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Home My WebLink AboutApplication for Zoning ComplianceM IZ flee DATE FILED: t: `� �� PLAN REVIEW FEE: SO- R7);CEIPTNO.: <4IJ7'l PERMIT NUMBER: O7d5 C4-)H CONCURRENCY FEE: 150 RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED /:;a tiv 7,b -L C?VA C\ D �- SO I�St. Lucie County Building and Zoning 2300 Virginia Avenue "� �qP R1 4- Ft. Pierce, FL 34982-5652 C Lt � i6rA f 772-462-1553 APPLICATION for BUILDING PERMIT Y CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. 2. 3. 4. 1Y LOCATION/SITE ADDRESS: � t' 1131 S/D NAME: - SITE PLAN NAME: PROPERTY TAX ID LEGAL DESCRIPTION (attach extra sheets if necessary): \ (a v -- to 5. PLAT 6. PAGE 7. BLOCK 8. LOT BOOK NO. 'I NO. NO. 9, PARCEL SIZE: ACRES/SQ FT. LOT DIMENSIONS 11 X ]"X) 10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: It. SETBACKS (ACTUAL) FRONT: BACK: RIGHT: LEFT: Krej�j-. SIDE SIDE _Q ' 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION INTERIOR RENOVATION >y ' RESIDENTIAL [ ] COMMERCIAL ] INDUSTRIAL [ ] OTHER (SPECIFY) �tJC�c" S� T� A 13. DESCRIPTION OF PROPOSED USE: 14. Sq. Ft./CONSTRUCTION: 15. Sq. Ft. Ist Floor: 16. VALUE OF CONSTRUCTION: $�� 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 90fistruction 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 RECOROPI) Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 OWNER([i INFORMATION NAME: X r Mfg.. r e7A CITY: Y'kxyVN LitEH ` STATE: V-A-- ZIP -6441:iU PHONE (DAYTIME): ( ) 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: CITY: STATE: ZIP PHONE (DAYTIME): CONTRACTOR INFORMATION �^s ST. of FL REG./CERT #: CF ) C n L4'-) BUSINESS NAME: 15 QUALIFIERS NAME: �' - f �.. CITY: p STATE: PHONE (DAYTIME): O ARCHIT/ENGINE]ER: Cn�L- ADDRESS: , , l r),A CITY: SRA0.� STATE: PHONE (DAYTIME): a gL7460' BONDING COMPANY: 111-tC ADDRESS: v ST. LUCIE COUNTY CERT #: ZIP -27-P 0jq 0 ZIP CITY: � STATE: ZIP / MORTGAGE LENDER: ` Pr ADDRESS: CITY: STATE: ZIP IMPORTANT NOTICE: When a permit is issued and it is not picked up within AlLan after notification it will be voided ad returned to you by mail. CERTIFICATION: This applicg[jon 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. O C SIGNA STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this l day of )i is , 202, by a who is personally known to me or ho has produced Li'1-NM4,j054p;1 o as identification. --A, T Signature of Notary 7 ype or Print Name of Notary Commission No. (Seal) 0 CaTRAC-T0&SITrkn1 TAATE OF FLORIDA g OUNTY OF SA (A 8e _ e foregoing instrument was acknowledged fore me this I `I day of AaL, 20e by s 9 65. - 1 1who is personally nown to me or who has produced L F_% as identification. Liz 3 L Signature ofNota�ry Type or Print Name of Notary Commission No. (Seal) NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THE APPLICATION. For specific instructions see appropriate permit checklist. QFFICTFB . SECTION /••f► L V TOWNSHIP 27s RANGE ZONING LAND USE LOT CVG% TAZ NO. FLOOD ZONE FIRM MAP # ( 1ST FUR FLY MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC (after LOT SPLIT LOT SPLIT (before 1/90 1/90) REQUIRED APPROVED E 55 °^�,..3 .:.:n.._K' .:. .ua,vt..i3`ev PERMIT ADMINST LIBRARY PARKS VARIANCE IMPACTFEE IMPACT FEE FEE REPORT l� PUBLIC BLD HABITABLE RADON FEE CODE �O') IMPACT FEE AREA ��_•/�\\ DON SCHOOL GROSS ROAD DIT Y N TOTAL ROAD IMPACT FEE IMPACT FEE IMPACT FEE DUE SCHOOL CREDIT Y N TOTAL IMPACT FEE SCHOOL :; IMPACT FEE POLICE FEE FIRE FEE MISC FEE TOTAL POLICE/FIRE MISC FEES ELEer4-1e. ADDITIONAL Y SPECIFY TOTAL PERMITS �� of ALL REQUIRED FEES t F t: ,_i REVIEWS ZONING ZONING PLANS MISC VEGETATION SEA TURTLE MANGROVE REVIEWED BY EXAMING DATE s COMPLETE INITIALS 44 -