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HomeMy WebLinkAboutSUBMITTED PAPERSa -d.4?10E USE:ONLY: �`�il'1 �� - Qo� DATE FIIEED• PLAN REVIEW FEE: RECEIPT N6: --,. 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 SO ANNE®. 2300 VuginiaAvenue B Ft Pierce, FL 34982 5652 t• Lucie nA62-1553 rk ' (j' Q k &rj County 7 APPLICATION for BUILDING PERMIT CERTIFICATE -of CAPAMUZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: /. 'O OCC4AI ES7?47— 5 PRIVA 2. PROJECT NAME: SITE PLAN NAME: 3. PROPERTY TAx.ID #: 4.' LEGAL DESCRIPTION (attach,extra sheets ifnecessary): 5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO. f 9. PARCEL _SIZE (ACRESISQ FT.): LOT DRAENSIONS: 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: C&r11 Pzg 715 Plela4e- y jo -t- AT- Peee 4go,14 11. SETBACKS (ACTUAL) FRONT. BACK: RIGHT SIDE:- LEFT SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [xj NEW CONSTRUCTION [ J EXPANSION/ADDITION [ J INTERIOR RENOVATION [ J RESIDENTIAL [ ] COMMERCIAL [ J INDUSTRIAL [) OTHER (SPECIFY) 13..; DESCRIPTION OF PROPOSED USE: 14. SQ. FT OF CONSTRUCTION: 15. SF. FT Ist FLOOR: 16. VALUE OF CONSTRUCTION: The value of consftuction is used to determine the amount ofpena t fees to be assessed. St Lucie County reserves the right to question andlor modify the indicated:': value ofconslruction if it is demonstrated that the submitted figures are not consistent with similar types ofconshnction activities. If the value is =500 or more, a RECORDED Notice of Commencement must be submitted with this application SLCCDV Form No.: 001-02 UPDATED fia5J09 :8. OWNER INFORMATION. NAME: V 7-6, A(%A L ©A , L L ADDRESS: GG CITY: S 7,41V /: iyA 7 STATE: PHONE (DAYTIME): (�O j 36 5 Emil IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNERLISTED ABOVE; PLEASE,, FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: Si4mL ,4s 14 ADDRESS: CHy: STATE: ZIP: PHONE (DAYTM): (_) CONTRACTOR INFORMATION ST. of FL REG_CERT #: GGC. 4 O 7S� ST. LUCiE COUNTY CERT #: - 02 6 ?O 2 BUSINESS NAME: ' j GO TT 1_4eLdl S C0X 57T2yC T/�9ifl L L Cl QUALIFIERS NAME: Al. 4CO Ti 4)E_:E 4J/ S ADDRESS: O % 6 7 C%. AL CJ�— 33y70 PHONE (DAY raffl: (RD % 74 - ? Z 6 O FAX NO.5Xf - 3 33 - 79g a2 Email: �Co7TL Ew/5 Co c1STiQ�KT/onl @ Gm,4/4.Co•tit . ARCMVENGINEER: ADDRESS: CITY: PHONE (DAYTIME): U BONDING COMPANY: ADDRESS: CITY: STATE: STATE: ZIP: a MORTGAGE LENDERS ylil ©2 i G �4G� ADDRESS: CITY: STATE: ZIP: DRORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification it wilt 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 concmrency review: room additions, accessory structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & "accessory uses'to'snotlier 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. 