HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE ONLY:
DATE FILED: � _
PLAN REVIEW F : 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 �-.4N
772-462-1553 St `B1N�®
4c/
t?
APPLICATION for BUILDING PERMIT co�n41.
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
1. LOCATION/SITE ADDRESS: Co-7-4 �37CKSr>jdt-A Ta(1 fZ
2. PROJECT NAME: L J PJ Cam{ SITE PLAN NAME:
3. PROPERTY TAX ID #: 3L41 � - --76 i. - CCtA Z- GOc - G
4. LEGAL DESCRIPTION (attach extra sheets if necessary): O i-� W4 oC X i SNLi iZI,eL r SLv-Z L-T I O
(o. zri PC)( cA 3?yam- Zfi 0
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. Z 8. LOT NO. 1 °
9. PARCEL SIZE OACRE/SQ FT.): . Z ) � LOT DRvIENSIONS: I 65.ab t X t26. 'u o
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: I Z Y x Zh 5LA t3
Cup � `j }iLic LgA0 ij 3e i i ant. wf (I S 1'415.4 t
11. SETBACKS (ACTUAL) FRONT: _)j P� BACK: I� •l,`{RIGHT SIDE: 'Lt •GI ' LEFT SIDE: ZL .'7Z
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
NEW CONSTRUCTION EXPANSION/ADDITION [ ] INTERIOR RENOVATION
COMMERCIAL
RESIDENTIAL [ j INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE:
14. SQ. FT OF CONSTRUCTION: -L4(,, 15. SF. FT 1st FLOOR N A
16. VALUE OF CONSTRUCTION: $ 7. Z 6
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: ANC% 6�LL360&T
ADDRESnS: („�Z`� �JSCILLNSQ(J _ _
CITY: I'oR� STATE: zip:
PHONE (DAYTIME): Ct 1) 36 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 (DAYTM): (_)
CONTRACTOR INFORMATION
ST. of FL REG.CERT #:
STATE: ZIP:
ST. LUCIE COUNTY CERT #:
BUSINESS NAME: Abater CK- ' �Nilsl
QUALIFIERS NAME: 6t')" fV) Af -coiir--
ADDRESS: 1 ZC� PVI"
CITY: E6trC S; L r'STATE: ZIP: i �3
PHONE (DAYTIME): 72 L 3 `�U' 22'10 FAX NO. 341)" 7F�7 Email:
ARCHIT/ENGINEER:
ADDRESS:
CITY: STATE:
PHONE (DAYTIME): �)
BONDING COMPANY:
ADDRESS:
CITY: STATE:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE:
"Al'
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
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.
�,2
O ER OR CONTRACTOR SIGNATURE
STATE OF FLORIDA
COUNTY OF ��-
The foregoing instrument was acknowledged before
me ibis day of 20 12- ,
by �L- �Ij��� C� t 1 #,.e_
' r l
who is personally known, --'--`or has produced
1,2��
NTRACTOR SIGNATURE
C
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before
me thiss � day of �7q , 20
a L_ YA)4-r (! 61�c_
who is personally known or has produced
as identification. as identification.
Sig re of Notary Si re of Notary JOSANDRA A. LONDO
m••.•••••••••••••`••qA A. LONDO "„°"° Comm# DD0742647
Commission l�o. �� �c# DD07 Commission No 1~
pComm res j12
31912012 +� ref'
fires r� ry
,�� .. .,,��cr� Fb da Nota Assn., Inc
"a�Era�a'A. Fsorfda Notary Assn., Inc = �............... ............................�
,' .xH.•. u. n...........�
NOTE: TWO (2)nSIGNATURES 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 B
N
/���
TOWNSHIP
RANGE
�_ .
MAP NO.
,
,, j L
LAND USE
LOT CVG %
TAZ NO.
ZONE
rLOOD
FIRM MAP #
IT FLR ELV
MAX HGT
TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF REC
Before 1/1990
LOT OF REC
After 1/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
--
HABITABLE
AREA
RADON
FEE
PERMIT
FEE
LIBRARY
BRACT
FEE
PUBLIC BLD
BRACT FEE
CORRECTION
PUBIC BLD
BRACT
FEE
GENERAL
PARKS
BRACT
FEE
SCHOOL
BRACT
FEE
ROAD
DRACT
FEE
CREDIT
Y
N
LAW ENF
IMPACT
FEE
FIRE MS
BRACT
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
FEES
DATE SENT TO ADDRESSING: /
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
P AX/S'
RE W
VEGET O
RE W
SEA TURTLEMANGROVE
REVIEW
REVIEW
DAM
RECEIVED
DATE
COMPLETED
INTfIALS
JOSEPH E . SMITH, CLERK � �'HE CIRCT=-COURT -WW6AI T , COUNTY
FILE # 4314018 OR BOOK 4u02 PAGE''137"i, Recorded 05/3 , -J17 10:34 :47 AM
NOTICE OF COMMENCEMENT
Permit No.1ax Folio No.
