HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE ONLY:
DATE FILED:
PLAN REVIEW FEE: RECEIPT NO.:-�
CONCURRENCY FEE. RECEIPT NO.:
1.
2.
3.
4.
PERMIT NUMBER: T
CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
SCAN N E G 2300 Virginia Avenue
BY Ft. Pierce, FL 34982-5652
772-462-1553
.St. Lucie County,
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
LOCATION/SITE ADDRESS:/ V (o
PROJECT NAME: er / U e, uJ 4A SITE PLAN NAME:
PROPERTY TAX ID #:
LEGAL DESCRIPTION (attach extra sheets if necessary):
V
5. PLAT BOOK_ 6. PAGE NO. 7. BLOCK NO. 8. LOT NO. Z_
9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: �(� �(� / o`Z�: vD
10.
COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE: -0 0
TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ ] .INDUSTRIAL
[OTHER (SPECIFY) di-, `Ll P n J 4 RI
DESCRIPTION OF PROPOSED USE: a/�!/% P _ /0,9 Ad /
SQ. FT OF CONSTRUCTION: 15. SF. FT 1 st FLOOR:
VALUE OF CONSTRUCTION: $ 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.
SLCCDV Form No.: 001-02
UPDATED 6/25/09
OWNER INFORMATION
NAME: &V
ADDRESS: r l 0 T " c< L , V�i
CITY: STATE: ZIP:
PHONE (DAYTIME): ( 0 Email: 'T L.P-
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: STATE: ZIP:
PHONE (DAYTIME): (—)
CONTRACTOR INFORMATION
ST. of FL REG.CERT #: ST. LUCIE COUNTY CERT
BUSINESS NAME: _�e�^zi �Z
QUALIFIERS NAME:
ADDRESS:
CITY: STATE:/- ZIP:��
PHONE (DAYTIME): ���//—/J%oZ FAX NO. Email:
ARCHIT/ENGINEER:
ADDRESS:
CITY:
PHONE (DAYTIME):
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE:
STATE:
STATE:
ZIP:
ZIP:
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.
3
! ! I 1 1
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.
OWNER OR CONTRACTOR SIGNATURE
STATE OF FLORID
COUNTY OF
The foregoing instrument was acknowledged before
me this / day of 5�94t ` 20�
by Oe I1�7 #aN AJ
CONTRACTOR SIGNATURE
STATE OF F]
COUNTY OF
The foregoing instrument
me this / day of
who is personally known or has produced _ who is erson dly known
Bt as i entification._
V 4, t 14 C 10
Signature of Nbiary nature o otary
Commission No. pUDREY B• HUMPHR C mission No.
W COMMISS109 # EEO 2015
1159
•:�;....•••
*: 'r EXPIRESNarch6publUnderv+rWers
..... e� BondedThmNotary
r-
Ccknowledged before
-or has produced
�LC as identification.
J
(Seal)
NOTE: TWO (2) SIGNATURES A#F4 D. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR.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 9'hecklist.
OFFICE USE ONLY � � � �� #0 0 0
SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
J
LANDUSE
I
/
LOT CVG %
TAZ NO.
FLOOD ZONE.
FIRM MAP #
I ST FLR ELV
HGT
CONST TYPE
OCCUP TYPE
CUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF REC
Before 1/1990
LOT OF REC
After 1/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
/ �
HABITABLE
AREA
RADON
FEE
PERMIT
FEE
LIBRARY
IMPACT
FEE
PUBLIC BID
IMPACTFEE
CORRECTION
PUBIC BID
MACT
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
Whq
DATEp
COMPLETED
INITIALS
I
u
MOBIL.ECRETE
TECHNOLOGIES
Metered and Mixed Fresh On -Site
772.466.5070
3825 Selvitz Road, Ft. Pierce, Florida 34981 .
MC
❑ VISA
❑ AMEX
r
Date: �L/��l 7Z f Cubic yds. ordered: !
