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HomeMy WebLinkAboutApplication for Zoning ComplianceOFFICE USE ONLY BP #: L TOWNSHIP RANGE 1 "NO. 1� SECTION ZONING B LAND USE LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP 1ST FLR ELV ' MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER r 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 FEE PERMIT FEE ON) LIBRARY IMPACT, FEE PUBLIC BI-D IMPACT FEE CORRECTION . L6 PUBIC BLD IMPACT FEE GENERAL 1 PARKS IMPACT SCHOOL IMPACT FEE 5 g q 5 ROAD IMPACT FEE LA© 1� CREDIT Y O LAW ENF Il�IE = t:' FE E . FIRE/EMS IMPACT L ( DRIVEWAY REQUIRED Y N DRIVEWAY -FEE ADMINISTRATIVE VARIANCE FEE FEE SPECIFY SUBS REQUIRED MECHANIC `� ROOF ELECTRIC —' GAS PLUMBING %/ NON -CONFORMING LOT OF RECORD FEES MISCELLANEOUS FEES DATE SENT TO ADDRESSING: _ _/Zf__/_L3_ REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEATURTLE REVIEW _MANGROVE REVIEW - DATE RECEIVED "DATE • - .. COMPLETED 7. 7 - .. - . i INITIALS OFFICE USE ONLY: I , 17 DATE FILED: 7,0 O X-7 PERMIT NUMBER �� • oz, PLAN REVIEW FEE: RECEIPT NO.: CONCURRENCY FEEL RECEIPT NO.: CERT. CAP NO.: n ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue I / I Ft. Pierce, FL 34982-5652 `4 - V T l 772-462-1553 APPLICATION for BUILDING PERMIT 1�a 6 - � m� CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: �✓ SO%1 y F+ i� i 2rc -- 2. PROJECT NAMESITE PLAN NAME: 3. PROPERTY TAX ID 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 122UZ7 A Die 5. PLAT BOOK O ' ,26. PAGE -NO. ,3T 7. BLOCK NO. 8. LOT NO . 9. PARCEL SIZE (ACRES/SQ FT.)LOT DIMENSIONS: 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:, - bed 11. SETBACKS (ACTUAL) FRONT:: Q f—BACK:IGHT SIDE: LEFT SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [INEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL j ] COMiVIERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE, S 14. SQ. FT OF CONSTRUCTION: 15. SF. FT 1st FLOOR: 16. VALUE OF CONSTRUCTION: $ 1�7� 6w 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 $2506 or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: // 001-02 oca >e UPDATED a Jeff OWNER INFORMATION NAME:ill/A�D t T�OJI FE?2 ��5 ADDRESS": la 44kA-6#0a pw. *S38 CITY: /Vak7'N4 ��1-Lm &LH STATE: ZIP: 33 yoS PHONE (DAYTIME): (g) 3zl- yS/ ;Z Email: IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SEMPLE TITLEHOLDER: ADDRESS: CITY: PHONE (DAY.TIlvIE): ( ) CONTRACTOR INFORMATION NN ST. of FL REG.CERT #: ' C,en BUSINESS NAME: QUALIFIERS NAM] STATE: ZIP: ST. LUCIE COUNTY CERT ADDRESS: 2 %Q /C7200 CITY: STATE: ZIP: 7� PHONED YTRvIE): Q� kl� —90f' FAXNO.,%/-7�/�� Email: G�f/1�1C4/'/If��Glz7,4lL ARCHIT/ENGINEER: leg G29 )a t- &L0C // 7 e S ADDRESS: 1AZI S Ql' PA/I 3 CITY: ����PT STATE: 21P: PHONE (DAYTFAE): (7 M BONDING COMPANY: ADDRESS: CITY: STATE: ZIP: MORTGAGE LENDER:" = ADDRESS: CITY: STATE: ` • . 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. CERTMCATION: 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 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 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 YOURRIGHT, 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. OR STATE OF Fl COUNTY OF SIGNATURE The foregoing instrument was acknowledged before It this day of 20 •1 � , byr'1l�/ who is personally known or has produced identification. Signature of Notary CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this'_I'�' day of 20 by 14 zz I t �/ W who is personally known or has produced as identification. Signature of Notary Commission No. :;t�`4:: (§AMMANTHA N KONG: Commission No. :'� '•" ;; #WPANTHA N KO? : MY COMMISSION # DD966659 MY COMMISSION # DD966 _;N'EXPIRES March 0T. 2014 Vl ' EXPIRES March 01. 201, (I07) 39H-0153 FloridallotaryServica.cam (407) 39&0753 FloddallotaryService.rnm 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 OWNER/BUILDER APPLICANTS. For specific instructions see appropriate permit checklist.