HomeMy WebLinkAboutApplication for Zoning ComplianceDATE FILED -
PLAN REVIEW FEE O RECEIPT NO: PERMIT NUMBER: lS.l r 6 ? d
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE u FILLED INTO BE ACCEPTED
Jc,�e coG
y ST. LUCIE COUNTY PUBLIC WORKS �(Q'Y�(11�ci)QfgUC-
BUILDING & ZONING DEPARTMENT ��oy uu (14& ',,,�t cckkJJ
2300 VIRGINIA AVENUE U
�j pRtpP FORT PIERCE, FL 34982-5652
772-462-1553 C�c15
j0C4(
APPLICATION for BUILDING PERMIT —
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
1716ba 151-t41t Way r
PS L -34 g if PROJECT INFORMATION [Ltd Pn
1. LOCATION/SITE ADDRESS LcT li Ctn'ltst�--('r�v�v-ri'C.cka��3
r
2. S/D NAME: ('L7-I.fnn Coffin" of s ]e5 SITE PLAN NAME: iU �l(Zv L
3. PROPERTY TAX ID #: �aL 1 I - "� O 1 C)D7 000/� t
4. LEGAL DESCRIPTION (attach extra sheets if necessary): (6rvrtin, eskl' s L/
5. PLAT 6. PAGE 7. BLOCK 8. LOT
BOOK Lq b NO. 30 PAJ6 2y3®NO. NO. ( %
22-3,622-CB w6X 4ct�66 )[
9. PARCEL SIZE: ACRES/3aFT. Jf. l I4trl LOT DIMENSIONS awl t0 332.
10. DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: S M6I ( 176in;Ly R tS
O( 12-6 �3I , v
11. SETBACKS (ACTUAL) FRONT: )?. 50 BACK: a5S 9 RIGHT _ + [ EFT 5IS
SIDE ) j", 1 C SIDE: /55k .
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[Pr RESIDENIi IAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: S (L'`Ite "w -A{S
14. Sq. RJCONST
F2UCTION: 15. Sq. Ft. 1sfFloor i -A�
16. VALUE OF COINSTRUCTION: $ 3'7 5
The value of construction is used to determine the amount of pemut fees to be assessed. St. Lucie County reserves the right to question and/or modify the
indicated value of consWction it it is demonstrated that the submitted figures are not a;W'stent with similar types of construction activitles--11 the vahie Is $2500
or more, a RECORDED Notice of commencement must be submitted with this application.
Phone: (772) 465-8231
Fax: (772) 465-7873
ADDRESS:
Custom Nome Ruilder
Ober 30 Years Ex;fAence
Licensed 8 Insured
RR0060892
Michael Difrancesco,�
We'o It All, We Do It Right',
Cell: (772) 201-7797
st[ �y 1/U✓k fi 1 YIP�e—
✓i� �(�r/1
L ZIP
CITY: STATE: C� .
PHONE (DAYTIME): L 7�f Q
IF THE FEE SIMPLE TITLEHOLDER (PROPER OWNE IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS
BELOW.
FEE SIMPLE TITLEHOLDER:
ADDRESS:
CITY:
PHONE (DAYTIME):
CONTRACTOR INFORMATION
STATE:
dli
V
ST, of FL REG.ICERT #: 7� R_2 0 o6 a $5 2 ST. LUCIE COUNTY CERT #: ( ( 67'0
p
BUSINESS NAME- V {YL (45 W I� e % 1
QUALIFIERS NAME: hn I l.a. L j �� !I- 7C t S La
r
ADDRESS: 94a 40 I—d htc 12 IINA t--
CITY: STATE: � L. ZIP Yyq Y
PHONE (DAYTIME): ,L 1 1 0. FAX NO. y 6 � 7 27 3
ARCHITIENGINEER: Cit) 9 md. - M "[.,i
ADDRESS: p
CITY: ( T ... 7 `-r.<'i„`4- STATE: '1�'L- 21P _
PHONE (DAYTIME): f 1 L16 0 -77 5-f -
BONDING COMPANY:
ADDRESS: z
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE:
STATE:
Z!P
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.
0
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 permilted 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: 1 certify that all the foregoing information is accurate and that all wor be done in compliance
with all applicable laws regulating construction and z9mng.
NER/CON C R SIGNATURE CONTRACTOR SIGNATURE t/
The foregoing trument w acknowledged
z
before meth" bpy_
wh a all kno to in r who
s produc as en I Ica " n.
St a Notary" i
Type or Print Name of tom.„ ,
Notary Pi bli LORIEA.GERSTEMEVER
MY COMMISSION # DD 52013�7
Com RES: F®binary
YAN NMW pypiloUndern+rtars
�BfnFr
(sed)-
STATE OF F
COUNTY O
The foregoin? jn5trument w:
before me thiso( r_ day of
w
or t3 has oduce , s
of Print Name of Notary
known to me
"eta
Pubh Title
t IORIEA GER67EMEIER Com Ssl fMMISSION # DD 619319
'� . �;& EXPIRES. Februa id, 2010
(seal)°,tad" aontleA m�N.okry pubunCs wrrta+s
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED.
IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNEWBUILDER, THE OWNER MUST PERSONALLY APPEAR
TO SIGN THIS, APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION.
BP #:
`
TOWNSHIP:
c
RANGE: -
�,
MAP NO.:
SECTION:
1
.
'ZONING:
LAND USE:.
5
LOT CVG °%..
'�- .�
TAZ NO.:
FLOOD ZONE:
FIRM MAP #:.
tST FLR ELV:
MAX HGT:
(��.r'F'
..
CST TYPE:
-
OCCP TYPE:
MAX. OCCP:
# OF FLRS.-
��4��t G
WATER:
SEWER
n 1 -
SPRINKLERS
STORMWATE
R
LOT OF REG (befr 1190)
iOT OF REC (atlr 1/9W)
/.
LOT SPLIT
.LOT SPLIT
REOTJ
APPRV'D
(
DECAL
LIBRARY
Q
��i
PERMIT
NUMBER
IMPFEE
IMPACT FEE
FEE
j REPORT _
PUBLIC BLDG
�- �
HABITABALE
-
RADON FEE a
CODE
IMPACT FEE
Q
AREA
1
(RADON) .
"' (��
Y
N
ROAD
`
GROSS ROAD
*l `�,.
CREDIT
TOTAL ROAD
IMPACT ZONE
IMPACT FEE
dam'
IMPACT FEE
DUE
Y
N
" x
SCHOOL-
�/^t.//^y�
CREDIT
e
h
'
TOTAL
IMPACT FEE
. "1
are,
SCHOOL
l
.
IMPACT FEE
ePOLI& FEE
FIRE FEE
MISC FEES:
TOTAL
�-�yf�
III"
POLICEIRRE/
MISC. FEES
ADDITIONAL
SPECIFY:
Q'j.,yp.,��
TOTAL ALL
PERMITS
FEES
REDD
...
a
REVIEWS ZONING ZONING PLANS.. -VEGETATION SEA MANGROVE
. REVIEWED BY EXAMINING TURTLE
DATE
COMPLETE
INITIALS