f
Time of job:
Customer Name: " ` ' Phone:
Delivery Address:
City:
j 5
Project Name: P.O.#:
YARDS
MIX DESIGN
PEA ROCK
PRICE
USED
REG /PUMP
#57167
PER YD
AMOUNT
l
a J t
jI.
f
J1�
l�wa 1 F` e{ �
FIBER 1 AD MIX
OTHER
TIME
TIME
TIME
DELIVERY
ON JOB
STARTED
FINISHED
CHARGE
a
TRUCK
O.T. FEE
SHORT LOAD
10 Minutes of FREE
FUEL SURCHARGE
unloading for every yard.
ENVIRONMENTAL
$1.00 per Minute After
- _
I 'OTAL
"Jc1
v DUE
7L'
lye �
�p and quality -of concrete when
material requested on the job.
damage where delivery is made
Driver: f t
Truck Number:
JOSEPH E. SMITH, CLERK 017--'7HE CIRCUIT COURT — SAINT LUCIE COUNT
FILE # 3926898 OR BOOK; 5 PAGE 1989, Recorded 02/20/2014 ate. :25 AM
NOTICE OF COMMENCEMENT
Permit No, IJ o • Q I ! T Tax Folio No. 14 o Z _ G ( 0— O K 79-- ()00 3
State of Florida County of St. Lode
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.
le�a� gsvlptlon afproperry: (and street addressif available):
(s�7<t urv: rAlk 8 7 /_r,7 .2
General description of improvement: v v%
Owner Information or lessee Information If the Lessee contracted for the Improvement:
Name 1 _ O. V'r
Address to L 0 °t
Interest In property:_
Name and address of fee
Contractors
ContractorA
Owner listed
Phone
Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $
Name and address: Phone number:
Lender Name: Phone Number:
172
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: Phone Number:
Address:
In addition to himself or herself, Owner designates of
Uenor's 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 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 71113, 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 facts stated therein are true to the best of
my knowledge an belief. /
(Signature of Fer or Lessee, or Owners or Lessee's Authorized Officer/Director/Partner/Manager
(Signatory's Title/Office)
The foregoing Instrument was acknowleedged before me this l 4 day off ¢ , 20 4
t
By rr —. rw •c chi as for
Name of arson Type of authority (e.g. officer, trustee) Party on behalf of whom Instrument was executed /
Personally known- orproduced ldentification 1�/
(Signature of
(Pdnt,Type, ssldned4A OR1101WI Public Type of Identification produced -"C ,, .
t s Notary PUNT: • swo of "Oft
iMy Comet. Eapim'FaD II 2015
,ff comdiitabn 0 EE Gt22II
STATE 0'F FLOMA
ST. LUCIE COUNTY
THIS ISTO CtPITIFYTHAT Twic ie
r _
L --.;G AND DEVELOPMENT S�s_'�VICES DEPARTMENT
Building and Code Regulations Division
2300 VIRGMIA AVE.
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: / / l' ADDRESS: 1,�CZ/ —t&,?� 40,0 -
1, , am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be finaled. Further, I
understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification
O RBLDR OR CONTRACTOR SIGNATURE
int Name
.DATE
STATE OF FLORIDA
COUNTY OF t' �^—
ACKNOWLEDGED BEFORE ME THIS c DAY OF _ , 20 �J
BY Ogk f e FE h n WHO IS PERSONALLY KNOWN TO ME ✓ , OR
HAS PROVIDED AS IDENTIFICATION.
STATF,OF FLORIDA, County of
SIGNATURE OF N00ARY v V SEAL
FOR OFFICE USE ONLY:
Number of Open Inspections: 4 een Total Inspections: C�
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = $ Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee) RECEIVED'
Revised &24/2014
OCT 2 3 2015
0 W c-e, K
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,
� 0 0)k,-6fy— 011S'— 000--3 EMDf Uw.7 Alk.27 L Z
(Parcel Id#/Legal description/Address) 5� cl Q G �� ! �� d,.e j.� , /( 3qj&1
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.
