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HomeMy WebLinkAboutSUBMITTED PAPERSOill USE DATE FILED PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER: CONC.URRENCY 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 SCANNED .7724624553 BY St. Lucie County APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: l`o (� a M 11EA )' Cf ' 2. I PROJECT NAME:SPI�Ii�/S/��/�i�IPS Yt/�SITE PLAN NAME: . 3. PROPERTY TAX ID #: —,. D O p- 0�_5' 3 -0 067 - / / 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 971VI5/� ,lAi ec-5 F�i'ii4�,.�ys /3W_391G,o7` A-57- (vR /.S/9-a 6;Zg/3a/ 5'. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8._ LOT NO. 6600 9. PARCEL SIZE (ACRES/SQ FT.): 01 /vim LOT DIN[ENSIONS: /;? D X SS 10. • COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: 11.0 SETBACKS (ACTUAL) FRONT,,��/-` BACK: �7/� RIGHT SIDE: of LEFT SIDE: �'= 12.0 TYPE OF CONSTRUCTION (Check all appropriate boxes) Ol✓] NEW CONSTRUCTION [ ] EXPANSION/ADDITION . [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL . [ ] OTHER (SPECIFY) 13.9 DESCRIPTION OF PROPOSED USE: 14.4F SQ. FT OF CONSTRUCTION: s ,L 15. SF. FT 1st FLOOR: 16. A* VALUE OF CONSTRUCTION: $ /, D ©O .-- 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 are 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 6125/09 OWNER INFORMATION NAME: 4 ADDRESS: 6(o oZ 7 YeA I C f'y U CITY: �/( elel�C C� STATE: ZIP: PHONE (DAY TIlmIE);(4 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): C___) CONTRACTOR INFORMATION ST. of FL REG.CERT #: BUSINESS NAME: QUALIFIERS NAME:. fly �C1 ADDRESS: CITY: PHONE (DAYTIME): ( ) ARCHIT/ENGINEER ADDRESS: CITY: PHONE (DAYT ME): �) BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: STATE: FAX NO. STATE: STATE: ST. LUCIE COUNTY CERT #: ZIP: Email: �lI ZIP: ADDRESS: CITY: STATE: ZIP: IMPORTANT NOTICE: When a permit is issued and it is not picked up within 64 days after notification it will be voided- and returned to you by mail' CERTMCATION: y: 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 do accessory uses to another non- residential use. NOTICE TO OWNER: YOURFAILURE 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. o� r R OR CONTRACTOR GNATURE STATE OF FLORID -- i COUNTY OF - - _\� i „: :<••. I The foregoing instrument was acknowledged before a��a me this A( day of 20 1 x c y�vav -21 byE1��r� `��`'2 �� ��o' ��zc who is personally known or has produced V m m x ai��� as identification. �. � a Zture of otary CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument s acknowledged before me this day o , 20 by who is pe*nally known or has produced Signature of Notary as identification. Commission No. (Seal) 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 OWNER/BUILDER APPLICANTS. For speck instructionssee appropriate permit checklist. OFFICE USE ONLY ` ��� _ �� -4: VZ� bR, -. SECTION bV TOWNSHm. �� RANGE. 