HomeMy WebLinkAboutSUBMITTED PAPERSOFFICEaJSE ONLY '
DATE FILED: i 3
PLAN REVIEW FEE: 1 RECEIPT NO.:
CONCURRENCY FEE: RECEIPT NO.:
2.
a
4.
5.
1.9.
PERMIT NUMBER:
CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Avenue SCANNeD
Ft. Pierce, FL 34982-5652 BY
772-462-1553 St. Lucie county .
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
LOCATION/SITE ADDRESS: 70 d5,q Ai ,dda/ W4
PROJECT NAME: SITE PLAN NAME:
PROPERTY TAX ID #: 3 44 P- 7 - / v / - 6 ro R 07 -
LEGAL DESCRIPTION (attach extra sheets if necessary):
PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO.
PARCEL SIZE (ACRES/SQ FT.):
LOT DIMENSIONS:
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
.j�f;;-A yYl fn -"� Soo Q • S T-
11. SETBACKS (ACTUAL) FRONT:. BACK: RIGHT SIDE: LEFT SIDE:
,13.
h4',
TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ti] OTHER (SPECIFY)
DESCRIPTION OF PROPOSED USE:
SQ. FT OF CONSTRUCTION: A 0 AW 15. SR FT 1st FLOOR:
09 VALUE OF CONSTRUCTION: $ q �0 -
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 inodify 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 Noticc of Commencement must be submitted with this application.
SLCCDV Form No.: 001-02
UPDXfED 6/25109
J
OWNERINFORMAT1Q.N-
NAME: .5'0 LA AJ C-6 R 1 CliAR!l 1�0 ed �S67 :� X
ADDRESS: -o a el u9x;1-P1
CITY: _ Og p_r _ g� , fclCf STATE: ZIP: TIP 3
PHONE (DAYTIME): &±h 0 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): U
CONTRACTOR INFORMATION
ST. of FL REG.CERT #: 0
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY: STATE:
PHONE (DAYTIME): (_ ) FAX NO.
ARCHIT/ENGINEER:
ADDRESS:
CITY:
PHONE (DAYTIME):
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE:
STATE:
STATE:
ST. LUCIE COUNTY CERT #:
Email:
ZIP:
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.
StAucie County makes no representation that its granting of a permit will authorize the pen -nit 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. IFYOU 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.
OR CONTRA00k SIGNATURE
STATE OF FLO A
COUNTY OF
The foregoing instrument was acknowledged before
me this day of J20 /7 ,
by a (i � �� U m u�
who is personally known or has produced
as identification.
CONTRACTOR SIGNATURE
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
me this day of
by
who is
Signature of Notao Sig�ture of Notary
;k�isEvledged before
�/ , 20 ,
or has produced
as identification.
Commission No. (Seat) **—Commission No. (Seal)
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 OWNERBUILDER APPLICANTS.
For specific inptructions see appropriate permit 5hecklist.
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19
1142 Water -Tower Road, -Lake Park FL 33403
Administration Office: 1-877-484-9994 1. Fax: 6612848-1501
South East Florida Division Dispatch: 561-844-9994 / Central Florida Division Dispatch: 407-339-5311
'Concrete Tested El Yes El No LOT # o
Water Added'at Customer's
Cylinders Taken ❑Y6S 0
Iff < —Request
gals to full load
Comments
Is. to 2/3 load
IS. to 1/3 load
Wfner's Rep)- Water Added
V
NOT RESPONSIBLE FOR
WARNING IRRITATION TO THE,'SKIN AND EYES
ADDMONAL: WATER ADDED TO THIS
OR VARIATION IN COLOR
Cement polymer or freshly mixed concrete may cause skin injury. Ayold contact with
skin and wash exposed skin areas promptly with Water. If any cement powder or
CONCRETE WILL REDUCE -4-T.S�ST4iNdTH
SURFACE DISCOLORATION.
mixture gets into eyes, rime immediately and repeatedly with water and get prompt
m attention. Keep children away, from cement .powder and 611 freshly mixed
6dical aft
AND DURABILITY. ANY WATER IS
AT CUSTOMER'S :OW R1,41K.
