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HomeMy WebLinkAboutSUBMITTED PAPERSO. CEU$EbNLY: } D TE ILED: - _ — P VIEW FEE: R Lv. I RECEIPT NO:: PERMIT NUMBED'' C.r CY RECEIPT NO.: CERT. CAP. NO.: r ALL INFO MUST BE COMPLETE & FILLED INTO BE PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE' REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL-34992 5652 . 7724G2-1553' ����F® r APPLICATION for BUILDING PERMIT,-' CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: © pCl ��,� S G �, F<" P/r 2c 3 �py9 2. PROJECT NAME: A v1xLOy SITE PLAN NAME: 3: PROPERTY TAX ID #: 6603 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. S. LOT NO. - 9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR,WORK ACTIVITY: SETBACKS (ACTUAL) FRONT: BACK _ RIGHT SIDE: LEFT SIDE: —_ TYPE OF CONSTRUCTION (Check all appropriate bo%eS) [ ] NEW 'CONSTRUCTION [ ] RESIDENTIAL [ ] ' OTHER (SPECIFY) — [ .] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ]-COM1b1ERCIAL [ ] INDUSTRIAL - DESCRIPTION OF PROPOSED USE: SQ. FT OF CONSTRUCTION: 16. VALUE OF CONSTRUCTION: $ '15. SF. FT 1st FLOOR: The value of construction is used to determine the amount of permit fees to be assessed St Lucie the indicated County reserves the right to question sudlor modify e value of construction if it is demonshated that the submitted figures are not consistent with similar types ofoonshuction activities. If the valve is modify 0 to monq WMRDED Notice of Commencement must be submitted with this application iLCCDV Form No.: 001-02 UPDATED 05/09 OWNER INFORMATION NAME: U AVA LbAj , L G. G ADDRESS: CITY: STATE: ZIP: PHONE (DAymffi): "" 6S 35 �5 Email: 17/�/ �d �- �•S/l! L3: �%t IF THE FEE SMILE'TITLEHOLDEX(FROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SMILE TITLEHOLDER: ADDRESS: CITY: STATE: ZIP- PHONE (DAYT ME): C__) CONTRACTOR INFORMATION = ST. of FL REG.CERT #: CG -C 15-0 76.y'I ST. LUCIE COUNTY CERT BUSINESS NAME: gG-v 7-7r— 1-EGA!$ QUALIFIERS NAME:•' " /l ADDRESS: 14 6 D> 7' C f A CTTY: D�Ci� �a4 i C/�i� .—STATE. A�RJ (W ZIP: PHONE (DAYTIlbIE): f ��) 77?- I94D FAXNO. 6X Y33-7p�2_ Email inarr��wisc ARCHIT/ENG][NEER: ADDRESS: CITY: PHONE (DAYTIME): C--) BONDING COMPANY: ADDRESS: Crry: .i& MORTGAGE LENDER: ADDRESS: _ CITY: STATE: STATE: STATE: VAN A I' IWORTANT 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 MROVEM ENTS 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. rA0 �.., /,., 7., STATE OF EI COUNTY J The foregoing instrument was acknowledged before me this day of 20JJ_, by Vv I who is personally known or has produced CONTRACTOR SIGNATURE STATE OF FLO COUNTY OF , l U EJ P, The foregoing instrument was acknowledged before me tMsSD day of 2 by I `. . 4 who is personally known or has produced LI-e r QQ as identification. �I v�r 16,nas idea ' cation. Signature of N Signature of N Commission No. ;'�'"�"! AU WILLMOT Commission No. ; t►>i"''''. i��r 'AUD0101IaIVILLMOT MY COMMISSION # DD973168 =` •: MY COMMISSION # DD973168 -; EXPIRES March 21, 2014 ,?!;�•'EXPIRES March 21, 2014 (407) 398-0153 Floridallotaryservice.com (407) 3913.0153 Flondallotaryservice,com NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYIN 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 OWNEWBUILDER 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 # Iff FLR ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC LOT SPLff LOT SPLff Before 111990 After 1/1990 REQUIRED APPROVED REPORT HABITABLE RADON PERMIT CODE AREA