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HomeMy WebLinkAboutCertificate Of Capacity - Zoning ComplianceQ�FICE,U, §E ONLY:6ATE FILED: �%�' f s• ^Q PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER: ] AI. 0 ©" CONCURRENCY FEE: . RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue •//`p� ��� �S Ft. Pierce, FL 34982-5652 772-462-1553 ,j,5 �-- �.�,vn,�►a r� APPLICATION for BUILDING PERMIT CERTIFICATE ®f CAPACITY/ZONING COMP L4N CE PROJECT INFORMATION I — -- ---- — ----- — - — 2. PROJECT NAME: �� 1 1 l SITE PL 3. --PROPERTY TAX ID #: 4. ' LEGAL DESCRIPTION (attach extrasheets if necessary):_ av-f 5. PLAT BOOK 6. PAGE NO. 9 10, PARCEL SIZE (ACRES/SQ FT.): 7. BLOCK NO. 8. LOT NO. i D Y LOT DIMENSIONS: 3 (f' (a(/ COMPLETE DESCRIPTION OF CONSTRt 11. SETBACKS (ACTUAL) FRONT: . 3 ` BACK: 5 12. 13 14. OR WORK ACTIVITY: RIGHT SIDE: •.3 LEFT SIDE:_ TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION K RESIDENTIAL [ ] COMMERCIAL [ ] OTHER (SPECIFY) DESCRIPTION OF PROPOSED USE: Te51r. 16; l 0' _ SQ. FT OF CONSTRUCTION: 16, VALUE OF CONSTRUCTION: $ a ` 0-- [ ] INTERIOR RENOVATION [ ] INDUSTRIAL 15. SF. FT 1 st FLOOR: The value of construction is used to determine the amount of permit fees to be assessed. St. Lucie County resen es the tight 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 valtuclis $2500 or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 UPDATED 6/25/09 OWNER 9 ORMATHON NAME: ADDRESS: CITY: STATE: 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: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): CONTRACTOR INFORMATION ST. of FL REG. CERT #: O ST. LUCIE COUNTY CERT BUSINESS NAME: QUALIFIERS NAME: —TV-\C>Cr-,G'-S 00i ADDRESS: 3-a>�JH �Aenr(A e2 CITY: STATE: PC • ZIP: PHONE (DAYTIME): WP_qq-Qb85FAX NO. Lip 2 3%iail: ARCHIT/ENGINEER: ADDRESS: CL,.,r t�t r-L� Ago D k-"... CITY: STATE: ZIP: 4PHONE (DYT _50 BONDING COMPANY: ADDRESS: CITY: STATE: ZIP: MORTGAGE LENDER, ADDRESS: CITY: STATE: ZIP: 60 days after notification IMPORTANT NOTICE: When a permit is issued and it is not picked up within - it wifi be voede¢i and returned to you by mall. , CEATIFICATIONo 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 pen -nit 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. 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. . —, I /�� � /= e, _5�� OW OR CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF P&A-IL_ The foregoing instrument was acknowledged before me this _nil% day of n 20 12 , by mom s r w�U�-4,A who is personally known or has produced as identilrWation. ignature of N ry Commission No. %4A NCY y1ln' ARNiSTRO, My rOMW,ISSIQRv # FEO69652 CONTRACTOR SIGNA E STATE OF FLORID COUNTY OF The foregoing instrument was acknowledged before me this day of �1 ZO �3 , by who is personally known or has produced a tification, r Tignatu�rei�ofry APPLYING FOR ?PEAR:TO SIGN S APPLICATION IN THE OFFICE LISTED ON TIIE FRONT OF THIS APPLICATION. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS. { For speci e i nqtzructi®n s see appropriate permit hecuns t, i Commission No. _ c�NANCY MIMS ARMSTRONG MY COMMISSION # EE059652 EACH SIG] W"'FMftW' A t �Q rf�.J. �yllI1 'l(�/1 FENCE lY SE C L 1l ,� .V.i��3� 1/ V Ty SECTION TOWNSHIP RANGE MAP NO. ZONING LAND USE LOT CVG % TAZ NO. ( FLOOD ZONE OE 6 FIRM MAP # 21,J 1 ST FLR ELV 6 MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC LOT SPLIT LOT SPLIT Before 111990 After 1/1990 REQUIRED APPROVED - `REPORT �` %�-�-' _ -HABITABLE— � � � i2t�DON � -?-ERIVIIT'—__— --- — CODE (,/ O AREA FEE FEE / (RADON) LIBRARY PUBLIC BLD PUBIC BLD PARKS IMPACT IMPACT FEE IML41 IMPACT .FEE CORRECTION FEE G SCHOOL . ROAD CREDIT N LAW ENF IMPACT IMPA IMPACT FEE FEE FEE FIRE/EMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE IMPACT REQUIRED FEE VARIANCE FEE FEE SPECIFY MECHANIC ROOF NON -CONFORMING MISCELLANEOUS SUBS ELECTRIC GAS LOT OF RECORD FEES REQUIRED PLUMBING FEES DATE SENT TO ADDRESSING: REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW DATE t RECEIVED /R�EVIEEW DATE +� „ COMPLETED k� INITIALS