Loading...
HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE O DATE FILED: PLAN REVIEW %FEE: RECEIPTNO.: �✓ ` PERMIT NUMBER: CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INJF0 MUST BE COMPLETE & FILLED M TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION ' i k 2300 Virginia Avenue 8 Y Ft. Pierce, FL 34982-5652 pez /w l- St. Lucre County 772-462-1553 V� �' O \� APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE LOCATION/SITE ADDRESS: 2. PROJECT NAME: PROJECT INFORMATION Lc- SITE PLAN NAME: 3. PROPERTY TAX ID #: 4. LEGAL DESCRIPTION (attach extra sheets if necessary): E PLAT BOOK 6. PAGE NO. PARCEL SIZE (ACRES/SQ FT.): 7. BLOCK NO. LOT DM ENSIONS: 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: 'Z�r.J� surf 8. LOT NO. ©ti e.-u,. 11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE: 12. TYP OF CONSTRUCTION (Check all appropriate boxes) [NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INTERIOR RENOVATION [ ] O[ ] INDUSTRIAL THER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: 7[!KIy3 — 14. SQ. FT OF CONSTRUCTION: /D % Sa lffl 15. 16. VALUE OF CONSTRUCTION: $ 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 S2500 or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 V J�t Poll � � ► a - 6 �� 5 UPDATED 6/25/69 OWNFR INFORMATION ADDRE! CITY: ,�C7-- &A,,,D STATE: PHONE (DAYTR E): V V'S , ?A I 't- Email: ZIP: 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 L CONTRACTOR INFORMATION STATE: ZIP: ST. of FL REG.CERT #: C co C- 10Z3 ST. LUCIE COUNTY CERT #: _ BUSINESS NAME: N QUALIFIERS NAME: fYPOI-X 3 `J •' .`Su.ADDRESS: ��3'"�n� /L CITY: A4- STATE: 14- i- ZIP: (4 3 PHONE (DAYTIME): 1( l L) f 733 - 2—S FAX N0. 7iZ "1 -!SS8Z.Email: ���.x.s o •+tea-. �vr�_1-� ARCHIT/ENGINEER: I>f-f> AI So SIAV -` S ADDRESS: F3 33 sneo CITY: STATE: ZIP: xy?gj� PHONE (DAYTIME): CT7j- Zao- et- %Co BONDING COMP ADDRESS: CITY: MORTGAGE LEA ADDRESS: CITY: STATE: STATE: 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 P., u,,t to do the work and installations as indicated, ana 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. NE RACTOR S NATURE TA F FLO D COUNTY OF�/�l CL The foregoing instrument was acknowledged before me this ;�'r day of byJ6j1)C who is personally known or has produced as identification. S Signature of Notary SIGNATURE ST43"F FL041DA COUNTY OF '/ /� D�� Q A /1 fi The foregoing instrument was acknowledged before me this �day of IC 11h hG 20 by , Cp who is personally known /or has produced as identification. Signature of Notary Commission No.Commission No.e �Ey�� �5 (gl d �SA M. BLACK i Commission # EE 077305 d -;ESA M. BLA:0773(0651 Fx-res June 10, 2015 i { A ComkccErn # EE 'my F, o Insuran 85385M ;:b0f6s June 10, 2%I* Th u Troy Fain InsuraNOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST B �G 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. oa�a rrmr a m �rn � o cc� ��' m 2 ' x ao �� �' a o� °`� �o mr so "o a z cn z m `� C ''rJ d CA C7 >� Qn c Oil C7 cn c n Im woo tz z �L 20 m �Zz z m zo Ln�t IV 1 �w z cn r r o � W m < n m �m z .. m cn IV cn JA 02/03/2012 07:11 77277P^r-"0 VERO SHOP FAX JOSEPH E. SMITH, CLE r THE CIRCUIT COURT SAINT LUCIE COL FILE M 3668137 OR 8-___ 3357 PAGE 2558, Rocordtad 01/25/2012 at U3:32 PM PAGE 01 Ann itacnap1m.3-1ETIM -- �Il01-03 �(C ?2kMtT Nibrnk vptrr i• . .: m wr w•MUut %a: , LYS? C� QF 9 MENC MENT The undersigned lweby given eotloe chid tnW ovamens w:jl be nt►de to certain real property, artd In accordanon with Cnapttr 713, Florida statute dnc followig thfOmution is provided in the Notice of coxtynenccNcer, I, D&SC7MvTION OF PROPERTY (Lc&W tlemirdon and vim Wrists) TAX FOLIO NUMBER.1*S 4ce-0/7tif-GOO-f 9UBDIY1S10N TRACT,,,,,,_ -.LOT BLD(; UNiY_ 2, GENERAL DESCRWMN OF WLMOVEME Nft .iR�i�tF�OPs PNO 3. OWK= WFORMA71ON: a. Na �m�e-&Q, c��• wr Atitl�dM.�j}*,...,0 Q.w •s.If b Addtcu TQ DRJI a k%%*C. ihc"u to ProP�Y� d. Naana sad address of tee simple 1111eheldar (if other Nan owner) a. C0jVMCTOR'S NAME. ADORESS AND PHONE NUMBER: �+ _ •..� ��aaatMlr A'SURRTY'S NAME. ADORM AND PHONE NUMBER AND BOND AMOUNT: ,6:1.F2YDER'S NAME. AaDRES9 AND PHONE NUMBER Persons within the State of Florida designatad by Owner upon whom notices w other dommieals m(y be utvcd as provided by Section 713.13 OXU 1., Pkirkk Statuses: N4N& AADB$SS AM THONG NUM3MR. Aoln addition to himself or herself, Owner destignata the following to receive a copy of the Lienor's Notice as provided in Sectiost 713.13 (t)(b), Fbrtda Sestutes; NAMgf ADDREW AND PHONE NI MEL 9. Exyntkun date of rodet of etrWWr Bronx (Ibe expiration Ow Is I ysar frusti dra duo of recording unless a different dam is specified) 20- �f4c,c�Tlk-s �l���ia� Pried Name and Provide S►gttafory7TltjwOM. Owner's Asthor ttd O�cer/Dprectar/Partnar/Mroycr State of Flo / (bunny of O /_l The forell g Inpwment ackanwledgW before me this � Hof 2�. By Lr7T+ . .as. FTt (N ) �J74-Assn.% (Type of aothorky...e.g. Owner. officer, wsta, attorney to firm) For (Name of pony on behalf of whom Iosauntent was examied) Personally Kaowrl^, a ptoduce0 the following type of [D:.,,,,,._. WFQ �uy�h�Kn/w �a� (�u( ((cinwdNo=allowyPubtu) gd ncf haetllwn foftwwFeaslsts Undu penalties of perjury, I' declare Ibu i have the fOregosng and teal the face in it art true to the best of my knowledge sod Wid (action 92.523, Rlonda Swnxa). Slaaat�linwi) of D-xserW or Owoer/s)' Audsuxixad OfBestr0rectw/Pattorr/ManaM who dpprd above: By; L By ew. twtraMu STATE Of ROAM ST. l_K17t C04JNTY IN161i;DGE?TIFYTF4':THISISA T; 7;f AIiG i •:. �?,�:G i�QFY 04 i Hf .t'�`,(s� 'r� t;. J O'S r` i fr�r'.• amp COUINTY IF 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, 3y03 - 50Z-- 012Y - 0c)0-3 (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 ///Z-031 S , 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. #05l (e F pmwwrie'I/ v r &X-M qc tc Property Owner Name (Please Print) qe�4- � 46 , 4 R9f 'frIVC 0 -li roperty O ignatur D e STATE OF FLORIDA, COUNTY OF /'�� " ACKNO�Y;:C-j D BEFO ME THIS DAY OF ` BY � �� WHO., PERSONALLY KNOWN TO ME OR WHO HAS AS IDENTIFICATION. 6J Z; nvvL" m-P --- SIGNA OF NOTARY PUBLIC TYPE OR PRINT NOTARY COMMISSION NUMBER i�.....! KARLA CUMMINGS ZIMMERMAN (ierfl *jon # EE 079084 Expires May 4, 2015 Baled Thru Troy Fain InwWw aW-W7019 SLCPDSD Revised 08/24/2010 F A_ _J CEMEX _la -0313 54131973 Job: Arrive Job Start Unload: Finish Unload: �L( Retum Plant: Customer Code Customer Name: Customer Job Number. O'de, Cod" 1)aue Project Code. Pm)W Name: Project P.O. Number: Order P.O. Number. Ticket Date, Delivery Address: Map Page. Map/Row/Column: Delivery Instructions: Dispatcher: Ticket Number Due On Job Slump Truck Number: Driver Number Driver Nama. End Use 1 3( 0% ) I W I L I I AM DE NO W.DING: -.i AB LOAD CUMULATIVE ORDERED N1. QUANTITY QUANTITY QUANTITY I MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE I AMOUNT IF EB 15 Am 7:47,-, 1f­ 1. icy 121_111-71�18 FUE '$L1R(_;14ARGE .9 - 1. 