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Home My WebLink AboutBUILDING PERMIT - CERT OF CAPACITY - ZONING COMPLIANCE--D-ATETILEDf— BP#: PLAN REVIEW FEE. CAD RECEIPT NO.: PERMIT NUMBER: D5 a 10 6 60'NCURRENCY FEE: OS'LbRECEIPT NO.:0r0hW CERT. CAP. NO.: ALL INFO MUST BE COMPLETE u FILLED IN TO BE AtCEPTED ST. LUCIE COUNTY PUBLIC WORKS SECTION: BUILDING & ZONING DEPARTMENT 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 SCA/V/VED ZONING: LAND USE: LOT CVG %: TAZ NO.: 772-462-1553 St. Luce county* FLOOD ZONE: )q H FIRM MAP#-' ,RS167 1ST FLR ELV: :1700- MAX HGT: APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITYMONING COMPLIANCE CST TYPE: OCCP TYPE: MAX. OCCP: # OF FLRS: PROJECT INFORMATION WATE7R:T� SEWER: SPRINKLERS STORMWATE LOCATION/SITE ADDRESS: --S F540-4A-R�k DJC- 70 e-t- R 2. S/DNAME: Tffbip1\1 f-(VEr— 53--t-Ir-S&EPLAN NAME: LOT OF REC (befr 1/90) LOT OF-REC (aftr 1/90) LOT SPLIT LOT SPLIT REQ`D APPRYD - -2 6 CJ 9 ,j 3. PROPERTY TAX ID 4. LEGAL DESCRIPTION (attach extra sheets if necessary): -z. /Y b i'o- IV e-- 'E-S-na'rEa tt 1y; -t LIBRARY DECAL PARKS PERMIT 0C- r-- -07 - -r NUMBER IMPACT FEE 12 IMPACT FEE FEE REPORT PUBLIC BLDG Z�) 1 --10 HABITABALE RADON FEE 7.Z 5. PLAT 6. PAGE 7. BLOCK 8. LOT CODE IMPACT FEE (RA'DON) BOOK NO. /2 3 --J NO. NO. ROAD GROSS ROAD CREDIT TOTAL ROAD IMPACT ZONE IMPACT FEE IMPACT FEE 9. PARCEL SIZE: ACRES/SQ FT. Yl�)-��OT DIMENSIONS op >L's rz� x \2��.- z/— DUE /j 10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: Y N NMI SCHOOL, CREDIT TOTAL IMPACTFEE 31-- 0�� SCHOOL IMPACT FEE 11. SETBACKS (ACTUAL) FRONT:t BACK: RIGHT LEFT POLICE FEE FIRE FEE MISC FEES: TOTAL SIDE SIDE: o&R POLICEIFIRE/ 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) 4�'q Vb MISC. FEES -2. lo NEW CONSTRUCTION EXPANSION/ADDITION [I INTERIOR RENOVATION ADDITIONAL SPECIFY. TOTAL ALL RESIDENTIAL COMMERCIAL INDUSTRIAL PERMITS FEES OTHER (SPECIFY) REaD V7 13. DESCRIPTION OF PROPOSED USE: REVIEWS ZONING ZONING PLANS SEA MANGROVE 14. Sq. FUCONSTRUCTION: 15. * Sq. Ft. 1st Floor .REVIEWED BY EXAMINING TURTLE I I DATE 16. VALUE OF CONSTRUCTION: $ C� j COMPLETE D,�r T The value Of construction is used to determine the amount of Permit fees to be assessed. SL Lucie County reserves the right to question and/or modify th 7e indicated.value of construction if it is demonstrated that the submitted figures are not o3hststent with similar types of construction activities. If the value is $250 INITIALS I IJ or more, a RECORDED Notice of Commencement must be submitted vAth this application. - SLCCDV Form No.: 001-02 OWNER INFORMATION: NAME: ADDRESS: CITY: �qq STATE: FL ZIP JS 9 moo? PHONE (DAYTIME): q�/'/eC-`F 77d 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): r 1 CONTRACTOR INFORMATION ST. of FL REG.ICERT #: ST. LUCIE COUNTY CERT #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS: CITY: STATE: ZIP PHONE (DAYTIME): I 1 FAX NO. ARCHIT/ENGINEER: ,j 1r'C/�/�Fi`i�J7�� / ' ADDRESS: 1/p'�-•C� S 7 �,yb s- CITY: 'i Ci 4Ut_ �lCC �/ STATE: FL ZIP PHONE (DAYTIME): /� 7.f" L 1 / ' ��a 772-7�5_ BONDING COMPANY. 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 maybe 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. a OWNER'S AFFIDAVIT: 1 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. OWNERICONTRACTOR SIGNATURE STATE OF FL(5lRI A COUNTY OF `� (CCU The foregoing ins rument cwOas acknowledged,�� 1 before me this day of �L . 20%7, by g ag u-6-t who is personpally known to me or who hasAw9dur., as identification_ ignature of Notary Beatriz Serrano Commission #DD228304 Type or Print Name of Now ,,,,,P� Expires: Jul Ol, 2007 ridcvb?�` Bondedfiv Notary Public Title ��"'�"'`' Atlantic Bonding Co., fir Commission Number (seal) CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing in rument was acknowledged before me this day of 20_, by who is personally known to me or who has oduced as identification. of Notary ;Type of Print Name of Notary Notary.Public Title Commission Number (seal) NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNEWBUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION.