HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE
DATE FILED:
PLAN REVIEW -FEE: RECEIPT NO.:
CONCURRENCY FEE: RECEIPT NO.:
PERMIT NUMBER: , q03 0 2 -
CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Avenue
Ft. Pierce, FL 34982-5652 SCANNED
772462-1553 BY
St, Lucie County
APPLICATION for BUILDING PERMIT
CERTIFICATE' of CAPACITY/ZONING COMPLIANCE
1. LOCATION/SITE ADDRESS- pp / t
2. PROJECT NAME: 12 9-Ar W fS / SITE PLAN NAME:
3. PROPERTY TAX ID #: V j ® 2 j3)/ 0�q 7 o0o °—
4. LEGAL DESCRIPTION (attach extra sheets if necessary):���w
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO.
9. PARCEL SIZE (ACRES/SQ FT.): 200 LOT DIMENSIONS:
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: 5 4 !p/ -coop—,
1'7ok1Lp A�� t 6 AX -, e-Ir 3 000
6Aln1-w5A
11. SETBACKS (ACTUAL) FRONT: � BACK: L3 RIGHT SIDE: LEFT SIDE:
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
NEW CONSTRUCTION' [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ '] INDUSTRIAL
[ ] OTHER (SPECIFY) ` J I
13. DESCRIPTION OF PROPOSED USE: Y`6 i �_�0 � 1 �' A10A 5P
14. SQ. FT OF CONSTRUCTION: / yy 15. SF. FT 1st FLOOR:
16. VALUE OF CONSTRUCTION: $
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
t
rj)a
?6�t-
UPDATED 6/25/09
OWNER INFORMATION
ADDRE
CITY: L(% i1� 6 F-/,7 /ESTATE: ZIP: y�U
PHONE (DAYTIME): L� I Email:
IF THE FEE SMPLE TITLEHOLDER (PROPS TY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER:
ADDRESS:
CITY:
PHONE (DAYTEWE): (_)
STATE:
CONTRACTOR INFORMATION
ST. of FL REG.CERT #: Cefe l
BUSINESS NAME: x- . le-
QUALIFIERS NAME:
ADDRESS:
CITY: ^ 2� v * }° 11 STATE:
PHONE (DAYTRvIE): ( FAX NO.
ARCHIT/ENGINEER:
ADDRESS:
CITY:
PHONE (DAYTIME):
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE:
STATE:
STATE:
ST. LUCIE COUNTY CERT #: / dp i s
Email:
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.
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.
W R OR ONTRACTOR SIGNAT
STATE OF FLO
COUNTY OF ti a
The foregoing instrument was acknowledged before
me this day of 20�
by
who is personally known " or has proceed
SIG
STATE OF IF
COUNTY OF
The foregoing instrument was acknowledged before
me this6.day of 20-,
by
who is personally known or has pro ed
as identification. as identification.
Signature of Notary 'nature 2 Notary
+� DAWN MILONE°��"
.ti,,ar PCB., DAWN MILONE
� mission No.
Commission No. :%.��.), Notary Public - State of Flori '��° • `''.
�t �? + � ; Nota(S@ai)c -State of Florida
^_ •? My Comm. Expires Mar 22,. 2017 : e My Comm. Expires Mar 22, 2017
Commission # EE 877571 Commission # EE 877571
%° ���� Bonded Through National Notary Assn.
Bonded Through National Nolary Assn.
NOTE: TWO (2) SIGNATURE :EACH SIGNATURE MUST BE NOTARIZED. aF 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.
OFFICE USE ONLY
SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
LAND USE
LOT CVG %
TAZ NO.
FLOOD ZONE.
