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Home My WebLink AboutSUBMITTED PAPERSOFFICE USE-GNLY: DATE FILED: RE-C VURE(CEIPT NO.: CERT. CAP. NO.: PLAN REVIEW FE EIPT NO.: PERMIT NUMBER: a6 CONCURRENCY FFEE: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 Virortia Avenue I't. Pierce, FL 34982-5652 SCANNED 772-462-1553 St, Lu 0 y APPLICATION for BUILDING PERMIT Ce COUnty CERTIFICATE of CAPACITY/ZONIING COMPLIANCE PROJECT INFORMATION I LOCATION/SITE ADDRESS: 2. PROJECT NAME: SITE PLAN NAME: 3. PROPERTY TAX ID #: 1 -3 C 1 3 0 3 05-0 0 0 -7 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 9 10 PLAT BOOK 6. PAGE NO. PARCEL SIZE (ACRES/SQ FT.): 7. BLOCK NO. 8. LOT NO. LOT DD4ENSIONS: w COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: 15 1 'o -)n z Z)o b P4-:� i L14f --4;c k 11. SETBACKS (ACTUAL) FRONT: 12 13. 14. BACK: SQ RIGHT SIDE: LEFT SIDE: 7, '5- TYPE OF CONSTRUCTION (Check all appropriate boxes) NEW CONSTRUCTION EXPANSION/ADDITION INTERIOR RENOVATION RESIDENTIAL COMMERCIAL INDUSTRIAL OTHER(SPECIFY) -I-, �- N �> DESCRIPTION OF PROPOSED USE: ck-tirce SQ. FT OF CONSTRUCTION: '16 1) 15. SF. FT I st FLOOR. 16. VALUE OF CONSTRUCTION:$ 3,30 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 simdar 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 6t25109 OWNER INFORMATION NAME: <f RM L7 d I e in Ll +-f- ADDRESS:j 4, -,a CITY: T- + V�llt C- 9C e STATE: ZIP: !2:)LI 9's PHONE (DAYTRAE): Qs�b -7 3 fw,�� C 7 b Einail: IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM TliE OWNER LISTED ABOVE, PLEASE FELL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): CONTRACTOR INFORMATION ST. of FL REG.CERT #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS: CITY: PHONE (DAYTHVIE): (__) ARCHIT,TNGINEER-- ADDRESS: CITY: PHONE (DAYTM�4fl: C__) BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: FAX NO. STATE: STATE: STATE: ST. LUCIE COUNTY CERT #: Email: ZIP: ZIP: ZIP: IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification it wiH be voided and returned to you by maiL CATION - 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 ceri 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 TIHS 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. cl� at-i-L.Iiiiii� OWNER 01 rRACTOl �ATURE STATE OF FLO COUNTYOF_-!n- The foregoing instrument was acknowledged before me this day of 1)(�Wk 20-0-, by,2 i: �, 'P, who is personally known or has produced The foregoing instrumen , t was acknowledged before methis 1//dayof_143-V\1 20 by D who is personally known or has produced as idendfication. as identification. Signature of Notary -gig—nature of Notary Commission No. AI& Commission No. ON FXPIRE.S. a, EXPAESi HaNi, 221, 2D13 Onded ThI Nl 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 WELL BE REQUIRED FOR ALL OWNER/BUtLDER APPLICANTS. For specific instructions see appropriate permit checklist. OFFICE USE ONLY B. 11L):61 �lww SECTION TOWNSHIP RANGE 39�S N ZONING 0 LAND USE LOT CVG % TAZ NO. D R.00D ZONE R -0 0 FIRM MAP # I ST FLR ELV NM HGT CONST TYPE [WATEZ OCCUP TYPE MAX OCCUP # OF FLRS T V R SEWER SPRINKLERS STORMWATER I nT nr LOT OF REC Before 1/1990 LOT OF REC After 1/1990 LOT SPUT REQUIRED LDT SPLIT APPROVED REPORT REPO" CODE CODE 1,5 HABITABLE AREA (RADOM RADON FEE PERMIT FEE IBRA LIBRARY IMPACT AC FEE PUBLIC BLD IMPACT FEE CORRECTION PUBIC BLD IMPACT FEE GENERAL PARKS IMPACT FEE SCHOOL IMPACT FEE ROAD IMPACT FEE CREDIT Y N LAW ENF IMPACT FEE FRIE/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 FEES DATE SENT TO ADDRESSING: REVIEWS FRONT co ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED INITIALS Continental Florida Materials Inc. 1705185 1 13450 W. Sunrise Blvd., Suite 430 mI Sunrise, FL 33323 Him nimmin ka� lul: kzJO'+) 000-ulcu 6AU I 1U111! Freshly mixed cement, mortar, Drivers am pro IMENTGroup concrete or grout may cause - skin injury. Avoid from delivering concrete except under the contact with eyes where possible and wash truck's own power, and where site conditions exposed skin areas promptly -With water. If any permit the safe and proper operation of his equipment. Drivers are not permitted to cement mixtures get into eyes, rinse immediately and repeatedly with water and get prompt medical add water to the mix nor to go beyond the treatment, Sawing, or grinding of concrete 'Curb line, except upon the authorization of ft- Ah I masonry units may result in the release of dust the Purchaser/Purchaser's Agent arid his no of risk for any loss or d ge� 0 1 W* particles which, without the use of proper eye or accepta a ama respiratory protection, Gould cause eye or nose I acknowledge that I have received and 'L, irritation. The Material Safety Data Sheets for accepted the materials fiSW on this ticket i_,-_4h c,444 the products sold by Continental Florida I understand and agree to the terms on Curb line crossed at Purch��er/Purchaserls Agent request. Initials of Purchaseripurchaser's Materials Inc. are availabip Upon request. both the front and back of this ticket. TOTAL Agent WATER YARDS ON TRlJgX,4LGALS OF WATER ADDED APSED In-ftials of Purchaser/Purch ,Sees Agent acknowledging addition of water at Purchaser/Purchaser's 3 1 2 Agent request. 