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Home My WebLink AboutBUILDING PERMIT APPLICATIONOFFICE USE FEE: C=� (� ' I 0 DATE FILED: PLAN REVIEWW FEE: RECEIPT NO.: PERMIT NUMBER: CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: I. 2. ALL INFO MUST BE COMPLETE &,FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. P772A62-15532-5652 SCANNED BY APPLICATION for BUILDING PERMIT St. Lucie County CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 6<� LOCATION/SITE ADDRESS:_ `� I (p7 S. L(5 tcl�wa-/ rcati1 ✓T. 1Lcccc, Ff. PROJECT SITE 3. PROPERTY TAX ID #: 34 22- 211 DO 0 000 .(o 4. LEGAL DESCRIPTION (attach extra sheets ifnecessary): 22 3(c 4o RC6 AT SC Coa of NCVAV�NVOA 12uN G 2'r DEe. se) Mid E 210 Fr. lb N LJ of Rio AFw--DRiTIi S(.o 5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO. 9. PARCEL SIZE (ACRES/SQ FT.): 9.'94, LOT DIMENSIONS: 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: t' Ne t{vPrr wrier. 64c. doa6 . ey.;'AL, iD remain .0s is:' i 11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION INTERIOR RENOVATION [ ] RESIDENTIAL 4c] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: 14. SQ. FT OF CONSTRUCTION: 15. SF. FT 1st FLOOR: 16. VALUE OF CONSTRUCTION: $ S0#000. o D 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 arc not consistent with similar types of construction activities. If the value is $2500 or more, a RECORDED Notice ofCommencement must be submitted with this application SLCCDV Form No.: 001-02, UPDATED 625/09 OWNER INFORMATION NAME: f OeT 5T, LL c t e 1� 4 Z ti I t� C. YI tTf1- 1 ADDRESS: 112- PhVfr6 C{, CITY: [ (rnv + ( ,-V _ STATE: N.Y. ZIP: Ito0I PHONE (DAYTIME): (5f '132 - (o N( IG 511ya �e�. ail: IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: G\ r 9 f.9 CITY: PHONE (DAYTIME): I__) CONTRACTOR INFORMATION ST. of FL REG.CERT BUSINESS NAME: QUALIFIERS NAME: ADDRESS: SON STATE: ZIP: ST. LUCIE COUNTY CERT #: 6 CITY: C) STATE: TT ZI11P: oj4 Iq PHONE (DAYTIME): (17) -1N-1(alte FAXNO. -1-12- 1f)1-000�1O Email: Cl rn® �n srnc.( ARCHIT/ENGINEER: —Rro,4er- a AA `fir-'" O�gck _ ADDRESS: 41 l Co c o K Au l tiu a. CITY: PHONE (DAYTIME): '1( 7Z) 201 • 0258 BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: STATE: STATE: ZIP: 34tiy4 ZIP: 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. i— 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. 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 concurency 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. Z% rkr�/ SilrnO�r/�n" OWNER TkRACTORSIGNATURE1Au��,J,g, / CON CTORSIGNATURE STATE OF FLORID r (� `Af/Y/bt STATE OF FLOIiI V n 4(� COUNTY OF�f7tm COUNTY OF y The foregoing instrument was acknowledged before me this 114 day ofq�L 20 f 1 by I4iL-,; DJMsICA�l who is personally known _ or has produced The foregoing instrument was acknowledged before me this ( day of ck-- 201 by mt'� Ski"-" who is Penally known _ or has produced as identification. as identification. Signature of Notary Signature of Notary Commission No. tid., D�BIS IN COMMIS 87.5L4 Commission No.alf. DEEB(SIpIN •" MY COMMISSION W DD S75524 g EXPIRES: May 30, 2013 `�..... Bonded Thtu Notary Pe6lkUndenmters EXPIRES: May30,2013 Bonded Thm Notary PuNle Underndters NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNERBUILDER, 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. E ONLY ' #: TOWNSHIP RANGE MAPNO. K LANDUSE LOTCVG% TAZNO. FIRMMAP# ITFLR ELV MAXHGT ✓ ✓ OCCOP TYPE .� MAX OCCINP 7 J T # OF FLRS WATER SEWER SPRuoaERS STORMWATER LOT OF REC Befnre vi990 LOT OF REC After 1/1990 LOT SPLIT REQUIRED LOT SPLIT OVER REPORT CODE HABITABLE AREA RADON FEE PERMIT FEE LIBRARY IMPACT FEE PUBLIC BLD IMPACT FEE CORRECTION PUBIC BID IMPACT FEE GENERAL PARKS IMPACT — FEE SCHOOL BOACT FEE ROAD IMPACT FEE CREDIT Y N LAW ENF IMPACT FEE F]RE/EMS IMPACT FEE DRIVEWAY REQUIRED Y N DRIVEWAY FEE ADMINISTRATIVE VARIANCE FEE SPECIFY SUBS REQUIRED MECHANIC_ ROOF _ ELECTRIC _ GAS _ PLUMBING _ NON -CONFORMING LOT OF RECORD FEES MISCELLANEOUS FEES DATE SENT TO ADDRESSING: / / REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED �3 of C� �yS•99: �'yyp, 39�• y9 ,, ", ? C�' y2 = 5'30, SSG •°? OFFICE USE ONLY: 4 , I� DATE FILED: ` PLAN REVIEW FEE: RECEIPT NO.: CONCURRENCY FEE: RECEIPT NO.: 1. 