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HomeMy WebLinkAboutApplication for Zoning ComplianceOFFICE USE ONLY: DATE FILED: PLAN REVIEW FEE: RECEIPT NO.: /33�7 PERMIT NUMBER: CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ST. LUCIE COUNTY PUBLIC WORKS ,I BUILDING & ZONING DEPARTMENT 2300 VIRGINIA AVENUE 90 �51 FORT PIERCE, FL 34982-5652 561462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITEADDREJSS:l boa boHt OW I(/ / FL 3<ry5u 2. S/D NAME: f%Aa .%SITE PLAN NAME: )44 2�a«a 3. PROPERTY TAX ID o n o �/ - o o a /l /33�.� 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 5R =-� Zl3 j S 1/ u l 1z rl FA J.4ArkL'c" k'dt ,- ;"it: '21/ Y55 (&-(IG 5. PLAT 6. PAGE 7. BLOCK 8. LOT BOOK NO. %Fl - lb 1 NO. NO. o . `f7a7 A'Ieis 9. PARCEL SIZE: ACRESISO FT.",�'1 � LOT DIMENSIONS f / 10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: IC a c .✓ ! a ! I 11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT LEFT SIDE SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ I EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL N' COMMERCIAL [ j INDUSTRIAL [ j OTHER (SPECIFY) / 13. DESCRIPTION OF PROPOSED USE: &./z5in 4^ li'r+ ` [ o haw v i /y r-I A R 14. Sq. FUCONSTRUCTION: 15. Sq. Ft 1st Floor A��r�,1 16. VALUE OF CONSTRUCTION: $ ` n The value of construction is used to determine the T'-- uestion and/or modify the indicated value of construction if it is d amount of permit fees to ties. If the value Is $2500 in more, a RECORDED Notice demonstrated that the submitted fi u be assessed' SL Lucia County reserves the Of Commencement must be figures are not consistent with similar right to q,, submitted with this appiicatlon. types of construction ea;viL. g / •`'t f }� SLCCDV Form No.: 001-02 /U, •► [YJ+ V THE AVCRAGE PROCESSING TIME FOR MOST BUILDING PERMITS IS TEN (10) WORKING DAYS OWNER INFORMATION: J �( �1 1 NAME: �^�ARlou,2 J�Ir/SE, 0ai',2rY �wnir3Rr' ADDRESS: 1.2600 146.12 .� 13L ow CITY: STATE. ZIP , .. PHONE (DAYTIME): $ IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: N. ADDRESS: CITY: STATE: ZIP PHONE (DAYTIME): f I CONTRACTOR INFORMATION ST. of FL REGJCERT k: S P © /tiff ST. LUCIE COUNTY CERT #: � [P l` BUSINESS NAME: --'x S a 3--i k ,`L t�"-AOT z QUALIFIERS NAME: �Fl v,t/„. Co iz R l g IN ADDRESS: CITY: /ark 2 STATE: F L ZIP 9 T'% PHONE (DAYTIME): fS611: 2BG� //�2.5�y q'/ FAX NO. ARCHITIENGINEER: d � h o>✓c Y ^-'K/+s• .90R1Y ADDRESS: ..��_DLa S.E Ar T R t1• -. �hvy k., 7F .�.2.0 d CITY: I u n 2fi STATE: FL ZIP PHONE (DAYTIME):^ BONDING COMPANY: ADDRESS:<. _ CITY: STATE:, 'ZIP 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. 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. AND INTEREST THAT IS 9UBJECT TO ATTA HMENT• 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 with all applicable laws regulating con;t OWNER/CO �tjjr��rTRACTAOR SIG RE V STATE OF FLORIDA COUNTY OF LwcI r The foregoing instrument was acknowledged. before me this IL day of&L 20,Qg by�Li,-'/ �,fj AVM, who is personally known to me or who has produced W"A(/ Kda as identification. Signatur6 of Notary sl,�/e V,4 -� Type or P t Name of Notary Notary Public Title and that all work will be done in compliance zoning. SIGNATURE STATE OF FL0, fflA COUNTY OF 'r 1�`<irv' The foregoing instrument Was ^ acknowledged before me this • day of �, 20_L,� by who is personalty known to me d who has produce as identification. Sign atu f ry m4a-N &cz: Type of Print Name of Notary —oanrsy9si�n Number 8i * *MYComm"OnCC88Vta 4Commission Number (Seaq „,+� EVM Sa 28, 2001 - .PY MAROY BARZ (seal) MY COMMISSION # CC9368% EXPIRES: May 15,2004 NOTE: TWO (2) SIGNATURES ARE REQU �-64C �'r1aOR1ATURE MUST BE '��NOT�v RNo+ansarvKeaeaneirg �� IF APPLYING FOR THIS BUILDING PER&d Au Ak bWNER/BUILDER, THE OWNER MUST PERSONALLY APF)LEAF TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. BP #� /o IODA2Z OFFICE USE ONLY' SECTION: TOWNSHIP: - 3r/ .RANGE:D �j- _ .._ MAP NO.:� /( f ZONING: i / `(� {/ LAND USE: lj LOT CVG %: TAZ NO.: FLOOD ZONE: Vl FIRM MAP #: 1 ST FLR ELV: GT2. CST TYPE: OCCP TYPE: MAX. OCCP: # OF FLRS: WATER: SEWER: SPRINKLERS STORMWATE R LOT OF REC (befr 1/90) LOT OF REC (aftr 1/90) LOT SPLIT LOT SPLIT REO'D APPRV'D DECAL LIBRARY PARKS PERMIT NUMBER IMPACT FEE IMPACTFEE FEE �y REPORT PUBLIC BLDG HABITABALE RADON,FEE CODE IMPACTFEE AREA (RADON) Y ROAD GROSS ROAD CREDIT 21 TOTAL ROAD IMPACTZONE IMPACTFEE ,.-' IMPACTFEE DUE Y N SCHOOL CREDIT ': :... ' TOTAL ' ` SCHOOL IMPACT FEE F IMPACTFEE POLICE FEE FIRE FEE MISC FEES: TOTAL POLICE/FIRE/ MISC. FEES ADDITIONAL SPECI TOTAL ALL PERMITS FEES REO'O REVIEWS ZO,. G ZONING PLANS VEGETATION SEA MANGRO\' REVIEWED BY EXAMINING TURTLE DATE com'LETE fey !!!!!! 111 INITU S