HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE ONLY: p -
DATE FILED: D �� CII
PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER: [41 ^ DQ'�
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
1
2.
3
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 isAvenue
Ft. Pierce, FL 34982-56 52
772-462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
LOCATION/SITE ADDRESS: '1160 � F) 6-g-&1-e f3 R- L-1 0 j
PROJECTNAME: i `L l-�rv� �Z �Ntivn� SITE PLAN NAME:
PROPERTY TAX ID #: 4 5 ®Z- ClO C> — I
4. LEGAL DESCRIPTION (attach extra sheets if necessary): d C- ,cL t-t G, t-.r-t P--o /'c i
- t- �--i, 1.1 Lk f-) 1 A L4 0 V r-t 17 L, WA CL iL t r ( e- r5 x/- /Lti,4) n-I lit,
5. PLAT BOOK —tKYA 6. PAGE NO. 7. BLOCK NO. 8. LOT NO.
9. PARCEL SIZE (ACRES/SQ FT.): p- LOT DIMENSIONS: (mot /6—
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
i, g i -I- iv'i� -�- CUy 1-4->-�--
tl_
11. SETBACKS (ACTUAL) FRONT: 14 BACK: 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:
14. SQ. FT OF CONSTRUCTTON:-" 15. SF. FT 1 st FLOOR:
16. VALUE OF CONSTRUCTION: $ Z
The value of construction is used to determine the amount of permit fees to be assessed. St. Lucie County reserves the fight 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
Or 0 i5m UPDATED 6/25/09
i
OWNER INFORMATION
NAME: M X 9-1 L- -/ M ► L A tZ k r(, t-
ADDRESS: S b L ULq- W 0 l
CITY: (2"i X C-cd STATE: r `- ZIP:
PHONE (DAYTIME): 1( 2z) 'V-2 "A 15ZQ 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: N I%
ADDRESS:
CITY
PHONE (DAYTIME): C___)
CONTRACTOR INFORMATION
STATE: ZIP:
ST. of FL REG.CERT #: ST. LUCIE COUNTY CERT #:
BUSINESS NAME: \ � r � /', e-o.)JP l- L L-
QUALIFIERS NAME: A, ((, X -
ADDRESS: 2 L Aft- W A
CITY: STATE: i ZIP:
PHONE (DAYTIME): (?7z) Z Co 3 O (o -y FAX NO. �'1 Z 2�3 `� ! 5'�-Email: G � a�y P 1, �- c-
43 S &JiI-k, tic
ARCHIT/ENGINEER:
ADDRESS:
CITY:
STATE:
ZIP:
PHONE (DAYTIME): (__)
BONDING COMPANY: /4_
ADDRESS:
CITY: STATE: ZIP:
MORTGAGE LENDER:
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.
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.
OWNER O"ONTRACTOR SIGNATURE
STATE OF FLORIDA
COUNTY OF M A'KTI A)
The foregoing instrument was acknowledged before
me this Z day of �Til`7J 20 iu
by �/�'�L'L�/N kerltlL�ZL
who is personally known --"or has produced
CONTRACTOR SIGNATURE
STATE OF FLORIDA ,
COUNTY OF M PK r 112.
The foregoing instrument was acknowledged before
me this day of 3-A-N , 20 L,
by 1W t--` )q- 2-A-'J(1 t C
who is personally known ✓ or has produced
as identification. as identification.
SigA eure of Notary g ture of Notary
r'a""� GERTRUDE ZACCAI
Commission No. f F 00 SL ks%')Notary Public - State of Florida ommission No. t %a ll eM TRUDE ZACCAI
• •e My Comm. Expires Apr 13, 2017 •�+° . �: Notary Public - State of Florida
Commission # FF 005695 •= MY Comm. Expires Apr 13, 2017
•� ��'�� Banded Through NO" Notary Assn. F ; � Commission # FF 005695
NOTE: TWO (2) SIGNATU TURE MUST BEN D. BOW XPOLUlill+Ta(IIAOuse.
THIS BUILDING PERMIT AS AN OWNERBUILDER, THE OWNER MUST PERSONAL A P
THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION.
OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNERBUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.
1 -
OFFICE USE ONLY lip #:
SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
LAND USE
LOT CVG %
TAZ NO.
FLOOD ZONE
FIRM MAP #
1ST FLR ELV
MAX HGT
CONS TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORM WATER
LOT OF REC
Before 1/1990
LOT OF REC
After 1/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
(/
HABITABLE
AREA
RADON
RADON
FEE
PERMIT
FEE
LIBRARY
IMPACT
FEE
PUBLIC BLD
IMPACT FEE
CORRECTION
PUBIC BLD
IMPACT
FEE
GENERAL
PARKS
IMPACT
FEE
SCHOOL
IMPACT
FEE
ROAD
IMPACT
FEE
CREDIT
Y
N
LAW ENF
IMPACT
FEE
FIRE/EMS
IMPACT
FEE
DRIVEWAY
REQUIRED
Y
N
DRIVEWAY
FEE
ADMINISTRATIVE
VARIANCE FEE
SPECIFY
SUBS
REQUIRED
MECHANIC ROOF
ELECTRIC GAS
PLUMBING
NON -CONFORMING
LOT OF RECORD
FEES
MISCELLANEOUS
FEES
DATE SENT TO ADDRESSING:
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
INITIALS
JOSEPH E. SMITH, CLERK r?y'.-HE CIRCUIT COURT - SAINT LUCIE COUNTY_
FILE # 3913719 OR BOOR APAGE 459, Recorded 01/08/2014 at>' -- 53 PM
NOTICE OF COMMENCEMENT
Permit No. Zl/1'y�3 Tax Folio No. �l
5—G�o—c
State of Florida County of St. Lucie
The undersigned hereby gives notice that Improvement will be made to certain Teal property, and in accordance with Chapter 723, Florida Statutes, I
the following Information Is provided In this Notice of Commencement. I
Legal Description of Property: (arid street address if available):
-VtA LUrf�ni.UN �L.:L.M.f..K.t'S "� _V ,.t �rC J)I S h
General description of Improvement: IL t i G- . ,J
Owner information or Lessee Information If the lessee contracted for the Improvement:
Name It_.( iI A
Address A.
