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HomeMy WebLinkAboutZoning ComplianceL OFFICE_USE ONLY: DATE FILED: PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: _ ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED r' PLANNING & DEVELOPMENT SERVICES DEPA���j,�5 17�BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 772462-1553 - APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: 1 JT S US f4vv Y % PS L FL 3 4 95 2. PROJECT NAMNE: r sffo ah i GV6 e ITE P NAME: PO-0 S+ LV C,V ?I az o.- I 3. PROPERTY TAX ID #: -34 � - o� 1 001 O. 000 - Q0 © G 4. LEGAL DESCRIPTION (attach extra sheets if necessary): See a+6dged 5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO. 9. PARCEL SIZE (ACRES/SQ FT.): , 014 OCAS LOT DR-AENSIONS: 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: I� I VYy1 bl n Q , df EA-Vioo' I o►dd,1r'i� 9 ��cur axe cl a �+r�a .2� (�I an � slh�w► ► �-e�l 1 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) n . I 13. DESCRIPTION OF PROPOSED USE: K i.S T�l/V O'n 14. SQ. FT OF CONSTRUCTION: 10 1 3 8 °3 15. SF. FT I st FLOOR 16. VALUE OF CONSTRUCTION: $ 5 , 0 C1 O. O 0 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 UPDATED 6/25/09 �t OWNER INFORMATION NAME: P cf Y + S+ LJ & -p I� 1 CL -�- a I U,C ADDRESS: I 1 oZ Qh� V', CA I CITY: E1 M 0-n 4— STATE: N T ZIP: I 3 PHONE (DAYTIME): (__) 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 - ADDRESS: STATE: PHONE (DAYTIME): (___) rAl%g CONTRACTOR INFORMATION ST. of FL REG.CERT #: ci )O- b ND 211 ST. LUCIE COUNTY CERT #: BUSINESS NAME: 3 C my- "I In QUALIFIERS NAME: J)M CO N RO� ADDRESS: H 3 i() Si,) U VA d 4L CITY: POLL m CM24 STATE: FL- ZIP: 3'4 q q O PHONE (DAYTIME): (1-9 419 • j 6 6 (p FAX NO. (^I1 a0 q 1 R • J5 o � ( Email: 1 I C Clan r6 �I @ �l C�HOO . GOYn ARCHIT/ENGINEER: ADDRESS: CITY: STATE: PHONE (DAYTIME): L_) BONDING COMPANY: ADDRESS: CITY: STATE: MORTGAGE LENDER - ADDRESS: CITY: STATE: rAi0 ZIP: ZIP: IMPORTANT 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: OCT 0 3 2013 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, 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 JOBSTTE 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/ SUBJECT TO ATTACHMENT. O Inimnstrument TRACTOR SIGNATURE OR SIGNATURE STATEIDA S F FLORIDA COUNTm a_y+ 1 A CO OF ro ox-h Yl The forwas acknowledged before The or oing instrument was (acknowledged before me this of 2013me this s+ day of)1/i� , 20by(( by J`ry�l who is personally known or has produced who is personally known or has produced as identification. as identification. ware NePlplj esto-MU00 — X�L� stg—naturf of NoiiiA .•;I. Signs a of No s�oa •ao tiert,ged saaldx3 Commission No. aLt99�33 # I S��►YWOO AW Commission No. �" APOL ABREU n32leH iiadv • % ;,, :•_1 MY COMMISSION # EF-165774 EXPIRES February 02, 2016 (407) 398-0153 FW 48NnterySeMoe.00m' NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE 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. OFFICE USE ONLY BP #: SECTION TOWNSHIP RANGE MAP NO. ZONING c— LAND USE CCTI--\ LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # 1"'�r FLR ELV MAX HGT CONST TYPE OCCUP TYPE A07 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 8cq HABITABLE AREA (RADON) RADON FEE PERMIT FEE LIBRARY IMPACT FEE PUBLIC BID IMPACT FEE CORRECTION PUBIC BID FEE GENERAL PARKS IMPACT FEE SCHOOL IMPACT FEE OAD IMPACT FEE CREDIT Y N LAW ENF IMPACT FEE FIRE/EMS IMPACT FEE DRIVEWAY REQUIRED Y N DRIVEWAY FEE ADMINISTRATIVE VARIANCE FEE SPECIFY SUBS REQUIRED MECHANIC �e ROOF ELECTRIC V GAS PLUMBING �� NON -CONFORMING LOT OF RECORD FEES MISCELLANEOUS FEES DATE SENT TO ADDRESSING: / REVIEWS FRONT COUNTj3R ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REYIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED '7,r� • O •I DATE COMPLETED I © /. 07� J3 INITIALS