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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr• OFFICE USE ONLY — h;< #: SECTION ©� TOWNSHIP RANGE MAP NO. ZONING LAND USE LOT CVG % NO. FLOOD ZONE FIRM MAP # 1 s7 FL MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SE .SPRINKLERS STORMWATER LOT OF REC (before 1/90 LOT OF REC (after 1/90 LOT SPLIT REQUIRED SPLIT FAPEROVED t ADMINST VARIANCE -- LIBRARY IMPACT FEE PARKS IMPACT FEE IT FEE REPORT CODEC/1 g � PUBLIC BLD IMPACT FEE HABITABLE AREA (RADON) RADON FEE SCHOOL IMPACT FEE GROSS ROAD IMPACT FEE DUE C IT Y N TOTAL ROAD IMPACT FEE SCHOOL IMPACT FEE CREDIT Y N TOTAL SCHOOL IMPACT FEE POLICE FEE FIRE MISC FEE TOTAL POLICE/FIRE MISC FEES ADDITIONAL PERMITS REQUIRED N SPECIFY TOTAL of ALL FEES IEWS ZONING ZONING REVIEWED BY PLANS EXAMING MISC. VEGETATION SEA TURTLE MANGROVE DATE COMPLETE � 2 d . INITIALS i•I OFFICE USE ONLY: DATE FILED: � :PLANREVIEWF RECEIPT NO.: �53� PERMIT NUMBER: CONC,iTRRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE &FILLED IN TO BE ACCEPTED • JLE CO St. Lucie County Building and Zoning • F;`% 2300 Virginia Avenue 6�b70tlltl� <ORIOp'• Ft. Pierce, FL 34982-5652 Sb•AOCitl 561-462-1553 BY — — - - - - St. Lucia county APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SI//TE�ADDRESS: S�,%D2 �%]s�lt.//.(lGL CIS• hTV'122�`L � F,L ��q��� 2. S/D NAME:.tC�/(�Vac1 7�ylZ / n SITE PLAN NAME: g20 2 0 }292 Izt ctV-z 3. PROPERTY TAX ID #: — a //I --Q 01/ 4. LEGAL DESCRIPTION (attach extra sheets if necessary): d6�, r (.e /�.i/iIRQlrGtK� 5. PLAT 6. PAGE (� 7. BLOCK 8. LOT BOOK � NO. NO. � NO. fY7'19"a ?ll /A10'e 9. PARCEL SIZE: ACRESlSQ FT. �?_7/ LOT DIMENSIONS 10. DESCRIPTION OF CONSTRUCTION ,PROJECTOR WORK ACTIVITY:1�4/cz , 11. SETBACKS (ACTUAL) FRONT: BACK: H LEFT: SIDE SIDE 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIAL � [ ] INDUSTRIAL OTHER (SPECIFY) t�,?��' � �6L'//iJ! G1� i1zlf/,� �jy ,l%r�Gn12 13. DESCRHPTION OF PROPOSED USE: �Y f7d���/OU2 !/.>L r S[S2�Y✓�l G!�. 14. Sq. FtJCONSTRUCTION: r 15. Sq. Ft. 1st Floor: 16. VALUE OF CONSTRUCTION: $ Z"S % •���2` 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 52500 or more, a RECORDED Notice of Commencement most be submitted with this application. SLCCDV Form No.: 001-02 PI OWNER INFORMATION NAME: 4/GTOR (: �fRIA�tOJ t� w'(N/?J ADDRESS: CITY: - STATE: ebb- a PHONE (DAYTIME): 4� lYt ZIP o�OS Ty cr. 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 #: 6u1 A,ee- ST. LUCIE COUNTY CERT #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS: CITY: STATE: ZIP PHONE (DAYTIME): f - 1)5-< FAX NO. email: ARCHIT/ENGINEER: ADDRESS: CITY: STATE: ZIP PHONE (DAYTIME): (__) BONDING COMPANY: Se)F ADDRESS: CITY: STATE: ZIP MORTGAGE LENDER: AaVi 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. .t 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, 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. OWNER'S AFFIDAVIT: I 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. OWNER/CONTRACTOR SIGNATURE CONTRACTOR SIGNATURE STATE OF FLORIDA STATE OF FLOIjbDA COUNTY OF S%•'JGfe � COUNTY OF The foregoing instrument was acknowledged The foregoing i trument s acknowledged bef�oorqq me this ( day of Gn,r , 2d1� by �by�ore met is t day of'0& , 2017 by rn(- , who is personally \1t04V/' tVLL7t5 who is personally kn�qwn to me or who has produced kno to me or who has produced IYC D) , as identification. lV C SST *i gpoj�as identification MARGIE RAYNER Signature of Ittary �$ °� Notary Public, State of Florida S gnAure of No ^ry My comm. expires Mar. 27, 2007 " a-V-A 1 No. DD 196451 /,,V Type or Prrint Name of N tary Type or Print game of Notary CommissionNo.)16\,1bQ;0 (Sea .