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Home My WebLink AboutApplication for Zoning ComplianceOFFICE USE ONLY: DATE F1LEM PLAN REVIEW FEE: �CLIPTNO.: CONCURRENCY FEE: RECEIPT NO.: PERMIT NUMBER: 1"Do / — 00 96 CERT. CAP. NO.: INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/STFEADDRESS: 9 (PU J1/UG/b&-1'2-'V /1L%• /.. ;�!`t.7d-I-V+ 2. PROJECT NAME: SITE PLAN NAME: / g=L 4g a � JE Q Ala C7k lA 3. PROPERTY TAX ID 50 z " 06 / S-10 06 7 4. LEGAL DESCRIPTION (attach extra sheets ifnecessary): .5% 0 e_ C— 4,67 MAC' �t y/ 2 2 Al z 9S9 7 Si 5. PLAT BOOK g� 6. PAGE NO. U % 8 S 7. BLOCK NO. 8. LOT NO. // 9. PARCEL SIZE (ACRES/SQ FT.): % LOT DIMENSIONS: a y� 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: RtA4'0 (/E e 0r)_"11_ it. SETBACKS (ACTUAL) FRONT: n I ILI BACK: RIGHT SIDE: Z.r LEFT SIDE: _ I 12. 13 TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION pQ RESIDENTIAL [ ] COMMERCIAL . [ ] OTHER (SPECIFY) rip/Ac'E AOG.A-- f P11- DESCRIPTION OF PROPOSED USE: [I INTERIOR RENOVATION [ I INDUSTRIAL, 5,1600 q DoUL 14. SQ. FT OF CONSTRUCTION: �p 15. SF. FT I at FLOOR 16. VALUE OF CONSTRUCTION: $ o The value of con&uctiou 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 c0119m0fl4ion if it is demonstrated that the submitted figures ame not consisleM with similar types of construction activities. Ifthe value is $2500 or more, a RECORDED N6tuce of Commencement must be submitted with this application SLCCDV F,lKrD No.: 001-02 7 UPDATED 6/25/09 OWNER INFORMATION NAME: J✓%/'_ ��/S %Y//// Cell �%L%e� / ADDRESS: /20 (v/0 �id C / CITY: D /�yel-le STATE: FLo.ef D/4 ZIP: 3"�{9�d� y 4 $1z7 PHONE (DAYTIME): Q_� 5�� r�b�%b Email: �(JM�{Q�SNLaU , GO/hi 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: STATE: PHONE (DAYTIME): CONTRACTOR INFORMATION AI' v ST. of FL REG,CERT #: ST. LUCIE COUNTY CCERT #: / _!i� BUSINESS NAME: 41AI QUALIFIERS NAME: WAV /'/C d- ,+gyp Z ADDRESS: F 51 /� T/ CS/c CITY:,STATE: FLp//C�o PHONE (DAYTIME): S !f S b0 /Z FAX NO. Email: ARCHIT/EI` ADDRESS: CITY-. PHONE (DAYTIME): M r'y L� � _ Y/ ? BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER ADDRESS: _ CITY: ZIP: 3y9e7 STATE: ZIP: _.j 5f 4 Z- �t_ STATE: STATE: ZIP: IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification it will be voi and returned to you by mail. CERTIFICATION: 11ti§ 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, FENCES, ETC., not otherwise included with this building permit application.. St. Lucie County makes no representation that its granting of a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Homeowner Association rules, bylaws or any covenants that may restrict or prohibit such structure. Please consult with your Homeowner's Association and review your deed for any restrictions which may apply. The following building permit applications are exempt from undergoing a full concmrency 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: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOBSITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT TO ATTACHMENT: AS A CONDITION OF ISSUANCE OF THIS PERMIT, YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. A ,A:? OWNER ORCONT CTORSIGNATURE STATE OF FLOW�/te COUNTY OF , ` i The foregoin instrument strument was acknowledged before me this day o - �� 20 , 1 2- by C who is personally known �or has produced CONTRACTOR SIGNATURE f' STATE OF FLORA t COUNTY OF �j- The foregoing instrument was acknowledged before by this (/Jl day n by ,1�' Y�C`/l sC� wjw is-peksonally known V or has produced Signature of N04 ME �' Signature of No- LAPt sA LL Commission NI'n' eDlt[(�81ibN f F'E128�"� Commission N a fe pp,In t # 1 ti128426 EXPIRESSryrtembern7,2045. ,••;¢; EXPIRES Snialen.L.r01,2015 .._.. .. ...,. _.__ 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. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNERBUTAER APPLICANTS For specific instructions see appropriate permit checklist. OFFICE USE ONLY BP #. SECTION "�� TOWNSHIP �`� RANGE Lc �lJ y MAP NO. ZONING LAND USE L G LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # i`r` FLR ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC Before 171990 LOT OF REC After 111990 LOT SPLIT REQUIRED LOT SPLIT' APPROVED REPORT CODE. HABITABLE AREA (RADON) RADON FEE PERMIT FEE LIBRARY IMPACT FEE PUBLIC BLD IMPACT FEE CORRECTION PUBIC BD vffACT FEE GENERAL PARKS IMPACT FEE SCHOOL IMPACT FEE ROAD IMPACT FEE CREDIT Y N LAW ENF IMPACT FEE FIRE/EMS IMPACT FEE DRIVEWAY REQUIRED Y N DRIVEWAY FEE ADMINISTRATIVE VARIANCE FEE SPECIFY SUBS REQUIRED MECHANIC ROOF ELECTRIC GAS PLUMBING NON -CONFORMING LOT OF RECORD FEES MISCELLANEOUS FEES DATE SENT TO ADDRESSING: REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW. PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED �.. INITIALS _. C. OFFICE USE ONLY BP #: - SECTION. �r� i— TOWNSHIP RANGE Lio MAP NO. ZONING LAND USE LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # 1ST FLR ELV MAX HGT CONST TYPE OCCUP TYPE '.. MAX OCCUP # OF FLRS WATER SEWER - SPRINKLERS STORMWATER LOT OF REC LOT OF REC ''. LOT SPLIT LOT SPLIT Before 111990 After 111990 REQUIRED APPROVED REPORT HABITABLE RADON PERMIT CODE AREA FEE FEE RADON LIBRARY PUBLIC BID '.. PUBIC BLD PARKS IMPACT IMPACT FEE IMPACT FEE CORRECTION EE FEE GENERAL SCHOOL RO CREDIT Y N LAW ENE IMPACT IMPACT IMPACT FEE FEE FEE FIRE/EMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE IMPACT REQUIRED FEE VARIANCE FEE FEE SPECIFY MECHANIC ROOF _ NON -CONFORMING MISCELLANEOUS SUBS ELECTRIC GAS LOT OF RECORD FEES REQUIRED PLUMBING FEES DATE SENT TO ADDRESSING: REVIEWS FRONT ZONING. SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW JtEVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED INITIALS UIED !/v�/J//�' Y �✓ JUL 2'0 2012 Public Works St. Lucie County, FL. I r