1 NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT.1S. SUBJECT TO ATTACHMENT: AS A CONDITION OF ISSUANCE OF THIS PERMIT, YOU PROMISE IN GOOD FAITH TO DELIVER COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. ti OWNER OR COMMACT GNATURE STATE OF FLORIDA COUNTY OF I� The foregoing instrument was acknowledged before me this 3 day, of 20 ( l by �l ex A who is personally known or has produced ' 1 CONTRACTOR SIGNATURE STATE -OF FLORID COUNTY OF �t'. L JAi _J P , The foregoing instrument was acknowledged before me thb—,P_day of -_ A' , 20_LL who is personally known or has produced 1 ✓ j ,1 G P as identification. L1C•P_ rYV . ' as identification. Signature of N rf Signature of ry '��*" AUDRELMOT Commission No. == S�a Commission No ,ta�� "AUDR LLMOT OMMIS ION Dl)973168 •' MY GQMMISSION # DD973168 ? EXPIRES March 21, 2014 EXPIRES March 21, 2014 (407) 398-0153 noridallotaryservice.com •�°i , (407) 398-0153 RoridalloterYService.com 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 OWNER/BUILDER APPLICANTS. For specific instructions see appropriate permit checklist. OFFICE USE ONLY BP #:'=,- SECTION TOWNSHIP RANGE MAP NO. ZONING LAND USE LOT CVG'% TAZ NO. FLOOD ZONE. FIRM MAP # 1srFLR 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 1/1990 After 1/1990 . REQUIRED APPROVED REPORT HABITABLE RADON PERMIT CODE AREA FEE FEE (RADOM LIBRARY PUBLIC BLD PUBIC BLD PARKS IMPACT IMPACT FEE DACT IMPACT FEE CORRECTION FEE GENERAL FEE SCHOOL ROAD CREDIT Y N LAW ENF IMPACT IMPACT IMPACT` FEE FEE FEE FiRFIEMS DRIVEWAY Y N . - DRIVEWAY ADMINISTRATIVE IMPACT REQUIRED FEE VARIANCE FEE FEE SPECIFY MECHANIC ROOF NON -CONFORMING MISC$LI:ANEdUS ' -SUBS ELECTRIC GAS LOT OF RECORD FEES REQUIRED PLUMBING FEES DATE SENT TO ADDRESSING: / / '[ " _ a REVIEWS FRONT ZONING,', i SUPERVISOR PLANS VEGETATION SEA TURTLE _• �,. - MANGROVE ; COUNTER. 'REVIEW '' Itt4'; REVIEW REVIEW REVIEW ' 61'REVIEW DATE RECEIVED - - F ' i , -• s`.:a:. < . -, _:... i �' .._ i. COMPLETED , INITIALS JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY FILE # 3606166 OR 12100(!'v1105 PAGE 1123, Recorded 07/01/2011 _r 1:10 AM The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida statutes the following information is provided in the Notice of commencement. 1. DESCRIPTION OF PROPERTY (Lcgal description and street address) TAX FOLIO NUMBER: SW% �7-�Cl� SUBDIVISION�LOCK_TRACT LOT���uLDG UNIT /SD D � A�tl E,TrAri=S OR 2. GENERAL DESCRIPTION OF IMPROVEMENT: cam+--kF>, PM We V La-A-4- _ 3. OWNER INFORMATION: a.NZ,&Aj b. Address29 Lr4AAcAi "Mk , S7*At6M2D, KY H4P-Y jEY c. interest in property d. Name and address of fee simple titleholder (if other than owner) 4. CONTRACTOR'S NAME, ADDRESS AND PHONE NUMBER: t %T LF_c_k5 e0A&Mrx 7 .OA/r [ Le 11609 6770 W Al ZM.4WAIKN6E, AL. 33V70 5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT: 6. LENDER'S NAME, ADDRESS AND PHONE NUMBER: 7. Persons within the Slate of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (1)(a) 7., Florida Statutes: NAME, ADDRESS AND PHONE NUfdBeO•'&2rjdEA= Cml;g; P ,& ft a ? /I MMAN, R. M—S0D 8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienoes Notice as provided in Section 713.13 (1)(b), Florida Statutes: NAME, ADDRESS AND PHONE NUMBER: Scarri'ad/s /_'nwSi_ ti4iNE 4S At?AdE 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) , 20_ le/mePtu Print Name and Provide