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Home My WebLink AboutBUILDING PERMIT APPLICATIONOFFICE USE ONLY BP #:DATE FILED.. SECTION ®� TOWNSHIP J� S RANGE �I C MAP NO. "1✓v ZONING i LAND USE LOT CVG % TpZ NO. FLOOD ZONE FIRM MAP # ) 1 15T FLR ELV 7 I MAX HGT O�OV CONST TYPE J��C•••111r OCCUP TYPE � 2 �J MAX OCCUP # OF FLRS WATER 1JJJ �1 SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC (after LOT SPLIT LOT SPLIT � afore 1/90 1/90 REQUIRED APPROVED ADMMST LIBRARY PARKS PERMIT VARIANCE IMPACT FEE IMPACT FEE FEE REPORT PUBLIC BLD HABITABLE RADON FEE CODE � OI IMPACT FEE AREA (RADON) SCHOOL GROSS ROAD CREDIT Y N TOTAL ROAD IMPACT FEE IMPACT FEE IMPACT FEE DUE SCHOOL CRE Y N TOTAL IMPACT FEE SCHOOL IMPACT FEE POLICE FEE FIRE FEE MISC FEE TOTAL POLICE/FIRE MISC FEES ADDITIONAL SPECIFY TOTAL PERMITS of ALL Pt REQUIRED FEES REVIEWS ZONING ZONING PLANS MISC. VEGETATION SEA TURTLE MANGROVE REVIEWED BY EXAMING DATE �O COMPLETE I a INITIALS � OFFICE USE ONLY: ^^ PLAN REVIEW FEE: RECEIPT NO.:t//asPERMIT NUMBER: QFW + � � CQ Q CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE &FILLED IN TO BE ACCEPTED �E G St. Lucie County Building and Zoning • �, 2300 Virginia Avenue RO Ft. Pierce, FL 34982-5652 lck 772-462-1553 t" no reC APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE ^- PROJECT INFORMATION ✓ SCAf�NF.D 1. LOCATION/SITE ADDRESS: I �C� �.� �+�� 1 v� tA�ltl� S� LAC-i2P9j,Rjgr 2. S/D NAME: N�±BeS,� (A—U SITE PLAN NAME: 3. PROPERTY TAX ID #: a • 5o 1 - (" �Q I ---) - DC)() - 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 1 ��cyy 5. PLAT 6. PAGE 7. BLOCK 8. LOT BOOI( NO. =pj-rc NO.NO. �M.2.Q9. PARCEL SIZE: ACRES/SQ FT. p�T DIIvIENSI NS � ' / 10. DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: I tt v 15 � 1.00 V 11. SETBACKS (ACTUAL) FRONT: BACK: � RIGHT: LEFT: LO SIDE � SIDE s 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROPOSED USE: c�� •�Q,M,�,1 i L1 EenI (lelr ✓ ' 43 14. Sq. Ft./CONSTRUCTION: a�:� - 15. Sq. Ft. 1st Floor: 16. VALUE OF CONSTRUCTION: $ g35 �,G jj# " 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 $2500 or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 OWNER INFORMATION NAME: mil t I H U Y 1 � A1J 1-7I ._ I - I ADDRESS: Z> 1 b n-�_ CITY: _l..aL160 1 e, STATE: ZIP PHONE (DAYTIME): (0.� r�� fJ c�� P email: IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: STATE: PHONE (DAYTIME): CONTRACTOR INFORMATION ZIP ST. of FL REG./CERT #: (`$_a, ST. LUCIE COUNTY CERT #: CTt �i BUSINESS NAME: • ZIP email: ARCHIT/ENGINEER: �� ADDRESS: C4:�l C 1ST• J io `I�iti_.+ �S? , CITY �� i�� STATE: G 1_� ZIP, — PHONE (DAYTIME): (_) BONDING COMPANY: ADDRESS: CITY: MORTGAGELENDER: 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 will be performed -to -meet -the standardsofall_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 ning. O CON RA O SIGNATURE CIQIqTlACTOR SIGNATURE STATE OF FLO VI COUNTY OF The foregoing instrument was acknowledged before me this l day of 20f 8, by Type or STATE OFF !O rk r X COUNTY OF (,(� The foregoing instrument was acknowledged before me this day of 20� by I tl o is pers a y known a or who has produced as identification. Type & l&'_ PGB, I�l�r�s tiatlyl(ellV +t%_ °&B Christin Kefty Commission No. Commission Ncg�� fY 14 985 i 1, ;DO&,IZQ86 d;euw6llul�ry�,�6!�1�A�Ir1 ,,ip " a`ExpiresFebruary14,2010 for ceo ngemiay�ara.�mc,dpR?bk�@dS�os,uie �oF ape ao�reaum r�.�M��.i�pp.l8siat4 NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE AOTARIZED. IF APPLYING FOR THIS BUILING PERMIT AS AN OWNER/BUILDER, THE 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.