HomeMy WebLinkAboutSUBMITTED PAPERSOF,kT� ONLY: �>
DATE FILED
PLAN REVIEW FEE: / RECEIPT NO.: PJC2`4
0
V PERMIT NUMBER: / �� `y aa0
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE CONIPLETE & FILLED IN TO BE ACCEPTED
St. Lucie County Building and Zoning
j�df tmG
�;. 2300 Virginia Avenue
j0R1L'p Ft. Pierce, FL 34982-5652 6C
772-462-1553 BY
St. Lucie County
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT Ili 1FORIVIATION
1. LOCATION/SITE ADDRESS: aid ILen ral N1- C1 Jy -FL 3 y c7/(:>
2. PROJECT NAME: u`I SITE PLAN NAME:
3. PROPERTY TAX ID #: I 1 a np` O�Cp�LS,,
4. LEGAL DESCRIPTION (attach extra sheets if necessar ): Gfeer%6c'-:5i('
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO
9. PARCEL SIZE (ACRES/SQ FT.): 04 LOT DIMENSIONS:
8. LOT NO.
10. COMPLE �F V&A'l OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
Cam.-der-�oc6 onA usQ
IL SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE:
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION --C,,' INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY) 1
13. DESCRIPTION OF PROPOSED USE: St !ale. �i'htTa Ctgnt�
14. SQ. FT OF CONSTRUCTION: , 15. SF. FT Ist FLOOR:'
16. VALUE OF CONSTRUCTION: $ �C7+ C70 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
OWNER INFORMATION
NAME:
ADDRESS: D\\\
CITY: (-G iO\ 6-�
PHONE (DAYTIME): lam)
-+- Ca h (-P-
�a 10 �A��r7Q�n 14VEi
d STATE: �L- /V � ZIP: 3 l `i `T (D 10 % 0
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
PHONE (DAYTIME): ( )
STATE:
ZIP:
CONTRACTOR INFORMATION�n
ST. of FL REG.CERT #: C&G 5 I QD ` " ST. LUCIE COUNTY CERT #:
BUSINESS NAME: 1O �lA� aye �lnS�orn �rr5 �`
QUALIFIERS NAME:
ADDRESS: '?7151 �'D
CITY: STATE: FL. ZIP: l
PHONE (DAYTIME): (���) �� `� FAX NO. 960"Et f �� Email: SYLI ��� �c{ ►Y1 �q'�Q S��
ARCHIT/ENGINEER: Y� (� S �►\�lS '�
ADDRESS:
CITY: q STATE: FL ZIP: 33V 3
PHONE (DAYTIME): l) L I n— 3 1 I
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE:
STATE:
F nu
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.
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, 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: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO
OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE TO APPLICANT: AS THE APPLICANT FOR THIS BUILDING PERMIT, IF IT IS NOT YOUR RIGHT, TITLE.
AND INTEREST THAT IS SUBJECT TO ATTACHMENT; AS A CONDITION OF THIS
PERMIT YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED
CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT
TO ATTACHMENT.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance
with all applicable laws regulating construction and zoning.
OWNER OR CONTRACTOR SIGNATURE
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before
me this `�I2 day ofDD�3.r 20VO ,
by ':f- � 'Q-n \\�7��►�
who is personally known or has produced
C NTRACTOR SIGNATU
STATE OF FLORIDA�
COUNTY OF}}
The foregoing instrument was acknowledged before
me this Z`2— day of , 20Y,
by�1
who is personally known or has produced
as identification. fl L RA0—r?_Z0 —. as identification.
aA I J -If& A1%.
of Notary Sign re otary
`•,Nu.u.,� SUSAN O'NEILL
Commission No. S" Public - State of Florida Commission No. t 3eal)SU� O'NEILL
My Commission Expires Oct 7, 2011 =o <<'; Lary Public - Stab of Flori a
Commission of DO 701065
_ . • ' . ? My Commission ExpNfr.Oct 7, ill
'� oc Commission tf 00 701065
.I,,,,,,,� Bonded Th o* National Notary Assn. .F dr,.
°F Bonded NaMorrsl Notary
NOTE: TWO (2) SIGNA A ATURE MUST BE N
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 OWNERBUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.
OFFICE USE ONLY BP #: ZO n �-
SECTION
Jz
TOWNSHIP
M
RANGE
D C—
MAP NO.
y y1
ZONING
LAND USE
LOT CVG %
TAZ NO.
