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Home My WebLink AboutBUILDING PERMIT CERTIFICATE OF CAP - ZONING COMPLIANCE�� -tom �o�ran - CG� FiJa� �' � �epfi- BP#: DATE FILED: C—Q*z 1-05 -PLAN REVIEW FEE: LE:0 - RECEIPT NO.:q C&C'URRENCY FEE: QS ALL INFO MU E 0, �t E ". rz PERMIT NUMBER: DCz__%_n, CERT. CAP. NO.: 4AA Lo UD IN TO BE ACCEPTED SECTION: TOWNSHIP: RANGE: MAP NO.: ST. LU 36S co CIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 ZONING: 4 LAND USE: LOT CVG %: TAZ NO.t 0 772-462-1553 Neal (A -� FLOOD ZONE: FIRM MAP #: Z APPLICATION for BUILDING PERMIT X P 1 ST FLR ELV: MAX HGT: tcm CERTIFICATE of CAPACITY/ZONING COMPLL.NC� CST TYPE: OCCP TYPE: MAX. OCCP: # OF FLRS: PROJECT INFORMATION WATER: SEWER: SPRINKLERS STORMWATE 1. LOCATION/SITE ADDRESS: R 2. S/D NAME: i0aA-L_UL&2— SITE PLAN NAME: LOT OF REC (beir 1/90) LOT OF REC (aftr 1/90) LOT SPLIT LOT SPLIT READ APPRV'D 3. PROPERTY TAX ID_#: 0 - 0 03/ -1) OO 4. LEGAL DESCRIPTION (attach extra sheets if necessary): DECAL LIBRARY i Q PARKS PERMIT NUMBER IMPACT FEE I U IPACT FEE FEE REPORT PUBLIC BLDG BITABALE RADON FEE CODE c) IMPACT FEE AREA -_7 0 .PLAT_. 6. PAGE 7. BLOCK 8. LOT 5. {RADON) .130OK NO. NO. NO. HA A (F A ROAD GROSS ROAD CREDIT Y N TOTAL ROAD 'D IMPACT ZONE IMPACT FEE 2-0-5 IMPACT FEE 9. �'PARCELSIZE: ACRES/SQ FT. 2LOT DIMENSIONS 3 -24- A 13 iLi E X 76,a,:� ... 10. DESCRIPTION OF CONSTRUCTION CT OR WORK ACTIVITY: el CY-) Cnl Y* N . .......................... SCHOOL CREDIT TOTAL C� SCHOOL IMPACT FEE IMPACT FEE SETBACKS(ACTUAL). 4ONT: BACK: RIGHV LEFT L/ SIDE SIDE: 14 POLICE FEE FIRE FEE MISC FEES: TOTAL e-111 2q4 POLICE/FIRE/ 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) q- 48, �Q_L3 H5 MISC. FEES Y N NEW CONSTRUCTION EXPANSION/ADDITION INTERIOR RENOVATION PERMITS FEES ADDITIONAL SPECIFY: TOTAL ALL RESIDENTIAL COMMERCIAL INDUSTRIAL READ Vol OTHER (SPECIFY) 13. DESCRIPTION OF -PROPOSED USE: f PA REVIEWS ZONING ZONING PLANS VEGETATION SEA MANGROVE -7 REVIEWED BY EXAMINING TURTLE 14. 'Sq. Ft./CONSTRUCTION: -tow 15. Sq. Ft. I st Floor: DATE VALUE OF CONSTRUCTION: $; flik #0 COMPLETE 14j1fjjuS_ 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 t_�D indk�ted value of construction if it is demonstrated that the submitted figures are not coiti.sistent with similar types,of construction activities. If the value is $2500 INITIALS or more, a RECORDED Notice of Commencement must be submitted with this application. ---------- SLCCDV• Form No.: 001-02 OWNER INFORMATION: 1 NAME: L O ` O C3.tQ [mil C.� ADDRESS:— — CITY: f STATE: ZIP c1 PHONE (DAYTIME): ( 1 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): If i CONTRACTOR INFORMATION ST. of FL REG./CERT #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS: S r c CITY: n`�•�J ST. LUCIE CCOUNTY CERT #: PHONE (DAYTIME): (%7,?) 2 ARCHIT/ENGINEER: ADDRESS: CITY: PHONE (DAYTIME): BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: 6 V%'7y9 STATE: ZIP FAX NO. -r/1467low STATE: -5;Ajk r\c_"S STATE: ZIP ZIP 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, 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 structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non- residential use. NOTICE 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. NOTICE 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. OWNER'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. E CONTRACTOR SIGNATURE CONTRACTOR SIGNATUR c M1 STATE OF FLORIDA COUNTY OF 0-, L4-�O- The foregoing Le ent as acknowledged .f The foregoing instrument 4bef me thio , 20by nn�e�a before t 's ay of , l Az9,a, who i n to me or who is pe h rodugAd as 'dentification. or h s pro ed _ i Signature of Not ry Signature of Notary r � j d 6 f Type or Print Name of Notary Type of Print Name of Notary Notary Public Title Notary Public Title STATE OF FLqqlDA r COUNTY OF ° C-(ei 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. acknowledged - 2005 , by as identification. Commission Number Commission Number EE �•LORI A. KARABAICH Sealy ;yLORI A. KARABAICH( ) .:�; (seal) �`*: MY COMMISSION # DD 217769 MY COMMISSION # DO 217769 EXPIRES: June 1, 2007 EXPIRES: June 1 2007 BondedThru Notary Public Underwriters a Bonded Thru Notary Public Underwriters NOTE: TWO (2) SIGNAT IGNATURE 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.