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HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE ONLY: J. I I. AN REVIEW FEE: / RECEIPT NO.: CONCURRENCY FEE: RECEIPT NO.: PERMIT NUMBER: 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 �CAfvl v"f 772462-1553 aft L UC/� count APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: a5 4/W 1DX-A Dos 2. PROJECT NAME: � �t1 )�r SITE PLAN NAME: 3. PROPERTY TAX ID #: 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 5. PLAT BOOK 1.2— 6. PAGE NO. 41a -'qI 9 7. BLOCK NO. 1-1 S. LOT NO. 9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: 9 —3 -"-K i a 0 a i0. 11. 12. 13. 14. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK A hTIVIV Ilk SETBACKS(ACTUAL) TYPE OF CONSTRUCTION (Check all appropriate boxes) NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL �� [ ] INDUSTRIAL [ OTHER (SPECIFY) 0,D DESCRIPTION OF PROPOSED USE: % La i< SQ. FT OF CONSTRUCTION: A--.R 0 /( 15. SF. FT I st FLOOR: I ;!Zb 16. VALUE OF CONSTRUCTION: $ B �. ` tqq 4) 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: V o / A9,09 E �� G -- ADDRESS: 9 'K5 S C Z AJO by, A- D>,C-- CITY: Pr' sr- k t(C-X d5- STATE: r-J7 ZIP: ` �- PHONE (DAYTIME): (7M Email: IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SR PLE TITLEHOLDER: ADDRESS: CITY: __- STATE: ZIP: PHONE (DAYTR%4E): (_) CONTRACTOR INFORMATION ST. of FL REG.CERT #: ST. LUCIE COUNTY CERT #: BUSINESS NAME:qr-- QUALIFIERS NAME: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): FAX NO. Email: ARCHIT/ENGI/N->EER ( r o c, cC N� n G d 7) ADDRESS: go(, e w fZ. A CITY: f % f 7 -9�c e / STATE PHONE (DAYTIME): a n �1 l� � "' 7 St BONDING COMPANY: ADDRESS: CITY: J Ar'r-,l IteC�-i" F zip: 3 e/ 01S 0 STATE: ZIP: MORTGAGE LENDER:. ADDRESS: CITY: STATE: 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. f PLANNING & DEVELOPMENT SERVICES DIVISION BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Ave Fort Pierce, FL 34982 BUILDING PERMIT SUB -CONTRACTOR SUMMARY 11 1 C..(0-L )-k A-0 - will be using the following sub -contractors for the (Company/Indiridualy ame project located at)f%!% ve- �- (Street ad' ss or Property Tag ID #) It is understood that if there is any change of status regarding the participation of any of the sub -contractors fisted below, I will. immediately advise the Building and Zoning Department of St. Lucie County. Trade Name of Company/Contractor St. Lucie County/ --`State- ofFlorida - License Number Electrical Plumbing AVAC/ Mechanical Roofing W - e Gas OFFICE USE ONLY: PERNIIT I ISSUE DATE: NUMBER: PLANNING & DEVELOPMENT SERVICES DEPARTMENT ^ ' BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT _ SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (ifapplicabi-e)::-UL� Lam' 1. C� �` ill have agreed to be the C-D �? sub -contractor for (Trype= of_TTade)y (Primary Contractor) iect (Project S_ftdTAddrtss or Property Tax ID #) It is understood that, if there is any change of status regarding our participation.with the above mentioned project, I will immediately advise the Building and Zoning Department of St: Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED P<B NT NAME DATA Business Name(:_ Address: City%Statelzip: L— � Phone: 772 _g7�?, 2 & (j,_ email: OFFICE USE ONLY: PERMIT # ISSUE DATE w ST. LUCIE COUNTY ..; BUILDING & ZONING -v 