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HomeMy WebLinkAboutCertificate Of Capacity -ZoningWE SECTION. �3 TOWNSHIP s RANGE MAP NO. ZONING LAND USE On LOT CVG % TAZ NO. FLOOD ZONE PO FIRM MAP # I /� 17 Isz FLR ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER I I SEWER I I SPRINKLERS I I STORMWATER LOT OF REC LOT OF REC (after. LOT SPLIT LOT SPLIT (before 1/901 1/90) REOUIRED I I APPROVED ADMINST LIBRARY PARKS PERMIT VARIANCE IMPACT FEE IMPACT FEE FEE REPORT PUBLIC BLD HABITABLE RADON FEE CODE V . . IMPACT FEE AREA (RADO ••L ©®,-TOTALROAD IMPACT FEE IMPACTFEE iSCHOOL ME Im 'iTOTAL •TOTAL •• . MISC FEE • • •rew', PERMITS' • • .Fr®� �� v /ofALL TOTAL REVIEWS- ZONING ZONING PLANS MISC. VEGETATION SEATURTLE MANGROVE RE)IIEWED BY EXAMING DATE COMPLETE INITIALS PLAN REVIEW FEE: O RECEIPT NO.: (Z:;CPt7t- PERMIT NUMBER: -' 2 CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: --ALL INFO MUST BE COMPLETE &.FILLED_IN-TO BE ACCEPTED Pep St.. Lucie County Building and Zoning i9awc� , 2300 Virginia Avenue • °��4R10Q • Ft. Pierce, FL 34982-5652 T� F K 772-462-1553� l �2, �� �rvti�-tocJic�sDS APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS-. ao 2. S/D NAME: i.w j S. p-eyt._t its G r n-e.cl 11713 PLAN NAME: . 3. PROPERTY TAX ID 4. LEGAL DESCRIPTION (attach extra sheets if necessary):04 t1—P ' 5. PLAT 6. PAGE 7. BLOCK 8. LOT BOOK NO. NO. NO. 9. PARCEL SIZE: ACRES/SQ FT. dl,4 LOT DIMENSIONS A INST4 LL T-wti of A 40 10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: e IV 0 IL SETBACKS (ACTUAL) FRONT:" , BACK: � RIGHT: LEFT- , v4 _ SIDE %. S = SIDE r� 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL OTHER (SPECIFY) OT #4A1 E. YI 1e ilA+1Xs+E�! T'D pl�.wL.k.: 13. DESCRIPTION OF PROPOSED USE: S n-1�- _ _ _ �I:SI® "C's 14. Sq. Ft./CONSTRUCTION: ® 4P 15. Sq. Ft. Ist Floor: /lj6 16. VALUE OF CONSTRUCTION: $ r �! a b • �° 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 OWN NAME: ER FORMATION . ADDRESS:—'? O �-7� L' c ray/1 a %i' Lye �id -• l 7 CITY: -t STATE:. % l ZIP Y PHONE (DAYTIME): g Z 1 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 (DAYTR,4E): - (_ CONTRACTOR INFORMATION ST. of FL REG./CERT #: R 13 0 O S-6 S' `/ ST. LUCIE COUNTY CERT #: 18 L R BUSINESS NAME: ca ry CiCJ r C 1 %� Ls o' LoL�6L� • rc. �- QUALIFIERS NAME: � a r✓ (� r 1 `� t�J ADDRESS:-7o / /-�v1- 1�c1 vim VZ o ✓I-� CITY: C— T 0 Per C__ c STATE: ZIP IL 7 PHONE (DAYTIME): r77A-_ y (Q / -6-,t-3v FAX NO. Z Z Z--L I email: ADDRESS: r CITY: �-�- "� . L- uy! `e STATE: / � ZIPS PHONE (DAYTIME): 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. 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 woik 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 THIS PERMIT YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. 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. Lowt_) OWNER/CONTRACTOR SIGNATURE CONTRACTOR SIGNATURE STATE OF FL A _ STATE OF FLO ` ',�..�; COUNTY OF ►—�� COUNTY OF • 1 Q__1 The foregoing instrument was acknowled ed fore me _0day o -' _6 R_ , 20 y who is personally own to me or who has produced as identification. Commission No. Seal) DAWN FURTADO * W COMMISSION # DD 45M EXPIRES: November 19, 2009 Bonded Tlw Budget Notary Services The foregoing instrument was acknowled ed before th�wbaoslproduced 37-~ , 20 y wh�is person} - own to m as identification. Si ature of otary II Type or Print Name of Notar�,� DAW14 FURTADO AA I MY COMMISSION # DD 41 Commission No_ ea�i(PIRES: November 19, F �`OP\�r Bonded Thru Budget Notary Sr 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.