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 Description of Property: (and street address if available); r� /
I 1�� -V'N Y, %o t f
General description of improvement-3QnL Evlplosure w k 7Ln(s
Owner information or Lessee informatton if the Lessee contracted for the improvement:
Name o. cc Q--:Dl \.\01 r`1
Address
Interest in property;
Name and address of fee simple titleholder (if different from Owner listed above):
Contractors Name: _ D "�( `+L(1 ((
Contractor Address:_. _ Phone Numbers 1J
Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $
Name and address: Phone number.
Lender Name: Phone Number:,
Lender's address:
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
713.13(1)(a)7., Florida Statutes:
Name: Phone Number:
Address:
In addition to himself or herself, Owner designates of
Uenors 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
contractor, but will be 1 year from the date of recording unless a different date is specified)
WARNING 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 BEFORETHE 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 perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of
my knowledge and belief,
(511n)ture of Owner or Lessee, or Owners or Lessee's Authorized Officer/Director/Partner/Manager
( to YL1!
(Signatory's Title/Office)
The foregoing instr Enent was acknowledged before me this day of , 70—
=l
By 1 as hu t it l(jff for
Na a of Tson Q�\Type of authority (e.g.office r,trustee) Party on behalf of whom instrument was executled
KAREN S. NIELSEN
? Commission # FF 1 Q'9fial known_ or produced Identification .
(Signatureof NotaryPublic-StateofFlorida) 3pay Comm iss on Fxpl, es R
(Print, Type, or Stamp Commissioned Name of Nota ,1 uno 1 2 , 20 Type of Ic i ntification produced,
o --i to
pm�• rn
m
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE -
FORT PIERCE, FL 34982 n i : e d :. �:• - f , �r
(772)462-1553 Fax (772) 462-1578
MAY 3 ? 2017
PERMIT RENEWAL REQUEST PEWAI?Tia'G
St. Lucie
PERMIT NUMBER: - O 12 ADDRESS: �Z`�y `�\ ►�S��,T� Y r' �SL �L
C-,, �� , am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be finaled. Further, I
understand that this is a ONE TIMERENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification -E�v"-�- Y,Ok c'
kw
O RBLDR OR CONTRACTOR SIGNATURE DA E
Print Name
STATE OF FLO A
COUNTY OF
ACKNOWLEDGED EFORE ME THIS ( DAY OF ` 1 11R�I •20t rl
By '11 WHO IS PERSONALLY KNOWN TO ME , OR
HAS PROVIDED AS AS IDENTIFICATION.
KAREN S. NIELSEN
Commission # FF 115637
`Y�Woc MY Commission Expires
SE
�,,,i�„o• June 12, 2018
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = $ t[5-��Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014
MAY 3 1 201?
PLANNING & DEVELOPMENT SERVICES PE[1,A -Ti,\;u
BUILDING & ZONING DIVISION St. Lucie Court:,
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
_CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
and the new contractor of record for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
commencing any work. There is a $50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be signed by the general contractor only.
The new subcontractor must fill out a Subcontractor Agreement Form which is signed by both the contractor and
subcontractor. There is a $50.00 fee for the Change of Sub -Contractor.
CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: �h rv,� Permit Number:
Site Address: UTDA �.'A_\Y\�,pv) VQf r �`�L , (,
INII OrQ ) Q-)rJ C K Dul e-,V111 rt-- State License SLC License
Original GC, subcontractor o owner/builder T—
State License SLC License
a 10 111D( 1 'A H I I o ler
New GC, subco tractor or ownerlbuilder
Reason for Cancellation
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of
contractor/subcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed.
SIG TURF OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable)
PR T NAME —\_)P, hitc-r— GN`�l6 PRINT NAME
State of Florida, County of St. Lucie County State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this The following instrument was acknowledged before me this
day of 2011 by day of , 20_, by
whwis personally known to me who is personally known to
or who h produc • Q 1_ as ID. me or who has produced as ID.
