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HomeMy WebLinkAboutAPPLICATION FOR BUILDING PERMITOFFICE USE ONLY: DATE FILED: 6 3 14 PLAN REVIEW FE a O , O O RECEIPT CONCURRENCY FEE: RECEIPT ALL INFO MUST BE CO PLANNING �v APPLICATION f CERTIFICATE of CAPA PERMIT NUMBER: OA C)G '43a 5 1 CERT. CAP. NO.: & FILLED IN TO BE ACCEPTED DEVELOPMENT SERVICES DEPARTMENT ING & CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL 5652 772-462-1553 �ju,10 I LioLQ — '�.J `Lir 621553 I BUILDING PERMIT TY/ZONING COMPLIANCE hh PROJECT ]NFORMATION 1. LOCATION/SITE ADDRESS: ' V 1 J ��� ��.U� Lb T 6 8 �(N= &a 2. PROJECT NAME:? I n (1 SITE PLAN NAME: n �5 3. PROPERTY TAX ID #: — — 0 034 0C) 4. LEGAL DESCRIPTION (attach extra sheets if necessary), �Q� 0 `sno f 5. PLAT BOOK 6. PAGE NO. 1 7. BLOCK NO. 8. LOT NO. 9. PARCEL SIZE (ACRES/SQ FT.): 1 1 A uG03 LOT D I 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROM 12 OR WORK ACTIVITY: LO Jl }.rRj 11. SETBACKS (ACTUAL) FRONT: Li 3 . S BACK: _�RIGHT SIDE: LEFT SIDE: . S 12. T E OF CONSTRUCTION (Check all appropriate boxes) I j NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: 5 '- iicr � 14. 16. SQ. FT OF CONSTRUCTION: 2 ) S 3 v 15. SF. FT 1st FLOOR: d 15 3 VALUE OF CONSTRUCTION: $ Qqo CO 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 7 .7-It Otm, 101a 00, I ©MATION x 1AARCYli BRING ADDRESS: 1MI S_ OCEAN OIL LOT B8 Cny: JENSEN BEACH STATE: F- ZIP- 34957 PHONE (DAYT MP: ( 233r2 ' FM213 - THYRiiM10162GAIAILOOM IF TEE FEE MULE TI =OLDER CPROPFRTi OUTMM IS D vI' FROM THE OWNER. IBM ABOVE. PLEASE FUL INIZ4 A E AND ADDRESS BELOW- � PHONE {DAFT: C—) BUSMSS _ CD Mh U C.,\ on l ADDRESS:, "-I; Q \ ; �R'1 _ Cny-- (mod- STATF: PHOxE (DA�C'Ii.: M_ I ' _ Oil FAXNO �2, ARcmITs�Gl3v` R , ��� e S �� ADDRESS: L46-1 Svc cast'\ &an f �') e, =-- SrATE- VC PHONE {DA-c'II7MQ: en 223 - g S 63 RONDIlaTGCOWAxY: lV_� ADDRESS: cTrY: STATE: CObWW CEYXft: '14 11 ) MORTGAGE E%MER ►V �_�'► ADDRESS: Cli'Y: STATE: 23P: 3`4 q Ci -4- RUPOR ATNT NOTICE: Allen a permit is issued and it is not picked upniddn 60 !bp after notification it will be voided and retnraed to you I* maiL This ap Ucadm is hereby tnb to obtain a permit to do d)Le i(ak aad ftL9aDafims as indicated. and to obtain a contifimte of capachy if applicable: Jim the pwaitted wv ek_ I certify flint no 1wk or insa➢atiait hm commeiced prior to the issmce of a pmnit and dut all v� wM be to meet the of all laws'agilating cros=cdm in this jirisdictiaL Imulerstmd1hat separate pmmrts mny be reed for FLECFRICAL, PLUMMG, SIC&S, WbULS. POOLS, FURWACFS, BOWERS. 19FATERS, T-AMEL% AND AIR C016DMOMR% FENCES FTC not citii&wise irirMearl wM this b 15igpmmh appIiratioB 5t I.mi Comity makes no repzesautaden dm its g I Z of a wit will allifta iae the PMw holffar to bad the sulijact suw=e which is a conflict with any applicable Hamemmer Assoarfiaa rules. bylaws or any coiwmis that may resu= or ptrdytit smfl str wlimm Pose: con -nit w th yomr Hors r'!m=tim arfd reaiew you deed far anyrag-Lr=ms wiLkh my apply. ThE fdl ulil m IHAtims are a fill coazuz~r otidng g p®it apl+ e3empt'i � etaq reiri.�r_ ram adrlitims, aczessocy si_Mve; (all eypes). s1xfimicb pools. fences. walls. sigma screaa rems. utWity substations &- accessc ry use to anothff noit- r use. NOTICE TO OuTint YOUR FAILURE- 1-0 RECORD A NOnCF OF COMMENCO&ENT? AY RESULT IN YOUR PAYING TWICE FOR DAPROMMM TO YOURPROMETY ANOTiC£ OF CO TM- 11ENT MIDST BERECORDED AND POSTED ON THE 1OMSnE BEFORE TEE f FRSDWECYION YOU MOM TO OBTAIN F1fiT.' NCIDNG CONSULTW1MYOUR, L EFLOR.INATrORNETIEFORERECORDINGYOURANOTICEOF NOTICE TO APPLICANT: IF IT IS NOT YOUR. RIGHT THIE. ANM INTEREST TgLl3' IS SUSIECT TO ATTAC -r. AS A'fvOld'iDITTO'170F ISSUANCE OF TM Pam, YOU PROMM IN GOOD FATITI TO DEIATERA COPY OF THE CON-S RUCTION LIEN LAW NOTICE TO TEE PERSON WHOSE PROPEtTY IS SUBJECT TO ATTACMIE.NT: STATE OFFLORWIL MATE OF � c®u-NiTy OF cOtiWXY4 T%rJ The faregaing went vas &i3xw1adVd before ME fortgoing itishmment wM x1owuledged before RM this l f � of 104 y 201 t f� me U& 12 day of -7 20N by by xtio is persoaxIIg >�o� K or has Produced vir;a its piss 7 or hn produced 9-it re at?�nt�cy v�atttra of xaf� . Cotsisassi�Yo_ 2 Fp�DT+� Caii�ssimtllioF�Z.Z.1`��- :�4�r'�'' DANAj �•;►� 'o ��,� IJ n. ROCK y MY COMMIS, Notary Public - State of Florida l-�oF,nd'��' EXPIRES J My Comm. Expires Sep 21.2016 t j 407 3ta8.0153 Ftoridallota 11OTE_ ,moo (2� G�Iu'RFS '94t SIG'OiAYU I�iUST ��iO�ARI� 1F.11PPLIMG FOR TM ER, TM OVONMMUST PERSOM L Y 4 MIRTO SIGN TTILS API LICATTOlti IN THE OMCE UMMD ON TBE FRONT OF TM APPLICATION O E1UHMER:4FNETIr)I.I'M MUM BE REQUEI 0 FOR ALL OWAW-RmCnaER jm1LICt%,i%TS_ For specific instructions see appropriate permit checklist. EVANS N #FF12214� e 12, 20119