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HomeMy WebLinkAboutApplication for Zoning ComplianceDATE FILED: PLAN REVIEW FE RECEIPT NO.: CONCURRENCY FEE: RECEIPT NO.: 2. 4. 9 �� PERMIT NUMBER: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE TION LOCATION/SITE ADDRESS: PROJECT NAME: SITE PLAN NAME: PROPERTY TAX ID #: 3 yl 'l ® 0S ""'.7 © " 9 LEGAL DESCRIPTION (attach extra sheets if necessary): PLAT BOOK 6. PAGE NO. � 0, 66 PARCEL SIZE (ACR"/bQ F.): 7. BLOCK NO. 8. LOT NO. LOT DIMENSIONS: COMPLETE DESCRIPTION OF CONSTRUC I PROJE T OR WORK) j—. Q. SETBACKS (ACTUAL) FRONT: &�Z I BACK: " (c CO RIGHT SIDE T TYPE OF CONSTRUCTION (Check all appropriate boxes) [v]�NEW CONSTRUCTION [EXPANSION/ADDITION [ ] RESIDENTIAL �[ ]c� COM MRCI2 [v]'" OTHER (SPECIFY) J ce-t— L11-3 DESCRIPTION OF PROPOSED U E: t 1 SQ. FT OF CONSTRUCTION: I /0 . LEFT SIDE: 6 6 [ ] INTERIOR RENOVATION [ ] INDUSTRIAL 15. SF. FT 1st FLOOR: _, o®? -16:D VALUE OF CONSTRUCTION: $ 2 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 applicatiop. SLCCDV Form No.: 001-02 (` UPDATED 6/25/09 PFAUT-13 ADDRESS: %4 d0 �r�o-vCi CITY: STATE: ZIP: 3�5 PHONE (DAYTIME): ffk) J t-f ® 7 — 7 &6 % Email-2 j it E J-yL 0 �► +l'�iirrc � • C a'q IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SEM PLE TITLEHOLDER: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): L_) CONTRACTOR INFORMATION ST. of FL REG.CERT #: ST. LUCIE COUNTY CERT #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): (__ FAX NO. Email: ARCHIT/ENGINEER: ADDRESS: CITY: PHONE (DAYTIME): L_) BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: STATE: STATE: ZIP: 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: 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 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. I-- RORCONTRACTbpfGNATURE STATE OF FLORIDA COUNTY OF -&�C , I -OC The foregoing instrument was acknowledged before me this q�`day of by who is personally known or has produced �d as identification. CONTRACTOR SIGNATURE TE OF FLORIDA ZVTY OF The foregoing-!strument was acknowledged before me this day of , 20 , by who is personally known or as Signature of Notary s �, Signature of Notary EP�NP G1VENot Florida Commission No. 1 PNieudcaoec 1b,2�16 ' Commission No. (Seal) � JP�1 FUy<i�i Notary ExPl�es a58�61 .'-01 c omm�ss�e� aeon \Notary Assn • % _ * o_c C oAZhfOUg NOTE: TWO (2)' G,,,� REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BU110 IT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPL CATION 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 ONLT" BP #: I L 01•-01,&3 SECTION TOWNSHIP RANGE MAP NO. ZONING LAND USE LOT CVG % TA&NO. TmOI7 ZOI�—_-_--:X _ F1[LtVd�iIQ:P#:- �__. isxFfRFT•y :_ - - M.�,XTIGT - - -_ _= CONST TYPE OCCUP TYPE 16& OCCUP # OF FLRS WATER_ .....: _..._..._..--- ...-----.---- SEWER SPRDHaERS... : STORWATER LOT OF REC LOT OF REC - LOT.SPLIT . LOT SPLIT Before 1/1990 After 1/1990 REQUIRED APPROVED REPORT HABTFABLE RADON -Pmmff . CODE AREA FEE FEE N) - LIBRARY PUBLIC BLD PUBIC.BLD PARYCS IMPACT IMPACT FEE IMPACT I WACT FEE CORRECTION FEE FEE GENERAL SCHOOL ROAD . CREDIT Y N LAW ENF IlVIPACT IMPACT - RWPACT FEE :.... . FIRE/EMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE -RVACT REQUIRED FEE VARIANCE FEE FEE SPECIFY MECHAI�IIC ROOF ' NON -CONFORMING MISCELLANEOUS SUBS ELECTRIC GAS LOT OF RECORD FEES M1.11RED PLUMBING FEES DATE SENT TO ADDRESSING- / / REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE ..COUNTER. REVIEW REVIEW REVIEW . REVIEW. REVIEW DATE -_RECEIVED ((,,CCI COI BLETED 1! LA I-1b