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HomeMy WebLinkAboutCertificate Of Capacity-Zoning ComplianceOFFICE USE ONLY BP #: SECTION i i ``11 TOWNSHIP RANGE l4` ZONING LAND USE d w LOT CVG % FLOOD ZONE FIRM MAP # 1 IT FLR ELV OCCUP TYPE MAX OCCUP CONST TYPE SEWER SPRINKLERS T_ WATER LOT OF REC I I LOT OF REC I I LOT SPLIT Before 1/1990 After 111990 REQUIRED REPORT HABITABLE RADON CODE (f� % AREA FEE ni AnnNI LIBRARY PUBLIC BLD I PUBIC BI-D IMPACT FA ACT FEE IMPACT FEE CORRECTION GENERAL SCHOOL CREDIT IMPACT IMPACT FEE FEE FIRE/EMS DRIVEWAY Y N DRIVEWAY A PACT REQUIRED FEE FEE — SPECIFY MECHANIC ROOF NON -CONFORMING SUBS ELECTRIC --� GAS LOT OF RECORD REQUIRED PLUMBING _ FEES DATE SENT TO ADDRESSIN MAP NO. TAZ NO. MAX HGT # OF FLRS STORMWATER LOT SPLIT APPROVED PERMIT FEE FES FEEACT E Y N . " LAW ENF _ b,1PACT FEE ADMINISTRATIVE VARIANCE FEE MISCELLANEOUS._ FEES Libk REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE CO REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE 1 RECEIVEDDATE ' I l COMPLETED 1 L INITIALS OFFICE USE ONLY: DATE FILED: CQ � PLAN REVIEW FEE: --C2,;;L�0 RECEIPT NO.: fl CERT. NUMBER: I�� �' �c CONCURRENCY FEE: . . 8 0 RECEIPT NO.: 1, 2 3 4 5. 9. 10 ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONWD SION2300VtrginiaAvenue��G� Ft. Pierce, FL 34982-5652 772-462-1553 �`f�`� PERMIT e(e • e ►-�s�i APPLICATION for BU ELDING rn �� o p n CERTIFICATE of CAPACITY/ZONING COMPLIANCE v , 5 L�- PROJECT INFORMATION LOCATION/SITE ADDRESS: 10-7d,67 60-eP440 b/Z ! �%3a; PROJECT NAME: M k LAl 95 1_i "Rcek SITE PLAN NAME: PROPERTY TAX ID #: yell- 5Z7 ! ^ (2:0 .—.00R © 'I LEGAL DESCRIPTION (attach extra sheets if necessary): 40-r Y (, 81ock A 14Ol' � ou��A % 6. PAGE NO. a � 7 BLOCK NO. S. LOT NO. _ PLAT BOOK _� - PARCEL SIZE (ACRESISQ FT.): ` 0 5 LOT DIMENSIONS: a 3 '2s- S COMPLETE DESCRIPTION OF CONSTRUCTION PR03ECT OR WORK ACTIVITY: nZ S A)r 9,e 1 �QLe 11. SETBACKS (ACTUAL) FRONT: id BACK: S . RIGHT SIDE: LEFT SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [p�] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION RESIDENTIAL j ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: W A)�tJ.7 14. SQ. FT OF CONSTRUCTION: 15. SF. FT 1st FLOOR 16. VALUE OF CONSTRUCTION: $ 0? d 0. 0C) 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 )-l. UPDATED 6/25109 OWNER INFORMATION NAME: %^T 1U i 0% -i- Jy 1 ��v°�,20 ADDRESS: Q: GR �C CITY: 4+�J-k 2 iZ�D QK re/t / ` STATE: V-6 ZIP:: PHONE (DAYTIME): (SLjn �%% J `7 9'96� Email: 14-Am RbE ftl� GJ�I- UO . �tyl 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: PHONE (DAYTRVIE): (--) CONTRACTOR INFORMATION STATE: ZIP: ST. of FL REG.CERT #: ' C & Cr o S % 5 3 o / ST. LUCIE COUNTY CERT #: �'I 9 BUSINESS NAME: 0_0x) 5``/,z,4 e 4r O� — QUALIFIERS NAME: Jaek SCOT- F.16112 ADDRESS: CITY: t 02/ S7- Lrt �[� STATE: F jDlzii�i4- ZIP:9 PHONE (DAYTEVE): Z?�- _J70 " D/ 6( FAX NO. 7 %Z-33_7 `0 ' mail: ARCHIT/ENGINEER: ADDRESS: 2 b q a" Rtze-T S7 CITY: J � , �rte12� STATE: /� 0 r 014 �': PHONE (DAYTEVIE): (" IG oar1-075 BONDING COMPANY: ADDRESS: CITY: STATE: MORTGAGE LENDER: �( ADDRESS: CITY STATE: W 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, 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 witli-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. OWNS OR CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this day of 20 �/3 by 5c211' 6 19,/ who is personally known c/ or has produced as identification. Signature of Notafy CIN'ri-kTOR. SIGNATURE STATE OF FLORIDA COUNTY OF �f The foregoing instrument was acknowledged before me this day of _7� , 20 f3 , by who is personally known - or has produced as identification. Signature of Nodry Commission Or`taY.=vo hATi1YK.C�tiT eat) °Y3sion No.�T���K ��S (Seal) i--- idY CO i ,.::a .. 903173 ?* -MISSION # DD 903173 1;::;= EXPIRES:,;uly 17, 2013 a; o EXPOFS: July 17 2013 Bonded Thru 'F OF a •' Bop Ld T, • t,a4 Public Underwriters Notary Pu'cllc Urtdenw ters s 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.