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
UPDATED 6/25/09
OWNER ONFORMATROM
NAME: z3-AcnC,5 Lai r!)iAxE E—rhjLoR,
ADDRESS: -A �ba beai R-0
CITY: F0 S-'r P i E-q C' is- STATE: F zip: '3 Ef 9
PHONE (DAYTIME): 022k) � y q A 9 Email: C&f T-S[12TZEeM9 PrMAI
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:
PHONE (DAYTIME):
STATE:
ZIP:
CONTRACTOR INFORMATION
ST. of FL REG. CERT #: ST. LUCIE COUNTY CERT #: a 76
BUSINESS NAME: -PPK C&Acrefc
QUALIFIERS NAME:
ADDRESS: r 15,--
CITY: r —C Rel-+-c STATE: ZIP:
PHONE (DAYTIME): (77 1/65-c- FAX NO.
ARCHIVENGINEER:
ADDRESS:
CITY:
PHONE (DAYTIME):
BONDING COMPANY:
ADDRESS:
CITY:
STATE:
STATE:
MORTGAGE LENDER.
ADDRESS:
CITY: STATE:
?1616 -7 Email:
ZIP:
ZIP:
qu
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
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, 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.
CTOR S17GNATURE
ROR
STATE OF FLORIDA
COUNTY OF ST
The foregoing instrument was acknowledged �before
me this & day of � a� vwL6 20 1 I/ ,
who is personally known _�L or has produced
STATE OF IF
COUNTY OF
The forego' g instrument was acknowledged be
me this day, f 20
by J
who ' ovally known or has produced
�1
-nn -- as identification. a d tirication.
Signature of Notary Si re ar jv
.0 NO. C/' QA 7 ENO. LISA L. WHITE e
Commission I Notat of Flor
Py ARLENE RIGSBY o
MYCOMMISSION4FF027661. . = Ex Tres Dec 8. 2014
. • ; My Comm. P
EXPIRES: June 13, 2017 s • • o` Commission # EE 48013
qF1 Bonded ThruNotmPublic underwriters .��:;p`� gondedihroughNationalNolaryAssn.
NOTE: TWO (2) SIGNAT GNA PLYING FOR
THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR,TO SIGN
THIS APPLICATION IN THE OFFICE LISTED ON TIM; FRONT OF THIS APPLICATION.
OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS.
For specific ilnIptructilons see appropriate permit Oeeklist•
OFFICE USE ONLY - � BF '.
SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
LAND USE
LOT CVG %
TAZ NO.
FLOOD ZONE
FIRM MAP #
1ST FLR ELV
MAX HGT
CONST TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF REC
LOT OF REC
LOT SPLIT
LOT SPLIT
Before 1/1990
After 1/1990
REQUIRED
APPROVED
/
REPORT
HABITABLE
RADON
PERMIT
CODE
AREA
FEE
FEE
(RADON)
LIBRARY
PUBLIC BLD
PUBIC BLD
PARKS
IMPACT
IMPACT FEE
IMPACT
IMPACT
FEE
CORRECTION
FEE
FEE
GENERAL
`_SCHOOL
ROAD
CREDIT
Y
N
LAW ENF
IMPACT
IMPACT
IMPACT
FEE
FEE
FEE
FIRE/EMS
DRIVEWAY
Y
N
DRIVEWAY
ADMINISTRATIVE
IMPACT
REQUIRED
FEE
VARIANCE FEE
FEE
SPECIFY
MECHANIC ROOF
NON -CONFORMING
MISCELLANEOUS
SUBS
ELECTRIC GAS
LOT OF RECORD
FEES
REQUIRED
PLUMBING
FEES
DATE SENT TO ADDRESSING:
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
C UN ER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
INITIALS
t t ! t t 1
t
SW
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,
a�ae 3a2� 6� t7 o oar o io
(Parcel I #/Legal desc iption/Address) /
1 A .� W �oA S uv fy r Lz-:%S'3as5'r :for
S 35, 'yd tv ISD, ®� S 3�� fd
P'D P-xv( I
) 9ae- yr ,?4q(p - I SS6�
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.
d •
P operty owner erN me (Please Print)
roperty Owne ' ignature Date
uCL
STATE OF FLORIDA, COUNTY OF C�
ACKNOWLEDGED BEFORE ME THIS
v DAY OF
BY A/ 465 -I DiA-tJe MAV L WHO IS PERSONALLY KNOWN TO ME OR WHO HAS.
j AS IDENTIFICATION.
