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Home My WebLink AboutApplication for Zoning ComplianceOFFICE USE ONLY: DATE FILED: 6D3-10O PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER: D D CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: Vpv pioloo.47 �� s c�Gy ST. LUCIE COUNTY PUBLIC WORKS ' Q""_— WN jt' y BUILDING & ZONING DEPARTMENT QQ rr��n 2300 VIRGINIA AVENUE '20Ft�p FORT PIERCE, FL 34982-5652 561.462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: FL OR/D4 ivRn/PJ KF 2. S/D NAME: SITE PLAN NAME: 3. PROPERTYTAXID#: /226-333-0002-00o�y 4. LEGAL DESCRIPTION (attach extra sheets if necessary): S E E A T T A C H E b Sy Ry E Y 5. PLAT 6. PAGE 7. BLOCK 8. LOT BOOK NO. NO. NO. 2r32y X 1,32)'x 2 35 2'X 9. PARCEL SIZE: ACRES/SQ FT, 70. H$ A?lef-S LOT DIMENS ONS /� 321' (—SEC 5 vPVC 1 ) 10. DESCRIPTION OF CONSTRUCTION PROJECT OR -WORK ACTIVITY: OFF PREMISE SIGN 11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT LEFT 2.5 1, 260r SIDE 292' SIDE: 11992' 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [� NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: AbV ER-r 151/�JG SIGN 2 SI G-AJ F.4L'ES AT 14. Sq. Ft/CONSTRUCTION: 3-7 $ S4. --r. EA. 15, �Dor. SSG SF- 16. VALUE OF CONSTRUCTION: $ 2 S 000. 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 THE AVERAGE PROCESSING TIME FOR MOST BUILDING PERMITS IS TEN (10) WORKING DAYS OWNER INFORMATION: NAME: OLC , INC. ADDRESS: POST OFFICE 6c3 x /L/O14 CITY: FT PIERCE STATE: FL0R11>A zip 34979-4019 PHONE (DAYTIME): (56I) 464-5977 IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: SAME AS ABOVE ` ADDRESS: CITY: STATE: Zip PHONE (DAYTIME): (�' 1 CONTRACTOR INFORMATION ST. of FL REGJCERT R: ES 000007 q ST. LUCIE COUNTY CERT #: / 8 6 2 2 BUSINESS NAME: E L L ER M EO /A L o11,1P i/V y QUALIFIERS NAME: M/ G U EL M A RT) AJ E 2. ADDRESS: 5800 N. W. 77 eDURT CITY: MIAMI STATE: FLORIDA Zip 33I66 PHONE (DAYTIME): (305i 59 2- 6 2 5 0 FAX NO.C305) 4�1 �/ 0- 9 6 2 ARCHIT/ENGINEER: CG R C EN CT/AJEE R 1 /J CG Ot l NC ADDRESS: 55 L/ L/ \-/, I L4 7 '57 R EE T CITY: OA),� FoREST' STATE: TLL)//OIS Zip 60952- PHONE (DAYTIME): (708) L499-OyOO FAx:�-708) ygq-93go BONDING COMPANY: NONE ADDRESS: CITY: STATE: ZIP MORTGAGE LENDER: N ON E _ 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. 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 concurency 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, ANC INTEREST THAT IS at rQJECT TO ATTACHM NT7 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. ONTRACTOR ATURE STATE OF FLORIDA COUNTY OF.111i4mi- DAOE The foregoing instrument was acknowledged before me this /-/ day of DE( 20LG by M'&uEL M4Rri^ EZ who is personally known to me or who has produced Fc_ liC. as identification. ZM 635- 5v0 -y7 -OV6-0 ~1 Signature of Notary DA,A D Type or Print Name of Notary Notary Public Tide CONT CTOR &SIIC NAT STATE OF FLORIDA COUNTY OFiE l -1�'F'TE The foregoing instrument was acknowledged before me this _LL day of J{C 20_Lo� by M1&1/F 141%2Ay Ez . who is personally known tome or who has prod FL.".uGas identification. M63S-Syo-L/0rj6=o l� Signature of Notary bpi✓i[� Pol�c,4lf Type of Print Name of Notary I Notary Public Title PC q� 2 9� Commission Number DAVID CHOLAK eP9P3299 Commission Number NOTARY PUBLIC - STATE OF FLORIDA (seal) COMMISSION#CC983M DAVID CHOLgK EXPIRES 112IMN (seal) NOTARY PUBLIC -STATE BONDED THRU ARA I.NOTARy1 COMMISSION#C OF FLORIDA EXPIRES I7 C9B3298 BONDED THRUASA I W20W NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. yi IF F?PLYING FOR THIS BUILDING PERMITAS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPE9,r TO 1GN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. BP#: a�blpol _ OFFICE USE ONLY,! SECTION: _ /%„ TOWNSHIP: ' t,34 RANGE: Q u MAP NO.: ZONING:.. y LAND USE: av _� LOT CVG %: TAZ NO.: FLOOD ZONE: FIRM MAP #: ST FLR ELV: MAX HGT: CST TYPE:.- OCCP TYP MAX. OCCP: # OF FLRS: WATER: SEWER: SPRINKLERS STORMWATE R LOT OF REC (befr /90) LOT OF REC (aftr 1/90) LOT SPLIT REQ'D --J LOT SPLIT APPRV'D 4- DECAL NUMBER LIBRARY IMPACT FEE PARKS IMPACT FEE PERMIT FEE REPORT CODE G,1 PUBLIC BLDG IMPACT FEE I HABITABALE I AREA RADON FEE ROAD GROSS ROAD IMPACTZONE IMPACT FEE DUE SCHOOL CREDIT IMPACT FEE POLICE FEE FIRE FEE N Y N ADDITIONAL SPECIFY: PERMITS REQ'D ZONING ZONING PLANS REVIEWED BY EXAMINING JIN TOTAL ROAD IMPACTFEE VEGETATION I SEA laas�' MANGROVE