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HomeMy WebLinkAbout1006-0186 APPLICATION FOR BUILDING PERMITY r OFFICE USE ONLY: ° DATE FILED: PLAN REVIEW FEE: L9 0 RECEIPT NO.: CONCURRENCY FEE: _ RECEIPT NO.: i�J J 0 5 7 PERMIT NUMBER: 619 14 CERT. CAP. NO.: ALL INFO MUST BE COMPLET & FILLED IN TO BE ACCEPTED St. Lucie County Building and Zoning /do 0, 2300 Virginia Avenue Ft. Pierce, F7. 34982-5652 772-462-1553 P� APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACI Y/ZONING COMPLIANCE 1. 2. 3. 4. PROJECT INF RMATION LOCATION/SITE ADDRESS:. PROJECT NAME:Onhzw�% SITE AN NAME: PROPERTY TAX ID #: LEGAL DESCRIPTION (attach extra sheets if necessary): 5. PLAT BOOK 6. PAGE NO. 9. PARCEL SIZE (ACRES/SQ FT.): LOT 7. BLOCK NO. 8. LOT NO. 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: 11. 12. 13 SETBACKS (ACTUAL) FRONT: BACK: _ TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/A] [ ] RESIDENTIAL [ ] COMMERCIAL [ ] OTHER (SPECIFY) B3 jA R NZ4—� (L DESCRIPTION OF PROPOSED USE: RIGHT SIDE: 0 LEFT SIDE: [ ] INTERIOR RENOVATION J (] INDUSTRIAL 14. SQ. FT OF CONSTRUCTION: I 15. SF. FT 1 st FLOOR: O 16. VALUE OF CONSTRUCTION: $ ni 11 The value, of constriction is used to determine the amount of permit fees to be assessed. St. Luce 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. I SLCCDV Form No.: 001-02 06 CERTIFICATION: This application is hereby made to obtain a permit to do the wo if applicable, for the permitted work. I certify that no work or work will be performed to meet the standards of all laws regulal may be required for ELECTRICAL, PLUMBING, SIGNS, AND AIR CONDITIONERS, FENCES, ETC., not otherwise and installations as indicated, and to obtain a certificate of capacity, allation has commenced prior to the issuance of a permit and that all construction in this jurisdiction. I understand that separate permits ELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, ;luded with this building permit application. St. Lucie County makes no representation that its granting of a �ermit will authorize the permit holder to build the subject structure which is in conflict with any applicable Homeowner Associatiop 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 structures (all types), swimming pools, fences, walls, signs, residential use. NOTICE TO OWNER: YOUR FAILURE TO RECC PAYING TWICE FOR IMP] COMMENCEMENT MUST FIRST INSPECTION. IF Yl LENDER OR AN ATTORN COMMENCEMENT. NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, ATTACHMENT: AS A CON GOOD FAITH TO DELIVER THE PERSON WHOSE PRO] r STATE OF FLORTj/ COUNTY OF 3• L U e l e- The foregoing instrument was acknowledged before me this'21 day of ma 20 10 , by AOt0rtER— be 160f— Iwho is personally known x or has produced identification. Signature of Notary I" , CAR LAN-ELS ON Commission g�ti1PY �- MY COMMISSION # jive 61 EXPI S: March ' �. •'� BondadThruNotaryPublic lers going a full concurrency review: room additions, accessory rooms, utility substations & accessory uses to another non- i A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR DEMENTS TO YOUR PROPERTY. A NOTICE OF RECORDED AND POSTED ON THE JOBSITE BEFORE THE INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR BEFORE RECORDING YOUR NOTICE OF TLE, AND INTEREST THAT IS SUBJECT TO TION OF ISSUANCE OF THIS PERMIT, YOU PROMISE IN COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO RTY IS SUBJECT TO ATTACHMENT. NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIG THIS BUILDING PERMIT AS AN OWNER/BUILDER, THIS APPLICATION IN THE OFFICE LISTED ON TH OWNER BUILDER AFFIDAVIT WILL BE REQUIRED For specific instructions see appropriate permit I1 STATE OF FLORIDA COUNTY OF The foregoing 'hnstrument was acknowledged before me this a-eday of 20- ©, by Ly t S �P �, �f' Ul VD who s ersony or has produced as identification. Signature of Commission No. V" PA7R SALA7JIR MY COMMISSION # DD 625270 EXPIRES: APdI 28, 2011 Bwldad Thru Notary Pu*, UnderW ROrs kTURE MUST BE N HE OWNER MUST PERSONALLY APPEAR TO SIGN FRONT OF THIS APPLICATION. OR ALL OWNER/BUILDER APPLICANTS. I , OWNER INFORM TION ` a NAME: i pp ADDRESS: 5O 1 CITY: � Qa� ` Ii e cc STATE: i> `�-� ZIP: � G1 `� PHONE (DAYTIME): (_) 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 (DAYTIME): (_) CONTRACTOR INFORMATION /I p CERT #: ST. of FL REG.CERT #: ST. LUCIE COUNTY BUSINESS NAME: G CD QUALIFIERS NAME: I���j ► 2 6- a O S ADDRESS: CITY: STATE: ' C> VOL C ZIP: 33 ` 1LCtAL a PHONE (DAYTIME): (1) �� `1sI (� FAX NO. _ 33-�J 5 13Emai1: �� u _ \ c I l� eu,-MTzP IPPiF Z �l�1�, rl- 'v�A�LL (` C1 1�.2�t� ADDRESS: N\ -01X J k u t=jtA- -yL CITY: �� ) A 2 STATE: PHONE (DAYTIME): (� .� - 4WD 1p BONDING COMPANY: ADDRESS: CITY: STATE: MORTGAGE LENDER: ADDRESS: CITY: STATE: IMPORTANT NOTICE: When a permit is issued it will be voided and returned to you by mail. ' k�— ZIP: :3 L19 R ZIP: ZIP: it is not picked up within 60 days after notification