PRODUCED
A2Lzme. R«say
SIGNATURE OF NOTARY P IC TYPE OR PRINT NOTARY
,,,,,%COMMISSION NUMBER , �;�..y�% pRLENE RIGSB
=_ MY COMMISSION # FF 027661
EXPIRES; June 13, 201ZSE
a•, o'
,�q;� Bonded Thru Notary Publ'x Underwr ters
Planning & Development Services
�•,.; + Building &Code Regulation Division f 1
e 2300 Virginia Ave
Fort Pierce, FL 34982
_,"_.._._.,.,.._� ...._�.. _...:. 772-462-2172 Fax 772-"2-6443
I�
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
00,57
PERMIT #: ➢401-d059 JOB ADDRESS: -
BUILDER/CONTRACTOR: AA Oc_I-X� Q
PEST CONTROL CONTRACTOR: 1-6rm tp ktt✓ G
PEST CONTROL LICENSE #:
We, the undersigned, hereby certify that we have pretreated the above described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
Square feet if area treated: --- - Chemicals used: %Age�
Percentage of solution: V
Date of Treatment:
'Footing
i;Ts"Treatment
Re -Treat
Driveway
1-9` Treatment
Re -Treat
Other
Ist Treatment
Re -Treat
Total gallons used
Time of Treatment: ,! -` f
Slab.
I' Treatment
Re -Treat
Pools
T reatment
R -Treat
P rimet r for Final In
Note. There must be a completed form for each required tre#ment or re -treatment 0 this farm must be on the job
site to be picked up by the inspector at time of each inspectidh or the scheduled inspection will fail and a re -inspection
fee charged.
FBC104.2.6 Certificate of Protective Treatment for prevention of termites: A weather resistant jobsite 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 ofgallons used, to establish a verifiable record of
protective treatment. if 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.
zzcemex
I 1�0� -----o
55986026
Pivo—.
Bopitf Lwd[ttq:
I& Job:
Affiva Jab.- !3kad Unload!
FfMi9h Uttldaul:
Loawi} w
I Reform pia
092/1092
ouamwopor Cusm wnw mt
300821L8 DANNY WILLIAMS
Kvdcaft pv"anaaaea;
Tkilaogac 0Wkwx
01/14/14 2400 DADE RD
JUST NORTH OF BELL AVE OFF OF
CusfatserJahlheroar tk�fiart7a0aIWWs
184 41/14/14
PmF+ctP.a:t♦Yapeer: GrdexP.QNSsa�6�r.
VERBAL
mav PwK MOAK-oc-A—
v*www.
SHKL.UC I NEC
32957152
may., r,aacr.,aa�r: araarr�mer, ohm Fndtsa:
11:18 5. 00 1�5025754 1 w' 2 RAY MDR BLDNO: SLAB
t,t�m curdti Axn MEP" :tAs�riuu coax t ue�row ww UAN7t7N t�IMw"y tallAKffir va's I twTW= ANC
7.00 17.50 17.50 1028082 3000 RES YD3
5.25 13. 13 .75 1382600 FIB£RMESH 150 LB
1.00 1247818 FUEL SURCHARGE
1.00 1202749 ENVIRONMENTAL CHARGE
Did ycia W ywt
you yCiontu",
old vzu us4qttr:f: vjh%�,• `
ate yu:
Old you
dlspatONother d.A, ,
WATER ADDED: L7 GAt. YARDS IN DRUM:
WHEN ADDED.
G SItLNA,tiRE
tC CURB LIME CROSSED AT OWNER'S/AGENiS REQUEST:
_ .SHWURE
O LOAD WAS TESTED BY:
N+a*&, our dAw va mako wmy q tat to vim matadala a
pmpto *A mw aW IM MCtAL TElG l Aayw"addsd isal axtomenawn Mxr�rla addadoaJoe aona;vtr ! �'° ra'fjlar9 J fpr dM Errslda aa6 arty alm tothe k ro keQw qu--& WARNW& PM" mall CVA* 9dn and —"%kmw0 ,, cAutw. malww
ow ch:my and eaneraa as 1R Daa la t Amwa was wo aat s! our b
aoiffio1 aftrd hmyr. Carrtp v Vona any rar the rawt& No yam► 1r ar+d taNih FIw. rWr to wa twJcsida aT dra tkkat Gor tin
mh mmd emo *& 8�rs.+a s and daams a m ball6 � hancEbiY . _ +, urd to n+a mat � oaAhd� ahe�a for aed�lornd 6ibor�don
wafivd m us � AUAi
wffisnana Ec�oaasdry a'�r itrf a�taf ela.
e UNWRIM P'REV TRK: 10064623
ORIGINAL
ZZcEmmx
Plant
8egln Loading: To Job:
Wtive Job:
Stw unload;
Flntsh unload:
Leave Job: Return Plank
092/1092
wuanwcaax ta,amm.rrtamn:
3008218 DANNY WILLIAMS
i'so w Pr*ci
'lFdmt om 000MYAftem
01/14/14 2 400 DADE Rif
``
MERCE
04bwm Job kwy6w.. grft ep" l osss:
184 01/14/14
ftjw P.Q. Nam. ordw P:Q. tkerrber:
VERBAL
F&P Pew
R�HKLUGINEC
. 3295r7b72
ANTONUCCI GLDNG: SLAB
LOAD
o MMUCIMM eassawt" e1 tm pl=p
10- 50 10- 50 17. 50 102808Z 3000 REG YD3
7.88 7.88 75 1382600 FIBERMESH 150 LB
1.00
1.00
cam
c?"