Property Owner Na a (Pleasg Print)
V- 3 _ f
PrQpcA5FMwner Signature Date
STATE OF FLORIDA, COUNTY OR LAICk-O—,
1? sd- -- - -- - - ..I
HAS
-1�, i� :'f) l- C.'LU t-COMMISSION NUMBER
SLCPDSD Revised 08/24/2010
(SEAL)
ASHLEY DEATON
Notary Public. State of Florida
Commission # EE 872101
My comm. expires Feb. 06. 2017
,TION.
Property Appraiser - St.Lucie mty, FL
Page 1 of 1
Larry Quick Record: 1 of 2
Property Identification
Site Address:
5906 Bamboo Dr
Secrrown/Range:
12 :36S :40E
Map ID:
34/12S
Zoning:
RS-4
Ownership and Mailing
Owner. Larry Quick
Address: 6109 Cassia Dr
Port St Lucie FL 34982
PROPERTY RECORD CARD
«Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print
CIE
CG
ParcellD: 3402-610-0498-000-3
Account #: 38607
Use Type: SF Res
City/Cnty: Saint Lucie County
Legal Description
INDIAN RIVER ESTATES -UNIT 09- BLK 87 LOT 2 (MAP 34/12S) (OR
3573-935)
Sales Information
Assessment 2013
Date
Price
Code
Deed
Book/Page
2013 Final:
32600
10/17/2013
35700
0112
SP
3573 / 0935
Assessed:
32600
9/6/2013
100
0112
SP
3560 / 1797
Ag.Credit:
0
8/5/2013
18000
0112
CT
3545 / 2272
Exempt:
12/15/2008
100
01
WD
3044 / 0744
Taxable:
4/12/2006
100
01
WD
2539 / 2698
Taxes:
660.21
12/9/2005
100
01
WD
2508 / 0703
8/1/2003
88900
00
WD
1772 / 1911
10/22/1998
45200
01
DE
1181 / 0153
7/15/1998
100
01
WD
1160 / 0545
5/14/1998
100
01
CT
1148 / 1206
8/28/1993
44000
00
WD
0857 / 1378
2/1/1982
5000
01
CV
0372 / 0633
BUILDING INFORMATION
Total Land and Building
Land Value: 6900 Acres: 0.23
Building Value: 25700
Finished Area: 936 SgFt
Exterior Features
View:
-
RoofCover:
FS - Fibrglss Shg
RoofStruct:
HP - Hip
ExtType:
HD+- HD+
YearBlt:
1982
Frame:
-
Grade:
D+ - D+
EfIYrBlt:
1982
PrimeWall:
WS - Wood/Sheath
StoryHght:
0010 -1 Story
No.Units:
1
SecWall:
-
Interior Features
BedRooms:
2
Electric:
MX - MAXIMUM
PrmintWall:
DW - Drywall
FullBath:
1
HeatType:
-
AvgHUFI:
1/213ath:
0
HeatFuel:
-
Prm.Flors:
CU - Carpet
%A/C:
0
%Heated:
0
%Sprinkled:
0
Special Features and Yard Items
Land Information
Type
Y/S Qty.
Units Qual. Cond. YrBlt.
No. Use Type
Type
Measure Depth
FNW6 - WOOD FEN 6'
Y 1
180 AV AV 1989
1 0100-SF Res
215 -Front Ft
80 125
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?prelid=340261004980003 2/14/2014
Friday, Feb 14, 2014 08:21 AM
o cl o o a -EILOCK 87
59dr3 BAMBOO DRIVE, FORT PIERCE, FL 34982
tt - C> tn LOT 1. OCCUPIED
13LOOK 87-
N
OCCUPIED z LF-.AL
t*rnZ� BEING ALL OF LOT 2...BLOCK 87, ACCORDING TI
• PLAT OF INDIAN RIVER ESTATES UNIT NINE, AS
(7) RECORDED IN PLAT BOOK 10. PAOE 74; OF THI
RECORDS OF SAINT LUCIE COUNTY, FLORIDA.