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 �0R10� 462-1553 FILLED LANDS AFFIDAVIT I, the undersigned, am the owner of the following described property: 3 %493 (Tax ID/Legal description/Ad Mss14 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 Property Owner Signature Date STATE OF FLORIDA, COUNTY OF ; 01. y_J1L1&,e_,) ACK,NOW�LEDGEDPIDAYOF �1)2� 20 BYI -1 (, WHO IS RE ONALLY KNOWN TO ME OR WHO HAS PRODUCED SIGNATURE OF NO'rARY NOTARY PUBLIC TITLE IDENTIFICATION.O - TYPE OR PRINT NAME OF NOTARY COMMISSION NUMBER Q�� °y'•, DR AU s;�• ' �,: E1' B. HUMPHREY N # DD COhAMISSIO 633047 EXPIRES; March 6, 2011 '�d;;,tk ` Uonded rhru N61dFy PWIC Undon,,jt, s 'suean, (SEAL) St. Lucie Cou :- ® 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 applic a 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 ho t meet the minimum code. Initial —. I understand that as an owner -builder that any contract disputes with sub -contractors and I must be andl d 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 requir e licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and IVIO) cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my constructio - they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relat d, rp d'c cost, which could include loss of wages during recovery from their injury. Initial 1J 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 Depart t to' the Florida State Department of Professional Regulation. Signed and acknowledged on this AL day of of 20 - Owner/Builder�i�� STATE OF FLORIDA AA \.!�% '- _ - ) // L/ COUNTY OF The foregoing instrument was acknowledged before me this day of , 20 by b 0 who is personally known to me, or who has produced l as identification. -) /„/ 6 - YIV D . ;kVSignature of tary a or Print Name of otary (Seal) Title: NotgavXblic Commission Number y S\WY PV •i a;+ °ova AUDREYB.HUMPNREY MYA. COMMISSIbN # DD sa3oa7 = " EXPIPE8; March 8 2011 '401" BOOM Thru WAT Fpubud Uhderwri(9rs {��f4i.ru,._e rr a .e •a / ra i cr r 1 l� Ic 1 a r >r e- e e r•r a ®�.:� i{ �y��, v rl .1:61 Itttp:/(documen=.stludeco,aov%t:,ebGnk7/ElectronicFile.aspx'docid=143953'Ab;d=i7 L j I�1 o�Gooale - Nc- Edit Go To Favorites Help �I y Favorites I } Suggested Sites - rJ Web Slice Gallery - (" f�http:(fdocuments,sUuaeco.govfweblink7/ElectronicFil... ^I f'= - t J E-I fug - Page- Safety- Tools- (®j- ilk i Find - 11d (id�.. 4t � i .� � , e� _---.._ ' .t-�re er 2 S 4`; 4 `bteao• ��i�s�M �o'i9w;�. _� u _ •_- - --- -. _ __ _ _�..: -' - -- — 6 ,-yP� 3 Z ♦�, f ii- r; 15 n ssyzx /� q L^. �� r,�• � � 9••!p• S71�2J 5 zo p n �✓ ni. z 9 Y]d/OSO� l •fd7'I7S�p1'�' 60, [- aY/LT• �'J� /,J��, 64J' bRTL�47'd 4TH32]:�y.. , o ` �; ` /4 J 14yT • +�vss A''lr.2w1, ''J DRIVE y b 14 �.k-a Ggp Y`t //O' /!O' i .tBY^J OD'E SRT'SG S a p 60• W q F b T.+6 L h b +Y' � p JZ, .Es/eISOA' GO, 1F•%al' . � 2• /YO' /00' J9 � n 2 8 � !ro' t � � Y � Id� �CJ2 s / F 4 � � J • � w n V ` R ?S ;",•''M-,,.. /2 3 !2 `: 3 Z v'�. `[ J! 2 ,� Z h p10 // `AV a e . •i} ••i'ir%` i E i /D 5 /D N4 9 "k _ ;I �.z S i $ 6 a (9 CK w 9 6 �' a '� a r ° �,. e• 4A O �.,.. { B 7 n :E ` ' t�R`'i'?.'a / `O• //O' ma, 60' ba nb /!5 s I SELVA COURT e 7 ; G ti 7 /2 6-11 ti /3 37.20 x 26.00 in 4 IIJ unknown zone_ t{ ILL .:Af ►. M i e . �: K07 i -. ell . e • �.. S . e dr B - •♦VCYk c '� " .- ,Oct 19, 2010 11:21 AM so CERTIFICATION: . • . 