BATCH TIME
ducts.
cement pro 2
-
Load To Job a Job Begin Pour Begin Wash L_T_ Plant
At Plant
PLANT
OR
DE
#
LOAD .,SIZE _
MIX SLUMq_
'2
DATE-
ash ra
8 4 1,�_ 53'
11, 2
1 84
500
00 13_1�i G;
-4.
20--Se P-- 3
CUSTOMER #
SOLDTO
P.O. #
PROJECTO
-300
COD lillaha-d
.250
DELIVERY ADDRESS
zo NE#
USE
RIVER
7 02 BE Hiddei' River- Dr -K-*PREPAID
T STLUCCIE
SLABS
William Rios
INSTRUCTIONS
DUE
PSI-
�TIME
13.-25
CUMULATIVE
ORDERED
PRODUCT CODE
PRODUCT DESCRIPTION
U.O.M.
UNIT PRICE
AMOUNT
•0-1
I gliff
QUANTITY
QUANTITY
.5. 00
1 00
15.00
2. 5045STO
2500 REO
Y D
89i, (10
445.00
1.00
FIBERR
FIBERR
150
1.. rol (0
ENV I RO
ENVIRDI G SPOSAL
15. 00
115. 00
1. 00
2
FUEL. 81PRCHARGE
R7. 2'5
7
CL!::.,j
SIGNATURE
WARNING
OR REOEIPT - CONCRIETE-WID
ACKNOWLEDGE
A C
ENT OF HAZARD
:E ;)G.E ENT T 0 FMH
OWLI
2A
. om an U e
mraam�� yer Concrete Company will n ume flab IF any property damage or any SUB -TOTAL
514. 75
if ment damage for any deliveries you
TAX
3 3. 4E
AUTHORIZED BY
SHIPMENT SUBJECT T( CONDITIONS ON'REVERSE SIDE. TOTAL
548.21.
ir-,x-th
it
1142 Water Touter Road
;.,Administration Office 1 877-'484-
rSouth East Florida_ptvision Dispatf
t
e Park FL 33403 : <z
Fax: 561-848.-1501 �
�8 41 9994 / Central.,Florida. Ulvlslon p spatch: 407-339-531,1
Ism
Concrete Tested
Xes LOT #!
Water Added at Customer's
Cyrnders Taken
Yes o
Re uest
N, gals. to full .load
Comments
gals. to 2/3 load`•+,
gals. to 1/3 load
s er' e - Water Added
NOT RESPONSIBLE FOR .' WARNING IRRITATION TO THE SKIN "AND EYES
ADDITIONS ATE ADD 1tiDT0 THIS.
VARIATION IN COLOR OR Cement polymer or freshly, mixed concrete may cause'skin injury' Avoid contact with
skln and wash exposed skin ateas•promptly with',water. If any.cement powder or
CONCRETE WILL' -RE UCE ITS, STRENGTH,
SURFACE DISCOLORATION' mixture gets into eyes, rinse imr' ediately'and repeatedly with water and get prompt
AND DURABILITY. A: Y WATER ADDED IS
BAT C.:p IME
medical attention. Keep children away.from cement.powder and all freshly mixed
AT CUST.OMER'S OWN RISK.
.
cement products.
To Job On Job Begin Pour Begin Wash
To Plant At Plant
PLANT : ..;
}Ai
TICKET# _
i [.�ii ` •<
ORDER # 5
° k
TRUCK #
'd4,�.r.'
LOAD SIZE
1.0 f`ttjj`
MIX
-
� i`if} 0.. x M' -
SLUMP
"o
w
(t; C �7. ' i
_
.CUSTOMER #
SOLD TO
P.O. #
PROJECT#
DELIV-ERY`ADDRESS
ZONE! . �
USE
DRIVER
"'102 13E Hidden River- Dr-
STI.,.t,1 IE
SLABS
N ike-Aiar-..di...