Signature of Notary ,..,� ture of Notary
.........KAREN S. NIELSEN
YVB '"i
" Commission k FF 115637
Revised 05/18/2017 ,• My Commission Expires
June 12, 2018
Date
Planning & Development Services DepartmeRL
�-+ R
Building &Code Regulations
2300 Virginia Avenue
Fort Pierce, Florida 34982
(772) 462-1553 MAY 3 2017
OWNERBUILDER AFFIDAVIT DISCLOSURE STATEMENT PER Jii rTi,%1G
F.S. 489.103 (7) EXEMPTIONS St. Lucie County, FL
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 for your use and occupancy. You
may also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for your own
use or occupancy. You may not build or improve said structures for the purposes of selling or leasing that building.
If you sell or lease a building you have built or improved within one year after construction is complete, then a
presumption is created that it was built or improved 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. Your construction must comply with a 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 a 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 iable for the
cost of the license. Initial 4--
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�ededical
cost, which could include loss of wages during recovery from their injury. Initial 1'
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
J_�_ day of of 20 —a.
Own Builder Signature
STATE OF FLO DA
COUNTY OF
The oregoing ins nt as ac owledged before me this , day of!(`(�pc�l , 20,
by 1 �l l MT who is personally known to me, or who has
produced as identification.
Signature of Notary Type or Print Name of Notary —
Title: NotPublic Commission Number 1J� -s
<AREN S NNIELSEN
ary
- n: c
Comm ssion # FF 1 i 5G37
My Commission Expires
June 1 2 , 2 01 8
SLCPDSD Revised 05/15/2014 'F
LEGAL DESCRIPTION:
Lot 10 in Block 2 of
OLEANDER PINES
according to the plat thereof
as recorded in Plat Book 28
page 14 of the
Public Records of St. Lucie
County, Florida.
ABBREVIATIONS:
(-)-Not verified by field measurement
/=Volue as plotted k field measured
F.F.E.=Finished Floor Elevation
SET - Set 5/8" iron rebor l�yath
9re�llo* cop marked "PS 5543'
=Value as measured in field
OFF-OH—oH-= Over Head Fires
X—X—X-= Chain Link Fence
FD=Fgand 5/8" Iron Rebor
R.O.W.fight of Way
0-0--0-= W6od Fence
)j= FPL Transformer Pad
PL=Value as platted
R = Radius of curve
L = Length of curve
0 = Delta of Curve
Site Benchmark
AS. m Measured
S.F.=Squore Fool
CONC. = Concrete
C.P.= Conc(,ete Pad
EB= Water Meter
j= Po*er Pole LOT 2 BLOCK 2
= Bell South
®= We I I
FMND
REBAR 1 — �� No cAP —
SURVEYORS MOTES:
1. Unless other*ise noted only platted easements
are sho*n hereon.
2. No underground utilities or improvements *ere
located unless other*ise sho*n.
3. This site lies *ithin Flood Insurance Rate Mop
Zone X.
4. Flood Zone sho*n hereon is on interpretation
by the surveyor and is provided as a courtesy.
The flood zone should be verified by a
determination agency.
5. Bearings sho*n hereon ore based on the East
line of Lot 10 Block 2 as being S00.00'25"E
according to the Plat described hereon.
6. P.U.D.E. denotes Public Utilities and Drainage
Easement.
7. All Lot dimensions sho*n ore per plat unless
other*ise sho*n.
N89'59'35"E 105
5 P.U.D.E
a
LOT
o POCIL
O PaOI IJEM
CD
a N
CD
CZD
18.50' o
oM
(V
15.50'• COVERM
Gp' p14.15'
0
0
nJ
o �'10.55'
n
m w
0
I STORY CONC. BLOCI( o
o
U7)
M
O CV
CD
O
5.2'-
O
ON
v 13.20'
21.79' u 20.50' iv ' 17.20'
DIayE
FoLso 5/8' 1R011
REBAR WIN CAP
'CATJ9 4186'
11511w 105.00'
50' R.QW. - 20' ASPHALT ROAD
- — DICKINSON TERRACE
6724 Dickinson Terrace
SCALE: 1"=30'
Atlantic Land Designs
0l the Treasure Coast
7m v Jensen Bench Blvd. Jensen Beach, FL 34957
Moiling Address:
P.O. Box 1421 Jensen Beach, FL 349E
(772) 398-4290 ALD5543®gnoii.corn
DATE 1211/11
-
DRA#j: JC
2011-0543
DATE:
REVISIONS
i .' I
cr-L
r
— — 1tFOB R �p1�F1 GIP
'ChT,IB 4286'
C:)
O
CV N
m
a
0
w
ic7
CV
CD
21.61' o
O
Cn e
Fait 5/8' 6tOFl
RESAR 1111711 CAP
'ChTJB 4286'
1-
LAST FIELD DATE:12/1/11
ASBU I L T SURVEY
Certified to: Janice Gilbert
Christopher J. T*ohey, P.A.