1 • 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 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. CI R-OR CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF ---j!� JIXI 1i The foregoing instrument was acknowledged before me this ! day of 20 by D� f� IGt�1 o j/v `/2 ,8 c,, , /d, CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument wXacknowledged before me this day of by who is personally known or has pr du ed who is perso illy know or has produced El'i as identification. as identification. Signature of ary S• nature of Notary Commission No. ix"r� )HUMPHREY Commission No. (Seal) 11� TM `x A4Y C�IMMISSION # DD 633047 rXPIRE& March 6, 2011 .F, BondedihruNotaryPubllcUnderwdters 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. i OFFICE USE ONLY : ; , • • BP #: SECTION TOWNSHIP J/ RANGE MAP NO. ZONING LAND USE LOT CVG % /1/ �r�- TAZ NO. FLOOD ZONE FIRM MAP # 1ST FLR ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FIRS WATER SEWER �1 SPRINKLERS �- STORMWATER -T LOT OF REC Before 1/1990 / LOT OF REC After 1/1990 ✓ LOT SPLIT REQUIRED LOT SPLIT APPROVED REPORT CODE 3a HABITABLE AREA RADON FEE PERMIT FEE LIBRARY IMPACT FEE PUBLIC BLD IMPACT FEE CORRECTION PUB C BLD IMP CT FEE G PARKS IMPACT FEE SCHOOL IMPACT FEE ROAD IMPACT FEE z RED Y N LAW ENF IMPACT FEE FIItElEMS IMPACT FEE DRIVEWAY REQUIRED I Y - 4 D L�eADMINISTRATIVE FEE 1 VARIANCE 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 COMPLETED INITIALS St. Lucie Couli ty PUBLIC WORKS DEPARTMENT CODE COMPLIANCE DIVISION 2300 Virginia Avenue Fort Pierce, FL 34982 772-462-1553 Design Certification for Wind Load Compliance This Certification must be completed by the project design architect or engineer. This Certification must be submitted in duplicate with all applications for building permits involving the construction of new residence (single or multi- family), residential addition, any accessory structure requiring a building permit, and any nonresidential structure. This Certification shall not apply to interior renovations (provided that no exterior structural walls, columns or other components are being affected) and certain other minor building permits. ror further assistance, please contact the Building Inspection Office at (772)462-2172. Project Name �6 EN1 RPermitnit Street � umber Construction Certification Statement: I certify that, to the best of my knowledge and belief, these plans and specifications have been designed to comply with the applicable structural portion of the Building Codes currently adopted and enforced by St. Lucie County. I also certify that structural elements depicted on these plans provide adequate resistance to the wind loads and forces specified by current code provisions. Design Parameters and Assumptions Used (Please check or complete the appropriate box.) 1 Florida Building Code 20 O "? Edition with 20 oc1 Supplements and ASCE 7 2. Building Design is: Enclosed: Partially Enclosed: Open Building: 3. Mean Roof Height: t — o t Roof Pitch: 4 �_ Internal Pressure Coefficient: • I 4. Width of End Zone:. 