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HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE ONLY: �_ DATE FILED: �02• v9'11 10 PLAN REVIEW FEE: . (2 RECEIPT NO.: �P CONCURRENCY FEE: RECEIPT NO.: PERMIT NUMBER: CERT. CAP. NO.: /0ia. vdl ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BMDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 ��/�u�� fl� 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION Pt' ►Erc, Vtj 1. LOCATION/SITE ADDRESS: 2. PROJECT NAME: Srl rU SITE PLAN NAME: 3. PROPERTY TAX ID #: [ 3 691 " 6014 00 ST D©D Z A 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 'r kAt 2° L-6S 16♦�:7-,1S/ 5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. �Z °I 8. LOT NO. 6 I % I r 9. PARCEL S12E (ACRES/SQ FT.): is 3 Ac_05' LOT DIMENSIONS: 24 (9 x 1 _7y - 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: 'PC) LA t C6nGIt4C' S�4y Faf ��fkre Slte� l.J� �oeit�t A..d SIA� Fb f>YIv�w1c 11. SETBACKS (ACTUAL) FRONT: 4— BACK: _ RIGHT SIDE: LEFT SIDE: F- C 12. TYP OF CONSTRUCTION (Check all appropriate boxes) NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL { ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) cc� 13. DESCRIPTION OF PROPOSED USE: ..�rorcwt l w or K 5 k o0 14. SQ. FT OF CONSTRUCTION: 8 6 . 0 S� r� 15. SF. FT 1st FLOOR: �G �I S 9 �' 16. VALUE OF CONSTRUCTION: $ The value of construction is used to determine the amount of permit fees to be assessed St. Lucie County reserves We 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 sabmitted with this application. SLCCDV Form No.: 001-02 UPDATED 4/25/09 OWNER INFORMATION NAME: S ADDRESS: CITY: F± Pl yY gG STATE: _ ZIP: 3 LO S-I PHONE (DAYTIME): 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 TRACTOR INFORMATION ST. of FL G.CERT #: ST. LUCIE COUNTY CERT #: BUSINESS N QUALIFIERS N ADDRESS: CITY: PHONE (DAYTIME): U ARCHIT/ENGINEER ADDRESS: CITY: PHONE (DAYTRVIE): L_) BONDING COMPANY: ADDRESS: CITY: STATE: ZIP: FAX NO. Email: STATE: Mr STATE: ZIP: MORTGAGE LENDER: ADDRESS: CITY: STATE: ZIP: IMPORTANT NOTICE: When a permit is issued and it is not picked up w' in 60 days after notification it will be voided and returned to you by mail. �`�L�E CpGy ST. LUCIE COUNTY �< BUILDING & ZONING 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 F�OR►DA • 462-1553 FILLED LANDS AFFIDAVIT I, the undersigned, am the owner of the following described property: (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. l IAl I-} ` s '� Property Owner Name Property Owner Signature Date. STATE OF FLORIDA, COUNTY O 46 ACKNOWLEDGED BEFORE ME THIS DAY OF , 20LP BY -44 W WHO IS PERSONAL KNOWN O ME OR WHO HAS PRODUCED _ AS IDENTIFICATION. SIGNATURE OF NOTARY PUBLIC TITLE OR PRINT NAME 01F NOTARY COMMISSION NUMBER (SEAL) AUDREYB. a N; iUMPHREYMYCOMMISSlCN # DD 63304 EXPIRES: 7 ✓ March 6 2011 p i P ondod AM Notary P,byc Undantiriters a ' 1 1 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 CON IbIENCEMENT 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. OWNER OR CONTRACTOR SIGNATURE f . (Y// - STATE OF FLORID COUNTY OF. The foregoing instrument w cknowledged before me this day of C • 20 L by Eta j D 0S who is personall own or has produced CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument me this day of by who is personally known a ' euti5cation. Signature fNotafi t Commission No. ,o(e AUDREYB.HUMPHRCY m k ' AS MY COMMISSION # DD 63304 , }r EXPIRES: March 6, 2011 ; o Ft? > Bonded Thru Notary Public Underwrderz 17 of Notary :knowledged before , 20 , or has produced as identification. No. (Seal) NOTE: TWO (2) SIGNATURES ARE REQUIItED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNER/BUHMER, 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 SECTION �. I TOWNSHIP 3 RANGE 2 MAP NO. ZONING LAND USE LOT CVG % TAZ NO. ` FLOOD ZONE FIRM MAP # 1ST FIR ELV / MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER l SPRINKLERS STORMWATER LOT OF REC Before 1/1990 LOT OF REC After 1/1990 LOT SPLIT REQUIRED LOT SPLIT APPROVED REPORT CODE r HABITABLE AREA RADON FEE PERMIT FEE LIBRARY BRACT F PUBLIC BLD IMPACT FEE CORRECTION UBIC BID ACT R,4/ PARKS BRACT FEE SCHOOL IMPACT FEE ROAD BRACT FEE Y N LAW ENF IMPACT FEE FIREMMS IMPACT FEE DRIVEWAY REQUIREDVARIANCE Y fi_71AY ADM]NISTRATIVE FEE SPECIFY SUBS REQUIRED MECHANIC ROOF ELECTRIC GAS PLUMBING NON -CONFORMING LOT OF RECORD FEES MISCELLANEOUS FEES DATE SENT TO ADDRESSING: / 1 .REVIEWS FRONT COUNTER. ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE 6 r 11 Lit INITIALS �" _.a �i CO lFiIS FQI�;�i ISiD'� i•ILL� ��' r g:& of C at TO. P.. cJr� 1pniaj5 G• taj�- 1 A�2,rf"only . 4,0--4,4 AID A71 II. J �: vjli INW... NAME jr ��tJJding cps r.,i, d ampJ. �, i �axira: ir; brava; Gaon [ suhi--,aleap ,Ti - ,�: ru�;►cr eviu tl= tisass alb iavLa w,Ediis�keri by the of r Was C D '�� i i ?S .n �.N 7 V ,i Fit'I� .,]rti1[ICi t-na: !si-an ba InciLICt.. WIM r • �.C�K LUG; N I. RAM O; ZR�tTM= pJ[-i�-ic)D Or Pam? l� _ � T� c�� •fTfi�_ LI�,cACZ , 1 ;� �[?..J[;�u�1C'CIDCI Ali a i� a► as s n: d Ji �di Si.. 4 �tjci JIG'S nJl [s21"'�'Ti�% D V u,{ ' tS �1uT7v'a� ul��]LIIiL�i l�, G : a e oumcs� this daaum?tr ;lowtim. �� .r ;,rii �� ^zaE s � p �i �9 l TlY3 ',1d'f$. i7- p:9luinr� �,r.a �A�i« � 's1i�f0 Ti1F 1 a� . n, ?LSIi?m r e rt m� 'tan , L ` c ea caTst ��,?nJte.= uI-t�?u }YY^ `3L dr,"g.D: JOSEPH E. SMITH, CLERK OF _THE CIRCUIT COURT — SAINT LUCIE COUNTY__ FILE # 3609169 OR BOOK°; 7 PAGE 2579, Recorded 07/13/2011 al-4 :45 PM / O I a . CO/ O , NOTICE OF COMMENCEMENT The undersigned hereby given notice that improvement will be made to certain real property, and is accordance with Chapter 713, Florida Statues the following information is provided in the Notice of Commencement 1. DFscat) mm OF PROPEaTY (Leg al description and street address, if available) TAx FoLzo NaKam: ( SUBDIVISION f-AUWDOA i'_QM\\ — DIAQC _TRACE LOT �LDO cRSf `f 2. GENERjXDESCRWnONOFWROVED uyl dr-klLl�tv _A 3. OWNERDWORMASION: • d. Name and address of tee simple ddcholdw (f other than Owner) 4. CONTRACrOR's NAM$ ADDRESS AND PHONE NUMBER: /1 V t S. SURETY'S NAME, ADDRESS AND PHONE NUMER 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 may be served as provided by Section 713.13 (1) (a) 7., Florida Statutes: NAM& ADDRESS AND PHONE NUMBER: 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) (b), Florida Statutes: NAME, ADDRESS AND PHONE NUMBER: 9. Expiration date of notice of commencement (the expiration date is I year from the darn of recording unless a different date is specified): 20_ AOl l lv 012-, Signature o[ waer or Print N' a and Provide 1181tisatoryli Title/Office Owner's Authorized Officer/Director/Partner/Manager State of Florida M rr,•AUDREY B. HUMPHREY County of := MY COM411SSION r OD 633047 S t . Lucie f 'a EXPIRES: March 6, 2011 $ i `�; l�`, acrdc4 itW !J:.IurP eFeUn7arrrr,Wrs 6 The foregoing instrument was acknowledged before me this day of9kl?O- 20 BYVop d as ame p on) (type of authority,... e.g. officer, trustee, attorney in fact) Far� half o whom ns ent was executed) _ Personall own produced the following type of identification: 1'a .ri'11r (SignatureofNotarylie 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 92.525, Florida Statutes). 