HomeMy WebLinkAboutSUBMITTED PAPERS. USE ONLY:
` DATE FILED: I �'
PLAN REVIEW FEE: RECEIPT NO.: .16 PERMIT NUMBER:
CONCURRENCY FEE: RECEIPT NO.: 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 P772-462-1553 0
APPLICATION for BUILDING PERMIT
CERTIFICATE ®f CAPACITY/ZONING COMPLgANCE
PROJECT INFORMATION
1. LOCATION/SITE ADDRESS: G%06 a I q b it-
2. PROJECT NAME: ub rj�, 4�10 ! SITE PLAN NAME:
3. PROPERTY TAX ID #: Q D O (o
4. LEGAL DESCRIPTION (attach extra sheets if necessary):
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO.
9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS:
10.
11.
12.
13
COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: j lo[r_ Si-�Wes( (
SETBACKS (ACTUAL) FRONT:
TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL c [ ] INDUSTRIAL
[�] OTHER(SPECIFY) Da--r-hlyolml Ctim?'q
DESCRIPTION OF PROPOSED USE:
14. SQ. FT OF CONSTRUCTION:
15. SF. FT 1 st FLOOR:
_ 16. VALUE OF CONSTRUCTION: $ SCANNED BY
St. Lucie County
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 arc 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
UPDATED 6/25/09
OWNER INFORMATUON
NAME: �g �. n SV Ot a -
ADDRESS: n SGe-C' I A4
CITY: STATE: L ZIP: 5c4c(85 Z
PHONE (DAYTIME): L_) Email: Ox. t (G
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:
PHONE (DAYTIME):
CONTRACTOR 9NFORMATCON
ST. of FL REG.CERT #:
STATE:
ST. LUCIE COUNTY CERT #:
ZIP:
aC) (�_- >sO
BUSINESS NAME: 'A-1-
QUALIFIERS NAME: ✓ � t kl
ADDRESS: n��4tC�Ya-5 2
CITY: f`z& P-i: tr e 2G _ STATE: ZIP: s cJ1,4 `7
PHONE (DAYTIME): %( 7Z)?2 0 glt�1 FAX NO. 227 �� � Entail: G7l�i�y�cs��ostCz '5A*
ARCHIT/ENGINEER:
ADDRESS:
CITY: a)A") tez- STATE: ,L ZIP:
PHONE (DAYTIME): 017 27 -'3 2� i 0
BONDING COMPANY:
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 will be voided and returned to you by mail.
C u RTIFICATI O V o
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 witli 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.
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF c5fi L && &o, COUNTY OF
The foregoin�g instrument was acknowledged before
me this �(- l� day of 20 ,
by
The foregoing instrument was acknowledged before
me this day of 20--U
I � 10M C,
by Ek(a NIL- ( 9) -
who is personally known or as produced who is personally known " or hA Trod ed
ao 5�3 �l Vbas ide ification. rQo r
as id ntifi t'on.
b-)I PAu�L� —
Signature of Clotary Sign ur f N ry
C �,� (Seal) mission , ... 1l UFF (Seal)
`ol° Y •".� AN(i -* MY COMWSS10N # EE 083530
*= MY COM ELq M. HUFF j po= EXPIRES: April 12, 2015
a •' WSSION # ES 08353 �, jjp„ q ' Bonded Thru Notary Public Undervrriters
BEXPIRES - April 12, 2015 k
onded EXPIThru N
NOT rA . E REQUIRED. EACH SIGNATURE MUST BE�Z D. IF APPLYING FOR
THIS BUILDING - 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 tructions see appropriate perl>rait lecklist.
