HomeMy WebLinkAboutCertificate Of Capacity - Zoning Compliance 1-16-14OFFICE USE ONLY:
4. ... _. __�.., __ . __
DATE FILED: Ito . ,
PLAN REVIEW FEE: RECEIPT NO.:
CONCURRENCY FEE: RECEIPT NO.:
PERMIT NUMBER: / r=} ' ov 7�
CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Avenue
Ft, Pierce, FL 34112-1652
772-462-1553ly'Dul 04 r&,��71 0 r-- T,? 0&�,a I
i22® APPLICATION for BUILDING PERMIT S� d
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
1. LOCATION/SITE ADDRESS: 8 Z 3 2 S, o C c-Ay P/z , e/C-//s4y e4z N; r-�G 3 q °15
2. PROJECT NAME: A P,41V 0 V 1 TC J f SITE PLAN NAME: j%1,gA1V VA9 S41V1%S 4 o! 3 %
3. PROPERTY TAX ID #: 3,5Z% 5-0/ 003 -b D O O O
4. LEGAL DESCRIPTION (attach extra sheets if necessary): L. D %' 3J. O/A!'+��Nd� �S I11447— 2
5. PLAT BOOK �D 6. PAGE NO. 7. BLOCK NO. 8. LOT NO.
a
10.
PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: ? rS X 375
COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: e-'9A157AQ <- r
11. SETBACKS (ACTUAL) FRONJ�-�p—BACK: RIGHT SIDE: 7. LEFT SIDE:
12. TYPE OF CONSTRUCTION (Clck al ap ropriate boxesJS
f;
[Pf NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: F-S l 10
14.
2Q I SQ. FT OF CONSTRUCTION: 2 '0 %O 15. SF. FT 1st FLOOR 7
VALUE OF CONSTRUCTION: $ ` 0 �_ D � . C-
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 arc not consistent with similar types of cotistruction activities. If the value2is $2500 or more, a
RECORDED Notice of Commencement must be submitted with this application.
SLCCDV Form No.: 001-02
UPDATED 6/25/09
5-6
OWNER INFORMATION
NAME: T 'eR 9Z U1 /2 & 11'(1//4 R v/ r<11 /424
ADDRESS: 2yo8d ovF-2MA-5 ttwY a InAE4Lfl4.uO K ,y liz-L
rrTV• _S dMAI F-A i-a-A A *c rz Y STATE: 1:= L ZIP:
PHONE (DAYTIME): L-)
Email: 3 3 O L/ 2
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:
PHONE (DAYTIME): 7 tI s-- 2 7< ?-
CONTRACTOR INFORMATION
ZIP:
ST. of FL REG.CERT #: (' RC 013 6-3 9' ST. LUCIE COUNTY CERT It: 2706 3
BUSINESS NAME: - 4CgzAN F12oiy 7jWAsv2a dy'4 sc L L d.
QUALIFIERS NAME: m J4 a l D• A-leoy C c- )
ADDRESS: 3 5 JX! 6 /`fW V
CITY:STATE: ZIP: 3 v 9 �l %
PHONE (DAYTIME): (77 Z� 240 ?Sly G FAX NO. 2. S 8 2.0 2 Email:
2.1 d7 21�o oc iV tNT v/L .Co
ARCHIT/ENGINEER: R.O & a t1AA/5 l2o i� -
ADDRESS: Y513 P 1 gi%C MA14,� 9D
CITY: _tV . ?AL P1 130-M- M STATE: t= L ZIP: 3 3 51J %
PHONE (DAYTIME): ;R !) (ODJ S-6 t1 7
BONDING COMPANY:
ADDRESS:
CITY:
STATE. -
MORTGAGE LENDER:
ADDRESS:
CITY: STATE:
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.
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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 with 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-
`residcntial 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 YOUR RIGHT, 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.
OWNER OR CONTRACTOR SIGNATURE
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before
me this day of \1A1gV,4A Y 20 i'_
m
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am
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2 Fa M m9m
two=
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who is personall ow or has produced
l as identification.
Signature of o rye
R
o
Commission No. (Seal)
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SIGNATURE
ATE OF FLORIDA
IUNTY OF
foregoing instrument was acknowledged before
me this _&t day of V,4 !U/� J2 Zl , 20
is persqnaIlyJm4w—n_D or has produced
of
No.
as identification.
(Seal)
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH S' MATURE 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 OWNERBUILDER APPLICANTS. '
3 7 '
For specific in' tructions see appropriate permit checklist. 4
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OFFICE USE ONLY ` B. - 4 :
SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
416
LAND USE
LOT CVG %
TAZ NO.
FLOOD ZONE
�G1
FIRM MAP #
lsr FLR ELV
C 4CG
MAX HGT
vi
k'
CONST TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF REC
Before 1/1990
LOT OF REC
After 1/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
HABITABLE
AREA
RADON
FEE
PERMIT
FEE
(RADON)
LIBRARY
:IMPACT
-:FEE
PUBLIC BLD
IMPACT FEE
CORRECTION
PUBIC BLD
IMPACT
FEE
GENERAL
PARKS
IMPACT
FEE
"SCHOOL
IMPACT
FEE
ROAD
IMPACT
FEE
CREDIT
Y
N
LAW ENF
IMPACT
FEE
FIRE/EMS
IMPACT
DRIVEWAY
REQUIRED
Y
N
DRIVEWAY
FEE
ADMINISTRATIVE
VARIANCE FEE
FEE
SPECIFY
SUBS
MECHANIC ROOF
ELECTRIC — GAS
NON -CONFORMING
LOT OF RECORD
MISCELLANEOUS
FEES
REQUIRED
PLUMBING _
FEES
DATE SENT TO ADDRESSING:
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
I • I i�' I�
DATE
COMPLETED
1 I
INITIALS
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