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HomeMy WebLinkAboutSUBMITTED PAPERS.. �... DATE FILED: PLAN REVIEW FEE:RECEIPT NO.: 79PERMIT NUMBER: C 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 SCANNED 772-462-1553 BY St. Lucie County APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: 1318'6j S. IMbIAM (Z.IV�EIL_0f_. 'TFJ1_1SE,,il) er-4 . , f L . 3'f9.S7 2. PROJECT NAME: KF ITP'i > VhA"'IALEI SITE PLAN NAME: KEITIf 4 MA tZLA 7PP L" 3. PROPERTY TAX ID #: 12 f-A L 6_STATA II 4. LEGAL DESCRIPTION (attach extra sheets if necessary): It ATrAC 1446,L) LEGp l3>fscatPrtoN 00 N aE x T A 6-,F- ,4GE 2 5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO. gwr_1F1a6 7 13 3 - 1'1a8- 2 -E 41 E -rowNstkIP• 3-tS sE�t'►t q 9. PARCEL SIZE (ACRES/SQ FT.): 1 ). 32- LOT DIMENSIONS: S O X -70 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: 15irAlt2 GAS& QCgU1t_d — 0416-jAi&L S7-AtreS pN StTE 51�,G l ,?S IL SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE: 12. 13 14 TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ J INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL OTHER (SPECIFY) k-C 6U1 t_ D STA 12 iS ASE EX tS-rw6- DESCRIPTION OF PROPOSED USE: lEX►STtNk STAwCAS - SwcE I9F15 - J4wt/LIcA+►)C -D** TV STA 12S - 12EE3u1t,D-- SQ. FT OF CONSTRUCTION: 30 I 16. VALUE OF CONSTRUCTION: $ Cl D0. � 15. SF. FT 1 st FLOOR: 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. RecGived SLCCDV Form No.: 001-02 FEB 15 2011 UPDATED 6/25/09 ERD - K. Smith CERTIFICATION: t to do the work and installations as indicated, tothde issuance of a permit and that all This application is hereby made to obtain a permienced priorall if applicable, for the permitted work. I certify that no work or installation has comm 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 representatl.», 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 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. OR CONTRACTOR SIGN STATE OF Fl COUNTY OF The foregoiqg instrument w s acknowledged before me this day of 20 by DRlNeV Tv who is personally known or has produced Zz,h Z ` as identification. Signature of Notary CONTRACTOR SIGNATURE STAT OF FLORIDA CO OF The foregoin instrument was acknowledged before in this d of by who is personally known _\r or has produced Signature of Notary as identification. F "' : Sp,,� DAWN MtME Commission No. Seal Commission No. ( .+wY ( (Seal) 7ytP'ISSION N DD 852587 EXPIRES: March 22, 2013 1' n Bonded Thru Notary Public Underwriters 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 3 q RANGE �j4 I MAP NO. ZONING t LAND USE LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # IST 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 1/I990 REQUIRED APPROVED REPORT HABITABLE RADON PERMIT CODE( AREA FEE FEE (RADON) LIBRARY PUBLIC BLD PUBIC BLD PARKS IMPACT IMPACT FEE IMPACT IMPACT FEE CORRECTION FEE FEE GENERAL SCHOOL RO CREDIT Y N LAW ENF IMPACT CT IMPACT FEE EE FEE FIRE/EMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE IMPACT REQUIRED FEE VARIANCE FEE FEE SPECIFY MECHANIC ROOF NON -CONFORMING MISCELLANEOUS SUBS ELECTRIC GAS LOT OF RECORD FEES REQUIRED PLUMBING FEES -'tom u3ajj,/ Dom -- E+t �t�,,� �„✓� - I c,(E6 DATE SENT TO ADDRESSING: / / REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED 2� 1 DATE COMPLETED INITIALS - eb v-��al� PJo ;�cvcEedsin�e. �� `r 0 OWNER INFORMATION NAME: KEIr4 J M)+rLLA- `�­IAL&4 ADDRESS: 1 3 (9"1 S . 1 N D I" CITY: 7tA5t-fU 56 AM STATE: L • ZIP: 3qj S PHONE (DAYTIME): ( 3 i • 30 l Email: ��° l T ii �5 T�4�us �°o K•t IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. ^ FEE SIMPLE TITLEHOLDER: —57" E (y '4130 ove— ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): O _ CONTRACTOR INFORMATION ST. of FL REG.CERT #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS: CITY: PHONE (DAYTIME): (_) (Crt���2 /3 v e �. beP,-) � ST. LUCIE COUNTY CERT #: STATE: FAX NO. ARCHIT/ENGINEER: 1h &Aj A Kb h ADDRESS: t/V CITY: P 1 �6- I?