'INSTRUCTIONS
TIME DUE
PSL
ORDERED
PRODUCT CODE
PRODUCT DESCRIPTION
I.I.O.M.
UNIT PRICE
AMOUNT
!
!
QUANTITY
10.00
1 oj.^t fJ
1 5. i}('} '
C t}4°• +T' i
2500
O`1iD
9„ I;3ti
"go. 0{}
F":(;13ERR,"
F1i3I` RR
5.50
55.00 '
1.00
F.NV I R.D
ENVI R0 DIPPOSAL
I
5.00
15.00
SIG ATUR
WARNING'
OR RECEIPT -
CONCRETE ANDIACKNOWLEDGEMENT
OF HAZARD
mascrimeyer Concrete uqmpany will not assume liability for any propenry aamage or any
SUB -TOTAL
9 S 1 1!
equipment damage fora y deliveries beyond the curb line: • -':
M
TAX
. C, �4. 1 ia:.
_ L.,, ;• AUTHORIZED BY
SHIPMENT SUBJECT TO CONDITIONS ON REVERSE SIDE.. ' {• .
L
TOTAL
CP 1 J A
t
'I
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 3807769 OR BOOK PAGE 2651, Recorded 03/06/2013 ate-';,:03 AM
Doc Tax: $0.70
Prepared by and return to: Fober•t o evLvj4 Sf P. f eS a
Mtg Def Grp PLLC
99NW 183 St 8101
Miami FL 33169 (305) 6514268
(Space Above This Line For Recording Data]
Warranty Deed
This Warranty Deed made this date of Fe l 2 2013, between, Solange & Richard Dupoux Wife &
Husband, GRANTOR whose address 2615 Jackson Street Hwd FL 33020 to Cadem Gr e, Ell' bi
President with f ower ority to otect, co rve and o sell, or to lease toe cumber, r o erwise t
manage and d' ose o real pr petty escr' ein, ursua F. .
NW 183 St Ol tami, FL 316 to EE hose ddr s is 99
(Whenever us d he in the terms "grantor" d " antee" include all e p ies tot is i t and t heirs, legal resen fives, and assigns of
individuals, d th successors and assigns o orp rations, trusts and st )
Witnesseth, at ' grantor, for co side ion of the m o TEN A N /100 DOLLARS ($I0.00 an oth d and valuable
considerations t said for in h pai by sa' gran ceipt ereof' ereby ac o dged, has grant d, bargained, and Id to the said
grantee, and grant 's heirs and assigns f ever, the llowing descri d Iand, sit ate, lying and be' g in, to -wit:
Legal: HIDDEN RIVER ESTATES BLOCK 3 LOT 2 of the Public Records of St. Lucie County FL (OR
3422-2365)
Par eI 3003ZL000`-'0 702 Hidden River Drive Port Saint Lucie FL 34983
Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining.
Have and to Hold, the same in fee simple forever.
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the lawful authority to sell and convey said land; that the grant eby fully warrants p grantor has goad right and
claims ofall persons w soever; said land' ree of all en brances, xcept taxes accruing d and
ent to, e s e lawful
In WitnessWhed ofg for hunto et yand firs
ealedSigned, sdelredin above wri n.
our pr enc
4-ife nd 14tXocc
Witness ma Clenard C
Richard
State of FL County of Miami -Dade
The foregoing instrument was acknowledged before me this date of ��2013 by Solange and
Richard Dupoux who presented government ID and set their signatures hereto.
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
respnnsibilit foLsupervising work to,aLicensed 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 work
compensation for that employee, all as prescribed by law._ Your construction must comply with all applicable Kys—
ordinances, building codes, and zoning regulations. Initial
I understand that the building official and inspectors are not there to design or give advice on howkineet
the minimum code. Initial
I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handled
in a civil court with the advice of an attorney. This department will not mitigate any contract disputes.
Initial A�y�
I understand that if I compensate any person or company for work performed they are required to be
licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and liable f the
cost of the license. Initial
I understand that if any person that is unlicensed and uninsured gets injured on my construction project -
they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related m 'cal
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 signTeYilding
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 Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this
day of / f7 of 20.
