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Home My WebLink About0704-0263-APPLICATION FOR BUILDING PERMIT CERTIFICATE OF CAPACITYOFFI E USE.ONL;Y: _ DAT FILED:�� PLA 'REVIEW FEE:RECEIPT NO.: CON IURRENCY FEE: � =�� t• RECEIPT 8O.�,�1�1G6ae ( W tY PERMIT NUMBER: 07V VI CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED -� St. Lucie County Building and Zoning 2300 Virginia Avenue •'��ORlO Ft. Pierce, FL 34982-5652 772-462-1553 APPLICATION for BUILDING PERMIT 6'70-6, o� CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION \\.(.IN, %UQ 1. 2. 3. 4. LOCATION/SITE ADDRESS: S/D NAME: Ve%3,1C E C�J't SITE PLAN NAME: PROPERTY TAX ID #: \\_�\b- hbkM— Mti- LEGAL DESCRIPTION (attach extra sheets if necessary):\'QMAU., D0Y �smo C.�`� XryzlS?►�`eil. 5. PLAT 6. PAGE 7. BLOCK BOOK NO. NO. 8. LOT NO. `C b 4-7 9. 11 PARCEL SIZE: ACRES/SQ FT. of \ �C7 LOT DIMENSIONS 0•05 ZDo 10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: i 11. I SETBACKS (ACTUAL) FRONT: I BACK: RIGHT: SIDE LEFT: 12. 03' TYPE OF CONSTRUCTION CY SIDE g I (Check al] appropriate bCP NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION Q RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) ` 13. DESCRIPTION OF PROPOSED USE: V\Qz\:)- RR. `rk oM4' �n2. 14. Sq. Ft./CONSTRUCTION: 15. Sq. Ft. 1st Floor: 16. VALUE OF CONSTRUCTION: $�f %•�" The va�'oe 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 o 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 RECOPIED Notice of Commencement must be submitted with this application. Form No.: 001-02 .T R INFORMATION ADD ,SS: \�`�o\ C'1.e.. CITY: li 4�Q.W-1 S- - Ur- , yRAJ J ZIP PHO (DAYTIME): Lego— (o o - email: IF FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL I NAME AND ADDRESS BELOW. FEE SI LE TITLEHOLDER: CITY: lil STATE: ZIP PHO l (DAYTIME): (� CONTRACTOR INFORMATION ST. of L REG./CERT#: . - \TSl :?j ST. LUCIE COUNTY CERT � BUS I SS NAME: 1")twU \& \v QUAL FIERS NAME: t.W W \lj ADD SS: CITY: A STATE: F' ZIP PH O I (DAYTIME): t 1� DDO- \NS`' 5 FAX NO`�-� -ay'bQkmail: ARC IIT/ENGINEER: _AGDdcS1 ��`C�1�S ADD SS: IpOi`� �Q��CQ,CLS►J �� CITY: II (L STATE: ZIP 3�b�rj PHO (DAYTIME): a%& - S!Nn COMPANY: CITY: II MOR71 GAGE LENDER: STATE: ZIP ADD SS: CITY: STATE: ZIP I I IMP RTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification it wil ;Ibe voided and returned to you by mail. TIFICATION: This ap Ilication is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity, if appli able, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all work w 'll 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 A R CONDITIONERS, ETC., not otherwise included with this building permit application. The fol owing building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structur Is (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non- resident lal use. 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. 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. OWNS '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 construction and zoning. 14 OWNEILICONTRAC"rOXOGNATURE CONTRACTOR SIGNATURE STATE OF FLORIDA STATE OF FLORIDA COUN ,I OF Cn,A%1 MCOUNTY OF !\A �,<'1 The for going instrument was acknowledged before pie this Q. day o#T-L? , 200I by who is personally known tti me or who has produced as identification. of Notary II 11.•'s+"-----STELLA M. HUNTER Type or Print Name of Not .'z' e: MY COMMISSION # DD 630775 a•. a EXPIRES: January 23, 2011 • "�° Bonded Thru Notary Pubic Underwriters Commi sion No. The foregoing instrument was acknowledged before me this Q day ofF J$ , 200 by , who is personally knnoo_w, n to me or who has produce as identification. 4 `Ps Signature of Notary _ _ _ _ NAY STELLA M. HUNTER a _ EMISSION N DD 630775 Type or Print Nam ' EXPIRES: January 23, 2011 'h'�,pF;°a•` Bonded Thru Notary Public Underwdters Commission No. NOTE: lITWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN (THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THE APPLICATION. For sbecific instructions see appropriate permit checklist. I V 16AQ'1A - CERTIFICATION: I� This al plication 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 °ill be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits may required uired for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 9 AND 1IR 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 structu es (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non- residen ial use. 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. NOTI1 tE 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. I OWN a R'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 construction and zoning. n OVNER/CONTRACT4IR SIGNATURE CONTRACTOR SIGNATURE SIA1 OF FL RIDA STATE OF FLORIDA CO TY OF AR'� \ COUNTY OF M— Z %,k�t The fo iIegoing instrument as acknowledged The foregoing instrument as acknowledged fore me this day of , 211. by ,before me this !Z)_ day of 20, by 1� lei who i personally Nd , who i personally knov,ka;! o or who has produced k n to me or who has produced v1l as identification. '��0.3 yk as identification. Signat !'`re of Notary Signature of Notary F�:Oo',' :Y Pf;•, STELLA M. HUNTER ;* MY COMMISSION # Du 630775 T e o Print Name of Notary ?4' XPIRES: January 23, 2011 Type or Prin b �T M. HUNTER Yp ry ;P7; 8ondod That Notary Public Undorwdters a OMMISSION # DD 630775 EXPIRES: nu 23 2011 Commission No. (Seal) Commission o%R,h' 86ndedThruN ounderwdrers NOTE' TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THE APPLICATION. For $specific instructions see appropriate permit checklist.