3_ Wind Speed:. © (3 sec. gust) 5. Building Classification Table I.I. ASCE 7 1', r� B C Table 1604.5 6. Wind Exposure Classification: Adjustment Factor for Exposure & Height: l 7- Components & Cladding Wind Pressure on Roof Zone 1 271$ 2'`,.73—$3,°1 PSF 8. Components & Cladding Wind Pressure on Wall Zone 40t'7 PSF 9. Components & Cladding wind Pressure on Overhead Garage Door 4L4 'RRSE PLANS AND ALL PROPOSED WW1 10. Loads: Floor 5 PSF Roof/dead 15 PSF Roof/live zSF ARESUBJECT TO ANY CORRECTIONEE 11. Shear Walls Considered for Structure? Yes X No (if No, attach explanatREPUIRED BY FIELD INSPECTORS THP, 12. Continuous Load Path provided? Yes _X No (if No, attach explanation) " ' MX1 BE NECESSARY IN ORDER TO` 13. Are Component and Cladding Details Provided? Yes X No — (if No, attach exifitli811)�I � $'i ALL APPLICABLE. CODE 14. Minimum Soil Bearing; Pressure: Z560 Presumptive:_ By Test: PSF As witnessed by my seal, I hereby certify that the information included with this certification is true and correct, to the best of my knowledge and belief. Name: —`�` /" �(3r'9 %� Cert Design Firm: _r, Date: SLCCDV Form # 020-00 Revised 5/18/09 (CL) .AL ff h_ F Lh JOSEPH E. SMITH, CLERK_ OF THE CIRCUIT COURT - SAINT LUCIE COUNTY FILE # 3638289 OR EF 3332 PAGE 724, Recorded 10/17/2011.r')1l03:49 PM AFraR RECORDING-RFrURN'1'O- ERMIT NUMBER' 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. I. DESCRIPTION OF PROPERTY (Legal description and street address) TAX FOLIO NUMBER: C O f SUBDIVISION it t vc /i..�BLOCK �_L_TRACT LOT�,,BLDG UNIT �arC.rl�D ;j_�%`L_-s�a-vr�b7-c)oy•Z 2. GENERAL DESCRIPTION OF IMPROVEMENT: 3. OWNER INFORMATION: a. Name i•/,L'/e, &✓ %••Tel&., b. Address y S 5. L- S A M D L A 'a r "o, -T. Sc., w'f L.: e t e c. interest in property d. Name and address of fee simple titleholder (if other than owner i 7o16,4 NOo Ft 1, a rt [ r ( .3 5/y3 y 4. CONTRACTOR'S NAME, ADDRESS AND PHONE NUMBER: S E 1 F - oy c0 5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT: G. 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) T. Florida Statutes: -NAME, ADDRESS AND PHONE NUMBER: _ H. In addition to himself or herself, Owner designates the following to receive a copy of thetienor's Notice as provided in Section 713.13 (1)(b), Florida Statutes: NAME, ADDRESS AND PHONE NUMBER: 9. Expiration date of notice orcommencement (the expiration date is I year from the date of recording unless it different date is specified) __ __, 20_ % L'-: x . Signature of Owner or Print Name and Provide Signatory's Title/Office Owner's Authorized Ofrrcer/Directorll'ariner/Manager State of Florida County of & k0Cde The r-ofegoing instrument was acknowledged before me this ._ A -day of OC AQ /SP i , 20 / / By V i cki 4a rr,.e r Wo o-fR,- , a, Owme ✓ _ (Name of person) (Type of authority... e.g. Owner, officer, trustee. attorney in fact) For (Name of party on behalf of whom instrument was executed) Personally Known_ ur produced the following type of ID: PAULA J ANDREOZZI �autoJ v�di'eoZz : MYCOMMISSION #r0641 82 EXPIRES December O6, 2013 (Printed Nance of Notary Public) ��IS&iignauurmofoturyPublic) t{e) 79 A�53 _— FlariJxNa arySen•Icn.com Under penalties of perjury. I declare that I have rend the foregoing and that the facts in it are true to the best of my knowledge and belief (section 92.525. Florida Statutes). Signature(s) of Owners))oor Owner's)' Authorized Officer/Direclor/i'artner/Manager who signed above: R,•• Ilw uu4n]IR.,m.lintl 3TATE OF FORIOA ST. LWIE COUNTY T HIr ,.., •rn r,rr,TICV Tl>I.QTT1419 IT9 A TRU ORI By: Dal