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HomeMy WebLinkAbout1404-0377-BUILDING PERMIT APPLICATIONBY OFFICE �i SE ONLY: 11 \ /e L��O�®�� DATE FILED: �• c�� 7`' 'J�/,n, /' ��77 PLAN VIEW FEE: . Q n RECEIPT NO.: �0 PERMIT NUMBER: / i' lJ `l CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED �r 7 PLANNING & DEVELOPMENT SERVICES DEPARTMENT Ty BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 F� c✓.�� 772-462-1553 D� f n V n cy 1 V (� V 1 `° �Ci I V APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. I OCATION/SITE ADDRESS: [ Ls—)`{ 1 \J��"TiC �1\.1''► ��C.1y VT.I V f 1Ctl->�j I U 2. PROJECT NAME: ' 1SITE PLAN NAME: 3. (PROPERTY TAX ID #: --tt'��� ���� 4. LEGAL DESCRIPTION (attach extra sheets if necessary): NE+- I M x'Sbrd 1.i,-- (a 5. II LAT BOOKO 6. PAGE NO. JAF 7. BLOCK NO. 8. LOT NO. 12 ` t x �-ck x 5!S-%V � 9. jPARCEL SIZE (ACRES/SQ FT.): �I ' " -LOT DIMENSIONS: 10. (COMP ETE DESCRIPTION CONSTRUCTI N PROJECT OR WORK ACT VITY:���JL 11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: 0 LEFT SIDE: 12. iTYPE OF CONSTRUCTION (Check all appropriate boxes) I [Q,-'�W CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. j DESCRIPTION OF PROPOSED USE: 14. I SQ. FT OF CONSTRUCTION: 15. SF. FT 1st FLOOR: idJ W 16. VALUE OF CONSTRUCTION: $ p 7 The value lof 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 c 11nstruction if it is demonstrated that the submitted figures are not consistent with similar types of fonstruction activities. If the value is $2500 or more, a RECo D Notice of Commencement must be submitted with this application. I SLUU1V Form No.: 001-02 ' c / UPDATED 6/25/09 OWN R INFORMATION NAME: I AlllliClJ �: \ () �� ! VC �Tl�l� IV\�- • �-- CITY STATE: ZIP: L��5� PHONE I AYTIME): ( ©c�` D`(f Email: IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN 114 11 AME AND ADDRESS BELOW. FEES LE TITLEHOLDER: ADDRE S: CITY: STATE: ZIP: PHONE 'DAYTIME): U CONT1,1ACTOR INFORMATION ST. of F II REG.CERT #Q C� BUSINE II S NAME: ��-��K,� OUALIF RS NAME: , SHE ST. LUCIE COUNTY CERT #: L 41� � --r- . CITY: u STATE: rC_ ZIP: PHONE JDAYTIME)4-� FAX NO. Email: \ ARCHI VENGINEER \ Vl C� `NL11lS. IN� • ii �• � :• • COMPANY: CITY: STATE: STATE: ZIP: ZIP: MORT 'AGE LENDER. II ADDRESS: I CITY: STATE: ZIP: it J IMPO 'I NT NOTICE: When a permit is issued and it is not picked up within 60 days after notification it will $a voided and returned to you by mail. CER� IFICATION: This appl cation is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity, if applica le, 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 r quired for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AND 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 foll (wing building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structure (all types), swimming pools, fences, walls, signs, screen rooms, utility substations do accessory uses to another non- residents 1 use. 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 LENDEROR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 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 WI40SE PROPERTY IS SUBJECT TO ATTACHMENT. OR STATE 1 310F FLGRI]DA COUNTY"OF t �V.0 The fore I going instrument was acknowledged before me this,L1 ' day A I 20 j , by C 9-- o is p Frsonally k or has produced of Notary MARIM MILLS )n No. 1�YtE$14 � Col) F 023763 '1%.°4�i' P Bo&dThm�res Troj nInsuraJunceB00.3sI 1019 STATE OF FLA ���C.I 4 COUNTY OF �t The foregoing instrument was acknowledged before me this4�, day of 2o_�L by C who is personally know or has produced enttfication. r igna ure of Notary Commission No. MiSs%n# Commr 023763 W&M �Bonded ThmExpires e To MaIsumeeB003857019 NOTE: ii O .(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 TIHIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. PWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS. For sdecific instructions see appropriate permit checklist. II _r QFFI " E USE ONLY BP #: II SECTION TOWNSHIP RANGE MAP NO. ZONING �/� LAND USE _03 LOT CVG % TAZ NO. FLOOD Z IINE IlVF r✓✓ FIRM MAP # 1 1 1ST FLR ELV l I ,i� 1 MAX iiGT CONST PE OCCUP TYPE MAX OCCUP # OF FLRS WATER i SEWER SPRINKLERS STORMWATER LOT OF R Before 1/19 I C ii LOT OF REC After 1/1990 LOT SPLIT REQUIRED LOT SPLIT APPROVED REPORT CODE �) HABITABLE AREA RADON RADON FEE PERMIT FEE. LIBRARY IMPACT FEE PUBLIC BLD IMPACT FEE CORRECTION pJB BLD IMPACT FEE GENERAL PARKS IMPACT FEE SCHOOL IMPACT FEE ROAD ACT FEE CREDIT Y N LAW ENF IMPACT FEE FIRE/EM IMPACT FEE ! DRIVEWAY REQUIRED Y N DRIVEWAY FEE ADMINISTRATIVE VARIANCE FEE SPECIFY SUBS REQUIRED MECHANIC _ ROOF V ELECTRIC GAS PLUMBING NON -CONFORMING LOT OF RECORD FEES MISCELLANEOUS FEES DATE SENT TO ADDRESSING: / REVIE ii S FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVE II LhulkA DATE COMPLE 11 D 1 ice! INITIALS