2. �3: 47 s. 9. 10. 11. 12. 13. 14. 16. PERMIT NUMBER CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPAF BUILDING & CODE REGULATIONS DIVISIONI J`AA1n1C® 2300Pierce, Flnia Avenue 1v1VG Ft. Pierce, FL 34952-5652 t�j1J l.X BY 772462-1553 ;t wde County APPLICATION for BUILDING PERMIT-t��y 1 CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION LOCATION/SITE ADDRESS: S. U•5 1 S . L L• PROJECT NAME:1I bop SIM IAN NAME: PROPERTY TAX ID ##:: 34 a a of I I Mtn QCSO 6- LEGAL DESCRIPTION (attach extra sheets if necessary): jDraL 3G� 4C) &9 c:,- - SE C Or r Ier- n-F N E 1�4 CA N U IJ�j Ku0 5- al 1199 355 Inin E 01(A a +e) M Q o-f Alo 03ar PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO. PARCEL SIZE (ACRES/SQ FT.): 9, 9Sn LOT DIMENSIONS: COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: p rinr, SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDIT]ON [ ] RESIDENTIAL L)d COMMERCIAL [ ] OTHER (SPECIFY) DESCRIPTION OF PROPOSED USE: LEFT SIDE: pq INTERIOR RENOVATION [ ] INDUSTRIAL SQ. FT OF CONSTRUCTION: 31(395 1.5. SF. FT Ist FLOOR: VALUE OF CONSTRUCTION: $ Coy , a�] 6 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 �+II0.SiS UPDATED 6/25/09 OWNER INFORMATION IUMNYM ADDRE Pam+ 51. t-tx,Y A/ot-q 2 4.C- 1;11Y: Gj�Ayrt STATE: �� + ZIP: 3� PHONE (DAYTIME): (11-4 6 (.)n - J S Ro Email: CuT � �; �„ 0 51 0PQ i I C o YTS 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): () CONTRACTOR INFORMATION ST. of FL REG.CERT #: BUSINESS NAME: STATE: ZIP: -old ST. LUCIE COUNTY CERT #: QUALIFIERS NAME: r M h dd K' fc A w ADDRESS: n7f59" 1 SE �e \n: nr S} CITY: '54, u o. t-a- STATE: i= L ZIP: 3 y 9 PHONE (DAYTIME): L7; 083-LOSG FAXNO7-7D-a$3- 1S�!Q Email: rorl1 1 1 11- ILirGlmmpn Cons}cua+4on. Coin ARCHIT/ENGINEER: fR rcaci P n e nJT c0.A P ,) PA ADDRESS: 411 Anoonjjj - CITY: S-W-a tea- STATE: ZIP: -N 19 (a PHONE (DAYTIME): - BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: STATE: ZIP: 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 Ail I 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 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. •�MhRkCt6R STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this 9aay of r� I 2ff11 by hlc eI Silvers+e;iq who is personally known l/ or has produced identification. CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTYOF _(Y\aV-Vr, The foregoing instrument was acknowledged before me this =day of , 20_L�., who is personally known ✓ or has produced as identification. r • lC, BOYCE r ; o N`Y CHENYL C. BOYCE Commission No. ,•'��"""Pe L. Commission No. :: .e', Nottl9did9tic-Stale of Florida Notary u e -State of Florida , •° My Comm. Expires Nov 17, 2014 s+`• �� My Comm. Expires Nov 17, 2014 - as �� Commission Y EE 42955 A Commission 0 EE 42955 ``'�f),;; ;,•,°°p •..��•••• Bonded Thro BNational NotaryAssn. Bonded Through National Notary Assn. NOTE: TWO (2 HH SIGNATURE MUST BE ARIZE 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. OFFICE USE ONLY 01 u SECTION �a TOWNSHIP RANGE O MAPNO. ZONING %^�� l�lJ LAND USE LOT CVG % TAZ NO. FLOOD ZONE FffW MAP # ISTFLR ELV MAX HGT CONST TYPE OCCUP TYPE _ 3 MAX OCCLIP f 7 # OF FIRS WATER SEWER SPRINIUM STORMWATER LOT OF REC LOT OF REC LOT SPLIT LOT SPLIT Before-111990 After 111990 REQLJRIED APPROVED REPORT HABITABLE RADON PERMIT CODE AREA FEE FEE LIBRARY PUBLICBID PUBICBLD PARKS IMPACT IMPACT FEE IMPACT IMPACT — FEE CORRECTION FEE GENERAL FEE SCHOOL RO CREDIT Y N LAW ENF IMPACT ACT IMPACT FEE FEE FEE FIRE/EMS - DRIVEWAY Y N DRIVEWAY ADMINISfRADW IMPACT REQUIRED FEE VARiANCEFEE FEE SPECIFY MECHANIC_ ROOF_ NON -CONFORMING MISCELLANEOUS SUBS ELECTRIC V GAS LOT OF RECORD FEES REQUIItED PLUMBING _ FEES DATE SENT TO ADDRESSING: I / REVIEWS FRO ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE Co REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED ' DATE I COMPLETED LAM INITIALS 3oit7 C�iyS 9%, �'yyp,,39�•y9