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Home My WebLink AboutBUILDING PERMIT APPLICATIONdFFId-U§E'OALY; DATEALED: 4. 13 PLAN RFVIE)AT—FrF: Ou RECEIPTNO.: PERMITNUMBER. I—M 11 CONCURPENCYFEE: V�() () RECEIPT NO.: CERT. CAP. NO.: TST BE Ca. PLETE & FILLED JA I U BE AU Up-r I h" P - — G-& M �LOPMWNT SERVICES DEPARTMENT LANNIN BUILDING & CODE REGULATIONS D11VISION 2300 Virginia Avenue Ft. Pierce, FL 34981-5652 Izadj 772-462-1553 gt APPLICATION for BUILDING PERAHT CERTIFICATE of CAPACITY/ZONING COMPLIANCE 1 0) 61m T > ro PROJECT INFORrvUTION 4 A A i —,,A-- 2. PROJECT NAME'- — 3. PROPERTY TAX IT) #: a yj 4, LEGAL DESCRIPTION (attach extra sheets if necessary): 5. 7. BLOCK NO. 8. DT NO. PLAT BOOK 6. PAGE NO. SCANNED 9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: BY St. Lucie County 10. CONTLETqDg. IT ,qCWTjpN OF CONSTRuc OV PROJECT OR WORK ACTIVITY: 11. SETBACKS (ACTUAL) FRONT: 10 BACK: /5 RIGHT SIDi-- L SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate ' boxes) I ( ] NEW CONSTRUCTION EXPANSiON/ADDITION INTERIOR RENOVATION ��'RESIDENTIAL COMMERCIAL INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: 14. SQ. FT OF CONSTRUCTION: W 15. SF. FT Ist FLOOR., 16, VALUE OF CONSTRUCTION: $A 117S -� 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 construc6on irit is demonstrated that the submitted figures are not consistent with similar types of construction activities. 1rthcvaluc*1s$2500or1noro'a RECORDED Notice ofCommcneemOnt must be submitted with this application. SLCCDV Form No.: 001-02 UPDXfED 6125109 0 W'--UM* P " � m # �M �-- "f. N"1 11, AA CITY: STATE: /I I / zip: 'ro Lou 7 PHONE (DAYTIME):'(=?� Email: IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOVJ. FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): CONTRACTOR OMFORMA71ON U U v (')�t '3y ST. of FL REG.CERT #: TH-1 0al 5-LICI STffIE COUMY CERT BUSTNESSNAME: LA& Ze �s 14OLi T4 QUALIFIERS NAME: Fiq-SY10-0 ADDRESS!: A/114 CITY: STAFE: Email: ZIP: PHONE (DAYTIME):WD 501q ARCHITIENGINEER. /it ADDRESS: CITY! STATE: ZIP: PHONE (DAYTIME): C__) BONDING COMPANY: All& 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 mad. CERTIFICATION.' This application is hereby made to obtain a permit to dothe work and installations as indicated, and to obtain a certificate of capacity, if applicable, for the permitted work. I cerLI)r that no work or installation has commenced prior to the issuance of apermit 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. St. Lucie County makes no representation that its granting of a permit will authorize the parmit holder to build the subjectstructme thiiinay— which is in conflict with any applicable Homeowner Association rules, bylaws or any covenants 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- w residential use. NOTICE TO OWNER: YOURFAILURF TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AM 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 A-PPLI &T_THA-T_ISS1IBJECT:T!O_—____L_ ATTACHMENT: ASACONDMONOF ISSUANCE OFTHIS PERMIT, YOUPROMISElN GOOD FAITH TO DELIVER A COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO TTIE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACMIENT. I /�. :;Z"_,_� OWNER OR CONTRACTOR SIGNATURE STATE OF COUNTYOVFS�)�_ L ;;- - �-� �51_ , � CONTRACTORSIGNATURE STATE OF COUNTY 06t� The foregoing instrument was acknowledged before The foregoing instr is acknowledged before me this —0—day of CA" 201311 me this IL -day by WA 5ra_� by . o is personally known or hasproduced who is personally known Zor has produced -,'X-\ as identifintion. as identification. N LA t ar Sigi Usi—inapte Of X%U _Q�_�,� 21 -11W. CY M MS ARMaTRONG ey COMMI ....... N&ANCY MIMS ARMSTROk�%a[) Cor I- SSION # EE05% Q anuary 30, 2015 My COMMISSION# EE059652 (407) 34&0153' FlorFdal,lotarySa"Icexom %N�i IN 0 EXPIRES January 30,2015 J . P (407)39"153 FlaridahloWysemice.wm NOTE: TWO (2) SIGNATURES ARE REQUIRED. ZD. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THF-FRONT OF THIS APPLICATION. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDFR APPLICANTS. For specific inftructions see appropriate permit 'heeldist. OFFICEVSE ONLY #: SECTION TOWNSHIP RANGE MAP NO. ZONING LAND USE LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # I � FLR ELV MAX HOT CONST TYPE OCCUP TYPE MAX OCCUP OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT �F REC LOT SPLIT LOT SPLIT Beforel/1990 Ater 111990 REQUIRED APPROVED -REPORT -HABITABbE— CODE AREA FEE FEE (RADON) LIBRARY PUBLIC BLD UBIC BLD PARKS IMPACT IMPACTFEE IMPACT IMPACT .FEE C FEE FEE GENERAL SCHOOL ROAD CREDIT Y N LAW ENF IMPACT IMPACT IMPACT FEE FEE FEE FIRE(EMS DRIVEWAY Y N DRIVEWAY ADMINISTRATIVE IMPACT REQUIRED — FEE VARLANCEFEE — FEE SPECIFY MECHANIC ROOF — NON -CONFORMING MISCELLANEOUS SUBS ELECTRIC GAS LOT OF RECORD FEES REQUIRED — PLUMBING FEES DATE SENT TO ADDRESSING: REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUI�TER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATB� RECEIVED DATE COMPLETED INITIALS 1. 14 el I