12478 SURCHARGE
120049 ENV RONMENTAL CHARGE
Did you Go your asflCb (.4 wfZW?
Did you fdentKy hazards?
D d you use your Loggias when at pWip$
DW you am your svely Cl7i'n?
Md you ox m.unlava unsats con
0spetWother drfmrs?
P44~ Iroertcco crewrM eU ea ccom
YARDS IN DRUM., —
WHEN ADDED.
CURS UNECROSSED AT OWN AGENT'S REQUEST.
—� _ s�Gw►nusa
0 LOAD WAS TESTED BY:
ncdcc� our dr wm WEI Rom every 632t to Wror awarwwtwm ma au bm& d bw 00 SPEcua ram: Anywatsr "s , b m awMn" owe d3X Rfwsbr Sanddsd onJs� ouinoos s"A"
Cwmw �Ms rsm mspmxbifly hr a hsbe, cNb or Prow y Irm C—mor ca ow h rw k n we rue& WARWM Prey
wma or aft ade Amy M Stan Vw b ra. ifit d a ,e da im natal
ooau� «� b. Om m tnoorcant tmias wRld:.e out at our rn.r b, twurdnma m � �v .,o twebtr. P9r� rmlar m Ur Erdatlde at tnls ed»i �
mrer�,mr r-ft0WWAYWerrs.eeraoa*&W ..r�anu w .noWftff WUftfjdsa aY. toc orr.
&ld, I W dwrwl w�D urftm mob ib us rnwr AWN' 0hwm�DsLl0- ate
08WOVERSAL WKo=v I KK: LOAD NUM»
anla�laaL
Confirm Payment - Cash Sales Payments Page 2 of 2
Email Address : CCOJPMConfirmation@cemexusa.com
IVVItS
Cali Notes Entry
Call Notes History
User validated by session transfer
Payor Details
Make Payment - Cash Sales Payments "
Verify Payment - Cash Sales Payments
https://admin.payconnexion. ,Y�.i/pconAdmin/admin/customerServiceie- mpressedPayment... 7/22/2014
C
ZZcc-mmX
55986034
purm
84n Ldsding:
TO J*b:
A Job:
Start Untoad:
Flntsh itnt—A. Lt�t►e Job:
I um Pd
c,oxw coda- cumwKwm Job NLwrbw.. om* collet
3008218 DANNY WILLIAMS 184 01/14114
ftledemv- ProteAumw. Pmj"P,iQ.Nmw. atdwP.d?.Nw%dgr
VERBAL
t om MAPS
01l14✓14 2400 DADE RD
UrT RTH OF BELL. AVE OFF OF 23TH
k MKLUCINEC
Fl 32957392
"FK
°'"'1` n.- 5 5. D0 t"?8S40,8 4 'TMNE WILFORD " BLDNG: SLAB
Wow
P�
S.00 5.00 5.00 154579E 3000 BLENDEDPRPM Y03
3.75 3. 75 .75 1382600 F I BERMESH 150 Lt-
1.00 1247818 FUEL SURCHARGE
1.00 1202749 EN V I RONMENTAL CHARGE
cis, ChOft f lAUM Coax stynser.d tAtv�Rooahtng rest, cash RemeR+ad soar a
CSC +xnwa
Oki you do your 6ra.o aw c~r WATER ADDEi: GAL YARDS IN DRUM
WHEN ADDED.
�b'iJA'YUR�
YOU Ct':i3::Stitti a = :: 1; ^ O ` . t#ii£ te CURB UNE CROSSED AT OWNER'SIAGENTS REQUEST:
O LOAD WAS TESTED BY,
aka: 6Our ofts
"noai ocw Inv s neM �ftaas m eadkdWaft d �"r�b �r+�
WpwmM
e+sa�rW aibr dafveM- a++9 ror the mu q rmoradt (u rayge m nsYtal ayp d�a stwaR torsOnrkdam wllest.
+a4Nnans +� to dum"a wee sa m& m us mwkleg: A- - -Yuk
sal,NNERM PREY TRKt 10025754 ORIGINAL
LOAD NUM: 3
AW fl 10 1/ *101-A
417
MAJ SHE h0'
as
SOa7?',-" Yd 17
41t, q
IDA'
4t
141d
Z\
IN
42
Of 71ye 1,'2 4 W<JZ 37 4