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Home My WebLink AboutAPPLICATION FOR BUILDUING PERMITSCANNED BY OFFICE USE ONLY BP #: SECTION TOWNSHIP 3 S RANGE MAP NO. �3 I v3 . ZONING LAND USE p LOT CVG % i TAZ NO. FLOOD ZONE FIRM MAP # i ® 1ST FLR ELV �S �7 MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC LOT SPLIT LOT SPLIT Before 1/1990 After 1/1990 REQUIRED APPROVED REPORT �� HABITABLE ." ' RADON PERMIT CODE AREA FEE FEE (RADON) LIBRARY PUBLIC BID PUBIC BI.D PARKS ACT PACT FEE IMP IM IMPACT FEE CORRECTION EE FEE GENERAL SCHOOL ROAD CREDIT Y N LAW ENF IMPACT ACT IMPACT FEE FEE FEE FIRE/EMS DRIVEWAY I Y N I DRIVEWAY ADMINISTRATIVE ~ OFFICE USE C' DATE FILED: pEIT NUMBER: --PL-AN-REVIEW FE : - - -- RECEIP_T_NO.: O _ j CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE. &•FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTME.N BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 c /' 772-462-1553 16 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: 3 I 0 FlM 6Law S i4U-e 2. PROJECT NAME: 9cAS4 (1zs SITE PLAN NAME: Mo+-itica'• i v1 Law 60.4sC. 3. PROPERTY TAX ID #: 3 3 401 D o D_? y' 0 0 Y 4. LEGAL DESCRIPTION (attach extra sheets if necessary): �o F S G r o o c1h x/ i I 1 e i4 ,^ e 5 5. PLAT BOOK 3 3 6. PAGE NO. S 7. BLOCK NO. 8. LOT NO. 3 3 Lt®, b 2 o 9. PARCEL SIZE (ACRES/SOT.): % 1 '2)- LOT DIMENSIONS: sir . _ 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: n—! 11. > ` "SETBACKS (ACTUAL) FRONT: $1- $6 BACK: .3q2, 13' RIGHT SIDE: y00+ j LEFT SIDE: 1 ° 3 r%j Jh 12. 13 14. TYPE OF CONSTRUCTION (Check all appropriate boxes) [V]' NEW CONSTRUCTION [ ] EXPANSION/ADDITION [V]" RESIDENTIAL [ ] COMMERCIAL [ ] OTHER (SPECIFY) DESCRIPTION OF PROPOSED USE: [ ] INTERIOR RENOVATION [ ] INDUSTRIAL SQ. FT OF CONSTRUCTION: 1-2-So -too-ti/L 15. SF. FT 1st FLOOR: 16. VALUE OF CONSTRUCTION: $ 6 % 9 Oa 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:_ 4 �- {�_ ��ro Vt S ADDRESS: 31U f} h rGw S t�re- CITY: 11-� STATE: ZIP: 114 q Y �' PHONE (DAYTIME): 7 2 Zo 1-7 7 17 Email: N G4 . 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): U CONTRACTOR INFORMATION ST. of FL REG.CERT #: R A. ST. LUCIE COUNTY CERT BUSINESS NAME: 7 co wS-1 r v cd re,n � vL L �� QUALIFIERS NAME: M j`ckp,,,r,(_ &,, ,h C,, co ADDRESS: BR 48 1,m-Kt- Sav„t ri,-c 1t- CITY: V-y p d-e rc • STATE: (rL ZIP: �LJ PHONE (DAYTIME): -i ,-0 ( -9 7 q 7 FAX NO. 77 z W s 7 S z3 Email: ARCHIT/ENGINEER: e Uo k mod- m e-necr-11 ADDRESS: '� o 6 D•e,l.aw a,— 2 CITY: f: T P STATE: ZIP: PHONE (DAYTIME): (7%) Y& O '7 7 S j BONDING COMPANY: V-1- ADDRESS: CITY: STATE: ZIP: MORTGAGE LENDER: ADDRESS: CITY: STATE: ZIP: 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. t 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 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 WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. WNER OR CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF Sri . LV e % jt, The foregoing instrument was acknowledged before me this L day of t'%b 20 by 1M:-,.% b'k �A q hCAt S G O who is personally known S-Syo -rS9- —or has produced 3-'a as identification. Signature of Not. D r V - . ��. State of Florida «v no ''� p ibllc ' P ��; -; Notary Ex ices Dec 16, 2016 Commission No. t�y Comj�,�` # EE 858761, ' -� 1 Comin`i btr Assn. nded ThIcuo National Notary . r CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF S k L %x The foregoing instrument was acknowledged before me this yday of 2014 by Yh:cti cyo,1 O J(a1 nC,% S c, 76 who is personally known or has produced hvto5-516'166t^4 %I- a as identification. Signature of Commission No. 'F OF BO 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.