FIRM MAP #
1ST 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 1/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
HABITABLE
AREA
RADON
FEE
PERMIT
FEE
LIBRARY
BRACT
FEE
PUBLIC BID
IIMPACT FEE
CORRECTION
PUBIC BID
BRACT
FEE
GENERAL
PARKS
IMPACT
FEE
SCHOOL
BRACT
FEE
ROAD
IMPACT
FEE
CREDIT
Y
N
LAW ENF
BRACT
FEE
FIREBMS
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
DATE
COMPLETED
INITIALS
SET 5/8" IRON
ROD/CAP "LS3335"
r4\\ NO IDENTIFICATION
t \P060
LOT �76
S7W24'38"E
PROPOSED RESIDENCE
PROPOSED MINIMUM
FLOOR ELEVATION -- 6,0
5'10")
5 1 8 1
ci
18*1 oll
--T4
-�A
rri
> cl�
zom rr
0 rrl U)
::� 0
5
z
.,4+ (195,")
cl> 19.4
f in 3
0
IN
FOUND 6/&" IRON ROD
NO IDENTIFICATION
313801100
TRASHn
PROPOSED
X ,,, PARKING
city 2 0.6'
---------------
8, x P
PROPAR
18,OSED'*""
KING
r
C)
3.8 r"
z
FT,
co
rr
corny a)
C4 0
i 3.7
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,
% 0gryl 000 —
(Parcel Id#/Legal description/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.
Property O er Name Please Print)
roper caner Signature Date
STATE OF FLORIDA, COUNTY OF 5-t- Lu �_, L
ACKNOWLEDGED BEFORE ME THIS 3 DAY OF fV� 6,'X 'iv \ 20 l 'i
BY WHO IS PERSONALLY KNOWN TO ME X OR WHO HAS
PRODUCED
SIGNATURE OF NOTAMY PUBLIC
Eatj50MMISSION NUMBER
SLCPDSD Revised 08/24/2010
AS IDENTIFICATION.
�/y I uk,rA, � 2 Ts" L-oV1
TYPE OR PRINT NOTARY
MICHELE J. BROWN
NOTARY PUBLIC
8TNEW FLORIDA
.. Comm# EE219335
Expires 10/1/2016
St L- ucie County In!_ ctions
2300 Virginia Avenue
Ft Pierce; FL 34982
(772) 462-2172
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT # /qo 3 0-1a 9 JOB ADDRESS_Z ! � g:- #I e s w�
Q2k La�'1�110
PEST CONTROL CONTRACTOR_A�i�ic1� �X7RP�n,
PEST CONTROL. LICENSE # q f Ce y
We, the undersigned, hereby certify that we have pretreated the above -described construction. for
subterranean termites in accordance with the standards of the National Pest Control Association. .
Square feet of area treated: /000
Percentage of solution: ' ? S
Date of treatment: Y -2 —/ t-%
❑ Footing
❑ 1st Treatment
Re -treat
Slab
❑ 1st Treatment
❑ Re -treat
❑ Driveway
❑ 1st Treatment
❑ Re -treat
❑ Pools
❑ 1st Treatment
❑ Re -treat
❑ Other
❑ 1st Treatment
❑ Re -treat
Chemicals used: t5C o 1---,u (1V T C-
Total gallons used: /o c) .
Time of Treatment: 19' ; Do A ",
FBC104.2.6 Certificate of Protective Treatment for prevention of termites.
A weather resistant jobsite posting board shall be provided to receive
duplicate Treatment Certificates as each required protective treatment is
completed, providing a copy for the person the permit is issued to and
another copy for the building permit files. The Treatment Certiftcate shall
provide the product used identity of the applicator, time and date of the
treatment, site location, area treated chemical used percent concentration
and number of gallons used to establish a verifiable record of protective
treatment: If the soil chemical barrier method for termite prevention is used,
final exterior treatment shag be completed prior to final building approvab
St Lucie County requires for the final inspection for CO, a Permanent
Sticker to be placed on the electrical panel box cover, listing all the
treatments and dates of applications
❑ Perimeter for Final Inspection
NOTE:
- e c
Signature of exterminator
There must be a completed form for each required treatment or re -treatment and thisform must be on
the job site to be picked up by the inspector at time of each inspection or the scheduled inspection wfil