FLOOD ZONE
FIRM MAP #
IS FLR ELV
MAX HGT
CONST YPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
j
WATEli
EWER
Cw
PRINKLERS
STORMWATER
LOT OF REC
Before 1/1990
LOT OF REC
After 1/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
%4
HABITABLE
AREA
(RADON)
RADON
FEE
PERMIT
FEE
LIBRARY
IMPACT
FEE
PUBLIC BLD
IMPACT FEE
CORRECTION
PUBIC BLD
IMPACT
FEE
GENE
PARKS
FEE
SCHOOL
IMPACT
FEE
ROAD
IMPACT
FEE
CREDIT
Y
N
LAW ENF
IMPACT
FEE
FIRE/EMS
IMPACT
FEE
DRIVEWAY
REQUIRED
Y
N
DRIVEWAY
FEE
ADMINISTRATIVE
VARIANCE FEE
SPECIFY
SUBS
REQUIRED
MECHANIC ROOF
ELECTRIC GAS
PLUMBING ✓
NON -CONFORMING
LOT OF RECORD
FEES
MISCELLANEOUS
FEESS
vsl
DATE SENT TO ADDRESSING: ! /
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
'REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
:a
SY j Q,
DATE .;..,,,
COMPLETED
::✓
TIALS ... ,
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 3445713 OR BO 1174 PAGE 1351, Recorded 02/26/2010 10:02 AM
AFTER F A IN .- Fn ranN TO' ---7
Ihn S[w•n+ir>er, nl for�norJmy iuln
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 NUMBERy 9a,
SUBDIVISION —BLOCK—TRACT—LOT BLDG UNIT
2. GENERAL DESCRIPTION OF
3. OWNER INFORMATION:
b. Address
c. interest in property w. rl 5
d. Name and address of fee simple titleholder (if other than owder)
4. CONTRACTOR'S NAME, ADDRESS AND PHONE NUMBER:
Save C&6kf\ t SISI SW (Sna .freak Tea-fla &° Y\6,:W'rL 3Yti90 570 Rli,;l,
S. SURETY'S NAME, DRESS 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 may be served as provided by
Section 713.13 (1)(a) 7., Florida Statutes:
NAME, ADDRES9AND PHONE NUMBER:
S. In addition to himself or herself, Owner designates thq fdkowing to receive a copy of the Lienor's Notice as provided in Section
713.13 (1)(b), Florida Statutes: ��''``��, '',, n y� , �" r 1 ,
NAME, ADDRESS AND PHONE NUMBER-' Y> K M6 n r J /S (S,3 � ct oct_ / e jr lM I 1 )'L S� i Tmd
9. Expiration date of notice of commencement (the expiration date is ]year from the date of recording unless a different date isSlol' a] �- 13��
specified) , 20.
Signature of Owner or Print Name and Provide Signatory's Tit e/Oflice
Owner's Authorized Officer/Director/Partner/Manager
State of Florida
County of
The foregAg instrument was acknowledged before me this jZ ay of Cam.,- . 20L0
By KtchAt6f, &zdelaf,®tu as oumne&y-
(Name o erson) /jam (Type of authority ... e.g. Owner, officer, trustee, attorney in fact)
For Y:, T�
(Name of party on behalf of wh ins ent was executed) Personally Known or produced the following type of M:
•`Nl!.,, SHIRLEY A.RIALI
+p. 4's Notary Public - State of Florida
/ - . • c My Comm. Expires Sep 20, 2013
rmt d Name ofN Public Si at a ofNo Commission # DO 902964
(P ( gn tary ic) (ti,ml) ,%.`;;p•° Bonded through Nabonal Notary Assn,
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).
Signature(s) of Owner(s) or Owner(s)' Authorized OfficerMirector/Partner/Manager who signed above:
By: By
It— uanamao�taaaamv
STATE Of FLORIDA
ST. LUCIE COUNTY
II-ty IAVrILA etoA
St. Lucie County Building & Zoning
2300 Virginia Ave
Fort Pierce, FL 34982
BUILDING PERMIT
SUB -CONTRACTOR SUMMARY
C(A will be using the following sub -contractors for the
(Company/Individ al Name) l _ J I,� P_1
project located at �J11�� v 1 Y A m 0 ly
(Street address or Property Tax Ib #)
It is understood that if there is any change of status regarding the participation of any of the sub -contractors
listed below, I will immediately advise the Building and Zoning Department of St. Lucie County.
Trade
Name of Company/Contractor
St. Lucie County/
State of Florida
License Number
F-�t,,
Electrical
� CU�"�� ���C�
Plumbing
�OII l�Q�l (I� /►�� C�.0
C�U7ty7�
HVAC/
Mechanical
Roofing
Gas
OFFICE USE ONLY:
PERMIT ISSUE DATE:
NUMBER:
2010-01-211915 >> 777R782854
ST. LUCIE COUNTY PUBLIC WORKS
y BUILDING & ZONING DEPARTMEENT
BUILDING PERMIT
SUB-CONYTR.ACTOR AGREEMENT
St. Lucie County Contractor Certification Number.
