HomeMy WebLinkAboutApplication for Zoning ComplianceOFFICE USE j Iz :
DATE FI EI) •- <Y1
PLAN REVIE%r FEE; RECEIPT NO. C E2 X! PERMIT NUMBER:
CONCURRENCY FEE: . RECEIPT NO. CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
J �E
St. Lucie County Building and Zoning
2300 Virginia Avenue
OR P • Ft. Pierce, FL 34982-5652
772-462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
TE
1. LOCATION/SIADDRESS: .50� I a L Y/I aN—t o 2
2. PROJECT NAME:j1n0Lron&Q ]erne S SITE PLAN NAME:
3. PROPERTY TAXIDti:
4. LEGAL DESCRIPTION (attach extra sheets if necessary): [—off Qwg�c rSv�e_ [t 1Ms
5. PLAT BOOK oZ� 6. PAGE NO. Q 00 7. BLOCK NO. 8. LOT NO. _
3S6
9. PARCEL SIZE (ACRES/SQ FT.): a LOT DIMENSIONS:
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: M • F•
SETBACKS (ACTUAL) FRONT: 25 BACK:
TYPE OF CONSTRUCTION (Check all appropriate
[1
NEW CONSTRUCTION
RESIDENTIAL
OTHER (SPECIFY) _
RIGHT SIDE: LEFT SIDE:
0 7—
f J EXPANSION/ADDITION (J INTERIOR RENOVATION
I J COMMERCIAL [ ] INDUSTRIAL
DESCRIPTION OF PROPOSED USE: , �. P. r J/J� - a�
SQ. FT OF CONSTRUCTION: a 3$ -7 15. SF. FT I st FLOOR: [ a)? a,
VALUE OF CONSTRUCTION: $
The value Of %listruction 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 constfktion 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 14mice of Commencement must be submitted with this application.
SLCCDV Pbrm No.: 001-02
04,14 , c�a6,-74i,13
OWNER INFORMATION
NAME: MARONDA HOMES INC.
ADDRESS: 4610 LIPSCOMB ST STE. 1 _
CITY: PALM BAY STATE: FL ZIP: 32905
PHONE(DAYTIME): (M) 725-5645 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
ST. of FL REG.CERT #: CRC 0 5 31 21 ST. LUCIE COUNTY CERT #: 1
BUSINESS NAME: MARONDA HOMES INC
QUALIFIERS NAME: JEROME ANUSZEWSKI
ADDRESS: 4610 LIPSCOMB ST STE 1
Cam. PALM BAY STATE: FL ZIP: 32905
PHONE(DAYTIME): C3211 725-5645 FAXNO.321_725_57II3 Email:
ARCHIVENGINEER: DONALD ROBERTS
ADDRESS: 4005 MARONDA WAY
CITY: SANFORD
PHONE (DAYTIME): (q 0 1) 121 _ n n 6 e
BONDING COMPANY:
ADDRESS:
CITY:
STATE: FL Z[P: 37.771
STATE: ZIP:
MORTGAGELENDER: BANK OF AMERICA
ADDRESS: 750 S ORLANDO AVE STE 202
CITY: WINTER PARK STATE: FL ZIP: 32789
IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days afteF notification
it will be voided and returned to you by mail.
1
CERTIFICATION:
This gfflication is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity,
if app){gable, 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 bo 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) AFFIDAVIT: I certify t all the foregoing information is accurate and that all work will bJ
m compliance
with all plicable laws regulating constructionjaid zoning �,
OR
OF FLORIDA
'Y OF
The foregoing instrument was acknowledged before
me this day o 20 l
by
rwho III personally kkn�ow, n _- o�h
r who- aas produced
y
W - as identification.
Tr
OF FI
Y OF
The foregoing instrument was acknowledged. before
me this `J' day of�l.,\ > 20�,
_
who is personally known -)(-- or who has produced
_ as identification.
