Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATION - CERT OF CAPACITY.y 3,•3_t£'_-c` ,� ; �t..'i�'� �'.a ^r,- r .JU3swl � i�r , ,�' �i. } x.�*� - x--a�.v-* .rn�i �., .� LOT OF REC —3+i�'i f.,nt -. '>lt'.�'.,z��$@'�"s �Yt"..V"� 2' ,'� �J Y l{.. Y FeF.. •�f "1. � b �v.��� \ 24+�ti1" 1�-. . 'i P �z.4*-�Yd4al�.i�r'}�, a � 7 x,�' :T6��}$,Ji� iai �.."'.rt.'�C't..._-.�+.4�%1�'k".�....?4��5Y'FlKkP���i7%�.xt'°�•.�t�".vYJ'�i�r. ��I ,'� s1s +\.� 1 a- �� 1 i J, � { `S%i�i �. Uty'�Z"¢,i `'�•sj .. [��a';,SyuN.a u�`'fJi �ll tip, '.rtFa�"�".rt�y 5 "Y�f �W �.��!iw�ai..�.:. ����; F Ns; f 7 .S'�x ,� �^'xrSV s •. 'e �. tsjy��e�i.�'Sr' ty LY1 ,t 'i "•yY S'`�,. ..� �t"Lz'�£" 3'. i,�.i5`-y4J'.1 5.� '�s �I`3x^v A�.Yh�3y. VARIANCE PUBLIC BLD IMPACTFEE SCHOOL SCHOOL ©®C'r v TOTAL �--���5 a� y 1+ A�.� iSCHOOL 11M JR ADDITIONALTOTAL' ss yy���� �* yM 17ki,..�a'�'a�`�' � yc l b k �s .,.�lS� SA�•P w^'S. v f-T.�.�.S�RI�tF�uL�.' �• y, t� ..S''.. � J• h5- %. �,:,t�� fafi:SlL�:1.Jti•1 � M ar "" \ t 4. A aR. F } �• $4. `A ;y � k`f%ltiG�l. 4 }&SE}�7 5 A+' y wlo "✓may `�^h.^i"$v ,g�y��r1�� �y �•4!'-�i f' C ?"G�• .i 5 wi:%..=`�..���":%c��� �:. y� �'� i fyc���v����� %iIR n w ,. �, - i x� FSS� ._.L•�wi:�.:.?d' �"��FE�� DATE FILED: � �3' PLAN REVIEW FEE: RECEIPT NO.: _ � O PERMIT NUMBER: 070 CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: - ALL INFO MUST BE COMPLETE &-F-ILL-ED-INTO BE ACUEYMI) St -Lucie County Building and Zoning, 2300 Virginia Avenue ORID�j• Ft. Pierce, FL 34982-5652 772-462-1553 ._... , '•.: _ _ . ". � . " - � vci� County APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION I 1. LOCATION/SITE ADDRESS: J� q U U CJ G ER K a ¢-/ VE V` % • r��C�' 3 S/ a 2. S/D NAME:I �� 6 2J),p SITE PLAN NAME: . 3. PROPERTY TAX ID #: . -3 400 - G O S - U go -L - Io UU- .3 1 41/1ZICla's 3,).a A3JAC A 1075 /,1, P.LT3- Lt'S•S 4. LEGAL DESCRIPTION (attach extra sheets if necessary): i Pl JeT Foa AD-a..ID A&L 02 8 /'J-a 670: t/tR t cli • S%D 8j)t A LOTS r, 3, AKD 3- LESS vV JI P? Loa IZD- ^,Jl AlL -- -:- I At,r» S ( Ba.Ac�E6'2�1T�c9ti BkN 5'91�.r�/� —kd`t 9) 5. PLAT 6. PAGE 7. BLOCK 8. LOT it Z, 3 BOOK S NO. NO. A NO. SI'ts �y l� / ��145� ll 3 � 9. PARCEL SIZE: ACRES/SQ FT. / p LOT DIMENSIONS C3- J-Ca'^r!� 10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: REPLACE Al"RR I cats .DEST2 EJ " saRe-eAe&-z EN CLOS4 2E ry %V CO.SE - R%sGGr IV00,7) CONS'rRctC?/O _ 11.0 SETBACKS (ACTUAL) FRONT.N BACK: '� RIGHT: LEFT: ' r � `,eEE/Y �DOM n _ IQ Z� - SIDE _ /,L SIDE 150 7 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER(SPECIFY) S'C'ROEN 6r4CLOSURE y 13. DESCRIPTION OF PROPOSED USE: Sc RE e w 6-j) E J,f C LoS[/.e•E 14. Sq. FUCONSTRUCTION: 7 2i & 15. Sq. Ft. 1st Floor: (��P7019 16. V VALUE OF CONSTRUCTION: $ i� • -- • - 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 �ab,aso,a� CERTIFICATION: OWNER INFORMATION NAME: OCL hne- GJp ADDRESS: 5 7 00 U LER4I71 CP. H-v '- CITY: STATE: . Fc • ZIP' PHONE (DAYTIME): CE'LL: zZ.2 4 email: tU 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: PHONE (DAYTIME): (�) STATE: ZIP I. . 0 TRACTOR INFORMATION.::. ST. ofFL'REGJCERT #: '%%'(( (1(19 `'ST. LUCIE'COUNTY--'CERT # ' = { = - • '.. ,a BUSINESS NAME: QUALIFIERSNAME: ADDRESS: CITY: STATE: PHONE (DAYTIME):,, ` (_) FAX NO. ZIP email: QARCIIIT/ENGINEER:`..JOSE, P f4..4 . gnDDREss: 100 l NI I 6 N t u4rk)la woods 31v'Z.a dU '3 &CITY: BO N I in . S ipfz r nI G S STATE: R .: " ZIP PHONE (DAYTIME): Ca Od 3 0 BONDING COMPANY: ADDRESS: CITY: —STATE: STATE: 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. This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain it 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 concimency review: room additions, accessory structures (al] 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 th foregoing information is accurate and that all work will be done in compliance with all applic a laws regulating construction and zoning. 0'WE1TJCON,SIGNATURE CONTRACTOR SIGNATURE / STATE OF FLSTATE OF FLORIDA ORI A COUNTY OF COUNTY OF The foregoing instrument wa ackno ]edged ore me this /o7- day of=02 by ; �D ho is personally •,; tom`: kno to me or who has produced �^ C14- D1�9• (J as identification. 'tea ma Signature o try (/ 3 N� Tvae or Print N e of Notary / �� �` The foregoing before me this known to me or or Print Name �of 20� by who is personally has produced as identification. Commission No.. (Seal) Commission No. (Seal) NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BULLING PERMIT AS AN OWNERIBUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN.TH% OFFICE LISTED ON THE FRONT OF THE APPLICATION. For specific instructions see appropriate permit checklist.