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Home My WebLink Aboutbuilding permit certificate of capacity - zoningSECTION: `I ZONING: FLOOD ZONE: 1 1 CST TYPE: WATER: LOT OF REC (befr 1/90) j rn�oirY.oe-e� : I�� TOWNSHIP: I �� LAND USE: FIRM MAP #:. 28 t 6 OCCP TYPE: SEWER: I'-`�wG LOT OF REC (aftr 1/90) RANGE: LOT CVG %: 1ST FLR ELV: 1 MAX. OCCP: SPRINKLERS LOT SPLIT READ -3 2 M*V 0� �= E MAP NO.: I ---2:L4 141 V TAZ NO.: MAX HGT: # OF FLRS: I II STORMWATE R LOT SPLIT APPRV'D DECAL LIBRARY Pli 1 1 S PARKS QQ by PERMIT NUMBER IMPACT FEE IMPACT FEE FEE REPORT. PUBLIC BLDG�� I.15 HABITABALE RADON FEE ! CODE ` L o IMPACT FEE AREA (RADON) Y N ROAD{ GROSS ROAD CREDIT TOTAL -ROAD IMPACT ZONE IMPACT FEE A.1115 IMPACT FEE . DUE IM SCHOOL- CREDIT TOTAL CT F EE IMPACT �a q -SCHOOL'_ - i IMPACT FEE P CE FEE (� FIRE FEE 8 V MISC FEES: do TOTAL POLICE/FIRE/ MISC. FEES Y N 0G�-, ADDITIONAL PERMITS SPECIFY: TOTAL ALL FEES / ��'(�.�,� READ. I,// REVIEWS I ZONING DATE COMPLETE INITIALS ZONING . PLANS REVIEWED BY EXAMINING �) I z VEGETATION ( SEA TURTLE DATE FILED: l9 7 PLAN REVIEW FEE: tb0 RECEIPT NO.: ate' PERMIT NUMBER: 03—d CONCURRENCY FEE: OS•b--O RECEIPT NO.: o��' CERT. CAP. NO.: ALL INFO MUST BE COMPL TE u FILLED IN TO BE ACCEPTED ST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT y 1 Gj 2300 VIRGINIA AVENUE '20R\Op a5 • �� FORT PIERCE, FL 34982-5652 772-462-1553 ki Zia la. ym- APPLICATION forBU1LItiG PERMIT CERTIFICATE of CAPACITYMONING COMPLIANCE PROJECT IN ORMATION i 1. LOCATION/SITE ADDRESS: � 2. S/D NAME: ; Zkn �� 1, 1 SITE PLAN NAME: I - 3. PROPERTY TAX ID #: a` oq &,6 l - o I Ct5-- 0 6 p C- 4. LEGAL DESP ION (attach ex ash is if necessary) U l ) ock g ` MANGROVE i f�,LNP-4 PIS 5. PLAT. 6. PAGE i A 7. BLOCK -8. LOT BOOKNO. NO. NO. . 10, 000 � 9. PARCEL SIZE: ACRES/SQ FT. i �3 LOT DIMENSIONS /�/ / ` / � 10. , DESCRIPTION OF CONSTRUCTION FjOJEQT R WORKA IVITY: i 1 -tot) 11. SETBACKS (ACTUAL) NT: BACK: RIGHT LEFT Tj��gs SIDE SIDE: v 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) NEW CONSTRUCTION [ J EXPANSION/ADDITION [ ] INTERIOR RENOVATION RESIDENTIAL [ J COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: � (Vt� 14. Sq. FUCONSTRUCTION: I' i4 0 15.. Sq. Ft. 1 st Floor. 1= 16. VALUE OF CONSTRUCTION: $ 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 construciion4f it is demonstrated.that the submitted figures are not consistent with similar types of construction activities. If the value is $2M or more, a RECORDED Notice of Commencement must be submitted with this application. z SLCCDV Form No.: 001-02 OWNER INFORMATION: V NAME: cia ADDRESS: "� - I e- CITY: A STATE: 7JP 341 PHONE (DAYTIME): 1 1 :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 (DAYTIME): ( 1 CONTRACTOR INFORMATION ST. of FL REGJCERT BUSINESS NAME: QUALIFIERS NAME: l �C ADDRESS: i _ PHONE (DAYTIME): ARCHIT/ENGINEER; ADDRESS: CITY: PHONE (DAYTIME): BONDING COMPANY. ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: 71bST. LUCIE COUNTY CERT #: - r' 1 i 0 STATE: -ZIP FAX NO P i/ STATE: ZIP STATE: ZIP i Zi STATE:. ZIP IMP.bRTANT NOTICE: When a permit is issued and it is not- picked up within- 60 daxs 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 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 construct" d zoning. �y /lam -� � •• '_, ,� /l ' OWN STATE OF FLOIkIDA COUNTY OF e—) The foregoing c-i�n� instrument ' ef'o� rme this RT day o Imo_ , who L%-Dersonal!l2 t acknowledg The L 20_&, by 4beYn to me or who identification. CONTRACTOR SIGNATURE STATE OF FLWI A COUNTY O e..� rument as acknowledged �` j day of , 20"_, byitCJ ho is r onally known to me d s Identification. P T Signatu a of otary Si nature f No Q N cT �f mor iJ_t, jeja r� Type or Print Name of Notary Type of Print Name of Notary aSQWZ M ¢ L Notary Public Title 0 W Notary Public Title Vmmission Number *'�o•.,. `JZ0) b rCommission Number (seal) rb0.Y'^i'�• LORI A. KARABAICH . aN*.r: (seal) �' 4. • •,r_ MY COMMISSION # nD 217769 EXPIRES: June 1, 2007 %ypf;°:�° Bonded Thru Notary Public Underwriters 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.