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HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE O Y_ : DATE FILED: n PLAN REVIEW F 'E: RECEIPT NO.: 11� 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 'Sc Ft. Pierce, FL 34982-5652 •9,v/V 772462-1553 t l_UCeY APPLICATION for BUILDING PERMIT County CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: ,r nn (, lk o \ ? I A C_f_ 1-1 . 1 l e rC 2. PROJECT NAME: IDS (� _O` SITE PLAN NAME: 3. PROPERTY TAX ID #: �� �A I O - 60 S- - 0111 - D O ®- Ce _ (� 4. LEGAL DESCRIPTION (attach extra sheets if necessary): S DO ?e I 1 C 4A SIc-Ago-1 oP i COLA TsIes 1, ►tit-V fir;- R 5. PLAT BOOK L 0A 6. PAGE NO. N I 7. BLOCK NO. N 1 A 8. LOT NO. C� " 9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: X b 10. COMPLETE DESCRIPTIONOFCONSTRUCTION PROJECT OR WORK ACTIVITY: q �.... - :SA 11. SETBACKS (ACTUAL) FRONT: �r BACK: 2 RIGHT SIDE: LEFT SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION (] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL OTHER (SPECIFY) R�: &t 5kLk" o rm, 13. DESCRIPTION OF PROPOSED USE: (!'-. r .L,�- %- ) 14. 16. SQ. FT OF CONSTRUCTION: (O X D 15. SF. FT 1st FLOOR: VALUE OF CONSTRUCTION: $ (6'1� b n 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: q�' C S C, c— ADDRESS: S° Qom\ �s��. Sv-' 0 ' Pl -c L CITY: '�� Q �n STATE:,. ZIP: PHONE (DAYTIME): 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: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): CONTRACTOR INFORMATION ST. of FL REG.CERT #: CS&C. ST. LUCIE COUNTY CERT #: BUSINESS NAME: As: Ou Ah `r�nSa�� QUALIFIERS NAME: ��a�_M'W%- '-- ADDRESS: 35.3 1 S -a T" S4— CITY: �t �>e z (-cc STATE: ZIP: 3-LIq g PHONE (DAYTIME): CMJ 3`t3 -0 oaf FAXNO. LtL%-.3 oZk Email: N pj��,A kLj n 1 !�tiK�, ARCHIT/ENGINEER: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): (_) BONDING COMPANY: ADDRESS: CITY: STATE: ZIP: MORTGAGE LENDER: ADDRESS: CITY: STATE: ZIP: E%IPORTANT 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. OWNE� OR CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF 5h . L V C The foregoing instrument was acknowledged before me this al A day of q 2014 , by 0 611 0, TA'- `A k i` who is personally known or has produced 0- %44 as identification. NNA►YENS of Florida Signature of Notary _ , Notary Public - BMWties Dec 16, 2016 • - My Comm. E. n # EE 858761 Commission No. C Qh Nallonal Notary Assn. �'';rFOFF;°` BOndedTh SIGNATURE STATE OF FLORIDA COUNTY OF S 3r, LUc1 Q The foregoing instrument was acknowledged before me this e1-'l ay of 31_\Y-, , 20%, by Dd►y:c\ Vy1� \\Itf who is personally known Signature of Commission N or has produced "© as identification. Notary Public - State of Florida M Comm. Expires Dec 16, 2016 4ommi(Se1kly EE 858761 Bonded Through National Notary Assn. NOTE: TWO (2) SIGNATURES ARE REQUIRED. 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 checklist. JOSEPH E. SMITH, CLM -;OF THE CIRCUIT COURT — SAINT '--IE COUNTY FILE # 3918902 OR B; ;;3598 PAGE 2041, Recorded 0:; 1/2014 at 01:11 NOTICE OF COMMENCEMENT Permit No. Tax Folio No, 3410 - SOB • 01-11- DOO-lp 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 Legal Decal on of property: (and street address if available : �. ^�- 52 1�e �.riy� '-a'.1 .'al Ill. I. P,-zrc CFI /( LcaI TQIc )j, General description of Owner I Name Address or Lessee Information If the Lessee contracted for the improvement: Interest in property: lls rin &,V Name and address of fee simple titleholder (if different from Owner listed above): contractor's Name: Day I rl t I 1 cc Contractor Address: _as a 1 S . Q S Phone Number: calk f]Cd7S Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $ 0 1 Name and address: Phone number: Lender Name: �% 1ti- 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 713,23I1) (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 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 facts stated therein are true to the best of my kn ed e d b li r- kk b 64 - Signature r Le e, or Owners or Lessee's Authorized Officer/Director/Partner/Manager (Signatory's Title/Office) The foregoing instrument was acknowledged before me this t day �r�r` 201 BAY) 1 1 C)` O q.