Revised 6/13/02 dmg
fail and a re -inspection fee charged
-
Mar, 14. 2014 10:19AM N T;A-FC DEPT
N.o, 3567 P, 1
ettles Island
February 251 2014
Jobn & Fatricla Lowe
761 Nettles Blvd.
Jensen Beach, F134957
RE: 761 Nettles Blvd
M1 SOUth Ocean WIN, Jensen Beach, FL 34957
(772) 229-2930
FAX (772) 22MS01
The review of your plans for lot #761 is complete. The site plan complies with the
required setbacks, and meets Nettles Island, Inc, two vehicle parking space requirements,
we have no objections. Any modifications that affect the Foot print of the house must be
resubmitted to Nettles Island for approval. Enclosed is a copy of Nettles Island
Procedures Governing Contractor and Building Activity on Nettles Island.
Upon completion, please send a copy of your final survey for our files.
Respectfully
Frank Fisher
Architectural Chairperson
CC: Laura Jones, LCAM, File
aFPRO�IEaD
I
w
572o Environment Drive
BUILDING RELATIONSHIPS FOR OVER 3l. ,. -ARS
I
Ft. Pierce, FL 34981
•
Tel. (772) 595-1020
Fax: (772) 464-8941
Headquarters:
`CONCRETE
2 01 M ami, FL 3 172e.
a - I ,
Dade: (305) 669-0611
Broward: (954) 434-1244
C1
Fax: (305) 599-2827
adonelconcrete.com
DATE:
SOLD TO: /
J
DELIVERY �.; (1� :`:i': C I_.I..si= :,',' (`,i�'. tiai�i l•?[::.:;
ADDRESS
REMARKS:
10327N.
i
WARNING
IRRITATION TO THE SKIN AND EYES
READY MIX CONCRETE CONTAINS PORT AND CEMENT.
AVOID CONTACT WITH EYES AND PROLONGED CONTACT
WITH SKIN. WEAR RUBBER BOOTS AND GLOVES.
IN CASE OF CONTACT WITH SKIN OR EYES, FLUSH
THOROUGHLY WITH WATER. IF IRRITATION PERSISTS,
GET MEDICAL AT rumOWKEEP CHILDREN AWAY.
i
DRIVER FILL IN
BATCH TIME
10 -11
LEAVING PLANT
10-97
10-1
ARRIVE ON JOB
STARTING UNLOADING
10-2
10-5
FINISH. UNLOADING
LEAVING JOB
JOB NUMBER
P.O. NUMBER
TRUCK NO.
DRIVER1/
PRODUCT CODE.
CUSTOMER NUMBER
h/, `
CUBIC YARDS
CITY. ORDERED
TOTAL DEL.
DESCRIPTION
UNIT PRICE
AMOUNT
f�`';.;,,(.irtl.i'`(p'{`{-!I.
4
/
�
A�°3 i 4 w,1112.50
,
SLUMP:
I HAVE AUTHORIZED THE DRIVER OF THIS TRUCK
TO ADD
GALLONS OF WATER ,'
STATE-S ES TAX
I
6
RECEIVED�BYR� / �--
,,-TOTAL
`
+�
If it becomes necessary to bring action to collect amounts due oh his invoice, purchase on this invoi`cd,:purchaser shall be responsible for reasonable attorney fees,
court costs, notice to owner, and lien cost incurred by vendor in s Puring collection. Interest shall ac rc ue 1-1/2% per month on outstanding balances.
TERMS: All invoices are due in full by the 25th of the month follo4ing delivery. Accounts with past due invoices over 60 days will automatically be placed on credit hold -
do not ship status until all outstanding balances are paid in full.
NOTICE: Purchaser assumes responsibility after concrete reaches curbline. Adonel Concrete is not responsible for any damages at the job site. If truck becomes
disabled on owner's property due to unconditional ground, property owner is responsible for towing expenses, waiting time $1.00
per minute (calculated at one hour after the truck arrives at the job site).
I