HomeMy WebLinkAboutSUBMITTED PAPERSSCAN
BY
Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Pew1 �
Address: q '1 l)< 4,F& Pf 3'rtvf T-b-f� Ply T-L 3 .'-1 7,15 -L—
Legal Description: [O-V I[/ , IS �-I Tk 1�1 �ti 1°t ��@.,, i ( 9 n
Property Tax ID #: a4nC7 �b b S D a� Lot No.
Site Plan Name: Block No.
Project Name: e�Oc4e.
Setbacks Front Back: Right Side: Left Side:
nai worK to De perrormea unaer tnis permit-
-Mechanical _ Gas Tank _ Gas Piping
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ ��C)0-rbo
aii tnat apply:
Shutters
Generator
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Windows/Doors
Roof
Building Height:
Name r 1 v Name:
AddreT'�
eC s Company:
City: ,-c 4-z State: v Address:
Zip Code: 2 Fax: City: State:
Phone No. 1 1eL Zip Code: Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page (if different E-Mail:
from the Owner listed above) State or Co u y License:
r
if value of construction is 2500 or more, a RECORDED Notice of Commencepient is required.
Q�ftP � LflAA1l�LAF �
..
DESIGNER/ENGINEER: ' _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your . A Notice of Commencement must be recorded and posted on the jobsite
before the firs ' ection. If you ' tend to obtain financing, consult with lender or an attorney before
commen ' work or recordingo r Notice of Commencement.
S g t"ure of Owner/ Agent/ L ssee
Signature of Contractor/License Holder
STATE OF FLORIDA ff
STATE OF FLORIDA
COUNTY OF_s:�c
COUNTY OF
The forging instrume t was,acknowledg efore me
The forgoing instrument was acknowledged before me
this ay of 20 by
this day of 20_ by
(Name of person acknowledging)
0� ,V� Q r�., 1-y� �1,9 0, 6 k
(Name of personacknowledging )
ignature of N ary Public- State of Florida)
(Signature of Notary Public- State.of.-Florida )
Personally Known OR Pr ged ification
Personally Known OR Produced Identification
An
Type of, Identification Produced
h
Type of'lde.ntification Produced
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
.DATE
7-
COMPLETED
Rev. 7/2014
Planning & Development Services Department
Building & Code Regulations
2300 Virginia Avenue
Fort Pierce, Florida 34982
(772) 462-1553
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
F.S. 489.103 (7) EXEMPTIONS
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even
though you do not have a license. You must provide direct, on -site supervision of the construction yourself. You
may build or improve farm outbuildings, a one -family or two-family residence for your use and occupancy. You
may also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for your own
use or occupancy. You may not build or improve said structures for the purposes of selling or leasing that building.
If you sell or lease a building you have built or improved within one year after construction is complete, then a
presumption is created that it was built or improved for sale or lease, which is a violation of this exemption. You
may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is
your responsibility to make sure that people employed by you have licenses required by state law and by county or
municipal licensing ordinances. You may not delegate the responsibility for supervising work to used
contractor who is not licensed to perform the work being done. Your construction must comply with al appli ble
laws, ordinances, building codes, and zoning regulations. Initial
I understand that the building official and inspectors are not there to design or give advice on ho to eet
the minimum code. Initial
I understand that as an owner -builder that any contract disputes with sub -contractors and I must be a led
in a civil court with the advice of an attorney. This department will not mitigate any contract disputes.
Initial
I understand that if I compensate any person or company for work performed they are require be
licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and la a for t e
cost of the license. Initial
I understand that if any person that is unlicensed and uninsured gets injured on my construction roject-
they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relat m is I
cost, which could include loss of wages during recovery from their injury. Initial
To qualify for this exemption under this subsection, an owner must personally appear and sign the building
permit application and initial the above.
I hereby acknowledge that I have read and understand the above disclosure statement and that I further
understand that any violation of the terms of the owner/builder exemptio be —repo-?N,,by the Building and
o 'ng Dep nt to the Florida State Department of Professional lation. Signed and.ac owledged on this
day of of 20.
Owner/Builder Sie ture---
STATE OF FLO D \
COUNTY OF
The goi!!a instfunie4i was c powledgfd Pefore me this IG day of 20
by is personally known to me, or who has
produced as identificatio .
�(\ l
Signature of N ary T pe or Prmt Name cyNotary (Seal)
Title: Notary Pdblic Commission Num er
SLCPDSD Revised 05/15/2014 �
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Angela Huff
From:
Katherine Barbieri
Sent:
Friday, September 12, 2014 4:04 PM
To:
Debra Zampetti
Cc:
Angela Huff
Subject:
RE:
The signature appears to be notarized so please proceed.
