HomeMy WebLinkAboutZoning ComplianceK;�, DATE FILED: Q �(� h�
59
PLAN REVIEW F�E •D IrCM-�1GRECEIPT NO.: 7% PERMIT NUMBER: `J
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTE
w St. Lucie County Building and Zoning
2300 Virginia Avenue
ORiOp' • Ft. Pierce, FL 34982-5652
772-462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING
1 COMPLIANCE
N�
PROJECT INFORMATION =Cz-
I. LOCATION/SITE ADDRESS: -StAl %q5 11S N\G\1WhU oAs' I fbILT ST Lucie 4/0/62-
2. PROJECT NAME: (o E 1S "x" CW &ITE PLAN NAME: SAM r.
3. PROPERTYTAXID#: 34\N^Sol- 191a-• 90o^(0
4. LEGAL DESCRIPTION (attach extra sheets if necessary): AN'ret c—SmeA
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 3 8. LOT NO. 1 Vj j I IL S-
9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS:
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: 1 nlrc-c)m r' FiU1`40L%+
A. f- n. Qn (: n:....c L-9i
11. SETBACKS (ACTUAL) FRONT:Nf_ BACK:Q tft RIGHT SIDE;_ LEFT SIDE: Q JP�—
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
[) NEW CONSTRUCTION [) EXPANSION/ADDITION [) INTERIORREN6VATION
[) RESIDENTIAL [ ] COMMERCIAL [ I INDUSTRIAL
[�} OTHER (SPECIFY) (Y\� t r \oY but �d out'
13. DESCRIPTION OF PROPOSED USE: C lr\ urth
14. SQ. FT OF CONSTRUCTION: 15. SF. FT 1st FLOOR
16. VALUE OF CONSTRUCTION: $ 39l tio. OD
The value of contraction is used to determine theamount of permit fees to be assessed. St. Lucie County reserves the right to question and/or modify the indicated
value of constntcdon if it is demonstrated that the submitted figures we not consistent with similar types of contraction activities. If the value is S2500 or more, a
RECORDED Notice of Commencement most be submitted with this application.
S CCDV Form No.: 001-02
;_
v
OWNER INFORMATION
NAME: e Ome�ss w1C
ADDRESS:: SOS L1 204y S�'rQe},
LL�
106..I._
h
STATE:
Pr0- ZIP: 2 52 03
CITY: ��r�:��s�., tir
PHONE (DAYTIME):L Z) 2fi4 bb ylo
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
ST. of FL REG.CERT #:
ST. LUCIE COUNTY CERT
BUSINESS NAME -D S)rckANOO U�\f�\nQ
�es%cKa�'\nr �VIC
QUALIFIERS NAME: \
-t�J¢sar
3533 -�DYar Sa- Ca1C�R.
ADDRESS: 1391 mW S1-.'"lut\e,
(31\ld
4 1 d (c
CITY: 000 - S)r . k I t c �
STATE:.
- ZIP:
- &
PHONE (DAYTIME): (Z_� Sol - -31X Z o3.:
FAX NO.
'BOo T 25 S 0141 Email: S4 5-C Ske'-ama WM
' ARCHITIENGINEER
ADDRESS: Deegn
CITY: ,eV�S A (}je at:.
STATE:
ZIP:
PHONE (DAYTIME): Mt—) I,aL_5909
BONDING COMPANY:
...
ADDRESS:.
CITY:
STATE:
ZIP:
MORTGAGE LENDER:.
ADDRESS:
CITY:
STATE:
ZIP:
IMPORTANT NOTICE: When apermit
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 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.
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 usesto 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.
OWNfi '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.
n
STATE OF FLORIDA
COUNTY OF 5f. LMC_ \E
The foregoing`` instrument was acknowledged before
me this ,5 \—lay of _20_C>J
by _tai/ 1 A Z P e_ d f _..
who is personally known _ or has produced
of Notary
Commission
SUSIETETREAULI
MY GQtIdMI tON It DD 673692
EXPi tember 13, 2011
Bon"dI to Nuiery PWIG Uu Wters.
CONTRACTOR SIGNVrUw
S
�9V %o s• aTBPiv4t
STATE OF FLORIDA
COUNTY OF 5* LtAc AE '
The foregoing instrument was acknowledged before
me this .2 4_day of SE eT- .200_,
by 'b A.I k D S. S'S!E
who is personally known' or has produced
as identification.
Signature of Nntnrv_
SUSIETETREAULT
,g4,`••.
Commission MY COMMISSION k692
a•. EXPIRES: September t3, 7 11
%'F„•yfm BoMetlThm No" Pubk UMOK16ters
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILDING PERMIT AS AN OWNER/BUILDER, DER, 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 #: - LA59
SECTION
�1
TOWNSHIP
i6
RANGE
l
"l
MAP NO.
ZONING
LAND USE
-�J '
LOT CVG %
TAZ NO:
FLOOD ZONE
'FIRM MAP #
I"T FLR ELV
MAX HOT.
CONST TYPE
v5
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 BLD
IMPACT
FEE
PARKS
IMPACT —...
FEE
SCHOOL
IMPACT
FEE
ROAD .'',_�
INTACT :�_ •'
FEE ,...
'.
CREDIT
Y
N
LAW ENF
.IMPACT
FEE:.
.
.
FIREIEMS
IMPACT
FEE
DRIVEWAY
REQUIRED
.,
ly
N
DRIVEWAY
FEE
ADMINISTRATIVE
VARIANCE FEE
SPECIFY
SUBS
REQUIRED
MECHANIC ROOF
ELECTRIC GAS --=.'.
PLUMBING L ::i
T
.:
NON -CONFORMING
LOT OF RECORD
'FEES
-
MISCELLANEOUS
FEES
DATE SENT TO. ADDRESSING:
REVIEWS
FRONT
CO
ZONING
REVIEW
��SUPERVISOR
REVIEW
PLANS
REVIEW....
VEGETATION
RE W
SEA TURTLE
REVIEW
MANGROVE
-REVIEW..
DATE
RECEIVED
1
DATE
COMPLETED
INITIALS