HomeMy WebLinkAboutSUBMITTED PAPERSE
I
OFFICE USE ONLY:,..
DATE FILED: �"
PLAN REVIEW FEE: 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 SCANNED.--.
Ft. Pierce; FL 34982-5652
.•
772-462-1553 BY:,
St. Lucie County
APPLICATION. for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
L. LOCATION/SITE "ADDRESS:. Ob %UogAl k Ow y
2. PROJECT NAME: 1'Ly.�l(� �iPZL SITE. PLAN NAME:
3. PROPERTY TAX ID #:
4.. LEGAL DESCRIPTION (attach.extra sheets if necessary): I2:35 31 . *F t1&4 l -LW O, A." A _ R kib
L¢s l-SS tiI� A.+a c,Es� lu-Ks Uwy A� �SSI�.�►� �-/� As r•.,' oR..2C.=z��r,Z�h-28c.�: Z-�7o1-3�u.
5. . PLAT BOOK 6.-.PAGE NO. 7. BLOCK NO. ' 8. LOT NO.
9. PARCEL SIZE (ACRES/So FT.):. LOT DIMENSIONS:
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: VM"1_
lZ 1 ` LaeW�(2
11. SETBACKS (ACTUAL). FRONT: 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: U4/4&4AA'r<1 14
14. SQ. FT OF CONSTRUCTION:.
16: VALUE.OFCONSTRUCTION: $.,•tea
15. SF. FT 1st FLOOR: �q�a
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 $2500 or more, a
RECORDED Notice of Commencement must be submitted with this application.
SLCCDV Form No.: 001-02
UPDATED 6/25/09
5
OWNER INFORMATION
NAME:lcoT.
ADDRESS: 66% p
CITY: �Ka/(�•� STATE: Tim ZIP: "dal
� da%
PHONE:(DAYTIMEEmail:.C�/i•af(itdl✓cZCGr►t"r . fro..
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER)'IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE.SIMPLE TITLEHOLDER: N I h
ADDRESS:
CITY: 'STATE: ZIP:
PHONE (DAYTIME):....( )
CONTRACTOR INFORMATION -
ST. of FL REG.CERT #: S �j 20 ST. LUCIE COUNTY CERT #: �2!1 G
3
BUSINESS NAME:. I. ,r !I�Ada. Cctfi LILC-
QUALIFIERS NAME: Lfrtyc �D6�-(��nA
ADDRESS:
CITY: STATE: ZIP:..
PHONE (DAYTIME): w 4.1653 FAX NO: 8&� • %. �3$ Email:APA(4N1.MWA*Ww i
ARCHIVENGINEER: /& I / D q—.4S -
ADDRESS:?6 Nir
:CITY` STATE: i ^�. ZIP:
PHONE (DAYTIME): O •17 ?7�i .
BONDING COMPANY:
ADDRESS:.
CITY: 11 I STATE: ZIP:
MORTGAGE LENDER:
ADDRESS: �T
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, constructionin 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 `Courity.'makes no'represeritatiori-that its granting. of a' permit wih authorize the permitholder 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.
Tlie:.foliowing 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 OR CONTRACTOR SIGNATURE
STATE OF F&GR1E921 ��f1 e yjlQ.J
COUNTY OF arm, .
The foregoing instrument was acknowledged before
me this day of20 I L ,
ba��.�
who is personally known ✓ ,or has produced
C NTRACTOR SIGNATURE
STATE OF AT9.n
COUNTY OF J . O Cr .
The foregoing instrument`was acknowledged before
me this �O day of �3CJ,1. , 20
o�rY Jtti ����w •
who is personally known '� or has produced
"dent VOtion.. ``` ia�s��dentification:
s ,,,
i natur of Notary •' (:3S)ig
afore of Nota g ry STATE ry .. �''►' STATE
OF OF
Commission No. = TENN@W�JEE • - =_ Commission No. = TENNL@S#_) • E
�2ai7
emission Expires April 2NOTARY NOTARY
` PUBLIC
' My Commission Expires April 2, 2917 • PUBLIC
NOTE: TWO (2) SIGNAT `�]u ` D. EACH. SIGNATURE MUST BE NOTA13t�.: �•••••. \,DYING FOR `.
THIS BUILDING,PER1Vi�A6i Y; WNER/BUILDER, THE OWNER MUST PERSON'
THIS AR 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.
Imo_ S
1 ,
OFFICE USE ONLY BP
SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
LAND USE
LOT CVG %
TAZ NO.
FLOOD ZONE
FIRM MAP #
I IT FLR ELV
MAX HGT
CONST TYPE,
OCCUP TYPE
MAX OCCUP ..
# OF FLRS `
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF REC
Before 1/1990
LOT OF REC
After I/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
8
HABITABLE
AREA`
(RADON)
RADON
FEE
PERMIT
FEE
LIBRARY
IMPACT
FEE:
PUBLIC BLD
IMPACT FEE
:.CORRECTION
PUBIC BLD
IMPACT
FEE
RAL
PARKS
IMPACT
FEE
SCHOOL
IMPACT
FEE
-,
ROAD_—'""
—INf :kCT
: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
I
. ItV
DATE
COMPLETED
1
p^
_
INITIALS
�.
