HomeMy WebLinkAboutApplication for Zoning Compliancef)LjSE;bIgL7 `n
DATE FILED. O° 0 PERMIT NUMBER: O Y 0 0 1
PLAN REVIEW FEE: O ECEIPT NO:: 6 i ��
CONCURRENCY FEE--- W' RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE &FILLED IN TO BE ACCEPTED
�JC\6 COG
St. Lucie County Building and Zoning ""' � y,� "
2300VirgimaAvenue ,�Gv`-[.[[.e 4OL/ylX wit
/ORIDP , D Ft. Pierce, FL 34982-5652 �.
e). 772.462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE 4ZW
PROJECT INFORMATION
'Ia
1. LOCATION/SITE ADDRESS: K6 wdBr' Soho wa 3 �y ��
2. S/D NAME: Wa Ter S o 09 SITE PLAN NAME:
N 3. PROPERTY TAX ID #: ys 9 2 — S� OaS'6 `9" / Z
4. LEGAL DE
PTION (attach extra sheets if necessary): L 0 - °i 2 010 -i✓dter5 off CI f Ld.i%.
5 Yc Co✓�8 a1 In P,6 q2- Or 4�6 Vrb/ cRscards 94'5't, leer ie Coui
5. PLAT 6. PAGE 7. BLOCK 8. LOT �/
BOOK Ll Z NO. NO. NO. /
9. PARCEL SIZE: ACRES/SQ FT. '� LOT DIMENSIONS qO `x Z 9' 3 3
I0.- DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: _
es / alert Q= Li 521,-Qa l rl F,a.d eonrr
11. SETBACKS (ACTUAL) FRONT: o LBACK: 3 q RIGHT
12.
13.
� SIDE
V 39.01
TYPE OF CONSTRUCTION (Check all appropriate boxes)
IZ NEW CONSTRUCTION [ ] EXPANSION/ADDITION
RESIDENTIAL (] COMMERCIAL
[ ] OTHER (SPECIFY)
/ ` LEFT: /
1 SIDE c�
[ ] INTERIOR RENOVATION
[] INDUSTRIAL
5 t/A
14, Sq. Ft./CONSTRUCTION: 7zI5. Sq. Ft 1st Floor: 'L %
16. VALUE OF CONSTRUCTION: $ 6.77 7'
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
- valu@ 0f 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
DESCRIPTION OF PROPOSED USE: K6_
`f2
OWNER INFORMATION
NAME. 14Z,
ADDRESS 7 /, G' ✓
CITY.. Tc�}? Aetp- STATE: FL ZIP
PHONE (DAYTIME),.) Z`" & - ��3� 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:
CITY: STATE: ZIP
PHONE (DAYTIME): (_)'
CONTRACTOR INFORMATION p
ST. of EL REG./CERT'#: C t�s C' t7 J ®s 9 ST. LUCIE COUNTY,CERT #: 37 C�7
BUSINESS NAME: r, fN
QUALIFIERS NAME: Oar
ADDRESS: S-X'a e Gfi BAN I e v y
CITY: Pi.l 8 ixch Gardcay.s STATE: ZIP
PHONE (DAYTIME): AL77j-//-747 FAXNO.(P6-Q 7TS Fj iO email: g�'n dPGWe/tus.�
I R
ARCHIT/ENGINEER: ganda/l S7oFF7- oq!551
ADDRESS: Lljj Ir virrr' r r E--
CITY: Vero f¢nch STATE: CL ZIP
PHONE (DAYTIME): M) 70-60/ /
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER:
ADDRESS:
C TY
STATE:
ZIP
STATE: ZIP
ion
UPORTANT NOTICE: When a permit is issued and it is not picked up within 6 days after notification
itll 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 otherwise included with this building permit application.
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: 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.
4OWNER/CVTRACTOR SIGNATURE
CONTRA OR SIGNATURE'
STATE OF FLORIDA STATE OF FLORIDA'
-COUNTY OF & /vn COUNTY OF der /h &-r-y— 1
The foregoing instrument was acknowledged The foregoing instrument was acknowledged -
Before me this Al day of �_, 20�; by before me this 1� day of ' , 20?q by
GgYY 1N P ✓uc k�r.�ho is personally �A✓Y PurueK�pwho is personally r
,known tome or who has produced- known
own t-- Lowe or who has produces
a
as identification.
s identification.
Signature of Notary Signature of Notary
encre � .�i'Ooc,Ge �7c? i i<g�th ,'l Aouc-e-2 Tla-
Type or Print Name of Notary Type or Print Name of Notary p
Kenneth A. Doucette a+ P�Kennetfi#k Doucette
Commission : �Op NSsiori#DD533987 Conmissior No.� D533987
So kpireS March 28 2010 ; o� Expires March 28, 2010
ERpa Bdoi�oY Fan Ir�siro IN 90U38i]ol: Ntft BgppdTroY Fam Vd113P�� es]ot
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF ApP
YING FOR
THIS BUILING PERMIT AS AN OWNERBUILDER, 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.
P #:DICE USE ONLY
SECTION
TOWNSHIP
s
RANGE
-%"
MAP NO.
ZONING
�`]�
LAND USE
�) �1
C/
LOT CVG %
TAZ NO.
/
FLOOD ZONE
n
,7
FIRM MAP #
I Q %
1 ('J
1ST FLR ELV
MAX HGT
CONST TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER-
LOT OF REC
LOT OF REC (after
'.LOT SPLIT
LOT SPLIT
(before 1/90)..
1/90)
REQURED
APPROVED
Lir-
ADMINST
LIBRARY
f yob
PARKS
Li g bO
PERMIT
VARIANCE
IMPACT FEE
1 11'"—
IMPACT FEE
( {r
FEE
REPORT
CODE
1
PUBLICBLDC
IMPACT FEE
015Di 4D
HABITABLE
AREA
RADON FEE
(RADON)
i a-nd
GROSS ROAD
CREDIT
Y
N
TOTAL ROAD
-
IMPACT FEE'
IMPACT FEE
66
IMPACT FEE
.DUE
SCHOOL
CREDIT
Y
N
-: TOTAL
IMPACT FEE
e0
SCHOOL
, ; i
`r >� ,
IMPACT FEE
POLICE FEE
FIRE FEE
MISC FEE
TOTAL
MISC FEES
.ADDITIONAL....
Y
N _,
SPECIFY
'
TOTAL
PERMITS
of ALL
REQUIRED
�J
FEES
REVIEWS
ZONING
- ZONING ...
PLANS
MISC.
VEGETATION
SEA TURTLE
MANGROVE
REVIEWED BY
EXAMING
-
DATE./-
COMPLETE
-Olr6g
INITIALS