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Home My WebLink AboutBUILDING PERMIT APPLICATIONOFFICE USE ONLY �3P #: 11Ob� oc�c1-1 SECTION 11 TOWNSHIP RANGE �` MAP NO. �J ZONING ► 1 ( 1 LAND USE LOT CVG% v TAZNO. FLOOD ZONE 'H�i FIRM MAP # 2 (^]3 c� 1 FLR ELV• 1 MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER 11 L SEWER I , w„ SPRINKLERS STORMWATER LOT OF REC Before I/1990 LOT OF REC After 1/1990 LOT SPLIT REQUIRED LOT SPLIT APPROVED REPORT CODE HABITABLE AREA RADON FEE PERMIT FEE LIBRARY IMPACT FEE PUBLIC BID IvIPACTFEE CORRECTION BLD IMPACT FEE GENERAL PARKS IMPACT FEE SCHOOL IMPACT FEE RO ACT FEE CREDIT Y N LAW ENF IMPACT FEE FIRE/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 VEGETATION REVIEW SEATURTLE REVIEW MANGROVE REVIEW DATE - RECEIVED - - tL tv —R7EVIEW /.,• I( , / - .IO-" DATE': . • .:c COMPLETED _ 1 %d' (f'' OFFICE USE ONLY: oD DATE FILED: PLAN REVIEW FEE: RECEIPTNO.: CONCURRENCY FEE: RECEIPT NO.: PERMIT NUMBER: CERT. CAP. NO.: _ I166 -60C 7 ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED 4,NNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION C/, 2300VirginiaAvenue ,�( �� Ft. Pierce, FL 34982-5652 ^l� 9;1 772462-1553 APPLICATION for BUILDING PERMIT ` CERTIFICATE of CAPACITY/ZONING COMPLIANC ANNED 14-' 0 e PROJECT INFORMATION BY C y St. Lucie County 1. LOCATION/SITE ADDRESS: 2. PROJECT NAME: i-r7a SITE PLAN NAME: 3. PROPERTY TAX ID #: 4. LEGAL DESCRIPTION (attach extra sheets if necessary): t�1� �"`�% G✓T /�3k La 3 5. PLAT BOOK 6. PAGE NO. 7. BLOC NO. � S. LOT NO. 9. PARCEL SIZE (ACRES/SQ FT.): �, 0 z LOT DIMENSI S: 10_ COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: ]C it. SETBACKS (ACTUAL) FRONT: /4? BACK: } RIGHT SIDE: Y i1 LEFT SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [�V] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION / [ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL OTHER CE IFY) 13. DESCRIPTION OF PROPOSED USE: 14. SQ. FT OF CONSTRUCTION: R o7G 15. SF. FT 1st FLOOR 16. VALUE OF CONSTRUCTION: $ 37�;, aeD 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 UPDATED 625/09 OWNER` INFORMATION NAME: S� LYa� } C yY3c�r'CCc � I t� S�w�r�1rG YtA W1.o v? ) ADDRESS: CITY: )--,> O L) S STATE: `T-vq ZIP: PHONE -(DAYTIME): < Z73 - Email: 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): CONTRACTOR INFORMATION ST. of FL REG.CERT #: Cca OS 9 Lt a ST. LUCIE COUNTY CERT BUSINESSNAME: Yz��UG��"`� QUALIFIERSNAME: %�-�'G`K )Y1-�i��S ADDRESS: �,o�Lb7 S d�-ate' CITY: ,T-GvthZvl-�� STATE: �r ZIP: PHONE (DAYTIME): (_, O`Z�.`Z�93r9 FAX NO. 'l`�`f� Email: rVJ6sGl46lx1 aL-yZy ARCHITBNGINEER::1�4L:� ADDRESS: 4ry "_52� CITY: ��`�''� STATE: ZIP: PHONE (DAYTIME): (_) P`ZG� r9L - I BONDING COMPANY: ADDRESS: CITY: STATE: ZIP: MORTGAGE LENDER: /vI� 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 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. �OWr1ER OR CONTRACTOR SIGNATURE CONTRACTOR SIG�ATM�� STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF IJ 7 The foregoing instrument was acknowledged before me this4g_Q day of '(Y)Cj�,X 20 by Sa ICJ t'0. N who is personally known---,— or has produced The foregoing instrument was acknowledged before me this C2_a_day of ,O - 20_Vt__, by ('6100rna who is personally known or has produced as identification. as identification. QA Signature of Sigoatur� a of Notary at Commission No. Dp�pKN13PER Commission No. .•''� DAVID N. KNEPP R 16 - on # DD 995518 emmissio Expires September 25, 2014 Y Expires September 25, 2014 �y '• �` Buded7huTiy'Fshm1mm 7079 - P?,BWedh Tmiran4�wara0093BS79i9 NM. NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE 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. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS. For specific instructions see appropriate permit checklist.