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Home My WebLink AboutAPPLICATION FOR BUILDING PERMITOFFICE USE ONLY BP #: SECTION 1 TOWNSHIP RANGE MAP NO. - L ZONING LAND USE LOT CVG % TAZ NO. y3f FIRM MAP # 1 sr FLR ELV MAX HGT ` FLOOD ZONE CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC -A LOT'OF REC LOT SPLIT LOT SPLIT APPROVED Before 111990 After 1/1990 REQUIRED — --yy- -HABITABLE--,- RADON PERMIT CODE - AREA -FEE FEE ---- 1 (RADON) LIBRARY PUBLIC BLD PUBIC BLD PARKS IMPACT IMPACT FEE IMP . FEE CORRECTION FEE GENERAL SCHOOL ROAD CREDIT Y N LAW ENF IMPACTIMP DvIPACT FEE E FEE FIRE/EMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE IMPACT REQUIRED FEE VARIANCE FEE FEE SPECIFY MECHANIC ROOF — NON -CONFORMING MISCELLANEOUS FEES SUBS ELECTRIC GAS LOT OF RECORD = REQUIRED PLUMBING -b� FEES DATE SENT TO ADDRESSING: / REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER RE w REVIEW REVIEW REVIEW - _ REVIEW REVIEW ( � �,=; RECEIVED' - 07q 1- ( - DATE _ COMPLETED - - � INITIALS I OFFICE USE ONLY: DATE FILED: AA is ov T NUMBER: PLAN REVIEW FEE: SG � 1 RECEIPT NO.: ��40EAdeMANT. �AP. NO.: �i1=1CONCURRENCY FEE: RECEIPT NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING &s CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION `r LOCATION/SITE ADDRESS: 6125 S C GC(an (-) Y 2-®� PROJECT NAME: SITE PLAN NANM: --P-RO-PERTY TAX ID #: 451 1- 60 l ' [ t<, - 060 - n t _i er- i _ : n DivV ) ,.4- 4. LEGAL DESCRIPTION (atta.cti extra sneers ii necessary). - — - - _ - e �I M - ATA ^ rAK.0 , OW r y 1 2 5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO_ 8. LOT NO. 00 9. PARCEL SIZE (ACRES/SQ FT.): -2�LOT DIMENSIONS: G 10. CONIPLETE DESCRIPTION ?j(CN1STRUqTjON PROD CT OR WORK ACTIVITY: BACK: :5 RIGHT SIDE: y r LEFT SIDE: - 11. SETBACKS (ACTUAL) FRONT;�� . 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) c 13. DESCRIPTION OF P OPOSED USFt; 6' : L 14. SQ. FT OF CONSTRUCTION. 15. SF. FT 1 st FLOOR 16. VALUE OF CONSTRUCTION: S 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 OWNER INFORMATION NAME: Da\i►d + L an -a yI�/1aCDona kd ADDRESS: 1(30 W f S+ 15+ �► e CITY: -J t (6 W 0 0 CY STATE: mew ) Z=ZIP: 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: PHONE (DAYTIME): (� CONTRACTOR INFORMATION ZIP: ST. of FL REG.CERT�#: (0 rjgl--I I2 ST. LUCIE COUNTY CERT #: v 1rL3�J BUSINESS NAME: 1 � I' V O il�"► YV C 'Il CX� QUALIFIERS NAME: ADDRESS: 10q 6-1 O cP a,r, O - CITY: �� Y�� Y� G ea LK STATE: �7L ZIP: PHONE (DAYTIME): "I(%2) ZZ9 - Q4 3 ck - FAX NO.1? 2 - `L24 - q q y 0 Email: Pw Yh ,_ Y ARCHIT/ENGINEER -� ` P -Z ;",-Too ADDRESS: - CITY: ��!}YL STATE: �p ZIP: PHONE (DAYT ,1E): BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: STATE: MA An, IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days'after notification it will be voided 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, 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. OWNER OR CONTRACTOR SIGNATURE CONTRACTOR SIGNATURE STATE OF FLORIDA 1 , COUNTY OF e- The foregoing instrument was acknowledged before me this �2 day of 20J3, by Mc\r_ K M o.� who is personally knoo Signature of Notary Commission or has produced identification. DAVID N. KNEPPER fission #-DD 995518 s September 25, 2014 STATE OF FLORIDA COUNTY OF S- � The foregoing instrument was acknowledged before me this I day of 20 13 , , by 'Mat--k a who is personally known � or has produced as identification. Signature of Notary Commission No. KNEPPER Co miss #,DD 995518 Xeq on September 25, 2014 %JFpd...V BondedThruTmyFain Inswance8M85.7019 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 THIS APPLICATION. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS. For specific instructions see appropriate permit checklist.