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Home My WebLink AboutApplication for Zoning ComplianceOFFICE USE ONLY BP #: SECTION TOWNSHIP RANGE MAP NO. ZONING LAND USE LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # 1s"FLR ELV MAX HOT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC LOT SPLIT LOT SPLIT Before 111990 Aher 111990 REQUIRED APPROVED 1 REPORT HABITABLE RADON PERMIT CODE AREA - - -FEE - - FEE (RADON) .� ` r LIBRARY r-, . ^ PUBAIdR I) - t ^t1. t• - , PUBI(�_713LI;?/-y . •-'�' I;QRKS :..-,:n "• IMPACT IMPACTFEE ' IMPACT IMPACT FEE CORRECTION FEE FEE T GENERAL SCHOOL ROAD CREDIT Y N LAW ENF IMPACT IMPACT IMPACT - - FEE FEE FEE .t FIRFIEMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE IMPACT REQUIRED FEE VARIANCE FEE .• \^ FEE SPECIFY MECHANIC _ ROOF — NON-CONFOWNG MISCELLANEOUS SUBS ELECTRIC _ GAS' LOT OF RECORD FEES REQUIRED PLUMB G _ FEES . DATE SENT TO ADDRESSING: I_/_ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED INITIALS OFF,ICE.USE'ONI: is DATE FILED (�• / d PLAN REVIEW FEE: RECEIPT NO.: CONCURRENCY FEE: RECEIPT NO.: 0 c soy- oG j:o E.s.,srEo # 06/.2- PERMIT NUMBER: 0,90 B' V/ 0 CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED St. Lucie County Building and Zoning 2300 Virginia Avenue F<OR10p'- Ft. Pierce, FL 34982-5652 ' 772-462-1553 - APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: 55_6SO N A I R t Ft. Re. ce 1 FP 3 `iR41 2. PROJECT NAME: Oee ise, SITE PLAN NAME: 3. PROPERTY TAX ID #: 1 1194- 220- wo 5 - oo-o 15 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 2 IIat. 4 !1 4 wed !1 1. _. r , .- n.1/' A A - . . r 5. PLAT BOOK 6. PAGE•NO.- .._ 7. BLOCK NO. ' . l : 8. LOT NO. 9. PARCEL SIZE (ACRES/SQ FT.): o q6 LOT DIMENSIONS: 10. COMPLETE DESCRIPTION OF CONSTRUCTION;PROJECP'OR WORK ACTIVITY:' `.c+nS7ruLito�1 r �;1 11. SETBACKS (ACTUAL) FRONT: �3Q t BACK: 10 t RIGHTSIDE: ---LEFT,SIDE:•_! 1 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) I J4- �(j NEW CONSTRUCTION [ ] EXPANSION/ADDITION [' ]"-INTERIWR` 14OVATION [ ] RESIDENTIAL [I COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) �^ 13. DESCRIPTION OF PROPOSED USE: J�/KQXa Yan� , hCSbiti� 14. SQ. FT OF CONSTRUCTION: -7te. Ivj�S 15. SF. FT 1st FLOOR: 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 $2500 or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 OWNER INFORMATION NAME' Myleltn 1', r t r rIC [.a. n` C �... ......� ADDRESS: IcqI Ji1 CITY: STATE: F'P ZIP: ��•51 PHONE (DAYTIME): (! WK DJ — SSS, Email: AdneLo 101 k f'YYlfd '17 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): cl—))'- r CONTRACTOR' li ST. of FL REG.CERT #: j BUSINESS NAME: —A QUALIFIERS NAME: �r_ ADDRESS: 1 r/ CITY: eL 1 PHONE (DAYTIME): CITY: YOB C 9Y, uL PHONE (DAYTIME): `M. ST. LUCIECOUNTY CERT #: f' . )" • • F ' ' h lu�t� at 2 lei 'L A Kos IJwL� �.J I 1 F� STATE: i"P ZIP: 1 r•Iq S1 r( ZZq� (355-7 FAXNO. 2Z9. 353% Email: /�t�o-_�± 1b1�� - _ .. STATE: JI ZIP: 34g5-:S :K BONDING COMPANY: ry M ADDRESS: - CITY: STATE: ZIP: MORTGAGE LENDER: �r ADDRESS:. tea W. L...ka.. CITY: Ma A-Aa+d STATE: I"1' ZIP: 3 I S EN4PORTANT 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 otherwis , included with this building permit application. i• n u' 1d St. Lucie County makes no representation that its granting of a permit will authorize the permit�hdlder to build the 'ject structure which is in conflict with any applicable Homeowner Association rules, bylaws or any covenants _That m4Y�rSstoc� or pr,2 rdbit such structure. Please consult with your Homeowners Association and review your deed for any restrictions which may apply. The following building permit applications are exempt from undergoing a full cLn ulrreucy 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 willl be done in compliance with all applicable laws regulating construction and zoning. STATE OF FLO� A COUNTY OFau Fl fl The foregoing instrument was acknowledged before me this day of _4C7 20DC/�._, by rb-n L 0 I tiila. who joV ersonally knolvn' or has produced identification. #TRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this day of by 20_, who is personally known _ or has produced as identification. Si n e ofWNo Nola Signature of Notary g (;ur' DINAR GCUSHMANNofary Public - state of Florldc CommissionMy�Jon28,2009 Commission No. (Seal) Commtulon # DD 377956 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 REQUIRED FOR ALL OWNER/BUILDER APPLICANTS. For specific instructions see appropriate permit checklist. I