Interest in property: p • ,
Name and address of fee simple titleholder (if different from Owner listed above):
Contractor's
Contractor A
STV 4R - (_ c o -) ' i-i Phone Number. '7—LS'LI G 7 C �t
Surety ( pP COPY Payment "�' `tot
Sure if a liress: a co of the a ment bond Is attached): Amount of bond: $ ►� /�
Name and address: � —�_
Phone number:
Lender Name: -
Lender's address: Phone Number:
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:
Name:_ Tt7SC Za r C r 2
Address. 25,) G . Phone Number: "71-z. j't-(� ? C & or
,L, G -- , t : r "¢ d:-r Ft-, � I. i It Ct at 7
In addition to himself or herself, Owner designates $Os2f� w Zp. i c g Z CfCI [ ? Lienoes Notice as provided In Section 713.13(1) (b), Florida Statutes. to receive a copy of the
Phone number of person or entity designated by owner:
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 COMMENCEMENT ARE 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 CONONG WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT. MME
Under penal 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 owle and belief.
(Signature of h r or Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manager
r7wiL �72
(Signatory's Title/Office)
The foregoing instrument was acknowledged before me this day of Z::�/
By �171 QX- a• r,,/ as
Name of Person for
Type of authority (e.g. officer, trustee) Party on behalf off whom instrument was executed
w e„ GtHiRUDE ZACCAI ersonally known'! or produced Identification_
( n ure of Notary IIc - State of Florid Notary Public - State of Florida
(Pd ,Type, orSta Commissioned Na IMy Comm. Expires Apr 13, 2017
CommWW 0 FF 00W ype of Identification produced
07ttIN Tiliw* NQrI MMi A11L
STATE OF FLORIDA
ST. LUCIE COUNTY
THIS IS TO CERTIFY THAT TLtio
IP n
PLANNING & DEVELOPMENT SERVICES
;wilding & Code Compliance D' `sion
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (If applicable): C CC / � 01 a S
Cc -R&IJ 00401,
(Company
15eN IC MC- oxpn&5 i
Name)
have agreed to be the
l m b`h sub -contractor for _ z ' G�� n
(Type of Tr de) (Primary Contractor)
for the project located at (�dy 6cokan d ( Lrol
(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 ofthe Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name: e e (do i P umb
Address: a zj SW TVn"y
City/State/Zip: F, 5 L
Phone: 77d - ,fn d�� 3 email: {CC'��d�N�f '14% cl��• r1� f'
SIGN (PRINT
S
DATE
STA OF FLORIDA, COUNTY O
,*.9L
THE FOREGOING INSTRUMENT
J WAS SIGNED BEFORE ME THIS �+�DAY O /J 20 %
@_WP 7 VHO IS PERSONALLY KNOWN —OR HAS PRODUCE �6( - dly-" l C .
IDENTIFICA I N. (STAMP)
SIGNAT,VltE OF NOTARY PUBL4C -ii PRINT NAtiM OF NOTARY PUBLIC
OFFICE USE ONLY:
AUDREY B. HUMPHREY
MY COMMISSION # EE 061159
EXPIRES: March 6, 2015
Bonded Thru Notary Public Underwriters
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE COMPLIANCE DIVISION
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
b r,, J> P, /� t % will be using the following sub -contractors for the
(Company/Individual Name)
project located at �(q C� p) O GC -A "( b {Z. H Q-) I
(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
L ,..c v ),,r ii` tc' C_'rz- I C_
r5 L -Z-, l Co
Plumbing
��� C���� �i-vr�vTP�%L.
1 �Iz-7
HVAC/
Mechanical
Roofing
Gas
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
Y
15- i 301/4 —15 -28
LW1539 LW3621 LW3339
-------------------'---------- y .
r---------- ; ..
3
LB15 LB15 ►Cb ; ;; LW1239[it J V— 0N
0 o C
.................... sink I CYi
free standing oven �Q L _ ________ N N
N W
finished end panel LB18FHD
FF&D 0
.....................
�ra�
JLW
\, L
jhting
DW N
�L
i
O
4 t
Scope of work: Y® i.
Remove existing cabinets and tops �°' a
Install new ceiling lighting ,L636RT-2 `e)
Depair drywall and paint M pull out shelves
Install new cabinets and counters spice rack
Reconnect sink & dishwasher LUT219312A LUT219312A
O
O�... .................... * ...........
® v..................................... i
33 —21 21
ro a o s e a Job: 9900 S Ocean Dr (401
�� A 36
y
Job: 9900 S Ocean Dr (401
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