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Home My WebLink AboutApplication for Zoning ComplianceLSE G St. Lucie County Building & Zoning p OR�O BUILDING PERMIT SUB -CONTRACTOR SUMMARY (Company/Individual Name) project located at will be using the following sub -contractors for the (Street address or Property Tax ID #) It is understood that if there is any change of status regarding the participation of any of the sub -contractors listed below, I will immediately advise the Building and Zoning Department of St. Lucie County. Trade Name of Company/Contractor St. Lucie County/ State of Florida License Number Electrical Plumbing HVAC/ Mechanical Roofing Gas OFFICE USE ONLY: PERMIT ISSUE DATE: NUMBER: ST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT <OR10 BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (I£ applicable): (Company Name/Individual Name) (Type of Trade) for the project located at sub -contractor for have agreed to be the (Primary Contractor) (Project Street Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED PRINT NAME Phone: email: OFFICE USE ONLY: DA E 3LCCDV Form No.: 001-02 DWNER INFORMATION: NAME: ADDRESS L r 4) UAA, CITY: rT V ( ER-0 L `-r PHONE (DAYTIME): j 70A oD STATE: T—,(-- ZIP �T� 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: PHONE (DAYTIME): CONTRACTOR INFORMATION ST. of FL REGJCERT 4- BUSINESS NAME: QUALIFIERS NAME: ADDRESS: STATE: ST. LUCIE COUNTY CERT #: ZIP CERTIFICATION: This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificz capacity, if applicable, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a p and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understanc separate permits may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEAT 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, acre; structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another residential use. NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAl TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB" FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORL YOUR NOTICE OF COMMENCEMENT. NOTICE TO APPLICANT: AS THE APPLICANT FOR THIS BUILDING PERMIT, 1F IT IS NOT YOUR RIGHT, TITLE INTEREST THAT IS SUBJECT TO ATTACHMENT; AS A CONDITION OF THIS PERMIT PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED CONSTRUCTION LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. OWN ER'S AFFIDAVIT: 1 certify that all the foregoing information is accurate and that all work will be done in compli; A with all applicable laws regulating construction and zoning. CITY: STATE: ZIP — _ OWNE ONTRACT SIG ATURE CONTRACTOR SIGNATURE PHONE (DAYTIME): 1 1 FAX NO. STA O FLO I A STATE OF FLORIDA COLIN OF LCOUNTY OF ARCHITIENGINEER: The fore Ing i ument a cknoged The foregoing instrument was acknowledged ADDRESS: fore met ' a , 2 _, by_ before me this day of , 20 , by ho is n to me or who , who is personally known to me CITY: STATE: ZIP has &0 ed as identificatio or who has produced as identification. PHONE (DAYTIME): Signature of Notary Signature of Notary BONDING COMPANY: ADDRESS: Type or Print Name of Notary Type of Print Name of Notary CITY: STATE: ZIP Nota Public 0 IRVIft. SAUNDE`RS Notary Public Title *;� MY COMMISSION # DO 104583 a€ EXPIRES: July 29, 2006 MORTGAGE LENDER Commi r�T9; mt ThruNotaryPublicUnderMters Commission Number ADDRESS: (seal) (seal) CITY: 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. NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNEF2/BUILDER, THE OWNER MUST PERSONALLY APPE TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. OFFU DATE FILED: BP M PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER: CONCURRENCYFEE: RECEIPT NO.: CERT. C". NO.: Z ... ........ . . ............... ............ . .......... ... .......... ; . . ALL INFO MUST BE COMPLETE U FILLED IN TO BE ACCE PT ....................... .. ........ .................. ............... .. ... . ................ . ....... ....... .................. . ..... . .. ... . ............ . ..... . ........ ......... C COG SECTION: TOWNSHIP: RANGE: MAP NO.: ST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT 2300 VIRGINIA AVENUE OIR FORT PIERCE, FL 34982-5652 ZONING: LAND USE: ,._. TAZ NO.: 772462-1553 FLOOD ZONE: FIRM MAP #: 1ST FLR ELV' MAX HGT: APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE CST TYPE: OC TYPE: MAX. OCCP: # OF FLRS: PROJECT INFORMATION WATER: SEWER: SPRINKLERS STORMWATE 1. LOCATION/SITE ADDRESS: R _Qz0z) 2. S/D NAME: SITE FLAN NAME: LOT OF REC (befr 1/90) LOT OF. REC (aftr 1/90) LOT SPLIT LOT SPLIT RECI'D APPRV'D 3. PROPERTY TAX ID #: d Cp D 0770 00018 4. LEGAL DESCRIPTION (attach extra sheets if necessary): DECAL LIBRARY PARKS PERMIT NUMBER IMPACT FEE IMPAczE FEE REPORT PUBLIC BLDG ABITABALE RADON FEE 5. PLAT. CODE IMPACT FEE AREA 6. PAGE 7. - BLOCK 8. LOT (RADON) BOOK NO. NO. NO. Y N ROAD GROSS ROAD CREDIT TOTAL ROAD IMPACT ZONE E F IMPACT IMPACT FEE 9- PARCEL SIZE: ACRESISQ FT. LOT DIMENSIONS DUE ON OF CONSTRUCTION Y, N PROJECTOR WORK AC V SCHOOL- IMP ACT CREDIT ........................... ....... TOTAL ................................. .. . ...................... ................................... SCHOOL w ................................. .................................. ................................... .................................. ........................ ..... . . ............................... ............................... ................................ IMPACT FEE SETBACKS (ACTUAL) FRONT: BACK: ell, RIGHT LEFT POLICE FEE FIRE FEE MISC FEES: TOTAL SIDE SIDE- POLICE/FIRE1 MISC. FEES 12- TYPE OF CONSTRUCTION (Check all appropriate boxes) ADDITIONAL Y N SPECIFY: TOTAL ALL NEW CONSTRUCTION EXPANSION/ADDITION INTERIOR RENOVATION RESIDENTIAL PERMITS FEES COMMERCIAL OTHER (SPECIFY) INDUSTRIAL REaD 13. DESCRIPTION OF PROPOSED USE: a w i REVIEWS ZONING ZONING PLANS REVIEWED BY EXAMINING 'VEGETATION SEA MANGROVE 14- 8q. FL]CONSTRUCTION: 15. ' Sq. Ft. 1st Floor: DATE' COMPLETE 16. VALUE OF CONSTRUCTION: $ INITIALS The value of cdnstrucgon is used to determine the amount of permit fees to be assessed. St- Lucie County reserves the right to question and/or mod inclicated, value of cortstructim if it is demDmlratpd that the submitted figures are not consistent with similar types of construction activities- If the value is of morea RECORDED Notice of Commencement must be submitted with this application.