SET NAIL & DISK
PSM f 4971 LEGEND * A1313REVAT101
F.ND IR in FENCE POST 6 wood fence NOTES AIR CONDITIONER
(NO b) 5
s ff5e�48'* E OTES'SLOCK
-0 00, BUILDING
k� JL 1 Z5 125;00' CBS IDENOTES
IE S CONCRETE BLOCK STRUCTURE
cgqc -7E CONCRE ;ETBACK LINE
=d 471 NO
. . . . . . —69.52* C DENOTES
CONCRETE MONUMENT
J 37 —2a.2V D E140 S
CA E dwTCRUNE UTILITY EASMENT
C) AGE 1. STORY D&UE DENOTES DRAIN
% dirt EUC* DENOTES ELECTRIC
s . FRAME E 95 0 existing
drive DENOTES ELEVA-00M
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o 28.2 LOT 2 0.2' over line
MOTES -FOUND
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x 8;96 BLOCK 87 C DENOTES CALCULATED FROM AELD MEASUREMON
I OCCUPIED LOT 20 P DENOTES PLAT DATA
—32.11., --uEor = — M DENOTES MEASUREDDATA
87 DENOTES JOENT1lo, 'Umam
DENOTES FLOW LINE
ID
00 qo. se tic %so, OCCUPIED
existfing DENOTES ELEVATION (TYPICAL)
tonk (no 0 DENOTES W^7ER METER
7-covered
porch DENOTES SEWER MANHOLE
qxlstlng,� M07ES uTiory POLE
< z ow G. DENOTES NORTH AMERICAN VERTICAL DATUM
covered' ZW 2.9w ID
entry
aLL 7z AL NOTf-5.
�601 GENERAL
66.74'
32.07- 1. THE BEARINGS SHOWN HEREON ARE REFER
L—F, -00'00"E. ACCORDiNG
11.07' HAVING AeEARING OF NOD
0.00, 7.83 focIr NINE. AS, RECORDED IN PLAT BOOK 10, PAGE 7,
DISK 8 . 9' . 56'48" E FND IR 125. '
12 6.'0 0'
SET IRC
10) 2. ALL ABOVE GROUND FIXED IMPROVEMENTS,
PSM #4:971
c: 3. UNDERGROUND UTILITIES AND UTILITY SERN-
4. FLOOV NOTE- BY GRAPHIC PLOTTING ONLY
To THE FLOOD INSURANCE RATE MAP. COMMUN
FEBRUARY 1.6. 20.12 THE EXACT DESIGNATION
LOT 21 CERTIFICATE.
BLOCK 87
tn -00 LOT 3 OCCUPIED 5. ELEVATIONS SHOWN HEREON ARE. IN FEET
-0 10 BLOCK 87 DATUM OF 1988.
OCCUPIED
c E HEREON WERE NOT ABSTRI
Ct I - 6. LANDS SHOWN p
EASEMENTS OF RECORD. OWNERSHIP, ABANDON
0 �6 N
rn 0 vo 7. THE LAST DATE OF FIELD WORK WAS OCT
ADDITIONS OR DELETIONS TO SURVEY MAP
FND IRC. -ntS:jS PROHIBI D WITHOUT WR
UNREADABLE Al PARTY OR PAR. TE
30.00,
00 -0 REPRODUCTIONS OF WS MAP ARE. NOT V
to RAISED SEAL OF A FLORIDA LICENSED SURVEY (-
NN L & DISK
JT"OIJT :r-1
COPYRIGHT ARNOLD SURVEYING, INC. 2013
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TED. TAND15 JQ.B No 13 1
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