Loading...
HomeMy WebLinkAboutApplication for Zoning ComplianceDATE FILHD: �J�{C� %j z PLAN REVIEW F E: RECEIPT NO.: I v 1 5" PERMIT NUMBER: 1l® � V9 CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO-: ALL INFO MUST BE COMPLETE & FILLEIY�I TO BE ACC t 11A A 4/I i CULL ru_a St. Lucie County Building and Zo 2300 Virginia Avenue N(%G 0� 'F�OR{Dp'• ' Ft. Pierce, FL 34982-5652 772462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION _ ^ ' _ I e— fejo1. LOCATION/SITE ADDRESS: 5000 ©(L 0(7E_ "E 2. S/D NAME: SITE PLAN NAME: 3. PROPERTY TAX ID It: .2401-9T4-00D) — D00 — 2 -- 4. LEGAL DESCRIPTION (attach extra sheets if necessary): L� /f2 0,F $G 11=4 beSS At K f , POO 6C5S 5 5, PLAT 6. PAGE 7. BLOCK �/ 8. LOT BOOK __ NO. � NO.. / Lo NO. 9. PARCEL SIZEt ACRES/SQ Fr. J�lq 1 OT DIMENSIONS 10. DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: L Pxq(� Cl�/^J D DliYl j 51.0E PA-uEZs - M (J' PrCV 02 (& 11V YL 214 ,9 (ta CoN u6X7' Si 0066r, coin 7t 0AFI cE IL SETBACKS (ACTUAL) FRONT: BACK: RIGHT: LEFT: N SIDE SIDE 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [) NEW CONSTRUCTION [ J EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL t f J COMMERCIAL [ J INDUSTRIAL [)} OTHER (SPECIFY) �l Pn l O.Ge. ru 13. DESCRIPTION OF PROPOSED USE: 14. Sq. FtJCONSTRUCTION:_ 1 ( 15. Sq. Ft. IstFloor: 16- VALUE OF CONSTRUCTION: $1pW C) The value gjconswction 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 coWlruction if it is demonstrated that the submitted fgnres are not consistent with similar types of construction activities. If the value is $2500 or more, a RECORDIMNotice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 OWNER INFORMATION NAME: to Tu UST rl CN421E5 3APD DANIb—Tv '[9a57MS ADDRESS: CITY: STATE: ZIP PHONE(DAYTIME): ( 9) u�u'�i»O email:'(u12�ND d>401 Cr� 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: l STATE: _ _ ZIP -- PHONE (DAYTIME): ( i i CONTRACTOR INFORMATION ST. of FL REG.lCERT #: O`O-O s 3 ST,. LUCIE COUNTY CERT #: �✓ � BUSINESS NAME: QUALIFIERS NAME: -7 ti ✓+�A S - r /� O��° ol� ADDRESS:S 'G3a 06/ CITY: r r61�11 p r C. PHONE(DAYTIME): STATE: IZ-6 ZIP email: �' ARCHIT/ENGINEER:' ADDRESS: CITY: STATE: ZIP PHONE (DAYTIME): �) BONDING COMPANY; ADDRESS: CITY: STATE: ZIP MORTGAGE LENDER: I ADDRESS: CITY: STATE: ZIP IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 Mays after notification it will be vp ded and returned to you by mail. CFRTIFICATION: 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 he 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 concbrrency 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, TTFLE, 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. OWNER/ O TRACTOR SIGNATURE CONTRACTOR SIGNATURE STATE OF FLORIDA- STATE OF FLORIDA COUNTY OF ,! % ,4QC(9 COUNTY OF Sr A4&0 The foregoing instrument was acknowled ed The foregoing instrument was acknowledged before me this of41 e 20b 4 by before me this ay of �¢ , 2007 by C NNRLBS 9'TY�R ,pyyr„ P rr /� 10_ , w oas ersonally mAS /1'%�iPF�ER/G/C, who is percya�ly. known to me or who has produced known to me or who has produced as identification. as identification. ✓ (/J/IO} Signature of Notary SSiignatuture of Notary BRENDA L. WHITE BRENDA L. WHTTE Type or Print Nam Type or Print N m otep l NDA L. WHITE 1:5 WNITE State ofFloridaCommission No_ 18, 2010 p My Comm tAar.10, 2010 Commission Nc r{dry 520296520296 pNN1Yl@bYltitiY ME RSONALLY INOWN BY ME [Ipppp{=l.0. NOTE: TWO (2) QUJRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILING PERMIT AS AN OWNERBUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN_ THU APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THE APPLICATION. For speckic instructions see appropriate permit checklist.