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HomeMy WebLinkAboutCertificate Of Capacity - Zoning ComplianceFLOOD ZONE 4 6 FIRM MAP # I-T FLR ELV MAX HGT CONST TYPE I / OCCUP TYPE 3 MAX OCCUP # OF FLRS WATER r 10UA SEWER SL SPRINKLERS STORMWATER LOT OF REC (before 1/90) LOT OF REC (after 1/90) LOT SPLIT REQUIRED LOT SPLIT APPROVED S t. ADMINST VARIANCE LIBRARY IMPACT FEE 1 C� PARKS IMPACT FEE R PERMIT FEE REPORT CODE h lt `! PUBLIC BLD IMPACT FEE -`60' 47 Cp /a J . 33 V" HABITABLE AREA RADON FEE 6 GROSS ROAD 3� CREDIT I� ,� IMPACT FEE DUE SCHOOL �+� 3�. CREDIT Y N IMPACT FEE •JR. POLICE FEE % Q 0 FIRE FEE ��+� c� MISC FEE ADDITIONAL Y N SPECIFY Ilu PERMITS Mo�( REQUIRED REVIEWS ZONING ZONING PLANS MISC. REVIEWED BY EXAMING DATE COMPLETE INITIALS Y N TOTAL ROAD IMPACT FEE TOTAL SCHOOL IMPACT FEE TOTAL POLICEJFIRE MIS C FEES TOTAL of ALL FEES VEGETATION I SEA TURTLE MANGROVE OD ME FFICE;USE QNLT': DATE FILED: b PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER:'teR CONCURRENCY FEE: aSd,.A RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED n St. Lucie County Building and Zoning �QQaQ ww ' 2300 Virginia Avenue �OR10p Ft. Pierce, FL 34982-5652 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITYIZONING COMPLIANCE PR INFORMATION PROJECT N ORMATION J 5 E 10 LOCATION/SITE ADDRESS : S/L NAME; j/t%L{ / iQb% /i J11J-. 1 Lrkl11 1`IrllY1L•. LEGAL DESCRIPTION (attach extra sheets if necessary): L eQL .Z 3 rNd tee s©H� PUlI 'L t / P/rirBooK Zf Z, �g 35� I�Irbl c RPcof�a(S PLAT� 6. PAGE 7. BLOCK 8. LOT /v BOOK "/ Z NO. NO. NO. PARCEL SIZE: ACRES/SO FT. 7,6 --7 LOT DIMENSIONS / 011 X �/69 DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: I u /P Fanv � Id A ,tee,;., 510'e/k yes/dam 6 Aebko m-r - 3 kt.LL. Aron 11. SETBACKS (ACTUAL) FRONT: �BACK: O, / RIGHT: p / LEFT: / 3 j0 SIDE o SIDE 8 12 13 14 16 TYPE E OF CONSTRUCTION Check all appropriate boxes) es ) [[ NEW CONSTRUCTION [ ] EXPANSION/ADDITION [RESIDENTIAL [ ] COMMERCIAL [ ] OTHER (SPECIFY) DESCRIPTION OF PROPOSED USE: S l�y� l� Fo�•m / �v Sq. Ft_/CONSTRUCTION: 36 6 [I INTERIOR RENOVATION I [ ] INDUSTItAL Sq. Ft. 1st Floor: VALUE OF s : C NSTRUCTIONU 'r— I- fi�� �• • 15 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 A, 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 CERTIFICATION: OWNER INFORMATION NAME: oh a ADDRESS: CITY: t o an doh o Beic,6 STATE: 6L ZIP S PHONE (DAYTIME): S`-) 785- 3 S3 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: STATE: ZIP A CITY: PHONE (DAYTIME): () CONTRACTOR INFORMATION co, . #:C-aCOS$05Q S�Trr TTtV7'Y�EERT #: Rq, SS N ADDRESS: 5-64, / P(r/4- 6L uD U T - 2 OF CITY: ���rn /�r���1 C�a-del's. STATE: �- ZIP 23 �//��7 PHONE (DAYTIME): (Sti!) i�FAXNO. /-77S4o4W email: ARCHIT/ENGINEER: _ ADDRESS: CITY: PHONE (DAYTIME): (_ ADDRESS: CITY:-,. ADDRESS: CITY: k) STATE: STATE: STATE: r ZIP 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. I 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'B.UILDING,PERMIT, IF IT IS -NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT TO ATTACHMENT 'AS•A CONDITION OP THIS.-' PERMIT,YOTJ PROMISE IN GOOD FAIT1.1 TO DELIVER A COPY OF THE ATTACHED CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. 7OWNNER/CO I certify that all the foregoing information is accurate and that all work will b done in compliance with all applicable laws regulating construction and zoning. ., CT R SIGNATURE CO TOR SIGNATURE STATE OF FLO A STATE OF FLOR.W � COUNTY OF COUNTY -OF I The foregoing instrument was acknowledged N o E The foregoing instrument was acknowledged 1a@fore me this/ day of2�.3, by - ---- w � N m before me this �� day ofr200 b L� °n -' , who i ersoia who i ersonally a>S p o to me or who has produced 8 o 0 z -Ili me or who has produced a,j ^ ° as identification. as identification. b "�q 5; a v <v a } Sjg ure of Notary f " rn Si nature of Notary Z & ra..- r r c O Type or Print Name of Notary N o° G Type or Print Name of Notary. a �•� Commission No. r (Seal) N Commission No. (Seal) 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. �, � PAMELAJTRUDEL MY COMMISSION # DD528262 �0if'p�P EXPIRES: Mar.14,2010 (407) 398-0153 Florida Notary Serv+ce com