HomeMy WebLinkAboutZoning Compliancek
OFFICE USE ONLY:
DATE FILED: p� -
PLAN REVIEW FEE: RECEIPT NO.: -7�1's
CONCURRENCY FEE: RECEIPT NO.:
PERMIT NUMBER �• l 7 3%
CERT. CAP. NO.:
JST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Avenue
Ft. Pierce, FL 34982-56982-5652 lll���J'/l
772-462-1553 Q
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
I. LOCATION/SrfE ADDRESS: 99.a I RA kl6 E W N r— RO,&Q
2. PROJECTNAME:�L21Z6t� (9987,19 SITE PLANNAME: Vrd aw (IM28 S.FL Rawdes
3. PROPERTY TAX ID #:
4. LEGAL DESCRIPTION (attach extra sheets ifneoessary): of 3"I 3B FQ%M We GOR o c sSC RutJ S. 0(
QQ Ml.At tiV iSEC W &LO (E4Y SCC W 32L.0 Fl FT -rD A08 Tta PdWrs
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO.
9. PARCEL SIZE (ACRES/SQ FT.): Li. GZ A C LOT DIMENSIONS:
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: &OD TW 2£ £ (1s)
Nt4T£NN&,S p)JO SIX (Q LOAY LINES Tp ExisrltS(r VtRF-%r'r
1�gct t-t-rY
11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE:
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: ExtSTNCr %c6' 'TaU41Q ADDIJCc ArtT4Nt41..$
14. SQ. FT OF CONSTRUCTION: 15. SF. FT 1st FLOOR:
16. VALUE OF CONSTRUCTION: $ I , 0 ® 0. 0"b
The value of construction is usedty determine the amount of permit fees to be assessed. St. Lucie County resetves the right to question and/or modify the indicated
value of construction if it is RECORDED Notice of Comm 9%t'Mt that the submittal figures are not consistent with similar types of construction activities. If the Value is $2500 or more, a
e4r6thent must be submitted with this application .
SLCCDV Form No.: OO142
UPDATED 6/25/09
OWNER INFORWATION
NAME: V-EIZ1Z01A WIQtIiSS
ADDRESS: -1-1-1 fWAATO RQAO , St.t ITT (e00
CITY: $OCIa QW1'ap STATE: Ft,_
PHONE DAYTIME ZIP: 33V31
(DAYTIME): O� 2Zt.-9 Z Z 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: W C A or- ST W C t g C- 0
ADDRESS: 0II R►vQt21{Ay 1k 1�100
CITY: oviuiTUN STATE: TX
PHONE (DAYTIME): 11 292-240U ZIP: 1i�L
��
CONTRACTOR INFORMATION
ST.ofFLREG.CERT#:_tCC-,e GIQ24'(pS `,
ST. LUCIE COUNTY CERT #: `7— 1 L} Z-
BUSINESSNAME: --* i Q go c� y s rEsy fi �
QUALIFIERS NAME: IEM rS f rE,lti5
ADDRESS: `4w a(.p -rw,y H.
CITY: kmst,%AR
PHONE (DAYTIME): STAFAX TE:
— i—mail:
ARCHTT/ENGINEER: FQft�, .. n....n
ADDRESS:
CITY: TAMP,4
PHONE (DAYTIME):
BONDING COMPANY:
ADDRESS:
CTI'Y:
MORTGAGE LENDER:
ADDRESS:
CITY:
A►dO�Rtt
STATE: F
STATE:
ZIP: e 4 -44
ZIP: 33 (pt O
ZIP:
STATE:
IMPORTANT NOTICE; ZIP:
it will be voided and r When a permit is issued and it is not picked
et�M to you by mail. up within 60_ days after notification
CEITIFICATION:
This plication is hereby made to obtain a permit to do the work and installations as indicated and to obtain a certificate of capacity,
if apo able, for ffie permitted work. I certify at
no work or installation has commenced prior to the issuance of a permit and that all
work ]kill be performed to meet the standazds of all laws regulat ng construction in this jurisdict on. I mderstand that sepazate permits
may �� requved for ELECTRICAL, PLUMBING, SIGNS, R ELLS, POOLS, FURNACES, BOILERS, 1ATERS, TANKS,
ANA AIR CONDTTIONERS, 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 concurretcy 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.
STATE OF FLO A
C®UNTY OF
Th@ foregoing instrument was acknowledged before
m@ this day of ��20 1 2.
by
who is personally known or has produced
identification.
STATE OF FLORIDA
COUNTY OF r,^, C6--"6_
The foregoing instrumentwasacknowledged before
me this day of ,tt--14 4 20 �
by
who is persulpilly known _ or haLprndnced
as identification.
gnstare of Notary Signature of rotary PUBLIC
BLIC
tICIT Commission No. -%§r ;; (Sea1pONNAA.HADIEY Commission No. omr�,,y SF)^6
MYCOMMISSIONkEE188284 tgg�to
EXPIRES: May 7, 2016
"Af W Boded TNu Nolay PU* UffWAen
NbTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILDING PERMIT AS AN OWNERBUH.DER, 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 CdeCkliSt.
��
OFFICE USE ONLY �• �� ;� #: /a D i /
SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
LAND USE
LOT CVG %
TAZ NO.
FLOOD ZONE
FIRM MAP #
IST FLR ELV
MAX HGT
CONST 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
31
HABITABLE
AREA
RADON
FEE
PERMIT
FEE
LIBRARY
IMPACT
FEE
PUBLIC BID
IMPACTFEE
CORRECTION
PUBIC BID
IMPACT
FEE
GENERAL
PARKS
IMPACT _
FEE
SCHOOL
IMPACT
FEE
ROAD
IMPACT
FEE
CREDIT
Y
N
LAW ENF
IMPACT
FEE
FIRWEMS
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
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
%d
DATE
COMPLETED
INITIALS