State of Florida Certificalon Number (If applicable} r—,L wo 30 7a
A-Ccut�?4TC Lecre cp l (�y1z -rw /AfC. have agreed to be the
(Company Name/Individual Name)
L r I C �1( sub -contractor for G< V'2, rjcy` I rl I e(A kr 1 (q
(Type of Trade) (Primary Contractor)
for the project located at Ay ��' u.�'1 h Ly) r7L 3 y(1 jD
(Project Street Address 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. ooa-ao)
BUSIIIiESS QUALIFIER (Name of the Individual shown on the Contractor's License)
OPJ NAL SIGNATURES ARE REOUMED
W ��' i''lNIV
SIGNATURE PRINT NAME
Business Name:
Address:
City/State/Zip:
Phone:
77a—V7,,?— q17/
OFFICE USE ONLY:
DA
email: L) c VR A,y C/-/ c;X-4 TT IV67
PERMIT# ISSUE DATE
ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number_ �� S
State ofFlorida Certification Number (if applicabk): LIEC_ 1 4 Z? 6 29
'Rw m g I N Ca LI-L have agreed to be the
(Company Name/Individual Name)
sub -contractor for � 446 ,'� _6n W yyV-S
(Type of Trade) (Pry Contra tor)
for the project located at &10_ 6ACIc L-Y� P�J!✓� 6"f-LY1 l C)
(Project Street Address or Property Tax ID #1)
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)
ORIGLNAL SIGNI ATURES ARTt. REOVIRED
ZO ZOI0
S PRINTNANIV DA E
Business Name: Loyt"VA. r�yrrl6�n�� l l 'k
Address: "Zb SE E��� iE6L2aGE
City#stateaip: S,-v a (Z-r_/ i= Loa ,c-)o / 3 40IR r-7
Phone: 17?,P 2-15 - 44o4 email: �r,,� n nno �.� P1vm A1(1�� �X o k. ►�Z-�
OFFICE USE ONLY:
PERMIT # ISSUE DATE
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a81533.08 1051474.76 Feet
Fr:` :ay, Jan 22, 2010 01:11 PM
Property Appraiser - St.Lucie I 7ty, FL
Page 1 of 1
PROPERTY RECORD CARD
Richard Humphrey JR) Record: 1 of 1
<<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print
Property Identification
�\)3CIE CO
Site Address:
Sec/Town/Range:
2111 NW Greenbriar Ln
25 :37S :40E
ParcellD: 4425-701-0052-000-8 �\X G�
Account #: 119283 ai 1
Map ID:
44/26S
Land Use:
SF Res
Zoning:
PUD
City/Cnty:
St Lucie County
Ownership and Mailing
Legal Description
Owner:
Richard Humphrey JR)
Constance
GREENBRIAR VILLAGE HARBOUR RIDGE -PLAT 2- UNIT 16 (OR
Humphrey (TR)
2538-1196)
Address:
10 Lawrence Ave
Tuckahoe NY 10707
Sales Information
Assessment 2009 Final Total Land and Building
Date
Price Code Deed
Book/Page
2009 Final: 297400 Land Value: 170000 Acres: 0.02
4/7/2006
399000 00 WD
2538 / 1196
Assessed: 297400 Building Value: 127400
12/2/2005
357000 00 WD
2442 / 2496
Ag.Credit: 0 Finished Area: 1714 SgFt
12/1/1998
189000 00 DE
1188 / 2768
Exempt:
9/8/1998
100 01 DE
1172 / 2600
Taxable:
10/21/1994
100 01 DE
0929 / 2877
Taxes: 5782.5
3/1/1988
192000 00 CV
0581 10207
10/1/1984
155000 00 CV
0444 / 2253
BUILDING INFORMATION
Exterior Features
View:
RoofCover:
CS - Conc Shingle
RoofStruct:
HP - Hip
ExtType:
HA - HA
YearBlt.
1984
Frame:
Grade:
A - A
EffYrBlt:
1984
PrimeWall:
BS - CB Stucco
StoryHght:
0010 - 1 Story
No.Units:
1
SecWall:
Interior Features
BedRooms:
2
Electric:
MX - MAXIMUM
PrmintWall:
DW - Drywall
FullBath:
2
HeatType:
FHA - FrcdHotAir
AvgHUFI:
1/2Bath:
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
Measare Depth
1 0100-SF Res
GFC -Site
1
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=442570100520008 1 /22/2010