HomeMy WebLinkAboutCertificate Capacity, Zoning ComplianceBP #: a�) 0 2 o?9-Q_ .
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SECTION:
n
TOWNSHIP:
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RANGE:
D
MAP NO.:
�� S
ZONING:
LAND USE:
LOT CVG %:
TAZ NO.:
FLOOD ZONE:
FIRM MAP #:
1ST FLR ELV:
MAX HGT:
CST TYPE:
OCCP TYPE:
�Occ
# OF FLRS:
WATER:
SEWER:
'd-
SPRINKLERS
STORMWATE
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R
LOT OF REC (be& 1190)
LOT OF REC (aftr 1190)
LOT SPLIT
LOT SPLIT
READ
APPRV'D
DECAL
LIBRARY
PARKS
PERMIT
NUMBER
IMPACT FEE
IMPACT FEE
FEE
REPORT
PUBLIC BLDG
HABITABALE
RADON FEE
CODE
IMPACT FEE
AREA
.(RADON)
Y
N
ROAD
GROSS ROAD
CREDIT
TOTAL ROAD
IMPACTZONE
IMPACT FEE
IMPACT FEE
DUE
Y
N
SCHOOL
CREDIT
TOTAL.
IMPACT FEE
H
SCHOOL
IMPACT FEE
"
0
POLICE FEE
FIRE FEE
MISC FEES:
TOTAL '
POLICE/FIRE/
`
�` •�
MISC. FEES
. Y -
N
ADDITIONAL
SPECIFY:
TOTAL ALL
1PERMITS.
FEES
: REQ'D
-
- -
REVIEWS
ZONING
ZONING.
PLANS
VEGETATION
SEA
MANGROVE
REVIEWED BY
EXAMINING
TURTLE
�I U
?116AO
COMPLETE
�'l a
Il1ALS"
7%
OFF i .E'O IL,X:
DATE FILED:
PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER:
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
FILLED IN TO BE ACCEPTED-, M 8� CC PTED
ALL INFO LIST BE COMPLETE
A
c�E O ST. LUCIE COUNTY PUBLIC WORKS �~
BUILDING & ZONING DEPARTMENT
2300 VIRGINIA AVENUE
�OFORT PIERCE, FL 34982-5652
561-4W-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
i
PROJECT INFORMATION
�
-7 Sd,y S LA s I
LOCATION/SITE ADDRESS: NE Corner of US 1 and Prima. Vista Blvd.
2.
S/D NAME: SITE PLAN NAME: prima Vista Crossing .
3.
PROPERTY TAX ID #: 3422-801-0001-000/1 and 3422-410-0000-000/4 Q
r 4.
LEGAL DESCRIPTION (attach extra sheets if necessary). see attached
f
i
5.
PLAT 6. PAGE 7. BLOCK 8. LOT
j
BOOK NO. NO. NO.
r, 9.
PARCEL SIZE: ACRES/SQ FT. LOT DIMENSIONS
r
� 10.
DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY:et aislbu�lout.�-, _
RUCTION C
s
11
SETBACKS(ACTUAL) LEFT
v9wRIGHTFRONT: BACK SIDE SIDE:
t
i 12.
TYPE OF CONSTRUCTION (Check all appropriate boxes)
] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
4
(] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
(] OTHER (SPECIFY) -
13.
DESCRIPTION OF PROPOSED USE: Retail Store UNTm 1 0 1 R 7 S Z- $
14.
Sq. FUCONSTRUCTION: 15. Sq. Ft. 1 st Floor.
±' 16.
VALUE OF CONSTRUCTION: $
The value of Construction is used to determine the amount of permit fees to be assessed. St Lucie County reserves the right to question andfor modify the
Inds 2500
Indicated value value is ue of t with mi . If the S . construction if it is fed that the not coAsisten .si lar of Construcion activities demonstrated .subrrritfed ores are types
or more, a RECORDED Noflce of Commerioement ifit tie wflh'this appticatieon:
1
SLCCDV Form No.: 001-02
OWNER INFORMATION:
Crescent Resources, LLC
NAME:
ADDRESS: 4 t
CITY: Cbar1 ntte STATE: NC Lp 28201-1003
PHONE (DAYTIME): (704) 373-5843
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS
BELOW.
FEE SIMPLE TITLEHOLDER: same as above
ADDRESS:
CITY:
PHONE (DAYTIME):
CONTRACTOR INFORMATION
STATE:
ZIP
ST. of FL REGJCERT #:
' CGC 033026
ST. LUCIE COUNTY CERT #:
BUSINESS NAME:
Keene Construction Co.
of Central Florida,
Inc.
QUALIFIERS NAME:
Gal;y T. Keene
ADDRESS:
1400 Hope Road
CRY:
Maitland
STATE:
FL - Mp 32751
PHONE (DAYTIME):
(407 ) 740-6116
FAX NO,
407-539-3468 _
ARCHIT/ENGINEER:
Tagliarini Architects
ADDRESS:
5720 Interbay Blvd.
CITY:
Tampa-
STATE:
FL ZIP 33611
PHONE (DAYTIME):
(8131 805-7838
BONDING COMPANY: n/a
ADDRESS:
CITY: STATE: ZIP
MORTGAGE LENDER: n/a
ADDRESS: _
CITY: - - STATE: • 23P
IMPORTANT `NOT ICEWfien'a`�perniit'-is'iss'.ued andYit is not picked "lip within OWN
after after notification it will be of 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 L_ _IEN
LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT.
OWNER' FIDAVIT: I certify that all the foregoing information is accu to and that all work will -be -done -in compliance
with all applicable laws regulating constru and zoni 'ger
zw�
OWNER/CONTRACTOR SIGNATURE CONTRA TOR SIGNATURE _
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF oranges COUNTY OFOEancle
The foregoing instrument wa acknowledged
before me this J�2_ day of 20Q2, by wry
T.newho is personally kno to me or who
has produced n / a as identification.
���111111III1111I///�,
Signature of Notary O
...►\SSiON n!.
Sheri L.Bonotto
Type or Print Name of Notary
Notary Public Title
Commission Number
The foregoing instrument was acknowledged
before me this j�, day'of 2002, by
ry GaL Keene . who is personall known to me
or who has produced n/a as identification.
Signature of Notary °0 � L.IBo,�°'
a � •�M\SSIO�y••
Sheri L. Bonott o
Type of Print Name of Notary
Notary Public Title
Commission Number
(seal) , (seal)
NOTE: TWO (2)`SIGNATURES ARE REQUIRED. _EACH SIGNATURE MUST BE NOTARIZED:
IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNEF�IBUILDER; THE OWNER MUST PERSONALLY APPEAR
TO SIGN THIS APPLICATION IN THE OFFICE LISTED.ON THE FRONT OF THIS APPLICATION. _ _