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HomeMy WebLinkAboutApplication for Zoning ComplianceDATE FiI ED: cdd✓ �`� PLAN REVIEW FEE: I RECEIPT NO.: �— CONCURRENCY FEE RECEIPT NO.: — ALL INFO MUST BE CO L TE &FILLED IN a O 13k: A4.:t=x•r jr-., St.;Lucie County Building and Zoning _ 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 Rl '772-462.1553 APPLICATION for .BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PERMIT NUIVM ER= ® po CERT. CAP. NO.: �W PROJECT INFORMATION 1. LOCATIONISITE ADDRESS. 2. S/D NAME: �'DSITE PLAN NAME: 1 ? ? -/ - dd/ 3. PROPERTY TAX ID #: D ? a'_„ 90 4, LEGAL DgSCRII'TiON (attach extra sheets if necessary): vt I- U rvdfv5/ �E�4 s � �y3 s�� °» /� .�Fr� Nj a��ssiT 5. PLA,fi/�' / T / � NO. NO. �? - BOOK NO. ;{ & LOT DIMENSIONS 9. PARCEL SIZE: ACRES/SQ FT— �� � � hill • !" !7 1/ 5 C� 10. DESCRIPTION OF CON STRU ICOR WORK ACTIVITY: TION PR MCT 11. SETBACKS (ACTUAL) FRONT: /0l � /I BACK r y , �IDE (o� y /! SM I 0 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) INTERIOR RENOVATION[) NEW CONSTRUCTION [ ll E�TSION/ADDITION INDUSTRIAL RESIDENTIAL OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: 14. Sq. Ft/CONSTRUCTION: 0 1 Z 40 v o " � 15. Sq. Ft. 1st Floor: Z 16. VALUE OF CONSTRUCTION: S or The value of coastructiatt is used W d ° submitted figntes nopermit fees to t car, isteat with similar types ofe assessed. SL 1.116C County rccoa auction a95 the accat tones If value is6$25U0 more, a value of constriction if it is demonstrated application. car, RECORDED Notice of Commencement>tmst be submitted with thus SLCCDV Form No.: 001-02 OWNER INFORMATION NAME: ,, , z 14 (fo r AL Cd I Day Gl "h fiA ADDRESS: d l iU ` W5 H14%1, I CITY: �'�(Ge SPATE: __�— 21P PHONE (DAYTIIvIB): o /(3�®02 email: �o4rn,�'��GdIo��Gj�blhlf�,CeY 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: CITY: _ - ZIP PHONE (DAYTIME): (—) CONTRACTOR INFORMATION 9- q ST. of FL REGJCERT #: ST. LUCIE COUNTY CERT #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS- _ 2�0/ G�Z- CTPY: �-% PZ[ogco STAVE: ZIP PHONE (DAYTIME): ( , fir �/g= 7 I'AX NO. ErS ri A � -7 fix" email: ARCIRVENGINEER: ADDRESS: 5 4,to Cam. � a br� LL �r.�[, t STATE: R 1 PHONE (DAYTHv1E): C v1 ;Lq BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY- STATE: M STATE: _ ZIP IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notif cation it will be voided and returned to you by mail. :BP #• ::v ITICE USE ONLY.. :..>- jq/3 TOWNSHIP Zq s RANGE L 0 G / SECTION 3S yy� 4/1r\ LOT CVG % TAZ NO. ZONING R 1 ' �j ` LAND USE ! � + `J �l �1 FIRM MAP # �T ISTFLR ELV MAX HGT 3 FLOOD ZONE X V ` MAX OCCUP # OF MRS CONST TYPE OCCUP TYPE I SPRINKLERS STORMWATER WATER SEWER fteLOT SPLIT LOT SPLIT LOT OF REC LOT OF REC (ar UIItED APPROVED `K efare 1190) I/90) PARKS PERMIT ADMINST LIBRARY IMPACT FEE I EE VARIANCE IIYIPACT FEE / HABITABLE RADON FEE REPORT t,� PUBLIC FEE BID AREA CODE 'v)A� (RADON) GROSS ROAD CRED TOTAL ROAD SCHOOL IMPACT FEE , IMPACT FEE R IPACf FEE . DUE : <- TOTAL SCHOOLCREDIT a�tf : , mz , ; SCHOOL IIvIPACf Fi:B DRACT FEE LICE FEE MISC FEE lpo PO CEME 11� I o 0. MISC m TOTAL ADDITIO L Y N SPECIFY of ALL PERMITS FEES RE REVIEWS ZONING ZONING PLANS NUSC. VEGEfATiON SEA TURTLE MANGROVE R�EjVIEWED BY EX/AM�IINNGG I CERTmc ATION: to obtain a certificate of capacity. application is hereby made to obtain a Pest to do the work and installations as indicatet issuance of a permit and that all This that no work or installation has commenced prior if, applicable, for the permitted work' I certify urisdiction I understand that separate permits construction in this jurisdiction BOILERS, yMTERS, TANKS, work will be performed to meet the standards PLUMB] SIGNS, WEIV, POOLS, nay be required for ELECTRICAL, t a lication. r�D AIR CONDITIONERS, ETC., not otherwise included with this building Permit PP from undergoing a full concurrency review: room additions, accessory The following building permit applications are exempt screen zooms, utility substations & accessory uses to another non structures (all types), swimming Pools, fences, walls, signs, residential use, T MAY RESULT IN YOUR FAILURE TO RECORD ANOTICE OP SOMIVIEN PROPERTY' NOTICE TO OWNER: IF YOU INTEND TO P16gN r TWICE FOR J11r1PROVENIENT YOUR LENDER OR AN ATTORNEY BEFORE OBTAIN 9NANCINiG, CONSULT WITH RECORDING YOUR NOTICE OF CONB ENCEMENT- FORTHIS BUILDING PERMIT, ]F IT IS NOT YOUR RIGHT TITLE AS THE APPLICANT A CONDITION OF THIS NOTICE TO APPLICANT: AND FST THAT IS SUBJECT TO ATTACHIVEI�T' A COPY OF _ PERMATTACHED IT YOU PRO LIEN L WGNOTICE TO TTIE PERSON WHOSE PROPERTY IS SUBJECT CONSTRUCTi0_ TO ATTACMdENT- 'A J�I certify that all fire foregoing information u accurate and that all work will be done incompliance OWNERS AFF1A with al� applicable laws regulating construction and zoning. CONTRp,CTOR SIGNATURE Oy�g/CONTRACTOR SIGNAi uici;', ,n^°;" STATE OF FLO A a:a COUNTY OF STATE OFk�-O� < �' y: oCOUNTYOwIdged going instrument The fort Y instrument was owled' ed �, befor me this�Ly of The foregoing �20© by !I Wv_, u, �'-��r_dc? ,rho is personally before me ' �1 day of who ersonally g �' z ' 312C,03 A ta e wn to a or who has produced osxa a -0 � s zo as identification. I to a or who has produced a x a as identification. a "5 � CO) o w m Signature of No Signature oY CD y �`� Type or Print 44ame of Notary Type � ameof Notary. Commission No. -----tSedI Commission No. __ (Seal) NOTE- TWO (2) SIGNATURES ARE REQU M' EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THLS BUII,ING PERMIT AS AN OWNER/BUILON THE FRO THE APPR MUST LICATYON.Y APPEAR TO SIGN THIS APPLICATION IN TA E OFFICE LISTED For specific instructions see appropriate permit cbeddist.