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
LOT OF REC
LOT SPLIT
LOT SPLIT
Before 111990
After 1/1990
REQUIRED
APPROVED
REPORT
HABITABLE
RADON
PERMIT
CODE
AREA
FEE
FEE
(RADON)
LIBRARY
PUBLIC BLD
PUBIC BLD
PARKS
IMPACT
IMPACT FEE
IMP
IMPACT
FEE
CORRECTION
FEE
GENERAL
SCHOOL
ROAD
CREDIT
Y
N
LAW ENF
'IMPACT
IMP
IMPACT
FEE
E
FEE
FIRE/EMS
DRIVEWAY
Y
N
DRIVEWAY
ADMINISTRATIVE
IMPACT
REQUIRED
FEE
VARIANCE FEE
FEE
I I
--
SPECIFY
MECHANIC ROOF
NON -CONFORMING
MISCELLANEOUS
SUBS
ELECTRIC GAS
LOT OF RECORD
FEES
REQUIRED
PLUMBING
FEES
DATE SENT TO ADDRESSING:
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNT R
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
INITIALS
t
H. JOHN GRIFFIN II
PE #38647
5398 SW 61 AVE.
DAVIE, FL. 33314
561-722-3890
DATE: 6-4-14
JOB ADDRESS: 905 OSCEOLA DR.
PERMIT# SLC-1309-0110
TO ST. LUCIE COUNTY BUILDING DEPARTMENT,
THIS LETTER IS TO ADDRESS MISSED INSPECTIONS. I INSPECTED THE ITEMS LISTED BELOW AN
APPROVE THE INSPECTIONS. IF YOU HAVE ANY QUESTIONS PLEASE DO NOT HESITATE TO CALL, THANK
YOU.
Welill ej t-IlKefflI&M
CODE 128 BOND BEAM
CODE 140 CONSTRUCTION ROUGH FRAMING
CODE 999 FINAL INSPECTION
H. JOIJN GRIFFIN II
PE #38647
042014
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SURVEYOWS C 1000W.
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SUIRVEVE:V-04 ITNE -FIELD. I FtqtTWR CERTIFY THAT THIS -m arm
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LEGAL DESCRIPTION:
m mwSHED BY CLIENT?
LOT lo & 11, SORORA SUBDIVISION, ACCORDING
TO THe PLAT THEREOF AS RECORDED IN PLAT
BOOK 10, PAGE 41, PUBLIC RECORDS OF ST. LUCIE
COUNTY, FLORIDA.
ADDRESS: 905 OSCEOLA DRIVE
FORT PIERCE, FLORIDA
SURVEY NOTES;w.
L NOT VALID UNLESS'' SEALED WITH AN ENBOSSEID
SURVEYORS SEAL.
P. LANDS. SHOWN 'KRM WERE'kOT.- ANTPXTED
FOR RIGHTS -OF -WAY, EASEMENT& OR, OWNElRSHIP.
& LAND DESCRWnON "MM WAS PR,OVIDP',BY
WCLIDENT.
SHOWN HERM ARE BASED ON; THE
or RU416
PURGE OF THIS SURVEY IS FOR USE IN
AV" TITLE -94URANCE AND/OR FRIIANCING
AND SM" NOT BE USED FOR fIDESIGN OR
CONSTRUCTION PURPOSES UNLESS OTHERWISE
STATED 04 THE SURVEY.
6. ELIEVATMNS SHOWN HEREON ISAM UPON
Krs.VJL 19m
7. DIMENSIONS PREVAIL OVER SCALE.
.SETBACK REG. MDrrMNS. OR IDELETIONS-10 -SURVEY.. NAPS OR
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im CONSENT
is pwome. wmwt wpaTvr IF THE SIGNING P*."- OR PARTIES.
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THIS SURVEY UNLESS SPECIFICALLY NOTM .
UNLESS NfffED' OR' DEPICTED OTWRVISE, ALL
PROPERTY CORNERS SHOWN WERE FOM AND HAVE'
NO IDENTIFICATION OR SAID WENTIFICAT]ION WAS
DI& THIS SURVEY -IS FOR THE EXCLIirSiYE USE
AND BENEFIT W OCY THE PARTIES CF3tTIFIED To
HEREIN, RMTS OR LtADR-ITY TO'ANY THIRD PARTIES
0 CANNOT BE TRANSFERRED OR.: ASIGNEIL'
PUBLICWORKS • lEb Tft
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