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HomeMy WebLinkAboutZoning ComplianceI�f)t*SNIY- DATE FILED: 'ego O PLAN REVIEW FEE:QQ RECEIPT NO.: ®� 1? y� PERMIT NUMBER:3�.�s9d� CONCURRENCY FEE: RECEIPT NO:: - CERT. CAP. NO.: ALL INFO MLiST B . COMPLETE 8i FILLED IN TO BE ACCEPTED ST. LUCIE COUNTY PUBLIC WORKS (� BUILDING & ZONING DEPARTMENTl OX 2300 VIRGINIA AVENUE •. '20RIOQ FORT PIERCE. FL 34982-5652 tztlt� -561-462-123/ in APPLICATION for BUILDIN PERMIT - ~� CERTIFICATE of CAPACITY/ZONING COMPLIANCE - PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: O / Z O S t'-of 2. S/D NAME: /�/i4 SITE PLAN NAME: 64A 3. PROPERTY TAX ID #: 4. LEGAL DESCRIPTION (attach extra sheets If necessary): Ice a ZjLa c G. �1 \0 5. PLAT. 6. PAGE 1 s / 7. BLOCK 8. LOT BOOK 16, $ ONO. NO. L? 916' Z� 9. PARCEL -SIZE: ACRES/SO FT. 0 y I q AD LOT DIMENSIONS ? 2 r" G 2 �10. DESCRIPTI& OF C N AUCTION PROR WORK ACTIVITY: G o01 S CA r. po� '?,d 1.. SETBACKS (ACTUAL) FRONT: - r BACK: 10 TYPE OF CONSTRUCTION (Check all appropriate boxes) P. NEW CONSTRUCTION [ j RESIDENTIAL [ j OTHER (SPECIFY) - 9 .f If -do — � / ; RIGHT LEFT 15' SIDE SIDE: [ ] EXPANSION/ADDITION D COMMERCIAL yo.. / 4 To,-r— . [ ] INTERIOR RENOVATION [ ] INDUSTRIAL DESCRIPTION OF PROPOSED USE: Sq. FtJCONSTRUCTION:. 0 2.-Y 15. Sq. Ft. 1st Floor 0 Z `1r VALUE OF CONSTRUCTION: $ g 0 000 Vof omtrucffm Is used to determine the amount of permit fees to be assessed. St. Lucie County reserves the right to question and/or modify the ue of construction If it Is demonstrated that the submitted figures are not consistent with similar types of construction activities. If the value is $2500 CORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 OWNER INFORMATION: / // // NAME: ra �� o�+ D v e (o •-,eti 7` �o.—, ah L L C ADDRESS: I 3SD /`.O t t n T a �M �i� e v &"v ' s c L O CITY: P S L- STATE: ZIP 3 y G PHONE (DAYTIME): _(.77. Z) 3 Vo - 3 S o o 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 REGJCERT 9: ST. LUCIE COUNTY CERT 1 �S� BUSINESS NAME: k4 /%H 7 ' 7(i✓//ra QUALIFIERS NAME: %�o !o a r. 7"' / 7.' c `i l! ' ' ADDRESS: %J. //"le.-C�oo.� CITY: Or �rt.ny� D 'STATE: ICZIP 3 7 8Z i PHONE (DAYTIME): (Yo7 t 370 - y,-o o ` FAX NO. Ya 7 3 70 - yY q y ARCHIT/ENGINEER: ADDRESS: CITY; ;PHONE (DAYTIME): BONDING,COMPANY. ADDRESS: CITY: of b It (10r) vyy - y6 9/ .,.STATE: -_,4' .L ZIP STATE: ZIP MORTGAGE LENDER: ADDRESS: Cam' STATE: ZIP IMPORTANT NOTICE: When a permit is issued and it Is not picked up within_ 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. 1 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: 1 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating cons o and zoning. O ERIC TRACTOR SIGNATURE T OR SIGNATURE STATE OF FLORIDA COUNTY OF Sf. I The foregoing instrument was acknowledged M me this /67 day of , 20S by W . who is pe ona(( v known to me or who has produced DA • .1 L fL As identification. ignature o04ota type or P174 Name of Notary Notary Public Title STATE OF FLORIDA COUNTY OF )L%Lt)64_ The foregoing instrument was acknowledged ore me this day of . 20 , by , � �Itao, who is personally known e o has produced asidentification. . 