�s 'Oa MARGIE RAYNER ConunissionNo. IS)�n1�0 (Seal) o c Nota Public, State of Florida My comm. expires Mar. 27, 2007 NOTE: TWO (2), SIGNATURES REQUIRED. DFMM SIGN TURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILING PERMTT AS OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THE APPLICATION. For specific instructions see appropriate permit checklist. Code Compliance Division 2300 Virginia Avenue Ft. Pierce, FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1148 http://stlucleco.g ov/ce Issued: 04105/2005 Job Location: 8202 COQUINAAVE BUILDING PERMIT ConfM 0638 Permit#: SLC- 0501-0685 City: FORT PIERCE Permit Type: Building (Miscellaneous) Job Description: REPLACE FLORIDA ROOM DESTORYED BY HURRICANE Subdiv: Lakewood Park Unit 8 Lot: 9 Block: 92 Property Owner Victor C Evans Parcel: 1301-608-0112-000/1 7815 Nc Hwy 53E Burgaw, NC 28425-3543 Property Owner Larraine L Evans 7815 Nc Hwy 53E Burgaw, NC 28425-3543 Setbacks Left: Right: Number of Units: 1.00 Floors: Minimum Floor Elevation: Job Value: $ 7,498.40 Front: Rear: Zoning: RS-4 Page 1 SCANNED BY stluripr.0u04t" Buildings: 1 Square Footage: 364.00 Flood Map: Flood Zone: Elev: Permit holder acknowledges through acceptance of this permit that separate permits must be obtained as required by the Florida Building Code including those for all electric, plumbing, mechanical, roofing, and structural work. Further, he/she acknowledges responsibility to comply with all requirements of the 2004 Florida Building Code. NOTICE: In addition to the requirements in this permit, there may be additional restrictions applicable to this property that may be found in the records of this County, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. s:553.79(10), F.S. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR BUILDING IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. s.713.135, F.S. Christopher Lestrange Building Official Date For Automated Inspections, Call (772) 462-1261 For Questions, Call (772) 462-2172 St. Lucie County Land Development Code Section 11.05.01 (A) (2) states; Building Permits shall expire and become null and void if work authorized by such Building Permit is not commenced, having called for and received a satisfactory inspection, within six (6) months from the date of issuance of the permit, or if the work is not completed within 18 months (permit by contractor) or 24 months (permit by owner) from the date of issuance of the Building Permit. Code Compliance Division BUILDING PERMIT SCANNM 2300 Virginia Avenue BY Ft. Pierce, FL 34982 �f.UGl2�®llY1 Phone: (772) 462-1553 Fax: (772) 462-1148 tv http:ilstiucieco.gov/ce Page 1 Issued: 04/05/2005 ConfA 0638 Permit#: SLC- 0501-0685 Job Location: 8202 COQUINA AVE City: FORT PIERCE Permit Type: Building (Miscellaneous) Job Description: REPLACE FLORIDA ROOM DESTORYED BY HURRICANE Subdiv: Lakewood Park Unit 8 Lot: 9 Block: 92 Parcel: 1301-608-0112-000/1 Property Owner Victor C Evans 7815 Nc Hwy 53E Burgaw, NC 28425-3543 Property Owner Larraine L Evans 7815 Nc Hwy 53E Burgaw, NC 28425-3543 Setbacks Left: Right: Number of Units: 1.00 Floors: Minimum Floor Elevation: Job Value: $ 7,498.40 Front: Rear: Zoning: RS-4 Buildings: 1 Square Footage: 364.00 Flood Map: Flood Zone: Elev: Permit holder acknowledges through acceptance of this permit that separate permits must be obtained as required by the Florida Building Code including those for all electric, plumbing, mechanical, roofing, and structural work. Further, he/she acknowledges responsibility to comply with all requirements of the 2004 Florida Building Code. NOTICE: In addition to the requirements in this permit, there may be additional restrictions applicable to this property that may be found in the records of this County, and there may be additional permits required from other governmental entities such as water management districts, slate agencies, or federal agencies. s:553.79(10), F.S. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR BUILDING IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. s.713.135, F.S. Christopher Lestrange Building Official Date For Automated Inspections, Call (772) 462-1261 For Questions, Call (772) 462-2172 St. Lucie County Land Development Code Section 11.05.01 (A) (2) states; Building Permits shall expire and become null and void if work authorized by such Building Permit is not commenced, having called for and received a satisfactory inspection, within six (6) months from the date of issuance of the permit, or if the work is not completed within 18 months (permit by contractor) or 24 months (permit by owner) from the date of issuance of the Building Permit.