Loading...
HomeMy WebLinkAboutAPPLICATION FOR BUILDING PERMIT\'� OFFIGE;U�E`ONLY BP #: A� 07�� DATE FILED: PLAN REVIEW FEE: D PERMIT NUMBER: M6 • 07� CONCURRENCY FEE• .R C CERT. CAP. NO.: 1. :. ::.::::::.::: :::::::::::::.....: ACCEPTED ALL INFO MAST BE COMPLETE 8z FILLED IN TO BE ACC OFFtC USE ONLY::. SECTION: �2 TOWNSHIP: GG ��.�J RANGE:0 MAP NO.:/✓ ,�j/ 'ST. LUCIE COUNTY PUBLICWORKS '� BUILDING & ZONING DEPARTMENT 2300 VIRGINIA AVENUE 1' '20RIOa FORT PIERCE,;FL;34982-5652 ZONING: � Ub LAND USE: IZ S LOT CVG %: 3� :39 TAZ NO.: 561-462-1553 NAMED FLOOD ZONE: Y- FIRM MAP #: 2�� F- 1ST FLR ELV: MAX HGT: APPLICATION for BUILDING PERMIT U&P2 nntn CERTIFICATE of. CAPACITY/ZONING COMPLIANCE CST TYPE: OCCP TYPE: MAX. OCCP: # OF FLRS: ..l PROJECT INFORMATION WATER: SEWER — —SPRINKLERS— STORMWATE 1. LOCATION/SITE ADDRESS: '7c> 4 L MA( i-P U;— 2. S/D PLAN NAME:ItD�? LOT OF REC (befr 1/90) LOT OF REC (aftr 1/90) LOT SPLIT REO'D LOT SPLIT APPRV'D 3. PROPERTY TAX ID #: ZZ — b5 — C� f 4. LEGAL DESCRIPTION (attach extra sheets if necessary): DECAL APARKS PERMIT NUMBER IMPACT FEE IMPACT FEE FEE REPORT PUBLIC BLDG HABITABALE RADON FEE �� �i 5. PLAT ti. PAGE 7.--�6eFC . 8. LOT CODE ©� IMPACT FEE _ I `J • �� AREA BOOK �ZJ NO. l� t 1,� -I l� NO. > NO. t �� (RADON) ROAD IMPACT ZONE I"LLa I GROSS ROAD IMPACT FEE Z��C% CREDIT TOTAL ROAD IMPACT FEE �,�� 5 �S 9. PARCEL SIZE: ACRES/SQ FT. LOT DIMENSIONS X ` 10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: SCHOOL HO 3 CREDIT Y N '• TOTAL F GL LN �4 S � Val D S E N T IMPAC T FEE SCHOOL L IMPACT FEE 11. SE TBACKS ACTUA L FRONT: BACK: RIGHT LEFT y � SID E: 8 SIDE S 4 POLICE FEE I FIRE FEE �4�4 MISC FEES: TOTAL POLICE/FIRE/ 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) IG�W j MISC. FEES Y N �U l F. DI NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION ADDITIONAL SPECIFY: t GTR < < TOTAL ALL �f RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL PERMITS VAS FEES [ ] OTHER (SPECIFY) REQ'D 13. DESCRIPTION OF PROPOSED USE: REVIEWS ZONING ZONING _ PLANS VEGETATI&I .- .1i;SEA MANGROVE 14. Sq. Ft./CONSTRUCTION: z`a 177 15. Sq. Ft. 1st Floor: Z8 �? - :'lREVIEWED BY EXAMINING =` ' `' °' TURTLE-- .. DATE - �` , _ " 16. VALUE OF CONSTRUCTION: $ 1i COMPLETE -n 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 ooilsistent with similar types of construction activities. If the value is $2500 INITIALS ) or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 OWNER INFORMATION:. II rr NAME: ADDRESS: CITY:�L_Nt, ��4� STATE: ZIP 4.© �' � PHONE (DAYTIME): 3_.9 y j Epp IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: Al. A ADDRESS: CITY: STATE: ZIP PHONE (DAYTIME): �L -ONTRACTOR INFORMATION iT, of FL REG./CERT #: CZr— 0L+6 a I D ST. LUCIE COUNTY CERT #: I '? 681p IUSINESS NAME:- KpaL.T @ R 5 ��N�tTu R� NnMES LNG 1UALIFIERS_NAME: \Q T J VA lL + B R ADDRESS: \ITY: STATE: ZIP--- �L __ -- --- -- - � HONE (DAYTIME)- ----=(772-) FAX NO. RCHIT/ENGINEER: his H Eta DDRESS: Z y On W IC, I+ %Z i r- TY: 3d`( (�Tp t•( Brzf�C�-} STATE: L- ZIP 3 3Ll 2/0 TONE (DAYTIME): f )NDING COMPANY: W A 1DRESS: rY: STATE, ZIP IRTGAGE LENDER: DRESS: Y: STATE: ZIP IPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days ter notification it will be YQL&A 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 constr ction d zoning. OWNER/CON C R SIGNATURE CONT TOR IGNATURE STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ST L.tAict C COUNTY OF Ste' Lucite The foregoing instrument was acknowledges The foregoing instrument was acknowledged jefo a me this day o �5� bbeforemethisy`ayof20, who Is ersona nown to me r who rod d n o m as I en I Ication. or wh s produce as identifica ion. of Notary Type or Print Name of Notary Notary Public Title of Notary Type of Print Name of Notary Notary Public Title Commission Number Commission Number LYNNE M )ORE (seal) Gomm# OW232&% LYNNE M00R5 Expires g/23/2007 (seal) Comm# O W232858 Bonded thru (8W)432-4254 Expires 9/23/2007 Florida Note Assn., Mc. Bonded thru (800)432-4254 NOTE: TWO (2) SIG _ E REQUIRED. EACH SIGNATURE MUST . a Notary Assn., Inc. 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.