From: Debra Zampetti
Sent: Friday, September 12, 2014 3:40 PM
To: Katherine Barbieri
Cc: Angela Huff
Subject:
Katherine,.
A customer wants to pull a building permit for his friend who is in the Isreali Military and has dual
citizenship. Attached is a general power of attorney that I felt you should see. No witnesses.... ?
Let me know the verdict...
Debra Zampetti
Zoning & Permitting Supervisor
Permitting Division
Planning & Development Services
2300 Virginia Ave, Second Floor
St. Lucie County, Florida
(772) 462-1558
(772)462-1578 (fax)
za m p e tti d @s tl u c i eco. o rg
Please Note: Florida has very broad public records laws. Most written communications to or from County officials regarding County business are public records
available to the public and rnedia upon request. It is the policy of St. Lucie County that all County records shall be open for personal inspection, examination and !
or copying. Your e-mail communications will be subject to public disclosure unless an exemption applies to the communication. If you received this ernail in error,
please notify the sender by reply e-mail and delete all materials from all computers.
Please Note: Florida has very broad public records laws. Most written communications to or from County officials regarding County business are public records
available to the public and media upon request. It is the policy of St. Lucie County that all County records shall be open for personal inspection, examination and
or copying. Your e-mail communications will be subject to public disclosure unless an exemption applies to the communication. If you received this email in error,
please notify the sender by reply e-mail and delete all materials from all computers.
NORTH
P
INDIAN RIVER ESTATES UNIT FIVE
��
(P.B. 10, PG. 58)
co
POWER
•Q`�
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POLE
OVERHEAD UTILITY WIRES
—jo. 1 I —I —I —I —I
—I — /PLAT LIMITS
FOUND 1 2"
\ ��
96
FOUND 1/2"
IRON PIPE
IRON PIPE
o/s 0.34'(N)
o/s 0.14'(S)
0.63'(E)
\ 0
0.04'(E)
m
\ v
34'
m
\ G
dCONC DECK e ' ° e
n
e
°
POOL
17.5'X9'f
°
m
a e, N �..
\N
12.0'
17.78'
0
POOL 44.35'
\
EQUIPMENT
ONE STORY C.B.S.
00
N
\
RESIDENCE #4705
N
LOT 11 BLOCK 28 N
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12.2'
17.85'
10.15'
8.0'
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PLANTER
8.9''
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N
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10.11'
20.1'
d
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FOUND 1/2"
N
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d
IRON PIPE
N
N
FOUND 1/2"
o/s 0.07'(N)
a'
IRON PIPE
0.10'(W)
°
o/s 0.11'(N)
WATER
80.00'
v dd
METER
CONC E]
c
I CONC
CULVERT
CULVERT
N
e'd•
:..;..
SEAGRAPE DRIVE:`
108.69'
'•• (60' RIGHT-OF-WAY-)• '•• ....; :.
20.3' ASPHALT PAVEMENT .
P.C.
FOUND NAIL
& DISC
#7064
SCALE: V = 20'
SKETCH NO.: 14-0847
DRAWN BY: SP
SIDE 2 OF 2
_ PINNELL SUR VEY, INC.
5300 W. HILLSBORO BLVD., SUITE 215-A COCONUT CREEK, FLORIDA 33073
PHONE(954)4184940 FAX(954)4184941 EMAIL: order@sfland.net
CERTIFICATE NO.: LB6857
SURVEY ADDRESS:
4705 SEAGRAPE DRIVE;
FORT PIERCE, FLORID?, 34982
FLOOD ZONE & ELEVATIONS:
FLOOD ZONE: X
BASE FLOOD ELEVATION: N/A
CONTROL PANEL NO.: 120285-0193-J
DATE OF FIItM INDEX: 02/16/12
CERTIFY TO:
1. TOM TIDHAR
2. INDEED TITLE CORP.
3.OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
POTENTIAL ENCROACHMENTS:
1. NONE VISIBLE.
LEGAL DESCRIPTION:
LOT 11, BLOCK 28, OF "INDIAN RIVER ESTATES UNIT SEVEN", ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 10,
AT PAGE 75, OF THE PUBLIC RECORDS OF ST. LUCIE COUNTY, FLORIDA.
LEGEND & ABBREVIATIONS:
A
= ARC
D.E.
= DRAINAGE EASEMENT
P.C.
= POINT OF CURVATURE
A/C
= AIR CONDITIONER
ELEV.
= ELEVATION
P.I.
= POINT OF INTERSECTION
A.E.
= ANCHOR EASEMENT
E.M.
= ELECTRIC METER
P.R.C.
= POINT OF REVERSE CURVE
ASPH.
= ASPHALT
F.P. & L. = FLORIDA POWER & LIGHT
P.O.B.
= POINT OF BEGINNING
B.M.
= BENCHMARK
L.B.
