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HomeMy WebLinkAboutBUILDING PERMIT CERTIFICATE OF CAPACITY - ZONINGOFFICE USE ONLY SECTION TOWNSHIP BP#. /mil-A•0/-2L RANGE I I MAP NO. ZONING LAND USE LOT CVG % 7—;?­A—A TAZ NO. - ZONE \ FIRM MAP # 1st FLR ELV ."�� MAX HGT FLOOD . CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER` SEWER SPRINKLERS STORMWATER It— —LU— LOT OF REC LOYOF REC . LOT SPLIT LOT SPLIT APPROVED Before 1/1990 After 1/1990 REQUIRED REPORT HABITABLE RADON PERMIT FEE CODE / AREA FEE rr O LIBRARY - PUBLIC BID PUBIC BLD PARKS IMPACT RvTACT . IMPACT FEE IMPACT FEE FEE CORRECTION GENERAL SCHOOL ROAD CREDIT' Y N LAW ENF IMPACT I PACT Il14PA FEE FEE FEE FIRE/EMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE VARIANCE FEE IMPACT REQUIRED -FEE FEE — SPECIFY MECHANIC ROOF L--" NON -CONFORMING. MISCELLANEOUS FEES SUBS ELECTRIC - GAS LOT OF RECORD REQUIRED PLUMBING _ FEES - DATE SENT TO ADDRESSING: 1 ! REVIEWS ` - FRONT .'ZONING. SUPERVISOR PLANS VEGETATION . SEA TURTLE REVIEW CO REVIEW RE W. : REVIEW ) i3 REvrEw' DATE 1tt RECEIVED 13 DATE COMPLETED INITIALS MANGROVE i REVIEW f OFFICE USE ONLY: DATE FILED: "�Y PERMIT NUMBER: • 0/ 2 �- PLAN REVIEW FEE: RECEIPT NO.:'i�ERT. CAP. NO.: CONCURRENCY FEE: t7 . RECEIPT � e w� ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOP MENT SERVICES. DEPARTMENT BUILDING & CODE REGULATIONS DIVISION • 2300 Virginia Avenue - _ Ft. Pierce, FL 34982-5652 a. / / Q D C . �2�t1 F6B ApPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: % 20 5 F_ Sk 2. PROJECT NAME: N` k po tl f- SITE PLAN NAME: 3. PROPERTY TAX ID #: 3A k q - Su 0 -03 t9 - D 0©- 3 4lk s 3 God �{ 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 8: ,,OT NO. y 5. PLAT BOOK 6. PAGE NO. 7. BLOCK,NO: 5 3 �2u l � 9. PARCEL SIZE.,(ACRES/S0 FT.): •Z OT DIldENSIONS i0. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY': G WS !?j�� 11. SETBACKS'(ACTUAL) FRONT:`k4 e 01 BACK: &I. 4b RIGHT SIDE:'L`;• �� LEFT SIDE. 2'� 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) - D4 NEW CONSTRUCTION [ ] ENPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE - Rem 4e-0 14. SQ. FT OF CONSTRUCTION: S L\ l 15. $F. FT 1st FLOOR LANA �1 16. VALUE OF CONSTRUCTION: $ l g ® 0 ed The value of construction is used to determine the amount of permit fees to be assessed St Lucie Counof cos ces titiun a ght v ties. If the value is $estion and/or 25 0 or motethe t a value of construction if it is demonstrated that the submitted figures are not consistent with similar types RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 UPDATED 05109 OWNER INFORMATION NAME: to �- y Gl e_ CAD y6-3.-k4-k ADDRESS: 'k 3 =� V3 -44\ S CITY: V-b QA P lettce, . ,. STATE: �- ZIP: 3 so PHONE (DAYTIME)°( L):4i67-- s%' S Email: MGVom c S+ kyc`e GO IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: N IPt STATE: i�r ZIP: PHONE (DAYTIME): CONTRACTOR. INFORMATION ST. of FL REG.CERT #: G C ' : S 1 `J� 5 ST. LUCIE. COUNTY. CERT #: BUSINESS NAME: Ole- GC1�SE�wG'�OOJ SeeU(G� QUALIFIERS NAME: tic ko 01W(w k ADDRESS: 3�3 ' ' SW �, O'eo P�_ st CITY: iL o Q.'� S� `.J L �° STATE: ZIP: 3 4A$ 3 P_Ht�NF-(nA-YTIMEl:-('r2-7-5-1�-2`ti`�el FAXNO. � X= 33Email: QICVisetu(Ct'.5P-4 1 . ' ARCHIT/ENGINEER P \ UJti G r- � 64sG ADDRESS:.. Vok a 4 5 h O, CITY: 1Q0 _-+ S t STATE: L ZIP: 9 J4 g d 4 PHONE (DAYTIME): ( } Z) .3 $ S - S X a BONDING COMPANY: (I� ADDRESS: CITY: PJ �� STATE: J W Ilk 21P: N �� MORTGAGE LENDER: Ll (k ADDRESS: N �� CITY: STATE: X : ZIP: -Coif 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- 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. OWNER­OR_@0tafflCTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this ! 0 day of - 20 by mPu, ► =LC J 0 0 C_r_l 1&.,n9_ _ who is personall own or has produced as identification. Signature 6f N ry Commission No. . (Seal) a c r 4 r '? SIGNATURE �'Doo a STATE OF FLORIDA - o COUNTY OF n 3 � o $ The foregoing instrument was acknowledged before me this day of 20 IS. , rnx� t�.�i c i Die/%nc ho is personal] own or has produced as identification. gm<y irn rn � T Signature otary "gym .2�0" m Commission No. (Seal) c- m m a IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification NOTE: TWO (2) SIGNATURES ARE REQUIRED. EANATURE MUST BE NOTARIZED. IF APPLYING FOR it will be voided and returned to you by maiL 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.