' l
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
State of Florida County of St. Lucie
The undersigned hereby gives notice that improvement will be.mad'e toicertain real property, and•,in accordance
the following information is -provided in this Notice of Commencement.
Legal Description of P{.o'perty: (an street address if available): i
General description of
Owner infor ation or ssei
Name r I I
Address D &Y, [oil
Interest in property: _
Name a,nd address of feasim
N Q�
Contractor's Name:(/ f
Contractor Address:I"b' r
r
if the Lessee contracted
the improvement;
,lit different trom Owner; listed above):
Surety (if applicable, a�cQQ y of the payment bond is attached):. Amount of bond: $
Name and address: M� Phone
Lender Name: N I� Phone Number:
Lender's address:
Persons within the State of Florida designated by Owner upon,whom notices or other documents•may be served as
713.13(1) (a)7,.{ Florida Statutes
Name: [�LeZs,.� �K�ffi�K Phone Number:,
Address:12os Sc.6vnA 7l.4 i(CL,0j0
In addition to himself or herself; Owner designates of ! it i to
Lienor's Notice as provided in Section 713.13(1) (b), Florida Statutes. ? li I .
Phone number of person or entity designated by owner: I
Expiration date of notice of commencement: (the expiration date may not be before the completioniaf construe
contractor, but will be 1 year from the date of recording unless a different date is specified)
WARNINGTO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER.THE EXPIRATION OF THE NOTICE OF CO.M
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 7,13.13, FLORIDA STATUTES, AND CAN RESULTIIN�V
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF'COMMENCEMENT MUST BE RECORDED' ANDIPOSTED 'ON TI
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR,AN ATTORNEY BEFORE C
RECORDING YOUR NOTICE OF COMMENCEMENT. I
i
Under penalty.of perjury, I declafe that I have read the foregoing notice of commencement and that the��tsr��
my knowledge and belief.
�D A.
I
i
Chapter 713 Florida Statutes,,.
^ I
i
i
(Signature of Owner or Lessee, or Owner's or Lessees Authorized Officer/Director/Partner/ki'an)
�dJlb 6i ydIc► I Go.Y,�.,,,, .�d �,-n b�r���.�, dr,�.►-r
(Signatory's Title/Office)/ / l
The foregoing instrument was acknowledged before me this day
B as Ao-yr % ri tA-CX ,i cithtor
EN
JO
S ,'vl/
sr4TE ., ;��
. r.`E�NESSE . ! �=
p1�TgRy
�B, I
P �
.
me of Person Type of authority (e.g. officer, tree)' Partyon behalf
• r ��" Personally known
(Signatu a of �
Notary Public - State of F1e
(Print, T pe, or Stamp Commissioned Name of 06taryPubl�ie� Type of Identification
My Commission Expires April 2, 2017
ad by, Section
ve a copy of the
it payment to the
ARE CONSIDERED
3 TWICE FOR
BEFORE THE FIRST
G WORK -OR
are true to the best of
whom instrument was executed
or produced Identification
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 3921527 OR BOOK 3600 PAGE 2649, Recorded 02/03/2014 at 02:37 PM
NOTICE OF COMMENCEMENT
Permit No. V lu131 "d -kS C� 1 Tax Folio No.�3101
State of Florida County of St. Lude
The undersigned I Full Legal Description . .,,, �' . A ,ice ♦ .1 _—. " - .. _.
the following info 12 35 39 SW 1J4 OF NW 1/4-LESS ORANGE AV RJW AND LESS 1-95 RIW AND LESS KINGS HWY AND LESS CANAL RIW AS IN OR 246-
2371,247.2861, 240.2170 AND 3122-1299. (19.60 AC) (OR 1077-606.608.609)
Le al D ipticn
General description of improvement:_ (awry,_ � L�01.�,C K.>rYrX1,Ii,1S
Name
Address
Interestin
if the Lessee contracted for the Improvement:
address of fee simple titliholder (If different from Owner listed above):
Phone
Surety (if applicable, a y of the payment bond is attached): Amount of bond: $
Name and address: ix Phone number: _
Lender Name: __Ll lac Phone Number:
Lender's address:
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 ��3.5
Name: L'f '(twMLLiw,1 �Y91>Ps'l Phone Number: 7
Address:i1Ab Saq T 'FwC N.AJO Qp (' I1ryLe.na.► GL 333W
In addition to himself or herself, Owner designates
Lienors Notice as provided in Section 713.13(1) (b), Florida Statutes.