Old Republic Notional Title Insurance Company
I hereby certify that the surrey shoAn hereon Is true and correct
and is based an actual measeurements token in the field. This
surrey meets the Vinimun Technical Standards of Chapter 5J-17
Florida administrative code. s N .4sr
Digitally signed by James c�.ytere car°o
Cesiro Jr.
James A. DW cn=James A. Cesiro Jr_
o.Adantic Land Designs o
the TC, ou,
e rnail=ALD5543@gmail.
Cesiro Jtin.t:=US �y
Date: 2011.12.0206:4137
-05,00' Suxvc`Is'
NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC SIGNATURE
AND AUTHENTICATED ELECTRONIC SEAL
:r
SLAB - THIC"'NED EDGE FOB, TING SIZES
GERNERAJ, NOTES
1- 6" X 6" 10/10 WWM OR FIBERMESH DED CONCRETE.
2- 6 MM VISQUEEN YAI'ORDMMERTE�UMED-=ON TERNffTE TREATED
SOIL WHEN NEXT TO LIVLNG SPACE OR UNDER HABITABLE SPACE-
3 _ COIvpATION TEST REQURED -W EN FILL EXCEEDS 18 95% MINWUM
COWACTION REQUIRED
SLAB/FOOTING USED
as ITWX SLAB 3flN
45 DENS 8'�
g»
4' IIM MN
Mo» -
O
45 DEGREES
1- #5 RF.BAR3
8"
4' 1 *11 K' K-AB MIN
2 - 4.15 REBARS lsl�
4- TIRCK SLAB MW-
4" NON STRUCTURAL
(NO FUTURE BUD -DING)
t2"
rLUNTYO
R 1 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,
(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.
_�G cv'% ce. Cam', %Q,
Property Owner Name (Please Print)
Pro y Owner Signature Date
STATE OF FLORIDA, COUNTY OF Xa
ACKNOWWLEDGED BEFORE ME THIS 17 DAY OF �� 20 1 Z ,
BY ZM 19 E &1L66_jtT WHO IS PERSONALLY KNOWN TO ME --OR WHO HAS
AS IDENTIFICATION.
2............ ..... .■.....................uu.
i JO A
OF NOTARY PUBLIC TYPE OR RTi?, Y `
i '=$� Comm# DD0742647 :
COMMISSION NUMBER =girExpires 3/9/2012
4Florida Notary Assn., Inc
"6...nae........, .....................e
SLCPDSD Revised 08/24/2010
Property Appraiser - St.Lucie County, FL
Page 1 of 1
PROPERTY RECORD CARD
Janice Gilbert Record: 1 of 1
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Property Identification
\,UCIE CO
Site Address: 6724 Dickinson Terr
ParcellD: 3415-706-0042-000-6
Sec/Town/Range: 15 :36S :40E
Account #: 145911
Map ID: 34/15S
Land Use: SF Res
City/Cnty: St Lucie County
Zoning: IRS4
Ownership and Mailing
Legal Description
Owner: Janice Gilbert
OLEANDER PINES REPLAT BLK 2 LOT 10 (0.289 AC) (OR 3347-
Address: 6724 Dickinson Ter
2988)
Port St Lucie FL 34952-8257
Sales Information
Assessment 2011 Final Total Land and Building
Date Price Code Deed
Book/Page 2011 Final: 153800 Land Value: 18000 Acres: 0.29
12/9/2011 198000 0001 WD
3347 / 2988 Assessed: 153800 Building Value 135800
9/6/2002 178600 00 WD
158 / 1508 Ag.Credit 0 Finished Area 2269 SgFt
Exempt: 75500
Taxable: 78300
Taxes: 2077.55
BUILDING INFORMATION
Exterior Features
View:
RoofCover:
SD - Dim Shingle
RoofStruct:
HP - Hip
ExtType: HB - HB
YearBlt:
2002
Frame:
Grade: B - B
EffYrBlt:
2002
PrimeWall:
BS - CB Stucco
StoryHght: 0010 - 1 Story
No.Units:
1
SecWall:
Interior Features
BedRooms: 0
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
Measure Depth
ENC2 - POOL ENC-AVG Y 1
1032 AV AV
2002
1 0100-SF Res
BI -Site
1
SWAV - RES POOL AVG Y 1
336 AV AV
2002
PA01 - POOL DK-AVG Y 1
696 AV AV
2002
THIS INFORMATION IS BELIEVED TO BE CORRECT AT
THIS TIME
BUT IT IS SUBJECT
TO CHANGE AND
IS NOT WARRANTED.
http://www.pasle.org/prc.asp?prclid=341570600420006 1 / 17/2012