00 749 FNV LI M NMENTAL CHARGE Cast, Check # r AUth Code Signature of Driver Receiving Cash CaO Received, Total COD Order Amount to Collect Check Without Standby Charges Charge Comments WATER ADDED: -GAL YARDS IN DRUM JV WHEN ADDED. 201 ."— SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST public Vvorks rounty, F� 'St. L-ucie SITNAMPr LJ LOAD WAS TESTED BY: Notice; Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS Any water added is at customers own risk. If water is added on job, concrete strength Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material terms of saleftnd delivery and accepts concrete as is. Due to important factors which are out of our may be hazarogus to your safety and health Please refer to the backside of this ticket for important control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handling Informalion, and to the material safety data sheets for additional information returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing IHORIZED SIGNAT Re: within one business day after the receipt of materials. r ­77,1 68UNIVERSAL . ; LOAD NUM: I CUSTOMER Property Appraiser - St.Lucie County, FL Page I of 1 Hospice Foundation/Martin/St L Record: 1 of 1 Property Identification Site Address: 5000 Dunn Rd Sec/Town/Range: 05 :36S :40E Map ID: 34/05S Zoning: AR-1 PROPERTY RECORD CARD «Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print �V�CIE CO ParcellD: 3403-502-0194-000-3 Account #: 39183 Land Use: HMSAGEDA�k City/Cnty: St Lucie County Ownership and Mailing Legal Description Owner. Hospice Foundation/Martin/St L WHITE CITY S/D 05 36 40 THAT PART OF LOT 101 LYG W AND SLY Address: 1201 SE Indian St OF DR DITCH 103 AND THAT PART OF N 182.40 Stuart FL 34997-5688 More... Sales Information Assessment 2011 Final Total Land and Building Date Price Code Deed Book/Page 2011 Final: 1102800 Land Value: 404000 Acres 7.47 1/6/2006 100 01 WD 2462 / 1453 Assessed: 1102800 Building Value: 698800 1/16/1998 583000 01 WD 1121 / 1433 Ag.Credit: 0 Finished Area: 15351 SgFt 11/1/1986 189000 00 CV 0521 / 0653 Exempt: 1102800 Taxable: 0 Taxes: 0 BUILDING INFORMATION Exterior Features View: RoofCover: ES - Enam Metal RoofStruct HP - Hip ExtType NURH - NURSING YearBlt: 2007 Frame: HOME Grade. Y_C+ - Commer C+ EffYrBlt 2007 PrimeWall BS - CB Stucco StoryHght: 0010 - 1 Story No.Units: 32 SecWall: Interior Features BedRooms: 32 Electric. MX - MAXIMUM PrmintWall: DW - Drywall FullBath: 0 HeatType: FHA - FrcdHotAir AvgHUFI: 1/28ath: 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 ASP1 - ASP1 HIGH Y 1 32688 AV AV 2007 1 7400-HMS AGED 535 -Sq Feet 244619 LGT1 - SINGLE LIGHT Y 1 9 AV AV 2007 2 7800-SNTRMS 210 -Acres 1.857 CURB - CEMENT CURB Y 1 1230 AV AV 2007 WAL3 - CBSWall6"Blk Y 1 33 AV AV 2007 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED Depth http://www.paslc.org/prc.asp?prclid=340350201940003 12/29/2011