Phone number of person or entity designated by owner:
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 specked)
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 1, 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.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the fly fife, ed therein are true to the best of
my knowledge and belief. s```1Q AS I,,�''i'
(Signature of Owner or Lessee, or Owners or Lessee's Authodzed Officer/Director/Partner/bTanavhr •• Sr' Te '-
-PUBLIC1 ♦ `
The foregoing instrument was acknowledged before me this day -F6 �2�� �' "• ♦ ``��` `
B as Ay,)i wri %d Agiith or '' r 0 is ��CO►>'t��r,k�rs L
me of Person Type of authority (e.g. officer, t�tee) Party on behalf of whom instrument was executed
5 r L...—wn— Personally kno✓or produced Identification_
(Signatu a of Notary Public - State of fkrlda)
(Print, T , orStamp Commissioned Name of Ociiary Public) Type of Identification produced
My Commission Expires April2, 2017
,STATE OF FLORIDA
ST. WIF COUNTY
THIS IS TO CERTIFY THATTHIS IS A
TROE PAD CORRECT COPY.Of TKf
OI'1iGIY'a�
By,
Data
•+ �-- PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE COMPLIANCE DIVISION
BUILDING`TERMIT
SUB-CONTRACTORSUMMARY
e
will 'be using.the following sub-contractors.forthe
(Company/Individual Name)
project located at
(Street address or Property, Tax ID;#) .
' It is understood °#hat 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.
OFFICE ;USE ,ONLY;
PERMIT ISSUE .DATE c
NUMBER:
From:
02/03/""11 10:44 #444 P.001/001
PERMIT # �'t.f D ` O r1 Co� ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
ImMam Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (If applicable): G co WNE0
have agreed to be the
(Company Name/Individual Name) +
e CJ C� I Sub -contractor for P t l „
(Type of Trade) { rimary Contractor)
For the project located at too (V 1� %, Aa s
(Project Street Address o Jroperty 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: 1 G
Address: 7V' G t) 0
City/State/Zip: San GrA-, Et 8 2 7-11
Phone �(�-?J2�j-Io30D email: �y � ✓1q � ��C� L.CC3*t ,,
�i� l�'�1G4y41 ?o4-
SIGN PRINT NAME DA' E
STATE OF FLORIDA, COUNTY OF XYI c 11 C7 �p
THE FOREGOING INSTRUMENT rd.- IMENT WAS SIGNED BEFORE ME THIS DAY OF -2 20�
BYWHO IS PERSONALLY KNOWN. OR HAS
PRODUCED
SIGNATU E OF OT PUBLI
SLCPDS: 2/16/2013
AS IDENTIFICATION.
Eo
TRT CAL
i EE 196668
Expires May 8, 2016
PRINT NAME OF NOTARY PUBLIC 1Tws ray"1nsxeMesrsts
RECEIVED
FB 03, 2014
PERMITTING
St. Lucie County, FL
PLANNING & DEVELOPMENT :SERVICES
Building &Code Compliance DiAsion
I31lILDIIYG fjp
SUO-CONTRACTOR AGREEMENT
$t'L LU County Contractor C6 jfi�at on _tt i, Numben
State offlorida Certification Number .(If app1icdb1e):. #1516673
Roberts Commercial Drywall Inc. agreed to beL the,
(Company -,Namd1/1)idivi L dual.Nime .
Drywall& Non Structural Frame $ub-contractor for AQP CONSRTURCTION INC.
(Typeof Trade) (Prii-nary, Contractor)
fmithe pirpOet Wated at 100 . N KINGS HWY FORT PIERCE FL 34945
(Pfoject,Strett.Address :or,Prqpooy,Tax .10#),
It is understoodtbat. if there is any change, Of status f.egadingottr:,par*ti,*o.ip,4tioii with the
art -
Of -St, Lucie County bypersonally fiJing.a Qbqnge.o.f (Form. S1,CQDV
No.404-09)
SITSITESS QUALIFIER (Name of the Individualshown on the.,Contractor-'s License)
ORIGI SIGMA URrN AT ��REQWRED
'
011ie Ayers Jr. 01/30/13
SIGNAtURE PRINT NAMF, PATE
AQP RESOURCES INC. DBA AQP CONSTRUCTION INC.
Business Name:
Addr'ess: 2854 STIRLING RD SUITE F
cit HOLLYWOOD, FL 33020
"Phone: 800 499-5096 'email: ollie@agpconstruction.com
m
'PERMIT4 ISSUEDATE
JL� 43 a.
PLANNING &DEVELOPMENT SERVICES
BUILDING. &.0G,0j&::C10Mft1AXCE DIVISION
BUILDING
svB-00NTWWTQk.,SVMMARY
AQP Construction,, Inc. " II-b ........... ------- i emsingth, e f6II6Wfijg,sub-contrhaqrg forthe
(Companylindividdii
100 N KINGS HWY FORT PIERCE FL 34945
............
Itismoderstood that if,,ther.eisrany change :QfStata$ZLregardiii fgib� 41 ractors
g C0 .1
fit a f4i, il,--ieda
ly advise B. jltling gnd Zo'n1"g,:A!barfitktfit of&,Lacie County.
Roofling
Gas
Roberts Commercial Drywall Inc. NA
DRYWALUNON.
STRUCTURAL
1302 State Route 12 B. Hamilton -NY.'1'3346:. NA
- LFRAMING
.. ..... . ..... — -------------
I &F
ISSU