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Date: ` ��o— � � �C Permit Number: 1WC% • �.
ANN�®
BY
St. Lucie County
h
• r
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 F•'
L� pp
;.
Address: 590& nrn YRTL iF
Legal Description: Z Al 10TON A.1.y' _, /Z EST ,42 9!5 - rrN-rT 08 - (3 L h 6 t LOT 15
(MA103111i14(og ioiq-2ro))
T
Property Tax ID #: 3 4 0A -60q -0333— 000-5 Lot No. i5
Site Plan Name: Block No. (01
Project Name:
Setbacks Front Back: Right Side: Left Side:
e/o/act 9' x 20"
l h,'e- wi�ti 3000 ASS w; � h
onal work to be pe
_Mechanical _ Gas Tank
Electric _ Plumbing
Total Sq. Ft of Construction: �0
Cost of Construction: $ s 1
permit — cnecK aii tnat a
Gas Piping Shutters _ Windows/Doors
Sprinklers = Generator _ Roof
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Name no-r-em 3 V e-Ie.t
Address: a 507 L e, z Nam A OC � �h
City: F= - A'&-Ce' State: LL
Zip Code: 3 4 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Company:
Address: '5W 0 .L a/m Or -
City: Ft loilerc-e— State: FL.
Zip Code: 3� 164 Fax:
Phone No. C77&5
E-Mail:
State or County License:
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
L E t. QNS1'R. fiI
1. .1:A�' N 4 0 T QI\I
'�
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 co venantsFthat-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 rec'nested permit; I -do hereby agree that I will; in all respects; perforrrr' 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 concucrency review: room additions,
accessoiry structures, swimming pools, fences, walls, signs, screen rooms and''acceswry uses to another hon-residential use
WARNING 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 lender or an attorney before
commencing -work or recording your Notice of Commencement.
Signature Owner/ Agent/'Lessee, -
Sign ure of.Contractor/License Holder,q
�=
-,,,,,
'`��_
STATE OF FLORID _
STATE OF FLORIDA
COUNTY OF
COUNTY OF
m
The forgoing instru ent was acknowledged befog
aie
The forgoing instrument was acknowledged bef
o
this day of 20 by
2 5 8
-
this day of f -�-� 20 by
N
rnm�
error^=
/!All%�
(Name of p on acknowledging)
�'
(Name of person ac no edging) �zi
� C,
Signature of6libtary Public- State of Florida)
(Signature of Not Public- State'pf Florida
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. (Seal)
Commission No. (Seal)',,
4
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE'
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/2014
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,
-5yd !Pot L,
(Parcel Id#/Legal descripti Address)
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.
roe Owner Name (Please r nt)
roperty Owner Signature \ / Date
a
STATE OF FLORIDA, COUNTY OFC 4
ACKNO EDGED BEFORE ME THI v DAY OF "`y/�' 20—
WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
P ODUCED AS IDENTIFICATION.
SIGNATURE1/jOOFrN�OTARY PUBLIC TYPE OR PRINT NOTARY
✓ / LMISSION NUMBER n
.•, x, (SEAL)
" P1l6LISSA'C;9�FORD
Iv�Y CONQd1SSI0N_ "16 ,
8�4: A> w 14.201
,. 1.
SLCPDSD Revised 08/24/2010-,.
Property Appraiser - St.Lucie !7 ��nty, FL
Page 1 of 1
13110130t+Y RECORD CARD
Karen S Gelety Record: 1 of 1
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Taxes Exemptions Permits Home Print
Property Identification
Site Address: 5806 MYRTLE DR
��UCIE�0
ParcellD: 3402-609-0333-000-5 �G,L
Secrrown/Range: 11:36S :40E
Map ID: 34/11S
Zoning: RS-4
Account #: 37866 yet
Use Type: SF Res, .�
City/Cnty: Saint Lucie County
Ownership and Mailing
Legal Description
Owner: Karen S Gelety
INDIAN RIVER ESTATES -UNIT 08- BLK 61 LOT 15 (MAP 34/11S) (OR
Address: 2507 Lazy Hammock Ln
1049-2101)
Fort Pierce FL 34981
Sales Information
Assessment 2014
Total Land and Building
Date Price Code Deed
Book/Page 2014 TRIM: 61600
Land Value: 7700 Acres: 0.23
12/4/1996 73500 00 WD
1049 / 2101 Assessed: 59510
Building Value: 53900
5/30/1990 12000 00 WD
0693 / 1079 Ag.Credit: 0
Finished Area: 1527 SgFt
3/23/1990 12000 00 WD
0684 / 1689 Exempt:
8/1/1976 2000 00 CV
0257 / 0769 Taxable:
Taxes: 1095.67
BUILDING INFORMATION/0 ->
-) 51
Exterior Features
View:
-
RoofCover:
SD - Dim Shingle
RoofStruct:
GA - Gable
ExtType:
HC - HC
YearBlt:
1990
Frame:
Grade:
C - C
EffYrBlt:
1990
PrimeWall:
FS - Frm Stucco
StoryHght:
0010 -1 Story
No.Units:
1
SecWall:
Interior Features
BedRooms:
3
Electric:
MX - MAXIMUM
PrmintWall:
DW - Drywall
FullBath:
2
HeatType:
FHA - FrcdHotAir
AvgHUFI:
1/26ath:
0
HeatFuel:
ELEC - Electric
Prm.Flors:
CU - Carpet
%A/C:
100
%Heated:
100
%Sprinkled:
0
Special Features and
Yard Items
Land Information
Type
Y/S Qty. Units
Qual. Cond.
YrBlt. No. Use Type
Type
Measure Depth
DWC - Driv-Concret
Y 1 720
AV AV
1990 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?prclid=340260903330005 9/16/2014
Tuesday, Sep 16, 2014 03:59 PM
PLANNING AND DEVELOPMENT SERVICES 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: I U I —0 2 ` ADDRESS: �806 V4 rile
I, ILq,m G�i�iltiam 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. (� i
Justification Co rr4- Cl l'-tit/ ' 1 v tC��" (l i d,
(�;�t
OWNER/BLDR OR CONpTfe'hl
RAACT R SIGNATURE DATE
k�cve � ClL
Print Name
STATE OF FLORIDA
COUNTY OF c J
l
ACKN �ILEDGED BEFORE ME THIS DAY OF 20�
gy��-C,�l IS PERSONALLY KNOWN TO ME , OR
HAS PROVIDED
STATE OF FLORIDA, County of
SIGNATURE OF NOTARY
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = $ Renewal fee
AS IDENTIFICATION.
SEAL
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014
fised NO-st=tni',r-
iny easement c),
ervAse approved.