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HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE �,-*ikY: nn - DATE FILED: -0 o(. (f • )� PLAN REVIEW FEE: RECEIPT NO.: CONCURRENCY FEE: RECEIPT NO.: PERMIT NUMBER: " 01 . C2 O CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 5G 2300 Virginia Avenue BPierce, Vt1.' Ft. FL 34982-5652 s 772-462-1553 C ayxpilee St. Lucie County eRA APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATI4 1. LOCATION/SITE ADDRESS: � �(n 0�'� U - �"—V/ 2. PROJECT NAME: SITE PLAN NAME: 3. PROPERTY TAX ID #: 3 l l2 4. LEGAL DESCRIPTION (attach extra sheets if necessary): I f —) rr L i �,. _ , _ 5. 9. 10. H. 12. 13. r• 0 � WOO. &L-G SL8'S' (FrrXTO PARCEL SIZE (ACRES/SQ FT.): © / %LLOT DIMENSIONS: 7 64e COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:I A Qa� M , (ACTUAL) FROM': BACK: 10 4 - RIGHT SIDE: ',?I SIDE: Y► TYPE OF CONSTRUCTION (Check all appropriate boxes) [l� NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] OTHER (SPECIFY) DESCRIPTION OF PROPOSED USE: [ ] INTERIOR RENOVATION [ ] INDUSTRIAL �'n n v 14. S . FT OF CONSTRUCTION: `� J �. S� F T 1st FLOOR Q 7:V! 16. VALUE OF CONSTRUCTION: $ t r 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 6/25/09 OWNER INFORMATION ` NAME: ADDRESS: r CITY: STATE: ZIP: PHONE (DAYTU%4E): ( Arlmail: 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): (_) CONTRACTOR INFORMATION ST. of FL REG.CERT #: A U ) BUSINESS NAME: QUALIFIERS NAME:. ADDRESS: CITY: STATE: PHONE (DAYTIME): FAX NO. ARCHIT/ENGINEER: ADDRESS: CITY: PHONE (DAYTIME): �) BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: STATE: STATE: ST. LUCIE COUNTY CERT #: Email: ZIP: P R1' 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 COUNTY ` F L O R I D A 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, G-D6o (Parcel 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. r C r �`6�- Co V (Please Print) Property Vfwner Signfture - vate - q,. " . , STATE OF FLORIDA, COUNTY OF • ACKNOWLEDGED BEFORE ME THIS Li! DAY OF 20 BY , WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED • AS IDENTIFICATION. Q U - - h 1A dj1 �. m?14 SIGNATURE OjlAR L OR PRINT NOTARY COMMISSION NUMBER r ) AUOREY B {iUMPHREY 'sue MY COMMISSION # EE 061159 Mar " k< EXPIRES: ch 6 2015 • I , .. ,_...,, . niters d thm Notary Public Ul) i_ SLCPDSD Revised 08/24/2010 J Planning & Development Services Department Building & Code Regulations o ; 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 applicab 1 s, 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 eet 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 relate 'cal 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 nmg Department o the Florida Sta a epartment of Professional Regulation. Signed and acknowledged on this day of of 20-7 " Own r uilder Signature STATE OF FLORIDA COUNTY OF 141 • -txcl b / The f regoing instrument ent was acknowledged before me this (� day of , 20 /A, by t Q_ who is personally known to me, or who has produced as identification. JA Signature of Noffry TyPe or Print Name of otary (Seal) Title: Notary Pu lic Commission Number SLCPDSD Revised 07/22/2010 A,w.. AUDREY B. HUMPHREY MY COMMISSION # EE 061159 ?k.o` EXPIRES March fi, 2015 Lg1$"'" Bonded Thru Notary Public Underwriters 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 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. OWNtk OR CONTRACTOR SIGN RE STATE OF FLORID "k COUNTY OF _' CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before 1 am a The foregoing instrument was /_ me this to day of 20 �vOG me this day of �E a Z PMm� b y who is personally known It produce �- m� m o � m { whopersonally own p.lGi • d/li _ Yit L' as identification. of NUary Y (/ Signa)dire of Notary :kn ledged before ,20 , or has produced as identification. Commission No. (Seal) Ommission 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 REQUITED FOR ALL OWNERIBUWDER APPLICANTS. For specific instructions see appropriate permit checklist. OFFICE USE ONLY B t: 0 SECTION IN TOWNSHIP RANGE // �" MAP NO. Ov t ZONING J LAND USE LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # I ST FLR ELV HGT CONST TYPE OCCUP TYPE # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC T OF REC LOT SPLIT LOT SPLIT Before 1/1990 After 1/1990 REQUIRED APPROVED REPORT CODE n �J' ` c HABITABLE AREA RADON FEE PERMIT FEE LIBRARY PUBLIC BID PUBIC BID PARKS IMPACT