2L,_70jW ✓Signature of Notary Type of Print Name of Notasei •.,, �,; Patricia Ann Miller Notary Public TitleWCoMMi h Z.2006 ,r B0MXDTHRUiR0YFMWSUk4jn , Commission Number Commission' Number (seal) �aiKeta�, AUDREY B. HUMPHREY (Seal) =0. MY COMMISSION # DD 190387 EXPIRES: MarchB 2007 '1pF F°e Bonded 7hru Notary Public Underwriters DOTE: TWO IRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNERIBUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. 4 BP #:. 4z?0?05 ....:.....:.:.................. .... ::.:. .......:................:: ;... . SECTION: �,� TOWNSHIP: RANGE: MAP NO.: CJ ZONING: �! ,` LAND USE: / C LOT CVG %: TAZ NO.: FLOOD ZONE: ' FIRM MAP #: 1ST FLR ELV: . MAX HGT: CST TYPE: OCCP Ar�( r� �l ICY TYPE: OCCP: # OF FLRS: WATER: SEWER: SPRINKLERS STORMWATE R LOT OF REC (befr 1/90) LOT OF REC (aftr 1/90) LOT SPLIT LOT SPLIT REaD I APPRV'D DECAL NUMBER LIBRARY IMPACT FEE PARKS IMPACT FEE PERMIT FEE REPORT PUBLIC BLDG HABITABALE RADON FEE CODE IMPACT FEE AREA j5 (RADON) Y N ROAD GROSS ROAD DIT TOTAL ROAD IMPACT ZONE IMPACT. -FEE., IMPACT FEE DUE SCHOOL C REDIT Y N OT TAL IMPACT FEE SCHOOL IMPACT FEE POLICE FEE FIRE FEE MISC FEES: TOTAL POLICE/FIRE/ MISC. FEES Y N ADDITIONAL,. , "SPECIFY: TOTAL ALL .. . PERMITS.:•:.: - <' FEES REQ'D REVIEWS ZONING ZONING PLANS VEGETATION SEA - MANGROVE REVIEWED BY EXAMINING TURTLE COMPLETE INITIALS All , f� v 0 CEi �-T f D PLAN RE RECEIPT NO.: CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED St.- Lucie County Building and Zoning 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 561462-1553 Ce en' 23010 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. 2. 3. 4. 5. PLAT 6. PAGE 158 7. BLOCK.-;-.�,1�.r..,'%-, BOOK - NO. NO. I 8. LOT NO. 9. PARCEL Sim, ACRES/SQ Fr. LOT DIMENSIONS .......... 10. 11 12. 13. SETBACKS (ACTUAL) FRONT: imBACK: RIGHT: LEFT: S SIDE IDE 4.4154 14. Sq, Ft./CONSTRUCTION: 024 15. Sq. Ft. I st Floor: 16. VALUE OF CONSTRUCTION: $0 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 it is demonstrated that the submitted figures are not consistent with 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 1 CONTRACTOR INFORMATION ST. of FL REG./CERT #. G _ G.:z2 J . <b { ST. LUCIE COUNTY CERT ARCHIT/ENGINEER: :..:.. .:. . .:.: ADDRESS: 8QO Douglas Entrance } _: _... CITY. Coral Gables; 3 STATE: r ZIP PHONE (DAYTIME).( BONDING COMPANY: ADDRESS: CITY....:.,_: MORTGAGE LENDER. NIA ....:... .... ADDRESS: STATE s: 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 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. OWNLt /CONTRACTOR SIGNATURE I CONTRACTOR SIG ATURE STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this _ day of , 20_, by , who is personally known to me or who has produced as identification. Signature of Notary Type or Print Name of Notary Commission No. (Seal) STATE OF FLO COUNTY OF The foregoing instrument w.knowledged fo me s/ d y of 16 ;�_, U w o is personally known to me or who has prod ced s identification NEILE TRUMBO Type or rini'gTsffie of 1, Y S: dune 2, 2006 t -aM3NOTARY FL Notary Service $ Bwft, Irta Commission No. ea NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILING PERMIT AS AN OWNERBUILDER, 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.