\ Sr Z- as (`)t l'P-- for A, [J t,..i,,� -■—sy'a s -.a. Name erscx Type ofauthority (e.g. officer, trustee) Party on behalf of whom instrument was executed vffl�,` "*'4j` MARGARET M ROSgI nally known_ or produucce�d Identification. (Signature of aryublic State of Florida Notary Public • State of Florn of Identification produced -Yl-, _lY_ �d¢� L\ C_D�,�L,t,.Print, Type, or5tamp Commissloned Name 1)My Comm Espiree Jul 22, 2p1' Commission • FF Ojj1 s BorrGed MtII0t111 STATE OF FLORIDA ST. L a�1 M THIN0 CERTIFY THAT T IS I(A):. TRUECORR��T C < PY ; F ;HE ORIGa, Date- a JAN 1 7`2014 -- A.* CEMEX 8 2 � 9 8 4 Plant: Begin Loading: To Job- Arrive Job: Start Unload: I Finish Unload: Leave Job: Return Plant: Customer Code: Customer Name: Projed Code: proied Name: Ticket Date: Delivery Address: Delivery instructions: r1F Due On Job: Slump: Truck Number. Driver Number. Driver Name: 7_1 i 4. Customer Job Number. Pmjed P.O. Number: Order Code/ Date: Order P.O. Number. Map Page: Map/Row/Column: D*DoW—. Ticket Number. End Use: LOAD QUANTITY CUMULATIVE QUANTITY ORDERED QUANTITY MATERIAL CODE -7--�UOM PRODUCTION DESCRIPTION IT UNPRICE 6 AMOUNT) F �v j-V Cash Check # Auth gode: Signature of Driver Receiving Cash: Cash Received: Total C& Order Amount to Coll) Check Without Standby Charges: Charge Comments: WATER ADDED: -GAL YARDS IN DRUM: WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWN ER'S!AGEN T- ,�.REQ ST I I 7— SIGNATURE UR El LOAD WAS TESTED j3Y-.` 4 Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water *Wis at custorde'rs own risk,)J4,atar Is added on job, concrete stren�. Company assumes no respomblifty for damages inside curb or property line. Customer agrees to the Is no longer guaranteed. WARNING: Product.` SW and/or eye Irritation. CAUTION: Matd, terms of sale and delivery and accepts concrete as Is. Due to Important factors which are out of our may be hazardous to yo�r*,fjty and heaftKr Please reto the backside of this ticket for Im control after delivery, this Company will not accept any responsibility for the firished results. No credit for returned concrete. Buyers exceptions and claims be deemed in safety handling in E I "' the mateMl sifety diiild sheels­f.,.�ditlon.l information. shall waived unless made to us writing a business day after the receipt 6f materials. within one AUTHORIZED I Sisl�l 68UNIVERSAL INVOICE s es 4s'�'E �� cQQ�pQ D"53b� a 206.03 574.00 7S' Sc" .. •• Sd' .ib' S2' S2' 43.0 . of tt 3S:P. -" o h I 2 5 g b h 7 8 9 0 10 �p�il I M ./� �,,•�,. 0 3 4 0 0 e i� 2,3 la',¢707' 2 "Zw SECTION .. $iz6.ss. a��.�a�:'. h 7S� S2' Sz' Sc''' I-".- S2' v� A 9./8' 25 /OS' /2/.30' ti 3 a e:/2•sza3.. c A-S3.90 b essa' „S 25 'h 24 23 = 22 = 21 20 h h 19 18 : 17 = 16 = 15 14 0 13 26 o v�0 O O �28` �36" /07.56' '� c Q= 8 22 %9 •• 4 �, o0 52 • .. ,, se, Josa' .. .. 5z' /06. ��' A �so� 27 719.00 /7.Q6• N -ITS• N e9 45 36'M 2 3 4 = /9' S2' .. S2•s-2• .. $g' 69.99 W Q N Q a a^ SEC ION 'iJ" _ h 'yp 28 = a 5 6 7 �a�e 10 11 12� a 13 14, 15 16 17 18 19 20 PH S ; PHA E 2 29 • $Z • .. .. ., sz " se, •. •• Te , 69. 92 ' ,PHASE 2 PHASE 1 PHASE 1 30 �I /o, PHASE 1 al s �� .. a r u :GO o.� LAKE NO. 2 1 . 31 FiON .s!¢r� 49Ec9yZ) I -� 08l 32 LL t-L P O�BfiNK s'�'/g.yti E /9z / /GiD ' 70' Sd" •• •• •• S2' 65 LL :ter/�, 20 2 I h 22 23 24 25 26 27 33 5+O-. 79 o \ 34 h 19 se • .. se' /GO' FLIQAI UAL PLJ55-00 .AKE NO, 3 I N e9 43 13'Y sa,S2• 35 150 14 13 12 II 10. 36 17 h 16 SECTION " G 11 sa, c 0 ss' .Ss'. Se No: 37 x r. 241 , GL-' N r � J S c t;2.0