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Home My WebLink AboutSUBMITTED PAPERSOFFICE.USE ONLY: DATE FILED: PLAN REV IER' FEE : RECEIPT NO.: PERMIT NUnT 1BER: CONCURRENCY FEE: RECEIPTNO.: CERT. CAP. NO.: ALL INFO MUST DE COMPLETE & FILLED IN TO BE ACCEPTED PLANT NING & DEVELOPMENT SERVICES DEPARTMENT BLILDLNG & CODE REGULATIONS DWISIO'\ 2300 Virginia Avenue Ft. Picrce, FL 34932-5652 C?i Gig 772-462-1553 (� APPLIIr,`,A'110N for B UIL-LA G YE_._ -- CERTIFICATE Of CAPACITY /7—ONING COMPLIANCE PROJECT INFORMATION I . LOCATION/SITEADDRESS: /(/ LQ 810 Oct V. 2. PROJECT \?AN E: SITE PLAID. NAME: 3. PROPERLYTAXID#: I3o[-603 C)1 J`�1 - 000- 4. LEGAL DESCRIPTION (attach extra sheets ifnecessary): La et,,00 d Park - UAJ � - QLK 1( LOT 17 5. PLAT BOOK O 6. PAGE NO. (, 3 n 7. BLOCK NO. d- ( S. LOT NO V 17 9. PARCEL SIZE (ACRESISQFT.): 2T aGreS LOT DIMENSIONS: (Jc)` X 50 12,000 . f tt, 10. COMPLETE DESCRIPTION OF ONSTRL'c n6N'.PROJECTORWORK ACTIVITY: 11. SETBACKS (ACTUAL) FRONT: �( BACK: 36RIGHTSIDE:_IS LEFTSIDE: qg 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEu' CONSTRUCTION [ ] EXPANSION/ADDITION' [ ] INTERIORRENOVATION [ ] RESIDENTIAL [ ] CONRA4ERCIAL, [ ] INDUSTRIAL OTHER (SPECIFY) S ed, 11 DESCRIPTION OF PROPOSED USE: 5-6 �'Gl076 14. SQ. FTOF CONSTRUCTION: ' 1 15. SF. FT 1st FLOOR: I 16. VALUE OF CONSTRIICTIOI\ : S ��ao The vahre ofconstruction is used to determine the amount ofpernt& fees to be assessed St Lt cie County reserves the right to question and,'or modify the nrlicated tahae ofconsiruction ifit is denorstrated that the submtted ft?tres are nor consistent vcsh similar t}pes ofconstruction acriviries. Ifthe value is S2500 cr more, a RECORDED NoticeofCommencea rnt mast be submitted Kith this applkation. SLCCDV Fo¢m No,: 001-02 UPDATED 6/25/09 . OWNERINFORMATION ADDRESS: nO � ke i • J Fort q" CITY: FoI�Ce / r� r� ^ sTA : F ZIP: PHONE (DAYTIME): 07o CG d �/ ii 11(.( (� Erimz Ue L 2 C,o /h �� < A'e t IF THE FEE SIMPLE TITLEHOLDER (PROPERTeTY OW- ER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FF- SIMPLETITLEHOLDER: IVA ADDRESS: CITY: STATE: ZIP - PHONE (DAYT IAE): �r CONTRACTOR INFORMATION ST. ofFL REG.CERT #: ,' , ,p ST. LUCIE COUNTY CERT# , BUSINESS NAME: �p,j F7)2- QUALIFIERS NAME: ADDRESS: CITY: STATE: ZIP: PHONE (D Y ME): _,FAX NO. Email ARCMT/ENGINEER: JaSor1 w • �+ rT' . Pr�Ac f�A ADDRESS: 463U (l k f-W (aw Prve . CITY: Ver-0_Ck ''ff STATE: FL ZIP: PHONE (DAYTII IE): (% 71 T�� - 25 7 ( BONDING COMPATv-Y: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: ,. STATE: ZIP: ZIP: IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification it -wilt be voided and retumed 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 ifapplicable, far the perrhitted work. I certify that no work or installation has conmwmed prior to the issuance ofa permit and that all work will be performed to meet the standards ofall 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 apphcatimL St. Lucie County makes no representation that its granting ofa 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 Wth your Homeowne' s Association and rLview your deed for any resiricticnswhich may apply. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures (all types), swirnnft pools, fences, walls, sins, screen rooms, utility substations & accessory uses to another non- residential use. NOTICE TO O'VVNER: YOUR FAILURE TO RECORD A NOTICE OF COv1MP.N'CEbiE1\T MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOBSITE BEFORE TBE 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. � NTRACTO SIGMA STATE OF FLORID. COUNTY OF �IV. C4� The foregoing instrument was acknovriedged before me this day of / t2 20 /, who is personally known or has produced as identification c Signature of tart' Commission No. (Seal) 0 jXc-ic 22 5-0 mm ?_ 9 o N - N W �zc 6�m� toO = N O � m C;, G a CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument this day of by — wino is before 20 , known or has produced of Notary Commission No. as identification. (Seal) NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE.MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERINIIT AS AN OWNERJBUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. OWNER BUILDER AFFIDAVIT V,1LL BE REQUIRED FOR ALL OWNERIBLILDER APPLICANTS. For specific instructions see appropaiate permit checidist. OFFICE USE ONLY BP #: SECTION TOWNSHIP RANGE MAP NO. ZONING LAND USE LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP 9 1 sP FLR ELV Y:. , MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC LOT SPLIT LOT SPLIT Before 1/ 1990 A$er 1/1990 REQUIRED APPROVED REPORT HABITABLE RADON PERMIT CODE AREA FEE FEE RADON LIBRARY PUBLIC BLD PUBIC BID PARKS IMPACT IMPACT FEE IMPACT IMPACT FEE CORRECTION FEE FEE GENERAL SCHOOL ROAD CRED Y NT LAW E[dF IMPACT IMPACT IMPACT FEE F FEE FIRESMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE IMPACT REQUIRED FEE VARIANCE FEE FEE SPECIFY MECHANIC ROOF NON -CONFORMING MISCELLANEOUS SUBS ELECTRIC GAS LOT OF RECORD FEES REQUIRED PLU�,OJ G FEES DATE SENT TO ADDRESSING_ REVIEWS FRONT ZONING SUPERVISOR PLANTS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REV V REVIEW REVIEW REVIEW REVIEW DATE RECEIVED ' DATE COMPLETED ` 6 ILI INITIALS i