_( F STATE: f::: L , PHONE (DAYTIME): t r �� _! �1 - rI qJ 1 BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: STATE: ZIP: Email: I i TyR� lA) C ZIP: 3 4 5 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. Planning & Development Services Department Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 (772)462-1553 OWNERBUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S. 489.103 (7) EXEMPTIONS State law requires coil-t-uction 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. Initial 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 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 1-7 day of f.66 • of 20 _1L. STATE OF FLORIDA Owner/Builder Sign e COUNTY OF The for ink i strument s ac owl ged before me this day of ,�i� 20 by / who is personally known to me, or who has ced as identification. It t MILONE 3Tgm"e of Notary Type or Print Name of Notary ........... �•�., A ON N DD 852587 Title: Notary Public Commission Number MY pIRE arc'h 22 eten BondedThN Publr- SLCPDSD Revised 07/22/2010 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, -* #So 9 — 1 x — 406> (Parcel Id#/Legal description/Address) - 0©013 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. Th - 11W Property Owner Name (Please Pri /y Property Owner Signatur Da e STATE OF FLORIDA, COUNTY OF ACKNOWL EDGED BEFORE ME THIS _ DAY OF. BY CED4OFNOTARY &,D 1 , 7SIGNA PUBLIC COMMISSION NUMBER SLCPDSD Revised 08/24/20I0 WHO IS PERSONALLY KNOWN TO ME TYPE OR PRINT NOT 20 �/ OR WHO HAS AS IDENTIFICATION. /on -e er r. - (SEALOA%VNMILONE R- 1: x. MY COMMISSION rr DD 852587 EXPIRES. March 22, 2013 E P" Bonded Thru Notary Public Underwriters Property Appraiser - St.Lucle r-1inty, FL Page 1 of 1 Keith M Daley Record: 1 of 2 Property Identification Site Address. 13189 S INDIAN RIVER DR Sec/Town/Range: 09 :37S :41 E Map ID: 45/09N Zoning: RE-2 Ownership and Mailing Owner. Keith M Daley Marla S Daley Address: 13189 S Indian River Dr Jensen Beach FL 34957 Sales Information Date Price Code Deed 1/26/2001 173000 00 WD 7/2/1998 170000 00 WD 7/29/1997 100 01 CT 7/22/1994 156200 01 WD 10/1/1984 37000 02 CV 6/1/1982 0 01 CV PROPERTY RECORD CARD ,F'iev Nem -> opec.Assmnt Taxes Exemptions Permit; ���CIEC0, ParcellD 4509-120-0011-000-3 �< Account # 122904 Land Use SF Res I City/Cnty St Lucie County �'• — Legal Description 9 37 41 BEG AT PT ON WLY R/W INDRIV DR 1400 FT S OF N BDRY OF SEC 9, TH RUN WLY 150 FT, TH S 70 FT, More... Assessment 2010 Final Total Land and Building Book,Page 2010 Final 190200 Land Value 93200 Acres 0.32 1363 / 1798 Assessed: 168017 Building Value. 97000 1157 / 2168 Ag Credit. 0 Finished Area 2216 SgFt 1090 / 1771 Exempt: 50000 0913 / 2717 Taxable: 118017 0445 / 1456 Taxes 2657.32 0380 / 1928 BUILDING INFORMATION Exterior Features View. RoofCover TN - Metal RoofStruct GA - Gable ExtType HC+ -HC+ YearBlt 1987 Frame. Grade C+ - C+ EffYrBlt 1987 PrimeWall: WS - Wood/Sheath StoryHght: 0010 - 1 Story No Units: 1 SecWall Interior Features Bed Rooms: 0 Electric. MX - MAXIMUM PrmintWall DW - Drywall FullBath: 2 HeatType. FHA - FrcdHotAir AvgHt/FI: 112Bath 0 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. Land Use Type DOK2 - WOOD DOCK Y 1 1400 AV AV 2007 1 0100-SF Res 240 -Front Ft 70 200 DWC - Driv-Concret Y 1 1200 AV AV 1987 FNW4 - WOOD FEN 4' Y 1 100 AV AV 1999 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=450912000110003 2/7/201 1 W.- fis-em we bawd an #w No* The of um wqwiy bows S 67'�WW 'K - t* one A Vemjw" ww *COW *mwww and dleWnces Aed for owwbuctim wWlar 46dr ==oolnolderd rod bemi,q_ gm as (Md mosswed Wpa"lan data wiess COM 16as now. not valid wmxlut the **Wb" mw w6ghbal 01 "d of Yar & mapw- basedaw"upon a daeor?ptian to *rived by the cUmt, t1w* ch of the pk"Ic raeard. done by " offk;a i Flood Zm'0 V)r. Ow wAr MLL 4 an W conwnunfty Pa" Flood lnsur0m* PnWmn Rate M4 13 F, wm an effoctive date of Auk 19v:- im.11% r- I wow am not *Y*kW$ b thla area. 5w. i(A . FIRE HYDKMT Mwm POLE Tue"ONIE XSER A wAIM &KlER CAN IOXYMM MM whim WOE POLE ANCHM mm Pam P= *AIM VEWR CL " OMMMM pp w EM OF PAVEMENT Dept. 01 b"41"' -vtotectlui. Poo I [ t'CIF -V r— A1VL2 )71 OAJ OF '-D--:- mfv!�� >JAI V- 4' gew of La* f1dd waft & NXIL 4Lnne" %* %nmft SurvOng + MaWng Ke" M. mad& S. Da 4M SL pM JL Lueb ftdwwd *A 10 FM* Port SL Lwim. !Folds34W 01 to7nj3L4= Z Trlvnam of MAL .-ba--ttfielacom PAUL WELCH M MECH-ELECT43M M 1984 BILTMORE ST. #114 PORT ST. L", MAY 14 MOR PAUL WELCH, P.E. FU WM-=OwAc