HomeMy WebLinkAboutZoning ComplianceOFFICE USE ONLY:
DATE FILED:
PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER:
PIoSOIZt)
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE 8t FILLED IN TO BE ACCEPTED
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ST. LUCIE COUNTY PUBLIC WORKS
BUILDING &ZONING DEPARTMENT
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
561-462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
1. LOCATION/SITE ADDRESS: 3206 Cwlf M1>1-LIsE Ropp, T.'7Frc{ZLE 1--L 349BL
2. S/D NAME: SITE PLAN NAME:
3. PROPERTY TAX ID #: 2�/2 - 5DZ-OGu1/- DDOIO
4. LEGAL DESCRIPTION (attach extra sheets if necessary): 56E A%rACN 577
5. PLAT 6. PAGE 7. BLOCK
BOOK NO. N NO.
9. PARCEL SIZE: ACRES/SQ FT. LOT DIMENSIONS
8. LOT
NO.
10. DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: Anp/r/On/OF/T DYEiZ61EdD �oOK
2n/EXT�ReOe14"4LG, W"�Oi1014-4 iYxP.P61- pii4z TWiD eeyl'h /s✓rivYP76/0�2 /lLtTi £irr! %Z�i+9�
11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT C LEFT
E r,? SIDE V� SIDE:
12.
13.
14.
16.
TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION (] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
U] OTHER (SPECIFY) /tlDI7/F/CA%%O/✓ oP 11GTE �wyTion/ ?o �X/STin/6s �ti/G1Jir✓�
DESCRIPTION OF PROPOSED USE: zvntisr/Zi.a,6L
0
Sq. Ft./CONSTRUCTION: .) C L hid h(• 15. Sq. Ft. 1st Floor:
VALUE OF CONSTRUCTION: $ /D,DOD•
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:
ADDRESS:
CITY:
r ,
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:
ADDRESS:
CITY:
PHONE (DAYTIME): L_L
CONTRACTOR INFORMATION
STATE:
STATE:
ST. of FL REG./CERT #: �'�'C�/BOp�� ST. LUCIE COUNTY CERT #: 9215
BUSINESS NAME: R/G%/Afe%/ e4-'f
ZIP
QUALIFIERS NAME: L�LIOrG/15 `�%A✓/.5 DES/i✓T
ADDRESS: ?��•f.3oX /5�
CITY: ,cr --I�IE,QGE.. STATE: 0L0.21DA ZIP
PHONE (DAYTIME): (5-671) FAX NO..S/Oi,�i(O�' Z�do.7
ARCHIT/ENGINEER: M/ 2w/G.
ADDRESS: /// Y'3 'ga
CITY: STATE: ZIP 329G f3
PHONE (DAYTIME):
BONDING COMPANY:
ADDRESS:
CITY: I 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.
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 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'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.
OWNER/ ONTRACTOR SIGNATURE CONTRA TOR SIGNATURE
STATE OF FLORIDA
COUNTY OF X LUG//G
The foregoing instrument was acknowledged
before me this /'day of PA/L, 2001, byAV61sff
P401 f who is Personally known to me or who
ha produced as identification.
ignature of Notary
I�oi�fT
Type or Print Name of Notary
Notary Public Title
CG�72_6�57 Commission Number
"AlIts ,.
Roger A. Priest
(seal) - o`P�Y Pp ,�0 Comrnission # CC 971587
Expires Nov. 7, 200�}
9
:g
Bonded T6ru
Atfsntic Annding. Co:. Ire.
STATE OF FLORIDA
COUNTY OF .LT La(2
The foregoing instrument was acknowledged
before me this ZLAday of,&jg , 20!�, by
who is personally known to me
or ho has produce as identification.
Aid4ature of Notary
CY/(%EQ Ll _ pa/za'l
Type of Print Name of Notary
Notary Public Title
l-4t'0;%
Commission Number
a�Pda,,
Roger A. Priest
(Baal)
`o'er 1 CominissionpCC9��7
7,
ExpiresBo
.'' .. a:F
ded
Bonded ThCo.,
inc.
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 APPEAR
TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION.
BP #
al o So/
SECTION:
rl�
TOWNSHIP:GJS
✓�
RANGE:
t _
MAP NO.:
'jaw
zr.�
ZONING:
,ZV
LAND USE:
LOT CVG %:
TAZ NO.:
FLOOD ZONE:
FIRM MAP #:
-45 FLR ELV:
MAX HGT:
CST TYPE:
OCCP
MAX. OCCP:
# OF FLRS:
WATER:
SEWER:
SPRINKLERS
STORMWATE
R
LOT OF REC (befr 1190)
LOT OF REC (aRr 1/90)
LOT SPLIT
LOT SPLIT
REO'D
APPRV'D
DECAL
LIBRARY
PARKS
PERMIT
NUMBER
IMPACT FEE
IMPACT F
FEE
REPORT
PUBLIC BLDG
H ABALE
RADON FEE
CODE
IMPACT FEE
REA
(RADON)
Y
N
ROAD
GROSS ROAD
CREDIT
TOTAL ROAD
IMPACT ZONE
IMPACT FEE
IMPACT FEE
DUE
t-
Y
IN
SCHOOL
.EDIT'
TOTAL
IMPACT FEE
SCHOOL
IMPACT FEE
POLICE FEE
FIRE FEE
.MISC FEES:
TOTAL
POLICE/FIRE/
MISC. FEES
Y
IN
ADDITIONAL
SPECIFY:
TOTAL ALL
PERMITS
FEES
REO'D
REVIEWS
ZONING
ZONING
PLANS
VEGETATION
SEA
MANGROVE
REVIEWED BY
EXAMINING/
TURTLE
CATE
OMPLETE
��
S 01
',. INITIALS
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