O-nerBui der Signature
STATE OF FLORID /
COUNTY OF The f egoing instrument was ackn wledged before me this / . [ 9 day of 20
by i �_� PU �,�� who is personally known to me, or who has
as identification.
I
�04
�m
igna e o otary T or Print Name of
tary
(Seal)
Title: Not& Public Commission Number
SLCPDSD Revised 07/22/2010
8 }NMPHRE`!
yP,
AUDRE'1
MY COMMISSIOa h 6 20159
S. M 15
EXPIRE Public Undervrtiters
T
Bonded ihN Notary
o� ;o?•
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,
.� 3-el 9 o3
(Parcel Id#/Legal description/
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.
E
Property Owner Name (Pl s6 Print)
Property wn r ignature Date
STATE OF FLORIDA, COUNTY O
ACKNOWLEDGED BEFORE ME THIS DAY OF 20 6
BY 2)`Fl �1 LL %C WHO IS PERSONALLY KNOWN TOME OR WHO HAS
COMMISSION NUMBER ,
SLCPDSD Revised 08/24/2010
(SEAL)
ti'" • :''• AUDREY B. HUMPHREY
*; ,r MY COMMISSION # EE 061159
p • ` EXPIRES: March 6, 2015
R . N?t` Bonded Thru Notary Public Underwriters
[ON.
Property Appraiser - St.Lucie County, FL
Page 1 of 1
Cadem Group Inc Record: 1 of 1
Property Identification
Site Address:
702 HIDDEN RIVER DR
Sec/Town/Range:
27 :36S :40E
Map ID:
34/27S
Zoning:
RS-3
Ownership and Mailing
Owner.
Cadem Group Inc
Address:
99 NW 183 St #101
Miami FL 33169
Sales Information
Date
Price Code
2/2/2013
100 0111
1/2/2013
72300 0112
8/15/2012
100 0112
5/12/2006
425000 DO
12/15/2005
0 01
5/20/2003
100 01
1/14/2003
225000 00
8/23/1996
100 01
8/1/1979
96500 00
5/1/1978
0 01
PROPERTY RECORD CARD
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Permits Home Print
ParcellD:
Account #:
3427-701-0037-000-0
115517
I ham(2
Use Type:
City/Cnty:
SF Res
Saint Lucie County
i
t'!
Legal Description
HIDDEN RIVER ESTATES BLK 3 LOT 2 (OR 3491-2651)
Assessment 2013
Deed
Book/Page
2013 TRIM:
112100
WD
3491/2651
Assessed:
112100
SP
3483 / 0615
Ag.Credit:
0
CT
3422 / 2385
Exempt:
WD
2563/1082
Taxable:
FJ
244111499
Taxes:
2270.3
WD
1716 / 0816
WD
1651 / 2912
QC
1037 / 0236
CV
0314/1132
CV
0286/1827
BUILDING INFORMATION
Total Land and Building
Land Value: 43200 Acres: 0.36
Building Value: 68900
Finished Area: 2161 SgFt
Exterior Features
View:
RoofCover:
SO - Dim Shingle
RoofStruct:
HP - Hip
ExtType:
HC+-HC+
YearBlt:
1979
Frame:
Grade:
C+ -C+
EffYrBlt:
1979
PrimeWall:
BW- Brk/WdFrame
StoryHght:
0020-2Story
No.Units:
1
SecWall:
WS-Wood/Sheath
Interior Features
Bed Rooms:
3
Electric:
MX-MAXIMUM
PnnlntWall:
DW-Drywall
FullBath:
2
HeatType:
FHA - FrcdHotAir
AvgHt/FI:
1/213ath:
1
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
1 01 00-SF Res
270 -Front Ft
109.12 142.97
THIS INFORMATION IS BELIEVED TO BE CORRECT
AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED.
http://www.paslc.org/pasle/prc.asp?prelid=342770100370000 9/10/2013