HomeMy WebLinkAboutApplication for Zoning ComplianceOFFICE_USE:ONLY:
DATE FILED:
PLAN REVIEW FEE: J • 0 RECEIPT NO.:
CONCURRENCY FEE: RECEIPT NO.:
PERMIT NUMBER:
CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
1. LOCA
PA
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Avenue
Ft. Pierce, FL 34982-5652 Wo 71htc-
772462-1553 *ele 7 0
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APPLICATION for BUILDING PERMIT _
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT
PROJECT INFORMATION
n a..... .I.
SITE PLAN NAME: CpLc r Adryr jnlslrcacn Cornplm
3. PROPERTY TAX ID #: .Q'4 to • JScA • O-+'+o • Coo • 8
4. LEGAL DESCRIPTION (attach extra sheets if necessary):jaemEc --Ar- cs4 achy6
T.
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO
9. PARCEL SIZE (ACRES/SQ FT.): UA LOT DIMENSIONS: _
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
0-f- in-krior ti� - 2ric' -Aoor Of, Gou.r*
8. LOT NO.
`-Pr6vi-oqsA,Q mcAote6 Code Com ' a►nce C-w qMadqcd -dromimas
11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LM SIDE:
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [y] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE�CMVo:bQn C(: SpXp_ •pr e.iEr- la . 4Vr-- w Q61tec%y
14.
16
SQ. FT OF CONSTRUCTION:
15 LD 0 �f 15. SF. FT 1st FLOOR:
VALUE OF CONSTRUCTION: $ 10, ODo .
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
UPDATED 6/25109
OWNER INFORMATION
NAME: DW(ZCr / bL,�j 16e_r
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME): R Z)4(.D2• i4ez �rrq'�'mnl Email:
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IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SEMPLE TITLEHOLDER:
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME):
CONTRACTOR INFORMATION
ST. of FL REG.CERT #: ST. LUCIE COUNTY CERT #:
BUSINESS NAME: C�L,�`7il�'Jra1lC�eJ'
QUALIFIERS NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME): {4WZ•14b?- FAXNO� 42 u-2- 14-44 Email �Iyr�nAL`sr�UUGCO.Or
r ry ' Rynn -T ro)ect Y'nQmyr
ARCHIT/ENGINEER:
ADDRESS:
CITY:
PHONE (DAYTIME): U
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE: ZIP:
STATE: ZIP:
STATE: 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.