PLANNING & DEVELOPI%IENT SERVICES BUILDING & CODE COMPLIANCE DIVISION BUILDING PERMIT SUB -CONTRACTOR SUMMARY Jq)`z,JU(', Le-ZAMekI(C-z, (Company/1 d'vid a) project located at 7 LA ke s( c/e (Stidsor will be using the following sub -contractors forthe Tax ID ff) It is understood that if there is any change of status regarding the participation of any of the sub -contractors listed below, I will immediately advise the Building and Zoning Department of St. Lucie County. Trade Name of Company/Contractor St. Lucie County/ State of Florida License Number Electrical Plumbing c HVAC/ Mechanical Roofing fi t. &ZA CG✓��C Gas OFFICE USE ONLY PERMIT ISSUE DATE: NUMBER: PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING FERMIT SUB -CONTRACTOR AGREEM�IT St. Lucie County Contractor Certifxation.Number: State ofFlorida Certification Number (ifappficabie): o S �� LC �'I 'C. to r G 2 have agreed to be the (Company War fnd',—, Y arr sub -contractor for (Primary Contractor) for the project located at 70 L�«Sid �/ �` (Project Street d rep or Property Tax ID ) It is understood that, ifthere is any change ofstatus regarding our participation with the above mentioned project; I wrll immediately advise the Bui]dirng and Zoning Department ofSt. Lucie County by personaly filing a Change ofConractornotice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER(NmrmofdheIndividual shown onthe Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED JPAIA10, LPIZA"Cw icZ 1 t0r4 Business Name: Address: City'StatelZip.: Phone: , OFFICE USE ONLY-. PERMIT # ISSUE DATE I 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 or a commercial building at a cost of under $75,000.00. The building or residence must be for your own occupancy. It may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved your self within one year after the construction is complete, the law will presume that you built or substantially improved it 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 a licensed contractor who is not licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide wo ker,�' compensation for that employee, all as prescribed by law. Your construction must comply with all applica 1tr�Gs, 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 eet the minimum code. Initial I understand that as an owner -builder that any contract disputes with sub -contractors and I must be an 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 required t9lbe licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and lia the cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my construction r..0 they may be entitled to workmen's compensation. I could be held liable for. all doctor, lawyer and relat dical 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 exemption shall be reported by the Building and Zoning Dep ent to the Florida Stat�epartment of Professional Regulation Si ed and acknowledged on this day o of 20 wner/B r Signa STATE OF FLORIDA COUNTY OF l The for om instrumen was ac o edg before me this J day o 20 / , by / L -(.-who is personally o to me, or who has pro uccd a identification. CM lgnature of N t Yype or Print Name of o 9Y (eal) Title: Notary lic Commission Number SLCPDSD Revised 07/22/2010 y,,,.. �'y�o� *: *_ E WE REKB. HUMPHREY MY COMMISSION ....... ..... Y N EE 06 Bonded Thra EXPIRES.' Mg arch 6 2015 NotaryPoblic Undenwiters 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, - ?C) 3 Lo, ke s r ale f j0, (` (Parcel Id#/Legal 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 WELL 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, 03mer Name (Please Print) 15roperty er Sign e D e STATE OF FLORIDA, COUNTY OQU ACKNNOOWLE,DGdE, D BEFORE ME TTHIS V DAY -OF 205--- BY o ), I J �� E� L1 WHO IS PERSO LY KNOWN TO ME OR WHO HAS 1141110010430111 Y PUBLIC V TYPE OR PRINT "COMMISSION NUMBER (SEAL) AS IDENTIFICATION. SLCPDSD Revised 08/24/2010 ti.'s$' AUDREY B. HUMPHREY r_ MY COMMISSION # EE 061159 EXPIRES: March 6, 2015 Bonded Thru Notary Public Underwriters TAN T C.O ' SULTTNG EN.61NEERS April 24, 20.14 . St; .Lucie County Building andInspections. 2300' Virginia:Ave. .: . Fort Pierce, FL, 34982 Re: -Shed -Structure Lezniewicz. Residence 7103 Lakeside Way. Fort Pierce, FL 34951 Permit .#TBD . To Wh6rn -It 1VIay'Concern:; This letter is 4ritten to provide certification that. I, as a Professional Engineer, .have 'bedn .retained .to establish compliance with the, St: Lucie County codes and regulations pertaining, to the detached. shed structure at -the residence.fisted above... Based on this firni's, analysis & site inspection; the shed has been built and -strapped. down per the attached plans and specifications, and is in accordance with the 2010 Florida Building Code.. The engineering services addressed therein have been-perforined and based upon my professional engineering. knowledge, technical documentation, information and :belief; and in accordance withcommonly accepted procedures consistent with applicable.standards.of practice, and'is not `a guaranty or warranty; either expressed or. implied.- Should. you have'any questions, please feel free to call meat (772) 473=2571.. 114111 0.6 18 ' *. anon W. Short, ' ,�I.ASCE RIONngi`� ��'S�41VAL b✓I1.1J6§h Lezmewicz