Sa
Signature A'ntary
Signatu ofN ryI, ggAtpIZGoyCOCH�+
n NogtANCHE SCHONECK Seal)
.gpIMISSION # OD 09143G
Commission No. �` '` IRgglJuly2,2011'- MYCOMMISSI'1tz4
ti! aan9adTn�uNrdeNNourUManvfiiaa '�@ EXPIRES'. Match 26,2010
Band+OTbm Notary Fublic UnEerv+ntars
NOTE; TWO (2) SIGNATURES ARE REQUHIEII. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
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.
C
OFFICE USE ONLY BP #; 0 9 -
SECTION
SIN
TOWNSHIP
Say
RANGE
31
vv5'l4
MAP NO.
I31I S
ZONING
PUJ)
LAND USE
/ ,i
LOT CVG %
ji) %
TAZ NO.
FLOOD ZONE
x
FIRM MAP #
11T F'LR ELV
MAX HGT
CONST TYPE
OCCUP TYPE
MAX OCCUP
n OF FLRS
WATER
LO&
SEWER
op
JL
SPRINKLERS
STORMWATER
LOT OF REC
OF REC
LOT SPLIT
LOT SPLIT
Be(ore 1/1990TITZ
1/I990
REQUIRED
APPROVED
REPORT
�O. I_
HABITABLE
RADON
PERMIT
CODE
T
AREA
FEE
FEE
(RADON)
LIBRARY
IMPAC
PUBLIC BLD IMPACT FEE
1
O( I q. 33
PUBIC BLD
G /
I 0 7
PARKS
FEE
IMPACT
/, 10
IMPACT —
CORRECTION
FEE
FEE
GENERAL
SCHOOL
IMPACT
//ROAD
O��Q •�
IQ!
yJ�3,
CREDIT
Y
N
LAW ENF
r
IMPACTtf
`
IMPACT
FEE
FEE
FEE
FIRE(EMS
IMPACT
�V V
DRIVEWAY
Y
N
DRIVEWAY
ADMINISTRATIVE
FEE
REQUIRED
—
FEE
VARIANCE FEE
SPECIFY
MECHANIC_ ROOF —
NON -CONFORMING
MISCELLANEOUS
SUBS
ELECTRIC GAS
LOT OF RECORD
FEES
REQUIRED
PLUMBING —
FEES
�
DATE SENT TO ADDRESSING: O•.7
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
/11-1 Q
1 E
COMPLETED
-`f'
INITIALS
DATE FILED: 4
PLAN REVIEW FEES RECEIPT NO_:
CONCURRENCY FEE: RECEIPT NO.:
PERMIT NUMBER: S
CERT_ CAP. NO.:
6 jo 1 - o6-1
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
St. Lucie County Building and Zoning 2300 Virginia Avenue
' aR1D Ft. Pierce, FL 1553 5652 "
772-462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROTECT INFORMATION
1:
2.
3.
4_
LOCATION/SITE ADDRESS: L 1 VV\ A, r "a S �
S/D NAME: « y 91 -L SITE PLAN NAME:
PROPERTY TAX ID #: 13 1 1 ` -1 oe - 0 2.0.? - (nOo - $
LEGAL DESCRIPTION (attach extra sheets if necessary):
Ld -Pr +cf 5-j.,t Q
A d Me
5.
PLAT 6. PAGE 7.'BLOCk
" S. LOT
BOOK NO. NO.,
NO.
9.
PARCEL SIZE: ACR2 _S/SQ FT. LOT DIMENSIONS
10.
DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY
PC-J Z S Ivy
] L
SETBACKS (ACTUAL) FRONT: `ZrBACK: zy RIGHT: !J LEFT:
SIDE.
` SIDE
12.
TYPE CONSTRUCTION (Check all appropriate boxes)
"[ NEW CONSTRUCTION [ ] EXPANSION/ADDITION
[ ] INTERIOR RENOVATION
[- ] RESIDENTIAL [ ] COMMERCIAL
[ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13.