3 MAP NO. ZONING D LAND USE LOT CVG %. ` TAZ NO. FLOOD ZONE. FIRM MAP # 1 ST 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 1/1990 After 111990 REQUIRED APPROVED REPORT / HABITABLE RADON PERMIT CODE (1� AREA FEE FEE LIBRARY PUBLIC BLD PUBIC BID PARKS IMPACT B RPACT FEE BRACT BRACT FEE CORRECTION FEE FEE GENERAL SCHOOL ROAD CREDIT Y N LAW ENF BRACT IMPACT IMPACT FEE FEE FEE FIRE/EMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE IMPACT REQUIRED FEE VARIANCE FEE FEE 6i SPECIFY MECHANIC RO 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 COUNTEPI, REVIEW REVIEW REVIEW REVTW REVIEW REVIEW DATE RECEIVEDDATE COMPLETED-7Z- IId1TIALS ---------------- ------ -------- _Wl - - - -_ --- o - 1,0=UTILITY_ EASEMENT - 'SET --1 R &: CAP - =-= -- =1NITNESSmCORNER � - ,- - _-- ---- — - - -- - - _ _ - - - -- - - - ---- - :FOUND=I:R T& � �� 20 IT GARAGE _ _ O O GRAPI{IC SCALE IN FE — T - >ltL`�i�{ � 1: � �' �eia -- -- F�''✓Jrc,QiTi�a'-� BLCCK 39 3` PROPOSED UNIT 1 B,LCCK `39- PROPOSED F.F.E. 25.11 �n" _ N t BLOCK -.39 star r7 -RONT I .. _ Z" 41..00: 7 �' 0 �/r .r tG; 10" UTILITY EASEMENT- --- TR AC TTB _--LEGEND __ -_-- ____�:_ _.__ ,-___---: CENTERLINE NOTES: __A -.--.-..,_.__._CENTRAL ANGLE-- - _, R. _ RADIUS _ _ 2 -BEARINGS :BASED -ON. CENTERLINE -OF AL-HELI, AS-SHOWN,- L.- ARG"LENGTH HAVING -A' BEARING"OF .SOO'22'28"W PER PLAT. -:-- P . S. PROFESSIONAL LAND SURVEYOR 3-AL-L INFOR7�TATFON SHOWN HEREON IS BASED ON BOTH CAP- P"L-ASTIC.CAP STAMPED LB#428.6 CALCULATED :& PLATTED, INFORMATION. EL. ELEVATION .. _- 4. ELEVATIONS, SHQWN__ARE_BASED__ON-N:.G.:V:D. 1929, - - I R 5/8-IRON-ROD DESCRIPTION EXISTING .ELEVATION LOT 10, BLOCK 39 OF SPANISH LAKES FAIRWAYS - NORTHEAST P.C. POINT OF CURVATURE' PHASE ACCORDING TO THE PLAT THEREOF AS 'RECORDED IN PLAT BOOK 35, PAGES 5 & 5A - 5C, OF THE PUBLIC RECORDS P.C.P. PERMANENT CONTROL''POINT OF ST. LUCIE COUNTY, FLORIDA. . P.R.M. PERMANENT REFERENCE MONUMENT FLOOD ZONE "X" PER F.LR:M. 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, (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 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. Property Owner Name (Please Print) Pro Owner. Sign ure 00 STATE OF FLORIDA, COUNTY OF Date ACKNOWLEDGED BEFORE ME THIS (:91 DAY OF , 20 COMMISSION NUMBER SLCPDSD Revised 08/24/2010 WI-1 C AUDDEY "UMPHREY MYCAMMIS%oN # EE 061159 EXPIRES: Match6,2015risers t0ery Fublic Undena�oZ` gondedThN Planning & Development Services Department �WwQBuilding &Code Regulations MR 2300 Virginia Avenue — Fort Pierce, Florida 34982 U -� (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 workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initia D,, I understand that the building official and inspectors are not there to design or give advice on how to meet 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 %/ ��- 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 for the cost of the license. Initial 1 '' 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 medical 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 Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this day of of 20. l er%Builder Signature STATE OF FLORIDA COUNTY OF % `n The foregoing instrument was acknowledged before me this _J,/ day of 20 � / , by 4 who is personally kno - me, or who has produced as id ntification. i Signature ofN ry fl, or Print Name ofN tary (Seal) Title: Notary Public Commission Number SLCPDSD Revised 07/22/2010 * AUDREY B. HUMPHREY 1'• ��'Pr ,Pyi' MY COMMISSION # EE 061159 EXPIRES: March 6,2015 Bonded Nota ryPublicUnderw6ters �I