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HomeMy WebLinkAboutCertificate Of Capacity - Zoning Compliance 3-26-08OFFICE USE ONLY SECTION 2 TOWNSHIPS RANGE �' MAP NO. ZONING LAND USE LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # l j , 1ST FLR ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER Slcc SPRINKLERS STORMWATER LOT OF REC LOT OF REC (after LOT SPLIT LOT SPLIT. (before 1/90) 1/90) REQUIRED APPROVED ADMINST LIBRARY l PARKS PERMIT VARIANCE IMPACT FEE 1� IMPACT FEE FEE FEE Z REPORT PUBLIC BLD HABITABLE RADON CODE CA IMPACT FEE 2 125 .� d3 (RADON) GROSS ROAD CREDIT Y N TOTAL ROAD I`� LL isL�S IMPACT FEE �� IMPACT FEE DUE SCHOOL CREDIT Y N ° TOTAL IMPACT FEE SCH IMPAOCOT FEE FEE FIRE FEE MISC FEE TOTAL ,P06CE ( 1 v �� 5�5 POLICE/FIRE MISC FEES MISC ADDITIONAL Y N SPECIFY $ / TOTAL PERMITS 1AJGl of ALL REQUIRED ��/� C� FEES E:�IS ONL�• IrII� - DATE FILED: !-�, PLAN REVIEW FEE: RECEIPT NO. �- V .. PERMIT NUMBER: 3 -� L �I CONCURRENCY FEE: RECEIPT NO.: CERT:.CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED i:i�FMi S St. Lucie County Building and Zoning ' 2300 Virginia Avenue 1p�y�Dp Ft. Pierce, FL 34982-5652 3 � � 772-462-1553 M In . ea a ucLKvr� , %bxco 61 e__pc for i-1 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE v PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: 0 4?32- L7/Gt 7er.son q U�Q �/ f �i`e ft Q J7 2. S/D NAME: bva ter 5"an GI SITE PLAN NAME: 3. PROPERTY TAX ID #: 4. LEGAL DESCRIPTION (attach. extra sheets if necessary): ly G 5. PLAT 6. PAGE 7. BLOCK NO. NO. 8. LOT . NO. BOOK W160IAA 9. PARCEL -SIZE: ACRES/SQ FT. , e LOT DIMENSIONS 10. DESCRIPTION OF CONSTRUCTION P OJECT OR WORK ACTIVITY: 13u 14 51 ny /,o �d�i i %y 9e-s/ we tie .5 11. SETBACKS (ACTUAL) FRO BACK: 3% Z� SIDE T.` • / SIDE h 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: i ILA I� 14. Sq. Ft./CONSTRUCTION: 15. Sq. Ft. 1st Floor: 1 16. VALUE OF CONSTRUCTION: $ t _51 8,�7 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 $2500 or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 OWNER.INFORMATION V NAME: O. ' ADDRESS:'. �. , * rgEl va.3 - L ZIP 0 CITY: 602� +0'47il SATE: PHONE (DAYTIME)` (�✓ %g�L. ' email: IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAMEAND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: - STATE: ZIP PHONE (DAYTIME): ( ) CONTRACTOR INFORMATION ST. of FL REG./CERT #: G GG J S ST. LUCIE COUNTY CERT #. o� BUSINESS NAME: QUALIFIERS NAME: & � a a le- ew om �S ADDRESS: D PG"I G v 6 in 7`� ZO �L ZIP CITY: P41Im A3-.�a,-h G-arrdP s STATE: �GrvPffo Gs (•�!���� �o�, email: PHONE (DAYTIME): U60 77S 1/7o FAXNOCg$��µ3 z ARCHIT/ENGINEER: ADDRESS: CITY: PHONE (DAYTIME): STATE: ZIP', BONDING COMPANY: ADDRESS: CITY: STATE: ZIP MORTGAGE LENDER:, ADDRESS:.. ' 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. 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 7HIS PERMIT YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED CONSTRUC' ION LIENLAW NOTICE TO `l;HE PERSON WHOSE PROPERTY IS SUBJECT . TO ATTACHMENT. L ------- ---------------- OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. _. . r OWNER/CQ TRACTOR SIGNATURE CONTRAC OR SIGNATURE STATE OF FLORIDA COUNTY OF fe-9 G j1 The foregoing instrument was acknowledged before me this ? day of Aare h , 20& by Gary w ©4,q /+�-� , who is personally knownto me or who has produced as identification. STATE OF FLORIDA COUNTY OF rid �t2r ��G The foregoing instrument was acknowledged before me this � 'day of &1&reA 20&,by who is personally known to me or who has produced as -identification. Signature of Notary Signature of Notary Ke�r�tti ft Ovr�c>° r7`� Type or Print Name of Notary Type or Print Name of Notary o�Pa� Pie, Kenneth A. Doucette - ,P"Y PV Kenneth A.: Dou Commission ° Commission g�§3398? Commis] ' �r� xpires a c 2010 � � Q Expires March 28, 2010 0 6 OF F,�e BaTed Troy Fain Inwra MIM 8003859019. 9l6 OF P a Band4Twy,Fam Insurance, Inc 8W3857019 NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THE APPLICATION. For specific instructions see appropriate permit checklist.