FEE FEE LIBRARY PUBLIC BLD PUBIC BLD PARKS WACT BRACT FEE ZTACT IMPACT FEE CORRECTION FEE FEE GENERAL SCHOOL ROAD CREDrr Y N LAW ENF IIOACT IMPACT ' IMPACT FEE FEE FEE FIRE/EMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE IlIMACT a : REQUIREp FEE VARIANCE FEE•. FEE SPECIFY MECHANIC ROOF NON -CONFORMING MISCELLANEOUS SUBS ELECTRIC GAS c. LOT OF RECORD FEES REQUMED PLUMBING t : ' 5 FEES DATE SENT TO ADDRESSING: REVIEWS FRONT ZONING_ •SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE '-REVIEW COUNTER- 'REVIEW .REVIEW` REVIEW REVIEW " REV19w � DATE _ ._... _ _ . . . RECEIVED`f DATE COMPLETED INITIALS JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY FILE # 3606155 OR BOO' -05 PAGE 1112, Recorded 07/01/2011 :' 1:10 AM NOTICE OF COMMENCEMENT 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 (Legal description and street address) TAX FOLIO NUMBER: S4G'Gb1/-"-r SUBDPYISION Vi4Lo BLOCK TRACC LOT BLDG UNIT 6H2D tcir-go / LESr.4i6S C,r' 2. GENERAL DESCRIPTION OF IMPROVEMENT: ai 227 PUAl L!_AUC 3. OWNER INFORMATION: a Name f /fY ar/ 1-99A1{ Lie, b. Address•.-qj-Z,!46 sip TSr.4nJFd ; KY _YOyB _c, interest in property d. Name and address of fee simple titleholder (if other than owner) 4. CONTRACTOR'S NAME, ADDRESS AND PHONE NUMBER: SCP ZZF�' s 4"m Mme- EAVAZO LtG ASP2 4 7TN Gr Al9,2MFli41'c -E, 64 33g70 5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT: 6. LENDER'S NAME, ADDRESS AND PHONE NUMBER: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents maybe served as provided by Section 713.13 (1)(a) 7., Florida Statutes: NAME, ADDRESS AND PHONE NUMBER: ScoTrLaws LNd/9i PD c'�ir 23y� PAt�lYar= l�.�[ 8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in Section 713.13 (1 xb), Florida Statutes: NAME, ADDRESS AND PHONE NUMBER: SCO% / LFtma- C4,w �Sr�/YI/" As A&ow-- 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_ �61UIt�( CGr�GeN, .hvAtS a� Print Name and Provide Signatory's TUdOfDee Owner's Authorized OMcer/Dlrector/Partner/Manager State of Florida , County of ST. it G1L � { 'ng 20 l/ The forcg instrument was acknowledged nowledged before me this _day of By Wf hA'!VI (Name of person)) (Type of authority... e.g. Owner, officer, trustee, attorney in fact) For, 14 7-6- 4VA`70 4,(,� - . (Name of party on behalf of whom instroment was executed) Personally Known_ or prodtt the following f ID9� ft ) AUDREY WILLMOT (Printed Nam of Notary Public) (Signature of No Public) °' 'e MY COMMISSION ft OD973108 , f EXPIRES March 21, 2014 Under penalties of perjury, I declare that I have read the forego g and that the facts in it are test of 4fIGtlQllaUl belief (section 92525, Florida Statutes). Signature(s) of Ow s) or Owner's)' Authorized ORicer/Dirsdor/Partner/MmWer who signed above: By: BY R., me©�wrt�.nr ST. LUCIE COUNTY BUILDING & ZONING 2300 VIRGINIA AVENUE O01 ME FORT PIERCE, FL 34982-5652 a 772-462-1553 FILLED LANDS AFFIDAVIT I, the undersigned, am the owner of the following described property: (Tax I )/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. L4T6- /aWAI,00i LUC, Property Owner Name Property Owner Signature ' Date STATE OF FLORIDA, COUNTY 01 --St uu i 4r'TCNoWIRDGED BEFORE ME THIS -DAY OF ,.I BY IS PERSONALLY KNOWN TO ME ��. W n*• _fin nminTT Y ^ SIGNATU O NOTARY TYPE OR PRINT N E OF NOTARY �� � NOTARY PUBLIC TITLE 3'01 COMMISSION NUMBER (SEAL) ;;pt'�"'•'':tj;: AUDREY WILLMOT MY COMMISSION # DD973168 V1•� EXPIRES March 21, 2014 40r 398-0183 FloddallotaryService,00m