HomeMy WebLinkAboutApplication for Zoning Compliancep�cr'vst'- LY: 3 091L. O107
DATE FMED: FIE NO-: � PERIvITT :VU1v1BER:
PLAN REVIEW FEE: RECEIPT NO.: — CERT. CAP_ NO.:
CONCit-RRENCY FEE:
Ag,1L Ti. FO lyrUS Fi' jBF, C0TM:'L.L�+ `TIE Ii+ +��� �N �® BE ACCEPTED
-� St_ Lucie county )EaJal€�inanda�Z�s��1g
a' s ? {_ 2300 Virginia Aveaue
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Ft Pierce, FL 34982-5652
o OFF—m-462-1553
APPLICATION for BUILDING G ]PERMIT
CERTIFICATE ®f CAPAACHTi YJZON-I G COMPLIANCE
pROjECT I-L\FORMATION'
r ( e-o f 3S
LOCA
SID NAME: , u 1UJ
PROPERTY TAX ID
LEGAL DESCRIPTI'
w N � LYt`rr - ,
PLAT 6. PAGE 7. BLOCK 8. LOT
BOOK S�� NO. �1� NO y (o NO.
7.'i /fV'% .OT D NSIONS n
PARCEL STLE: ACRESJSQ FT. - �7�n
A 1.t5�1/ r2�la6;/e /dine 40f xll
DESCRIPTION OF CONSTRUCTION PROJECT OR WORK A('TIVITY:
L' 1 LL!J SITE PLAN NA M-U:
a: IL133 —Ia-o �v/D^3� �- 1Yv N 3�6
)1,i (attach extra sheets t necessary):
V)B-F IA5-1 anA bC2&-'' SW 41''4 N �CoS.
� F—f
a-' S
LEFr�
! r/
11. SETBACKS (ACTUAL) FRONT: BACK:S t RIGSIDEET. SIDE. -� �5 '"
12. TYPE OF CONSTRUCTIOi I (Check all appropriate boxes)
[ ] NEW CONSTRUCTION[ ] EXPASITSION/ADDITION [ ] J VTEMOR RENOVATION
DMUSTRLAL
['kOTBER(SP se
(SPECIFY) rrtid� rveGSrje �'ro —
13. DESCRIPTION OF PROPOSED USE: 3 F
14. Sq. Ft./CONSTRUCTION: 15. Sq. Ft. 1st Floor: r 03 d-
16. VALUE OF CONSTRUCTION: S a
The value of construction is used to determine, the amount of pernut fees to be asswc& St Lucie County reserves the rigbtto question and/or modify the indicated
vatue of contrition if it is demonstrated that the submitted fia'ures are aotconsisteat xith a"ribr types of eonsttucficn activities. If the value is $2500 or more, a
RECORDED Notice of Cemmeneeae-at must be submitted with this anptietloa
SLCCDV Form No.: 001-0-1
OWNER INFORMATION
NAME: Ff rle ge^6 4 y(
ADDRESS: 6L0 D / /V • U.S-4
CITY: F+ • P+ e !4c e
PHONE (DAYTIM[E): (y�b Y7 7Gb
STATE: t l ZIP:
Email:
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:
STATE:
PHONE (DAYTIM[E): (---)
CONTRACTOR INFORMATION
P
ST. of FL REG.CERT #: -T ff 0000 O 77 ST. LUCIE COUNTY CERT #: p2 �I O C2
BUSINESS NAME: UA.Mr v G k O�JJT 1 �j
QUALIFIERS NAME:
ADDRESS- 7 5T I C.S 40 T /
CITY: a, 44- C r 7 l STATE: F ' ZiP:
PHONE (DAYTIM[E): AA) A I.S - 37.3 D FAX NO.
ARCHIT/BNGIlVEER: �T LEI O o
ADDRESS: %S0 j"MA, Pr
CITY:PSI- STATE: F ZIP:
PHONE (DAYTIM[E): �� - 775' 7 3A q
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE:
STATE:
rAi•
A
EVIPORTANT 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.
r
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, 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 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: 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.
le—.% l I e.4L.�
OR CONTRACTOR SIGNATURE
STATE OF FLORID& �_ '; STATE OF FLORID
COUNTY OF COUNTY OF
The foregoing instrument was acknowledged befo
The foregoing instrument was acknowledged before
,r
me this day of !�
.20 OW
0' cs
�. x o fl
V
, ., g.
me this day of s t/'
20co
=
,
Y
VP
who is personally own
or has produced
o w
who is personally own or has produced
Z m �
as identification.
as identificatio
. _ - z
c rn�
C,
aMo�i
Signature of tary
Signature Votary
Commission No.
(Seal)
Commission No. (Seal)
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. 1F 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 OWNER/BUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.
OFFICE USE ONLY BP #.-,., OX/l. OM7
SECTION
TOWNSHIP
C
RANGE
tD
MAP NO
Y/ 33/0,
ZONING
m
LAND USE
rJ
LOT CVG %
33,91
TAZ NO.
FLOOD ZONE
FIRM MAP #
-7 7�r
13'rFLRELv
MAX HGT
CONST TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER.
LOT OF REC
Before 1/1990
LOT OF REC
After 1/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
HABITABLE,
AREA
(RADON)
RADON
FEE
PERMIT
FEE
LIBRARY
IMPACT
FEE
PUBLIC BLD
IMPACT FEE
CORRECTION
PUBIC B
FN!:
PARKS
IMPACT
FEE
SCHOOL
IMPACT
FEE
ROAD
IMPACT
CREDIT
Y
N
LAW ENF
IMPACT
FEE
FIREtEMS
IMPACT
FEE
U
Ay
QUIRED
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
(10�
0
DATE
COMPLETED
INITIALS