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HomeMy WebLinkAboutApplication for Zoning ComplianceOFFICE USE ONLY: DATE FILED PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER: CONCURRENCY FEE: J • RECEIPT NO.: CERT, CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED LOPMENT SERVICES DEPARTMENT BUILDING ODE REGULATIONS DIVISION 00 Virginia Avenue •--77� '" OC— ® Ft., fierce, FL 34982-5652 // 772-462-1553 _ ` S' 4e AP or BUILDING PERMIT C?a. CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION C—P Of r4e 1. LOCATION/SITE ADDRESS: 3 1 O Z4- j �J Dc.IS M—LA (-' -AQ V-7 l id E— 34114 2. PROJECT NAME: SI�T�E, PLAN NAME: krE:- vs'i Pt:-L- AA g . t--m-p 3. PROPERTY TAX ID #: L- �G4' 01 0 S UV/ 4. LEGAL DESCRIPTION (attach extra sheets if necessary): lCf --� _2l� L V- r A-ie- R?q: t%jo , pAe* 5. PLAT BOOK { 6. PAGE NO. 7. BLOCK NO. 8. LOT NO. 9. PARCEL SIZE (ACRES/SQ FT.): � N,ln -SLOT DIMENSIONS: 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: M � caL. BL.�C / ft rCC 11. SETBACKS (ACTUAL) FRONT: BACK N RIGHT SIDE: ��°� LEFT SIDE: t 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) ! 13. DESCRIPTION OF PROPOSED USE: ., 14. SQ. FT OF CONSTRUCTION: �� tv 15. SF. FT 1st FLOOR: 16. VALUE OF CONSTRUCTION: $�, Grp 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 ^Y — I/.#LjA%! n !mil/ �, , /( 9 f� UPDATED 6/25/09 0 OWNER INFORMATION NAME: ti ADDRESS: CITY: w—; P -IF STATE: G_ ZIP: 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:' I ' � `"V ,u-tj ` �P ADDRESS: Xtao V I Ltii CITY: STATE: ZIP: --���J�,,,N 6 2, PHONE (DAYTIME): U CONTRACTOR INFORMATION ST. of FL REG. CERT #: � � ��I ST. LU-CIIEE COUNTY CERT #: c; ! 7" T V BUSINESS NAME: KJA QL4A-� C�O►�9S'TQ(.f�-�t i�'�-� .»" G(� Lie — QUALIFIERS NAME: ADDRESS: 360 '�(� �Z=55 L A-"o t.,46 -i>-Zi U t; CITY: LPX K r;a STATE: PHONE (DAYTIME): �?��2-FAX NO ARCHIT/ENGINEER aDnRFgq. 2 2 S lj Ci 0-A-kA -&v E ZIP: 2-7 CITY: STATE: ZIR S S6 © 3 PHONE (DAYTIME): BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: STATE: 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. 1 1 1 1 1 1 1 i i 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, FENCES, ETC., not otherwise included with this building permit application. St. Lucie County makes no representation that its granting of a permit will authorize the pen -nit 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 uses to another non- residential use. NOTICE TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOBSITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT TO ATTACHMENT: AS A CONDITION OF ISSUANCE OF THIS PERMIT, YOU PROMISE IN GOOD FAITH TO. DELIVER A COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. OWNER OR C N RACTOR SIGN TURF m STATE OF FLORIDACONTRACT GNATURE Z ARSTATE OF RI Z D � - o CO F •� �.. D m COUNTY OF2Lz s COUNTY OF . c The foregoing instrument was acknowledged before W o 9 The foregoing instrument —was acknowledged before me.this davof-17.rO ' 20 ��", me this J_day of 20 by e %X c a&G M7 \ by l ereto2 ' G �1 who is personally known or has produced who is personally known or has produced r- s identifications - - as identification. - rignaturc o otary" Signature of Notary Commission No. AUDREY B. HUMP mmission No. (Seal) *? MY COMMISSION d EE 061159 V EXPIRES March 6, 2015 Bonded thruNotary public underwriters NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNER/BUILDER, 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 OWNERBUILDER APPLICANTS. ' For specific in0tructions see appropriate permit checklist. 'OFFICE USE ONLY •,� #: 1/ • �_ _SECTION TOWNSHIP RANGE MAP NO. ZONING LAND USE .� LOT CVG %o TAZ NO. FIIZIvfMA1' #__ �-.T �- -1sT FI:R ELV-_ -MA-X-HGT- -— -_-- - -- - -� FLOOD ZONE. - - -; -CONST TYPE w. . ;.. r UGCUR TYPE: -- -a ; _ ; = hm OCCUP _ , --- - _ - VATER . _ - . - - - - - ;SEWER :, ' - - _ - -SPRINKI:ERS = - STORMWATEA - -- LOT OF REC Before 1/100 . LOT OF REC After 111990 LOT SPLIT REQUIRED. LOT SPLIT .APPROVED PERMIT FEE -REPORT CODE , . HABITABLE_ AREA RADON - - FEE LIBRARY IMPACT FEE PUBLIC BID IMPACT FEE CORRECTION 1 • �V PUBIC BID IMPACT FEE GENERAL (.�U PARKS IMPACT FEE SCHOOL IMPACT FEE- ROAD IMPACT TEE _ CREDIT Y N - LAW ENF IMPACT .FEE_ FIRE/EMS MACT -FEE-. DRIVEWAY -REQUIRED Y N DRIVEWAY FEE 60 ADMINISTRATIVE VARIANCE FEE �. SPECIFY SUBS _REQUIRED MECHANIC ROOF ELECTRIC GAS PLUMBING NON -CONFORMING -LOT OF RECORD FEES. MISCELLANEOUS FEES DATE SENT TO ADDRESSING:// l✓ - REVIEWS FRONT . CO ZONING . REVIEW SUPERVISOR REVIE PLANS - REVIEW. VEGETATION . REVIEW SEATURTLE REviEw MANGROVE REVIEW _ RECEIVED DATE -COMPLETED INITIALS