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HomeMy WebLinkAboutApplication for Zoning Compliance/ OFFICE USE ONLY: Opn?—d / DATE FILED: nl' m: flo PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER:_ I . - -T . �. NBEDs s rmt rc> C'aCCd C go/LOt2�% y O is.r� t�y ST. LUCIE COUNTY PUBLIC WORKS ~ BUILDING & ZONING DEPARTMENT 2300 VIRGINIA AVENUE F�aAt�p FORT PIERCE, FL 34982-5652 561.462.1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: 2 nj kJ 2. S/D NAME: SITE PLAN NAME: 3. PROPERTY TAX ID #: OOP 5 — bC)o5 4. LEGAL DESCRIPTION (attach extra sheets If necessary): w S yD F10.'n tLw C tJR O'c (;Qc: 7c)- s Soy21 ,1 Sec Alves !V zj"U 0'-- #'7 �t�7-1-r wnl.ao C.o�al do S! 14' a+" w 41�•ti5 h> /w S-N J camel 5. PLAT 6. PAGE 7. BLOCK 8. LOT BOOK NO. NO. NO. 9. PARCEL SIZE: ACRES/SQ FT. LOT DIMENSIONS 10. DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: C.... S 2-' ) ! /J6'_S'1:. c:. 11. SETBACKS (ACTUAL) FRONT: NaCK: 'r RIGHT LEFT 1 V/ V SIDE %�n SIDE: l 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ J NEW CONSTRUCTION [ ] RESIDENTIAL [ ] OTHER (SPECIFY) EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] COMMERCIAL [ ] INDUSTRIAL N0 13. DESCRIPTION OF PROPOSED USE: C.rv�-CL'�� C�c'C� ���C- 1417 14. Sq. Ft/CONSTRUCTION: 2 27` T 15. Sq. FL 1st Floor. 16. VALUE OF CONSTRUCTION: $L�'* c" "— 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 indicated value of construction if It is the is demonstrated that the submitted figures are not consistent w or more, a RECORDED Notice of Commencement must be submitted with this application, ith similar types of construction activities. If the value is 52500y SLCCDV Form No.: 001-02 I I', THE AVERAGE PROCESSING TIME FOR MOST BUILDING PERMITS IS TEN (10) WORKING DAYS OWNER INFORMATION: NAME: ADDRESS: CITY: Pi' IJ ae o STATE: 7"'l ZIP PHONE (DAYTIME): f5o/ 1 IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: ++�� U-)i // / I .PC Z` ADDRESS: ;)61_ E ! `0, CITY: /J 'IC-P��� �"JT STATE: .. ZIP 3 /?6D PHONE (DAYTIME): CONTRACTOR INFORMATION C/', W6� -C114 - �v ST. of FL REGJCERT A: - GG : // 6 l �/ ST. LUCIE COUNTY CERT 0: BUSINESS NAME: QUALIFIERS NAME: ' ADDRESS: 7 C ZC7 - E'/ ? q CITY: q (^I �?/��y� STATE:_ Q- LP PHONE (DAYTIME): ( l/1 ( /�'Z.d ��5�,. FAX NO. % J ARCHIT/ENGINEER:ir? ADDRESS: CITY: p� R L 17ul,/J{� Q STATE: ZIP PHONE (DAYTIME): BONDING COMPANY: i ADDRESS: CITY: STATE: • ZIP i MORTGAGE LENDER: ADDRESS: CITY: STATE: yp 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 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 ATTACHM NT• 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 STATE OF"F. COUNTY OF I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construcb'gih aptt zoning: The foregoing instrument was acknowledged before me this, y of G� by_ who i o me or who h4iproduo as identification. c Q Signatu / ' ot)ary 1 :S^-3 vtG/�u{�j Type or Print Name of Notary STATE OF F IDA COUNTY OF 0.4_,4 ,eQ__. The foregoing instrument was acknowledged before me this day of _bi?�' 20� by whczjs oerso -to me h s pro cpd s identification. Signature of ota L-,2 ,, U • I LJ r(i Type of PWrit Name of Notary _ Notary Public Title Notary Public Title - 7 3:5 �Cl •v.5'^j%'• LEONARDVIGuorn Commission Num sr ..= (seal) : _ MYCOMMISSION ACC735225 LFANARDVIGLIOTfI EXPIRES! April 19, 2002 (Seal) MY COMMISSION # CC 735226 ?p ry$`.Banded rnm Notary Pubic UnCBMTters r` - -f �= d EXPIRES. Notary Nbk 2602 �y�ea+' Bonded Thad Notary Pu6AcunEarnntata 7�'RfaCx"� NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY AV PEAF TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. BP #:- OFFICE- USE ONLY SECTION: � q TOWNSHIP: �� RANGE: '-jy ll MAP NO.: / L/ ZONING: / i 1- 7 LAND USE: Jet LOT CVG %: TAZ NO.: FLOOD ZONE: FIRM MAP #: - ' 1ST FLR ELV: MAX HGT: CST TYPE: OCCPjNPE: MAX. OCCP: # OF FLRS: r WATER: SEWER: SPRINKLERS STORMWATE R LOT OF REC (befr 1/90) LOT OF REC (aVtr 1/90) LOT SPLIT LOT SPLIT REQ'D APPRV'D DECAL LIBRARY PARKS PERMIT NUMBER IMPACT FEE IMPACT FEE FEE REPORT ` ,.( ' PUBLIC BLDG HABITABALE RADON FEE.«t CODE j IMPACT FEE AREA (RADON) ROAD GROSS ROAD F'C CREDIT TOTAL ROAD IMPACT ZONE IMPACT FEE ..-., „i" IMPACT FEE DUE Y N SCHOOL CREDIT TOTAL IMPACT FEE SCHOOL IMPACT FEE POLICE FEE FIRE FEE MISC FEES: TOTAL POLICE/FIRE/ MISC. FEES Y N DMONAL SPECIFY: TOTAL ALL RMITFEES L Q'D REVIEWS ZONING ZONING PLANS VEGETATION SEA MANGRO''t REVIEWED BY EXAMINING TURTLE DATE f 5 © ) COMPLETE G INITIALS