�7^
DESCRIPTION OF PROPOSED USE: /tCi3 ` LWM h0 A,,9
r
Z 3 L-
14.
Sq. Ft./CONSTRUCTION: 15.
Sq. Ft. I st Floor:
16.
VALUE OF CONSTRUCTION: $ _G 2- -711 ( • 1 3
The vahr 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 clydonstmction if it is demonstrated
that the submitted figures are not consistent with similar types of construction activities. If the
RECOMED Notice of Commrncement must be submitted with this application. alue is $2500 or more, a
SLCCDV Form No.: 001-02
}
OWNER INFORMATION
NAME: M tof }ply �� f .�F- a
ADDRESS: 20 Z Q ArL� �ctt �r
.CITY: 10, rn STATE: .. ZIP 1 Zvi r
PHONE (DAYTIME) 3( 21) 72 f- 5-6 `1� email: JId ArjA)44. CcA4, -
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 REGICERT #: C 8 C I Z 5 315-5- ST. LUCIE COUNTY CERT #: Z.S (
BUSINESS NAME: M A n.31) (' 0 A GLI�a C .' P I' 1. h A
QUALIFIERS NAME:11`1Q
ADDRESS: �G to L7 QsL+Mh gi /� L ,S,, A S
CITY: STATE: ��—
PHONE(DAYTIME): Ull)7ZS-S643-, O3 FAXNO..?21 "7LS-S1-3
ARCHITIENGINEER:' (M (>0
ADDRESS: YOBS MAr,(JOA-
CITY: S 0 STATE:
PHONE (DAYTIME): (Wl . Li 1- 3 2(- 006 Lf
BONDING COMPANY:
ADDRESS:
CITY:
STATE:
WA
ZIP 32, T-
email:
ZIP S L1
ANIJOA
MORTGAGE LENDER: -
ADDRESS:
CITY: STATE: 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, ETC., not otherwise included with this building permit application.
The -following building permit applications are exempt from undergoing a full conciarency 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 APPLICANTi 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.
A
OWNER'S AFFIDA
/ I rtt 1 the foregoing information is accurate and that all
i 1 appli able laws regulating construction and zoning.
sz /JJ
v„
ATURE ;
STATE OF FLO
COUNTY OF
The foregoing i arum-nt was acknowl aged
before me this day of Ag by
who is personally
kaam to me or who has prodced�_`
N10
Type or Print Name
Commission No.
be done in compliance
STATE OF FLM1
COUNTY OF
The foregoing instrument was aacknowles[ged
before me this 4� day of C 200M by
ll1 T.Z a who is personally
known to me or who has produzed—
�Ztureary
I QAjp A-(oest-pef e
Type or Print Name of Notary
Commission No. (Seal)
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 1peciflc instructions See appropriate permit checldist. LOAtEMIS510N �Ey q 17
v
� EXPIRES'. pByu u
. SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
LAND USE
LOT CVG %o
TAZ NO.
FLOOD ZONE
FIRM MAP #
I3TFLR 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
ADMINST
LIBRARY -
PARKS
PERMIT
-
VARIANCE -
IMPACT FEE
-
IMPACT FEE
FEE
REPORT
PUBLIC BLD
HABITABLE
RADON FEE
CODE
IMPACI'.FEE
AREA
(RADON)
SCHOOL
GROSS ROAD
CREDIT
Y N -
TOTAL ROAD
IMPACPFEE
IMPACT FEE
'IMPACTFEE
DUE
SCHOOL
CREDIT
Y
N
TOTAL
IMPACT FEE
SCHOOL
IMPACT FEE
POLICE FEE
FIRE FEE
MISC FEE
TOTAL
POLICE/FIRE
MISCEES
ADDITIONAL
P_::N:
TSPECIFY
TOTAL
PERMITS .
of ALL
REQUIRED
- FEES
.
REVIEWS ZONING ZONING PLANS MISC. VEGETATION SEATURTLE MANGROVE
REVIEWED BY EXAMING
DATE
COMPLETE .
INITIALS