HomeMy WebLinkAboutApplication for Zoning ComplianceOFFICE USE ONLY: y
DATE FILED: ' t'OY
PLAN REVIEW FEE: RECEIPT NO.:
C:ONC:URRENCY FEE: RECEIPT NO.:
PERMIT NUMBER:
CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
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St. Lucie County Building and Zoning
2300 Virginia Avenue
• ��ORt�p • Ft. Picrcc, FL. 314982-5652
772-462-1553
`4- .-H-- a 8 D fo ~ a 0 71)
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJEC1' INI
1. LOCATION/STTF ADDRFSS: 2012 ROYAL FERN CT
2. PROJECT NAME: ROYAL FERNVILLIAGE SITE
3. PROPERTY TAX ID #: 4425-605-0020-000-0
4. LEGAL DESCRIPTION (attach extra sheets if necessary):
(44/26N) (OR 2660-2261)
5. PLAT BOOK 6. PAGE NO.
9. PARCEL, SILL'• (ACRES/Sty IT.): N 0 I 0 L,OT
1.0. COMPLETE DESCRIPTION OF CONSTRUCTION
BREAKFAST ROOM ADDITL.ION
11. SETBACKS (ACTUAL) FRONT: BACK:
12. TYPE OF CONSTRUCTION (Check. all appropriate boxes)
[A NEW CONSTRUCTION [X] EXPANSION/A]
[X] RESIDENTIAL [ ] COMMERCIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE:
NEW LIVING SF
14. SQ. FT OF CONSTRUCTION: 521 SQ FT
TTON
NAME:
HARBOUR RIDGE
RIDGE-PLAT-6-ROYAL FERNVILLIAGE UNIT 6
7. BLOCK. NO. 8. LOT NO.
OR. WORK ACTIVITY: BEDROOM, BATHROOM,
16. VALUE OF CONSTRUCTION: $ . ��� 1 --".
RIGHT SIDE: V7 YJ LEFTSIDE,-:(5-20
[ ] . INTERIOR RENOVATION
[ ] INDUSTRIAL
15. SF. FT Ist FLOOR: 521 SQ FT
Iq� 9W �v
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 construction if itis demonstrated that the submitted figures are not consistent assessed,
similar types of construction activities. If the value is $2500 or more. a
RECORDED Notice of Commencement must be submitted with'this application.
SLCCDV Form No.: 001-02
OWNER INFORMATION
NAM.F..: RICHARD J CHABOT
ADDRESS: 2012 NW ROYAL FERN CT
CITY: PALM CITY STATE..:
PHONE (DAYTIME): (413 ) 626-2565
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER: NA
ADDRESS:
CITY: STATE: _
PHONE. (DAYTIME): (_)
CONTRACTOR INFORMATION
ST. of FL REG.CERT #: CBC047770 S
BUSINESS -NAME: JEFFERY J PAULY CONSRTUCTION INC.
QUALIFIERS NAME: JEFFERY JAMES PAULY
ADDRESS: 2420 SW MAPLEWOOD DR
CITY: PALM CITY STATE: F
PRONI3 (DAYTIMFI ): (772 ) 263-8268 FAX NO. 71
ARCHIT/F.NGINEER: DON J. NUELLE, P.E. #52046
ADDRESS: 6304 GARRETT ST.
CITY: JUPITER STATE:
PHONE (DAYTIME): (561 ) 629-6975
NA
BONDING COMPANY:
ADDRESS:
CITY: STATE:
MORTGAGE LENDER: NA
ADDRESS:
CITY: STATE:
ZIP: 34990
Email: richardchab@comcast.net
'FERENT FROM THE OWNER LISTED ABOVE. PLEASE
LUCIE COUNTY CERT #:
ZIP:
10811
ZIP: 34990
159 F_mai1: 11Pcbc@comcast.net
ZIP: 33458
ZIP:
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.
CERTIFICATION:
This application is hereby made to obtain a permit to do the work- G
if applicable, for the permitted work..I certify that no work or insta
work will be performed to meet the standards of all laws regulating
may be required for ELECTRICAL, PLUMBING, SIGNS, WI
AND AIR CONDITIONERS, ETC., not otherwise included with
The following building periiiit applications are exempt from
structures (all. types), swimming pools, fences, walls, signs,
residential use.
installations as indicated, and to obtain a certificate of capacity,
ion has commenced prior to the issuance of a permit and that all
istruction in this jueisdiction. I understand that separate permits
.S, POOLS, FURNACES, BOILERS, HEATERS, TANKS,
building permit application.
going a full concurrency review: room additions, accessory
rooms, utility substations & accessory uses to another non -
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IM1PROVt.MENTS TO YOUR PROPERTY. IF YOU INTEND TO
' OBTAIN I-INANCING, CONSU.T WITH YOUR LENDER OR AN ATTORNEY BEFORE
RE;CORDIN6 YOUR Nuncii 6i� COMMI`NCEMENT.
NOTICE TO APPLICANT: AS THE APPLICANT FOR
PERMIT YOU PROMISE IN G
CONSTRUCTION LIEN LAW
TO ATTACHMENT.
OWINER'S AFFIDAVIT: I certify that all the foregoing
— with all applicablelawstrc�ul
-
STATE OF FLORIDA 11�* y
COUNTY OF , I .
The foregoing instrument was acknowledged befo
e! R'
C,:::: 1, Ta
me this day of G) 20
W
by
who is personally
�own or has produced
identifi6tion.
ILI
A1
Signature of tart' v
Commission No. (Seal).
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH
THIS BUILDING PERMIT AS AN OWNER/BUILD
THIS APPLICATION IN'THE OFFICE LISTED ON
OWNER BUILDER AFFIDAVIT WILL BE REOUIT
BUILDING PERMIT, IF IT IS NOT YOUR RIGHT, TITLE.
'CT TO ATTACHMENT AS A CONDITION OF THIS
)D FAITH TO DELIVER A COPY OF THE ATTACHED
)TICE TO THE PERSON WHOSE PROPERTY IS SUBJECT
oration is accurate and that all work will be done in compliance
construction and zoning.
C(�3r)[IMCWR SIGNAWRE
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before
oZ. day of (—_L.Z2 .200 � ,
of
or has produced
as identification.
No. (Seal)
'qATURE MUST BE NOTARIZED. IF APPLYING FOR
THE OWNER MUST PERSONALLY APPEAR TO SIGN
E FRONT OF THIS APPLICATION.
FOR ALL OWNER/BUILDER. APPLICANTS.
For specific instructions see appropriate permit checklist.
C)rIT10E USE ONLY BY #:
SECTION
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MAX HC;1'
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LOT OF REC
LOT OF R.E.0
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LOT SPLIT
Before I/I990
After I/1.990
RI3QUIKF:sI)
APPROVED
REPORT
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SPECIFY
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St1.13S
ELECTRIC GAS �~
LOT OF RF..COItD
FEES
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REQUIRED
PLUMBING �
FEES
DATE SENT TO ADDRESSING:
RF.,V►F,V4'S
FRONT
70NING
SUPERVISOR
PLANS
VEGETATIOi`i
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
�
RECEIVED
f
by
COMPLETED