13 /� aturc(s of O wner(s) or owner(s)' Authorized Officer/ Director/ Parmer(Manager who signed above: Y �\J1J1_---�1 $ Rer.084)9A7 (S.Rewrding) STATE OF FLORIDA ST. LUCIE COUNTY THIS I.8 TQ CERTIFY THAT THIS 1S A TRUE fulh) CDRWECT COSY 4 f !HE ORIGINAL J H E SMITH, CLERK By: y4h. .�- Dsput Ott! St. Lucie Cov..:..j . . i r_ frt s a Building & Zoning Department 2300 Virginia Avenue Fort Pierce, Florida 34982 (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 appli ble laws, ordinances, building codes, and zoning regulations. Initial 4 I understand that the building official and inspectors are not there to design or give advice on h tQ meet the minimum code. Initial r( 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. (1 Initial L- F7 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 li 1F for the cost of the license. Initial Y `- ^ 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 rela� 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 Departme\nt to the Florida State Department of Professional Regulation. Signed and acknowledged on this I k ' dsv of r l hAr, t _ n£ nA STATE OF FLORIDA COUNTY OF The for o'n instrume by Signature of Title: Notary AUDREY B. HUMPHntr MY COMMISSION # DD 633047 _ EXPIRES: March 6, 2011 Bonded Th, Not Mq Pj llo Undavalters Owner ilder Signa ledged before me this6day 20_/_L, who is personal to me, or who has aation. 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A88REV1ATIONS: (•)=Not verified by field measurement =Value as platted & field measured F.E.=Finishgd Floor Elevation SET = Set 6/8 iroc r bar V �y th Vl logy cap marked PSi� 5543" S'as measured in field OH--OH—OH— Oyer Head Aires X--X--X- Chgin Link Fence R OFQund 5R/8htio n Raebor O--O--0-= W6od Fence = FPL Transformer Pad PL=Volue as plotted R = Radius of curve L = Length of curve = Delta of Curve = Site Benchmark EAS. = Measured Square Foot CO C. = Concrete C.P.= Concr�to Pad _ater Meter oWer Po I e = Bell South ®= We 1 I W a O O O O O O M SURVEYORS NOTES: . 1, Unless other*Ise noted only plotted easements are shorn hereon. 2. No -underground utilities or improvements Were located unless other*ise sho*n.. 3. This site lies Within Flood Insuronce Rate Map Zone X. 4. Flood Zone sho*n hereon is an interpretation by the surveyor and is provided as a courtesy. The flood zone should be verified by a determination agency. 5. Bearings shoyyn'hereon are based on the Center I* of Fort Pierce Blvd. as being N00'00'00"E according to t-he Plot described -hereon. 6. P.U.D.E. denotes Public Utilities and Drainage Easement. 7. All Lot dimensions shoiyn ore per plot unless otheriyise shotyn. LOt'15 BLOCK 29 S 90600'00" E 170.00' I EIOs*G .RESIDENCE PROPOSED I SHED ,; LOT 18 BLOtX 29 (err $9 N90000'00"E ' 170.00' LOT 19 BLOCK:29 Certified to: O O O N F r� W O O O Q O O Ln LAST FIELD DATE:1 5415 For{I C Land DeS I (�n5. t Pierce Boule.vord SCALE: i���„=4o r I do ` . ( hereby certify that the' survey sho*n hereon is true and correct of the Treasure Coast cad is based -on oee,tuai meossuremenls taken in the field. This survey meets the.tiinimum Technical Standards of Chapter 51017 DATE: 1 2/2/1 0 7114 NE Jensen Beach Blvd. Jensen Beach, FL 34967 Florida administrative code. s Dr:A�yN. �C Moiling Address: ' DlgitallyslgnedbyJames ��aTiaic�r P.O. Box 1421 Jensen Beach, FL 3495 A.Cesiro Jr. NM SS43 s 2010-0703 (772) 393-4290 ALD554309mo f I . com m Q o= cn=James A. Designs Jr., � a rl'l E S A , o=Atlantic Land Designs of "' `theMau, DATE: REVISIONS email..