HomeMy WebLinkAbout1306-03210 APPLICATION FOR BUILDING PERMITOFFICE US_EAONLY: n
DATE FILED: �o/Y' • /�•
PLAN REVIEW FEE: tr - RECEIPT NO.:
CONCURRENCY FEE: RECEIPT NO.:
ALL INFO MUST BE COMPL
PLANNING &
RV
S$ Lucie C®Ur
APPLICATION
CERTIFICATE of CAP)
PERMIT NUMBER V� r
CERT. CAP. NO.:
& FILLED IN TO BE ACCEPTED
EVELOPMENT SERVICES DEPARTMENT
fG & CODE REGULATIONS DIVISION
2Pie Virginia Avenue tenw
Ft. Pierce, FL 34982-5652
772-462-1553
for BUILDING PERMIT
LCITY/ZONING COMPLIANCE
PR03ECT INFORMATION
1. LOCATION/SITE ADDRESS: �(1�"I e-a N t n 6t b y
2. PROJECT NAME: ('SITE PLAN NAME:
� 3. PROPERTY TAX ID #: OS - �l 13' � 14 - 000-
4. LEGAL DESCRIPTION (attach extra sheets jiff necessary): CA, flaLjU.
`A
I
5. PLAT BOOK 66. nnPAGE NO. 7. BLOCK NO. 8. LOT NO.
Vjf'1
9. PARCEL SIZE (ACRES/SQ FT.): �. 1 46ttS LOT DIMENSIONS: C x I d
10. COMPLETE DESCRIPTION OF CONSTIRUCTION PROJECT OR WORK ACTIVITY:
1nA k ! !
Ou,
11. SETBACKS (ACTUAL) FRONT: BACK: LN RIGHT SIDE: LEFT SIDE: 3. 3
12. TYPE OF CONSTRUCTION (Check aH appropriate boxes)
[VrNEW CONSTRUCTION [ �] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [I ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE:/i
14. SQ. FT OF CONSTRUCTION: 1 15. SF. FT 1 st FLOOR:
16. VALUE OF CONSTRUCTION: $ C� ®1 c- o
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
UPDATED 6/25/09
INFORMATION
rJ I#, U'UR&AU a IIJM "IURV1l1J
CITY: �jY�',�� {� ST.
PHONE (DAYTIME): rI( coo
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY 0'%
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER:
ADDRESS:
CITY: STATE:
PHONE (DAYTIME): L�
CONTRACTOR INFORMATION
ST. of FL REG.CERT #: U , 146-1 Q DO
BUSINESS NAME: i-
QUALIFIERS NAME: l
ADDRES I
CITY: SII TATE:
PHONE (DAYTIME):% a) '77 S Z FAX NO.
ARCHIT/ENGINEER:
ADDRESS: S
CITY: 0
PHONE (DAYTIME):
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY:
IMPORTANT NOTICE: When a pen
it will be voided and returned to you t
STATE:
ZIP: `1 I U 1
Email:
IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
ZIP:
ST. LUCIE COUNTY CERT #: CR J~l Sq
/ ZIP:
` Z 1
Email: Twi
STATE: ZIP:
i
I
I STATE: ZIP:
I
t is issued and it is not picked up within 60 days after notification
CERTIFICATION:
This application is hereby made to obtain a permit to do the we
if applicable, for the permitted work. I certify that no work or i
work will be performed to meet the standards of all laws reguh
may be required for ELECTRICAL, PLUMBING, SIGNS,
AND AIR CONDITIONERS, FENCES, ETC., not otherwis(
�k and installations as indicated, and to obtain a certificate of capacity,
istallation has commenced prior to the issuance of a permit and that all
ing construction in this jurisdiction. I understand that separate permits
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS,
included with this building permit application.
St. Lucie County makes no representation that its granting ofla 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,land 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. I
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.
OWNS R CONTRACTOR SIGNATURE
STATE OF FLO �1
COUNTY OF ��T
The foregoing instrun
me this I day of
by (C - `t�
who is personally
was acknowledged before
A,(YU, 20 13 . i
or has produced
STATE OF FLORIQ'A
COUNTY OF lLLJ?_)
The foregoin�gg ii'n`str
me this' day
by
who is personally known
was acknowledged before
2013,
d
��or has produced
as identification.
W. MCrgW4,
Signitfui'e Nota►�}.,w _:: ''a, NOTARY PUBLIC `Signkifu of Not rv� �nn
(� f it ,NOTARY
OF FIARIDA I Lr
TE Commission N(. ��, "�I Comm# EEI ! Commission No.mm# EE( �? 'j�
Expires 8/10/2015 '� E it Expires $11012015
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 THISAPPLICATION.
OWNER BUILDER AFFIDAVIT WI i L BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.
DESCRIPTION:
FiaTin at tl-p- NE c=r of d
of t1he Sl- of t�ya 0 of the
2
unship 36 Szuth, 40
2,54 feet to a paht; diemm-
400 fE=-t to a paint; theme
E7 &g29 minesWest I
thm:De,bm-i ar-d rm �r st 100
ba3irJ; h=p `�dd point a
West 100 feet to a paint; th
1.62.5 feet to a paint; "d-o-c
100 fit to a F_d; thm tu
feet to a -paint of bs#xdng
&s� l a lot 6 of an uma
SMV= lying in the NzI
d.e N14 cff the SF4L of Sactir_r
RrW 40 :�st.
� � M, 10
1. LW13s -,to\n tramm vz-m
bar ricfits of � w ar]J/cz- Ea
raaxd by this offdce.
2. lagal des=ipticn tes, su
3. Ficcd '7-crn x
i%l=th �" feet
E�' & Sa�i. 5,.
Ist, rm Saith
im ard r-m West"
_Tm and rm Nzrth
3.4 feet to a paint;
bat for paint cif'
lmgirnzr�g catines
m tum and nn Saith
li= arr] run Etast
ard rm 162.5
EaW land being aL9D.
rcisd plat of MMM'S
375 feet Of the Sa of
5f Uwd-4 36 aLthf
�d by clierit.