BRACT FEE IMPACT 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 BRACT REQUIRED FEE VARIANCE FEE FEE SPECIFY MECHANIC ROOF 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 C UNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED 01 1to ha - DATE COMPLETED l INITIALS �' JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY FILE # 3671562 OR )K 3360 PAGE 1907, Recorded 06/2012 at 04:08 NOTICE OF COMMENCEMENT °a.6)057 ►�So1 3/OnooSbao (� :Permit No. D ` Tax Folio No. -L� State of Florida County of St. Lucie The undersigned hereby gives notice that improvement will be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. Legal Desc ' tlon of Prope (nd str et address if available): 0 / 2 ItOAl enerde rl4-�tiin Qn{pl'Bv-cYment: }_ tat Owner inforltt tD o Lessee Information i e Lessee contracted for the improvement: Name VV lip Address _ Name and address of fee simple titleholder (if different from Owner listed above): Name: .ontractors ontractorAddress: Ph a umber: Surety (If applicable, a copy of the payment bond is attached): Amount of bond: $ Name and address: Phone number: Lender Name: Phone Number: ,ender's address: fa _ _ Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.1 (1)(a)7., Florida Statutes: Name: Phone Number In addition to himself or herself, Owner designates of Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number of person or entity designated by owner: to receive a copy of the Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the :ontractor, but will be 1 year from the date of recording unless a different date is specified) ;;VARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of?-I, erjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowle e a -belie (Signatur Owner or Lessee, or Owners or Lessee's Authorized Officer/Director/Partner/Manager �X ': AUDREYB. HUMPHREY My C0k[MISSION A EE � t,2 a EXPIRES March 9, 20t5 :' Bonded Tvu"ry Pubin U,d_,jcrs (Signatory's Title/Office) The foregoing instrument was acknowledged before me this—b- day of_.;B�� 4y �1I e To Ili ft 1�� P _ as 112 31fi rc. for Name of Person Type of authority (e.g.officer,trustee) Party on behalf of whom instrument was executied Personally known_or produced Identification (Signature of No Pub is - Sta a Florida 4"l 'C (Print, Type, or Stamp Commissioned Name of Notary Public) Type of Identification produced STATE OF FLORIDA ST. LUCIE. OUNTY THIS' r, 'tRriFTRUEY i ORI `C31 RRrkT�� FtJ 1&�H- `�LVIKI V�'& .. `r Dare � ,jrnty c Y � I 4 rt� d � w. ��� LlflcoPY,4t MIN. SETBACK REQ. FRONT_ SIDES CNR SIDES? REAR J t ZNGV TECH. Property Appraiser - St.Lucie C-inty, FL _ Page 1 of 1 PROPERTY RECORD CARD Victoria Greer Record: 1 of 2 <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification P x �VUCIECO Site Address: 12623 S INDIAN RIVER DR ParcellD: 4-310-0005-000-6 _L 622 Sec/Town/Range: 04 :37S :41 E Account #: �� 122511 7`RCiT_ Map ID: 45/04S Land Use: City/Cnty: SF Res St Lucie County Zoning: RS-4 Ownership and Mailing Legal Description Owner: Victoria Greer 4 37 41 FROM SW COR OF LOT 6 BLK2 OF SPRING HILL S/D RUN S Address: 12623 S Indian River Dr 28 DEG 30 MIN E ALG SLY EXT OF W LIOF SD Jensen Beach FL 34957-2219 More... Sales Information Assessment 2011 Final Total Land and Building Date Price Code Deed Book/Page 2011 Final: 156500 Land Value: 113000 Acres: 0.56 12/21/2011 200000 0205 WD 3351 / 2179 Assessed: 156500 Building Value: 43500 10/11/2011 100 0111 WD 3335 / 0795 Ag.Credit: 0 Finished Area 2136 SgFt 9/14/2011 0111 PB 3327 / 0310 Exempt: 9/14/2011 0111 PB 3327 / 0307 Taxable: 9/7/2010 100 0311 WD 3307 / 2122 Taxes: 3184.13 11/24/2004 100 03 QC 2101 / 2366 8/4/2000 100 02 WD 1319 / 0221 4/1/1972 20500 00 CV 0201 / 1547 BUILDING INFORMATION fa " I" Exterior Features View: RoofCover. TN - Metal ExtType HC- - HC- YearBit: 1901 Grade. C- - C- EffYrBlt: 1960 StoryHght: 0020 - 2 Story No.Units: 1 Interior Features BedRooms: 0 Electric: MX - MAXIMUM FullBath: 1 HeatType: 1/2Bath: 0 HeatFuel - %A/C: 0 %Heated: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qual. Cond. YrBlt. No. Land Use DOK2 - WOOD DOCK Y 1 1212 AV AV 1960 1 0100-SF Res RoofStruct: GA - Gable Frame: PrimeWall: SB - Abs Shingle SecWall: PrmintWall: PB - PANEL BOARD AvgHUFI: Prm.Flors: SP - Sing Pine %Sprinkled: 0 Type Measure Depth 240 -Front Ft 76 322.5 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=450431000050006 2/6/20l 2