=,Alo) 543®gmall.co Cesiro J'r:=m;�= s.. 61ATS OF Date: 2010.1 Z03 12:51iii Rtoatv� -05'00' Y NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL F!\ OFFICE USE ONLY: DATE FILED: `� ' 1\ RMIT# REVISION FEE: GEIPT # * _ lf00 VIRGINIA AVENUE _FORT_PIERCE,EL-3.4982=5652 (772) 4624553 APPLICATION FOR BUILDING:PERWT \ - PROJECT INFORMATION 1. LOCATION/ADDRESS:SITE �� f r` � I ) P'rf-►r Myn _._ PA- --U 2. 3. 4. DETAILED DESCRIPTION OF PROJECT REVISIONS: n CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: BUSIIVESS NAME: QUALIFIIERS NAME: ADDRESS: CITY: PHONE (DAYTIME); OWNER/BUILDER INFORMATION: NAME: y A k- ADDRESS: 1 ' `r CITY: PHONE: -7 1 2 `-) ; I U-63 5. ARCHITECT/ENGINEER INFORMATION: w ST. LUCIE COUNTY CERT. #: STATE: Gir: FAX: / .STATE: ZIP: S `tll6) 1 - FAX... NAME: ADDRESS: ZIP: CTTY: STATE: PHONE (DAYTIME): FAX- PHONE 9123/09 Revised 04/26/2010 r• LEGAL DESCRIPTION: Lots 16, 17 and 18 in Block 29 of LAKEWOOD PARK UNIT 4 according to the plot thereof as recorded in Plot Book 11 poge(s) 2 of the Public Records of .St. Lucie County, Florida. ABBREVIATIONS: (+)=Not verified by field measurement MValue as platted & field measured .E.=Finishgd Floor Elevation SET = Set 6/8 frog r bar f�yrith Vl logy cop marked PSi� 6543" =Value'as measured in field OH--OH--OH-= Over Head Aires X—X—X-= Chgin Link Fence R OF and 5R/8htlroon Raebor 0--0��0- Mood Fence N = FPL Transformer Pad PL=Value as platted R = Radius of curve L = Length of curve = Delta of Curve = Site Benchmark ?F,.=Squore AS. = Measured Foot CONC. = Concrete C.P.= Conc{pte Pad _ dater Meter Polder Pole = Bell South ®_ We 1 I 0 0 0 N L. J O O O O O O SIDES - �N4t S1 I SURVEYORS MOTES: . 1, Unless otherwise noted only platted easements ore shown hereon, 2: No underground utilities or improvements Were located unless other*ise sho*n. 3. This site lies Within Flood Insurance Rate Vop Zone X. 4. Flood Zone sho*n hereon is an interpretation by the surveyor and is provided as a courtesy. The flood zone should be verified by a determination agency. 6. Bearings shown hereon are based on the Center Fine of Fort Pierce Blvd, as being N00'00'O0"E according to the Plat described -hereon. 6. P.U.D.E. denotes Public Utilities and Drainage Easement. 7..All Lot dimensions shown are per plot unless r e shorn. LOT'16 BLOCK 29 S 90900`00" E 170.00' opy uu LOT.1s eLocK 29 � 4 4FL UBCO 0 0 O N i L07 17 BLOCK 29 I EASING RE§DENCE . W fs0pO Z"" CD D 6.Oe L LOT 18 BLOCK 29 1. '4 N90000,0011E , ` 170.00r LOT 19 BLOCK 29 Certified to: LAST FIELD DATE:1 5415 Fort Pierce Boulevard SCALE: 1 "=40' t I ant i e Land Designs I hereby certify that the survey sho*n hereon is true and correct of the Treasurend Coast and is based -on actual measeuremenls token In the field. This DAiEO1 Z 2 1,sur;yly meets the minimum Technical Standordszol Chapter 61017 754 NE Jensen Beach Blvd. Jensen Beach. FL 34087 Florida.odministralive code. MA*: JC Moi I ing Address: ' Digitally signed by James I tIFICA P.O. Box 1421 Jensen Beach, FL 3495E A.CesiroJr. s No. 5543 2010-0703 (772) 398-4290 ALD56431111gmo f I .cam DN: cn=James A. Cesira Jr., ,J a m e s A6. o=Atlantic Land Designs of DATE: REVISIONS <' ''theMou, emall.=Ap,,�543@gmall.Co y C e s l ro J: r m, C=IJS,, ,. eTA78aP Date: 2010.12.0312:52,S6 ALORI Do- -05'00' NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL 0