= LICENSED BUSINESS
P.O.C.
= POINT OF COMMENCEMENT
B.C.R.
= BROWARD COUNTY RECORDS
L.P.
= LIGHT POLE
P.P.
= POWER POLE
C.B.S.
= CONCRETE BLOCK STRUCTURE
M.H.
= MANHOLE
R
= RADIUS
CHATT. =CHATTAHOOCHEE
(M)
=MEASURED
RES.
=RESIDENCE
CONC.
= CONCRETE
MAINT. = MAINTENANCE
R/W
= RIGHT-OF-WAY
C.L.F.
= CHAIN LINK FENCE
NO.
= NUMBER
T
= TANGENT
C.L.P.
= CONCRETE LIGHT POLE
N.G.V.D. = NATIONAL GEODETIC VERTICAL DATUM
(TYP.)
= TYPICAL
(C)
= CALCULATED
O.H.
= OVERHANG
U.E.
= UTILITY EASEMENT
C.B.
= CHORD BEARING
O.R.B.
= OFFICIAL RECORDS BOOK
W.F.
= WOOD FENCE
C.R.
= CABLE RISER
O/S
= OFFSET
W.M.
= WATER METER
= DEED
(P)
= PLAT
= DELTA OR CENTRAL ANGLE
D.B.
= DEED BOOK
P.B.C.R. = PALM BEACH COUNTY RECORDS
= CENTERLINE
M-D.C.R.= MIAMI-DADE COUNTY RECORDS .P.B.
= PLAT BOOK
= ELEVATION
GENERAL NOTES:
1. TYPE OF SURVEY: BOUNDARY
2. IF THIS SURVEY HAS BEEN REVISED AS INDICATED IN THE REVISION
BOX SHOWN HEREON, THEN ANY AND ALL PREVIOUS VERSIONS OF
THIS SURVEY PREPARED BY PINNELL SURVEY, INC. ARE NULL & VOID.
3. THE PROPERTY SHOWN HEREON WAS NOT ABSTRACTED FOR
OWNERSHIP, RIGHTS -OF -WAY, BASEMENTS OR OTHER MATTERS OF
RECORD BY PINNELL SURVEY, INC. THERE MAY BE ADDITIONAL
RESTRICTIONS THAT ARE NOT DEPICTED ON THIS SURVEY THAT MAY
BE FOUND IN THE PUBLIC RECORDS OF THE COUNTY, FOR WHICH THE
SUBJECT PROPERTY IS LOCATED IN.
4. UNLESS OTHERWISE NOTED, FIELD MEASUREMENTS ARE IN
AGREEMENT WITH RECORD MEASUREMENTS.
5. ELEVATIONS SHOWN HEREON (IF ANY) ARE BASED ON THE NATIONAL
GEODETIC VERTICAL DATUM OF 1929, UNLESS OTHERWISE NOTED.
6. UNDERGROUND IMPROVEMENTS AND UTILITIES ARE NOT LOCATED.
7. FENCE AND WALL OWNERSHIP IS NOT DETERMINED.
8. THIS DRAWING IS THE PROPERTY OF PRMLL SURVEY, INC. AND SHALL
NOT BE USED OR REPRODUCED, WHOLE OR IN PART WITHOUT
WRITTEN PERMISSION & AUTHORIZATION FROM PINNELL SURVEY, INC.
9. ALL EASEMENTS SHOWN ON THE ATTACHED DRAWING ARE PER THE
RECORD PLAT (UNLESS OTHERWISE NOTED).
10. THIS SURVEY IS FOR MORTGAGE AND TITLE PURPOSES ONLY.
CERTIFICATION:
THIS IS TO CERTIFY THAT I HAVE RECENTLY SURVEYED THE
PROPERTY DESCRIBED IN THE FOREGOING TITLE CAPTION AND
HAVE SET OR FOUND MONUMENTS AS INDICATED ON THIS
SKETCH AND THAT SAID ABOVE GROUND SURVEY AND SKETCH
ARE ACCURATE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND BELIEF. I FURTHER CERTIFY THAT THIS SURVEY MEETS
MIN MUM TECHNICAL STANDARDS UNDER RULE 5J 17,
FLORIDA ADMINISTRATIVE CODE, ADOPTED BY THE FLORIDA
STATE BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS,
THIS SURVEY IS NOT VALID WITHOUT THE SIGNATURE AND THE
ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR
AND MAPPER
i 1 :I *UbAlmJ
JASO . P L
PROFESSIONAL SURVEYOR & MAPPER
LICENSE NO.5734, STATE OF FLORIDA
SKETCH NO.: 14-0847
DATE OF SURVEY: 06/11/14
CHECKED BY: S.A.
FIELD BOOK/PAGE: 476/07
SIDE 1 OF 2