101 9 1 8 1 7 $,a )1 3 1 4 LEAVE JOB TIME ARRIVALTIME START POUR TIME FINISH POUR TIME I I PURCHASEPMRCHASER S AGENT RO. NUMBER / ORDERED BY ti f" 7 SOLD TO C ASH fiLF3 F P'l-FRIX, Pe-cAl.)ywy, U A 110- 7, irucil, # Air Eir' Galci, 6A� )elivery Instructions ;pecial Instructions I_ sulier Plas PURCHASER/ PURCHASER'S AGENT ZONE JOB NUMBER 1 TIMETICKETED DA IE TICKET DELIVER TO �_,ffp ConGrete Disposal: d 3 .-&a at Job Use -of Concrete Driver s Name kdri.-iiti, Adams U CONCRETE TESTED TOT FILE Crr�NN, ow py St. Lucie County 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 app ordinances, building codes, and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on !fw bmeet the minimum code. Initial --X T 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 IT,& 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 an�itrcl[ Id -Pdical cost, which could include loss of wages during recovery from their injury. Im a 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 Zoq' g Deparnent to the Florida State Department of Professional Regulation. Signed and acknowledged on this —day of �O/X, of 20 Owner/Builler Signature STATE OF FLORID.� COUNTY OF de_e� Th fo ing i e was c owledged before me this 0 day of 120 by —who is personally known ��. to me, or who has I duced as identification. o"uc 'I 00 MILONE y MM1SS10N#D085?587 e of Notary _�e or Mint Name of Notary E& arCh22,2,,11,- Ued T,�ru Not 'y f4lic Uniorwrijers Title: Notary Public Commission Number son. ;L-Weia.— COUNTY F ?L 90 �R I D A L PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 FILLED LANDS AFFIDAVIT 1, the undersigned, am the owner of the following described property, ? ) C) C) "�-) e 1 3 , Q +/ -'0 a (ftreil ld#/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 ),261 - 6 / (q, 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 WELL 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. Pkba44 Property Okvner Name (Please Print) Property Own� Sig�nature Date STATE OF FLORIDA, COUNTY OF AC 0 GEDB REP SO DAY OF 20 B 7WH(O IS PERSONALLY KNOWN TO ME 0 HAS I�RODUCED AS IDENTIFICATION. ATURE O� N T '9' DAWN MIWNE MY OMiISSION # DD 8M7 COMMISSION NUMBER lit- EXPIRES! M&rch 22, 2013 Bonded Th, u tg"bfic UndoWtfirs SLCPDSD Rev i sed 08124/2010 Property Appraiser - St.Lucie County, FL Page I of I Lloyd J Plouff Record: 1 of 1 Property Identification Site Address 7100 Sebastian Road Sec/Town/Range: 12 :34S :39E Map ID. 13/12N Zoning: RS-4 Ownership and Mailing PROPERTY RECORD CARD <<Prev Next >> Spec.Assmnt Taxes Exemptions Permits Home Print \,�CIE ParcelID: Account#. 3391 Land Use: SF Res City/Cnty- St Lucie County Owner: d J Plouff Magdalene Plouff Address: "OP010 Sebastian Rd AA Fort Pierce FIL 34951-5005 "1110- Legal Description LAKEWOOD PARK -UNIT 11 - BLK 150 LOTS 6 AND 7 (MAP 13/12N) (OR 3321-178) Sales Information Assessment 2011 Final Total Land and Building Date Price Code Deed Book/Page 2011 FinaL 63400 Land Value: 9200 Acres. 0.54 8/3112011 90000 0001 WD 3321/0178 Assessed: 63400 Building Value: 54200 10/21/1988 72000 00 WD 0608/0869 Ag.Credit: 0 Finished Area: 1504 SqFt 6/1/1984 55000 00 Cv 0436/0053 Exernpt� 63400 12/1/1983 0 01 Cv 0419/0670 Taxable: 0 4/1/1979 5500 00 Cv 0308/2450 Taxes 387.36 BUILDING INFORMATION Exterior Features View: RoofCover ExtType: HC- - HC- YearBIt Grade. C_ - C_ Ef1YrBIt: StoryHght: 0010- 1 Story No Units: Interior Features BedRoonns: 3 Electric: FullBath� 3 HeatType: 1/2Bath: 0 HeatFuel: %A/C: 100 %Heated: Special Features and Yard Items Type Y/S Oty Units Qual Cond YrBIt. 4CNT -4CNT S 1 1 AV AV 1980 3CNT -3CNT S 1 1 AV AV 1980 SDSF - SITE DEV S-F Y 1 1 AV AV 2001 SA - Asph Shingle RoofStruct- HP - Hip 1980 Frame- 1980 PrimeWall WS - Wood/Sheath 1 SecWall: MX - MAXIMUM PrmIntWaIl: DW - Drywall FHA - FrcdHotAir AvgHUFI STID ELEC - Electric Prm.Flors: CU - Carpet 100 %Sprinkle& 0 Land Information No Land Use Type MeaSt-Ire Depth I 0100-SF Res 61 -Front Ft 180 130 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. http://www.pasIc.org/prc.asp?prcIid=1 30161303050007 1/17/2012 n ILI, N V f7o MA