HomeMy WebLinkAboutZoning ComplianceOFFICE USE ONLY:
DATE FILED: �'11C0 •I 7a�zl I�2
PLAN REVIEW FEE: RECEIPT NO.:
CONCURRENCY FEE: RECEIPT NO.:
PERMIT NUMBER: D 0-4 o 'ii Ian
CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
St. Lucie County Building and Zoning
2300 Virginia Avenue ��y,p-^cam' ,,
FlOR10a Ft. Pi 5652
772-4 2-1553 S1�"i�p. • tcl`/Y
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIIANCE
PROJECT INFORMATION ✓
1. LOCATION/SITE ADDRESS: l40 1 E w6e- LtA-VUp1% t-
2. PROJECT NAME: V'1� ww-t "a2 SITE PLAN NAME: i �.
3. PROPERTY TAX ID #: y 2-0 1 ('3 4 U U/) _ ()I 0\ t5
4. LEGAL DESCRIPTION (attach extra sheets if necessary):
5. PLAT BOOK r 6. PAGE NO. - 7. BLOCK NO. -' 8. LOT NO. —'
9. PARCEL SIZE (ACRES/SQ FT.): ' _ LOT DIMENSIONS: T-� Q
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: I`w I42
I ' S
I t. SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE:
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION l`Fl EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [Y] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: l tl Ii1Cst—� �1� hL 1"�
14. SQ. FT OF CONSTRUCTION:
(15. SF. FT 1st FLOOR: N
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 mom,'a
RECORDED Notice of Commencement must be submitted with this application.
SLCCDV Form No.: 001-02
OWNERS `JINFO'RM_iATION
NAME: VOR4Z{44�7' U L
ADDRESS: 1pc�& f7 '
CITY: �,'ee� 1yf'061�0 STATE: �I ZIP:
PHONE (DAYTIME): WL &q3 -69;rq�6 Email: �r✓l.'t°E+riG�'Y`l op 'to 1 '
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS `B,�ELLOW..
V ` FEE SIMPLE TITLEHOLDER: � d sr,
ADDRESS: 1�,,,, V
iiw CITY: �STATE: T"P8 ZIP: 77e5lb
PHONE (DAYTIME): 141 6D1 y IC)" Vi ti w /
V
CONTRACTOR INFORMATION /n•�.`I
ST. of FL REG.CERT #: _C-(C & 2A 11 1 r4V� l7-0 2b ST. LUCIE COUNTY CERT #: /
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS: ;._._.1
-7 141
CITY:
PHONE (DAYTIME):
F
H
*-I)+ STATE: �I �lD�• ZIP:
.S ZJLb'iPS!; 1 FAXNO. 5(O1' Ji3�9 'CIC'il:
CITY: L �f STATE:
PHONE (DAYTIME): �4J�'o•7
:BONDING COMPANY:
ADDRESS:
CITY: STATE:
ZIP:
ZIP:
MORTGAGE LENDER:
ADDRESS:', 1� 1 t•f
CITY: _ STATE: ZIP:
11
IMPORTANT NOTICE; When a permit is issued and it is not picked up within 60 days after notification
it will be voided and retyrned to you by mail.
CERTIFICATION:
This application is he4y made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity,
if applicable, for the pgthitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all
work will be performe4 jo meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
may be required for RECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS,
AND AIR CONDrMf4ERS, FENCES, ETC., not otherwise included with this building permit application.
St. Lucie County mak@s 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 concurency 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.
jDAWLV6R-CCRTIftCTOR SIGNATURE
STATE OF FLQI2IpA
COUNTY OF C�
The foregoing instrument was acknowledged before
me this day of 20,
by :!E,� l l 7 SQY- 5
who is personally known __!(or has produced
as identification.
gttatu f�i to
Wen J0 Newman
Commission No. i
j� ommission # DD511805
F a Expires MY g, 2010
r wn •mamw. Inc E008t5.7019
CONTRACTOR SI ATURE
STATE OF FLORID
COUNTY OF
The foregoing instrument was acknowledged before
me this �5 d y of nOe� f�-� 2009,
byGl 1DI f 0 i 2Gth
who is personally known ✓ or has produced
as identification.
Signature of Notary
Y'ii1, CA��
Commission o.°lM' <x ion D
g EXO s August 31,2012
• `;�;,ftti eu�emNt�vFaninsaaKeaosaesro:s
NOTE: TWO (kUILDER
GNATURES ARE REQUIRED• EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BDING PERMIT AS AN OWNERBUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN
THIS AICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION.
OWNE AFFIDAVIT WILL BE REQUIRED FOR ALL OWNERBUILDER APPLICANTS.
For specific jhstructions see appropriate permit checklist.
OFFICE USE ONLY BP
SECTION
�1
TOWN§f
RANGE
38E
J
MAP NO.
ZONING
`T 1 \
J✓'i
LAND ME
LOT CVG %
TAZ NO.
FLOOD ZONE
FIRM MAP #
1ST FIX ELV
MAX BUT
CONST TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF RFC
Before 111990
LOT OF REC
After 1/1990
LOT SPLIT
REQUIRED.
LOT SPLIT
APPROVED
REPORT
CODE
/'1
HABITABLE
AREA
RADON
FEE
PERMIT
FEE
LIBRARY
IMPACT
FEE
PUBLIC BLD
IMPACTFEE
CORRECTION
PUBIC BID
IMPACT
FEE
PARKS
IMPACT _
FEE
SCHOOL
IMPACT
FEE
ROAD CREDIT
CT
FE
Y N
LAW ENF
IMPACT
FEE
CMS
IMPACT
DRIVEWAY Y N DRIVEWAY
REQUIRED FEE
ADMINISTRATIVE
VARIANCE FEE
FEE
SPECIFY
SUBS
REQUIRED
—
MECHANIC �r ROOF _ NON -CONFORMING
ELECTRIC v GAS LOT OF RECORD
PLUMBING _ FEES
MISCELLANEOUS
FEES
/43//W
p
J `
DATE SENT TO ADDRESSING:
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAR TURTLE MANGROVE
COUNTE REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE '
COMPLETED
INITIALS