HomeMy WebLinkAboutZoning ComplianceOFFICE USE ONLY: I t . ` fy
DATE FILED: UY
PLAN REVIEW FEE: RECEIPT NO.:
CONCURRENCY FEE: RECEIPT NO.:
PERMIT NUMBER:
CERT. CAP. NO.:
ap 1 l • (04 J-1
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
St. Lucie County Building and Zoning�k r„ „/
2300 Virginia Avenue *G
Ft. Pierce, FL 34982-5652
772-462-1553 d
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d�icD1�F� �ru,e
APPLICATION for BUILDING PERMIT
j CERTIFICATE of CAPACITY/ZONING COMPLIANCE
2.
3.
4.
PROJECT INFORMATION
LOCATION/SITE ADDRESS: II I t.� /rirM t_ CIA42 OGW* G1ENAIITSil`f
S/D NAME:
PROPERTY TAX ID #:
SFFE PLAN NAME: h.nlSP - O/i ' o01
14 cT • 8zo • coo-*- coo • 7
LEGAL DESCRIPTION (attach extra sheets if necessary): 1sfIFGNtrd.�
-IN
5. PLAT 6. PAGE 7. BLOCK 8. LOT
BOOK NO. NO. NO.
9. PARCEL SIZE: ACRES/SQFT. 411(o AcLOT DIMENSIONS
v514wY1
10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: eonJST►LpcTrwJ of A Frz4W•9VAPja
Z 1 Ei G'AtpGT S-rA ce . 4*fL*#J'—r • • GL40 F*vfz6V-114 • ftkc.*. czt-u . 4mzvwrj ^AL*CLi0A.
II. SETBACKS (ACTUAL) FRONT* BACK: �r , RIGHT: Is"'Or LEFT:
SOD * Ssa* SIDE 99:' t SIDE 1SO4-
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [ ]/EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [rj COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: APA -J Zoa wti^
14, Sq. FLICONSTRUCTION: 8 L7 SW 15. Sq. Ft. Ist Floor: 84-7 yF
at
16: VALUE OF CONSTRUCTION: $ I SOyoo0
Th@ Woe 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
valU of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction activities. if the value is $2500 or more, a
REEbRDED Notice of Commencement must be submitted with this application.
SLtJCDV Form No.: 001-02
OWNER INFORMATION
NAME; 5 c t Fv r 1E2>kt SBRv uEs oR FtAR t DA c
ADDRESS: 1929 A"Sc#1 PArzw44w ,1-- 05Lk4,
CITY; 1400s-re pj STATE: -r"A"? ZIP *77019
PHONE (DAYTIME): "I SZ$ 909)9 email:.joWO.oESrwt{io51c(�Sct-y5 ca✓�.
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):
CONTRACTOR INFORMATION
ST. of FL REG./CERT #: CAC 047 810 ST. LUCIE COUNTY CERT #:
BUSINESS NAME: G16r20LTACL A.puyp„�,u„ �OI�lr2UCT�pp1 CoyPA�Yy
QUALIFIERS NAME: JA7i.¢S h.oR2�se►�
ADDRESS: 1315 1 L164P-2-ry Ave —
CITY; STATE: PA
ZIP
PHONE ): S?I 5lv1 ,-FAXNO. 1S�22Gr
`IIZ M& 6497 email:
ARCIifT/FNGINEER: L A��'f 5 J USrri 1,
ADDY
SS:
CITY: _ P'tt epex)mejq STATE: PQ
PHONE (DAYTIME): LI� $% 155%!o ZIP 1 S22Ci
BONDING COMPANY:
ADDRESS;
CITY:
STATE: ZIP
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE: ZIP
IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 it will k voided and returned to you by mail. days after notification
TIFICATION:
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 afolicable, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all
wolf, 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 otherwise included with this building permit application.
The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory
struetures (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 will be done in compliance
with all applicable laws regulating construction and zoning.
�J
OWN R NATURE
Vite President
§TATE OF» Texas
POUNTY OF Harris
The foregoing instrument was acknowledged
ll6tore me this L.B day of Nov • , 20, by
rti G B gB who is personally
own to me or who has produced
as identification.
Signature of Notary
CO CTOR SIGNATURE
STATE OF 1tA Psansyl vaN r rt
COUNTY OF A I) tjb u
The foregoing instrument was acknowledged
before me this j day of W&Xn6er20o0L by
:'pw.et lqirvtteN , who is personally
know_ nn tome orwho has produced
as identification.
of Notary KeNeett+ 3 , 3 .-a}
_ Leslie Robles t =Wrl-, W
Type or Print Name of Not a yP BTwp Public,+�^••.. FYxilayTw.,Altegha N.Geu
LESLIE ROBLES or*Q@W Eli Feb. 21, I
Commission No. r MY COMMISSION EXPIRES Milimbef, Pennsylvania As etc os
January 13, 200I
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILING PERMIT AS AN OWNERIBUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN
THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THE APPLICATION.
For specific instructions see appropriate permit checklist.
SECTION
-05
TOWNSHIP
2I C
RANGE
1 40S
`7
MAPNO.
ii ,nfr�
`� v. ••J��
ZONING
-F
LAND USE
/F
/
LOT CVG %
TAZ NO.
FLOOD ZONE
FIRM MAP #
IST FLR ELV
X OCCUP
SPRINKLERS
MAX HGT
# OF FLRS
STORMWATER
CONST TYPE
OCCUP TYPE
_
WATER
LOT OF RE
LOT OF REC (after
LOT SPLIT
I LOT SPLIT
ADMINST
LIBRARY
PARKS
PERMIT
VARIANCE
IMPACTFEE
INTACT FEE
FEE
REPORT
PUBLIC BLD
HABITABLE
RADON FEE
G
CODE
IMPACTFEE
AREA
WAD ON
VVV
OGi
S6II991=
GROSS ROAD
CRED
Y
N
TOTAL ROAD
IMPACTFEE
IMPACTFEE
IMPACTFEE
DUE
SCHOOL
CREDIT
N
:TOTAL
IMPACTFEE
SCHOOL
IMPACT FEE
POLICE FEE
FIRE FEE
MISC FEE
TOTAL
POLICENIRE
MISC FEES
ADDITIONAL
Y '
N
SPECIFY
f V� Q / P✓
PERMITS
TOTAL
REQUIRED
Pt/s
of ALL
FEES
REVIEWS
ZONING
ZONING
PLANS
MISC.
VEGETATION
.SEA TURTLE
MANGROVE
REVIEWED BY
EXAMING
DATE
y
� /0 _ DG
l
Q�o
COMPLETE
I
I
B
INITIALS
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