Signatory's TiWoftiee Owner's Authorized OfReer/DlnrWdPaRner/Ma Lager State of Florida s County of S T Aft6f The 111 goyn�g instrument was acknowledged before me this _d',ay of y 20�. s By W (/l a. m D C'.o04%e as 04"Aysm (Nome of person)^ 1 (Type of authority... e.g. Owner, officer, trustee, attorney in fact) For (A-r& /'fY/4'LOA/ f�'_ (Name of party on behalf of whom instrument was executed) Personally Known_ or rptoduad the gllowi f t o of II] �. I t _ 1V�w AUDREY WILLMGT Our MY COMMISSION March 000973168 201406 Ohl (Printed Name o Not brit) (Signature of No Public) EXPIRES March 21, 201d t, 40 tae-0153 F rwvi= me Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are true to the best of my knowledge and belief (section 92525. Florida Statutes). S(gnature(s) of Ow ( or Owns(s)' Authorized Officer/Director/Partner/Manager who signed above: k y.. By: By Rev W30r rout= 1S) STATE OF FLORIDA ST. LUCIE COONTY THIS ISTOCEATIF,,YTHAT, TRIZJRH AIi1000RR-ECTCOPY . S$IT� , C(E Date- — 1-1 SISA _ST LlIC1.E,t.. � ST. LUCIE COUNTY BUILDING & ZONING 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: 1 yak - do- 002 7- oc?-2© (Tax 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. AvAtvat ux- �v� Property Owner Name STATE OF FLORIDA, COUNTY OF 5T,1-14CI Property Owner Signature Date ACKNOWLEDGED BEFORE ME THIS IST DAY OF Z:Tik BY W1111AM K/y' �+�I WHO IS PERSONALLY KNOWN TO M SIGNATUR NOTARY TYPE OR PRINT NALE OF NOTARY NOTARY PUBLIC TITLE - (A (SEAL) COMMISSION NUMBER r AUDREY WILO_IMOT :yp L MY COMMISSION # DD973168 '., EXPIRES March 21, 2014 407)39M153 Floridallotar Servica.com Property Appraiser - St.Lucie FL Page 1 of 1 UTG Avalon LLC Record: 1 of 1 Property Identification Site Address: 150 Ocean Estates Dr Sec/Town/Range: 03:34S:40 E Map ID: 14/03N Zoning: HIRD Ownership and Mailing Owner: UTG Avalon LLC Address: 99 Lancaster St P O Box 328 Stanford KY 40484 Sales Information Date Price Code Deed 5/9/2011 100 0311 CT 1/23/2006 20500000 02 WD No Sketch Available PROPERTY RECORD CARD «Prey Next» Spec.Assmnt Taxes Exemptions Permits Home Print ��UCIE 00G ParcellD: 1403-500-0027-000-0 Account #: 170003 y r < Land Use: Vac Res A City/Cnty: St Lucie County Legal Description AVALON BEACH PUD (PB 55-19) BLK 2 LOT 11 (OR 3292-247) Assessment 2010 Final Total Land and Building Book/Page 2010 Final: 150000 Land Value: 150000 Acres: 0.14 3292 / 0247 Assessed: 150000 Building Value: 0 2471 / 1213 Ag.Credit: 0 Finished Area: 0 SgFt Exempt: Taxable: Taxes: 3117.69 BUILDING INFORMATION Exterior Features View: - RoofCover: RoofStruct: - ExtType: - YearBlt: Frame: - Grade: - EffYrBlt: PrimeWall: - StoryHght: - No.Units: SecWall: - Interior Features BedRooms: 0 Electric: PrmintWall: - FullBath: 0 HeatType: AvgHt/FI: 1/2Bath: 0 HeatFuel: - Prm.Flors: - %A/C: 0 %Heated: 0 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qual. Cond. YrBlt. No. Land Use Type Measure Depth 1 0000-Vac Res N -Site 1 1 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. http://www.paslc.org/prc.asp?prclid=140350000270000 7/7/2011