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Home My WebLink AboutAPPLICATION FOR BUILDING PERMITr�. OFFICE;USE ONLY: '�_ � DATE FILED: -�,� PLAN REVIEW FEE: / REI.Crt"1 NO.: CONCURRENCY FEE RECEIPT NO.: PERMIT NUMBER: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue SCANNED Ft. Pierce, FL 34982-5652 \ (1 BY 772A62-1553 St. Lucie County , APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE 7 Z�a7➢Tiy� I�f�CiJNt'�/;Vy C�1�1 1. LOCATION/SITE ADDRESS: G: 5 t S. US-1 F+ r' l E2 C l; F 1- 2. PROJECT NAME: S I G N (adj , 0 i9 4 SITE PLAN NAME: 3. PROPERTY TAX ID #: ( a i t9 2 0o L N 000 9 i 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 5. PLAT BOOK -7 6. PAGE NO. L} I 7. BLOCK NO. ' 8. LOT NO. Z 7z 9. PARCEL SIZE (ACRES/SQ FT.): 1%t7 0� LOT DIMENSIONS: 2 1 Z)ed o 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: P-grp w c.e. S`VG N S tZEMoyE�J'-: Af'TtIZ 702twt?d2, Ri5�U7!r P- I rJ PTCGc92tDAwc� ^11Th1 6Al e �aSEi1 �1�NS 11. SETBACKS (ACTUAL) FRONT: BACK. RIGHT SIDE: LEFT SIDE: 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION " EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL COMMERCIAL [ ] INDUSTRIAL [ ] OTHER (SPECIFY) S 1 G tjs 13. DESCRIPTION OF PROPOSED USE: 1 N if 0 A 04 A7- i 1) N s WI S 14. SQ. FT OF CONSTRUCTION: N / A 15. SF. FT 1st FLOOR: AJA 16. VALUE OF CONSTRUCTION: $ iio-1'i �O�O f7 I f�7d.B 0 Ev� l ��+' JG 10 The value of construction is used to determine the amount of perrnit 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 valuo'is $2500 or more, a RECORDED Notice of Commencement must be submitted with this application SLCCDV Form No.: 001-02 i f UPDATED 6/25109 SCANNED OWNER INFORMATION BY NAME: 1" Ay-1-' P L,.L.0 St. Lucie County ADDRESS: ti Lk5- i _la CITY: ;F�f r LT 2 G Ti STATE: Ir(n ZIP: '�'-y 7 2- PHONE (DAYTIME): C723 2I6 - /8 7 '/ 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): C__) CONTRACTOR INFORMATION ST. of FL REG.CERT #: C G C I SO 5 I % a ST. LUCIE COUNTY CERT #: d S (v Ll BUSINESS NAME: `J r, r Q ( 6t S�-ro y-- QUALIFIERS NAME: % e a o ,`a wo.c� J c \ � ADDRESS: i/ f 9 /0 E wyt v- (�" 3 CITY: S4� a,. k- STATE: F (- ZIP: g y 4 4 ii PHONE (DAYTIME): Z) 33y 476c� FAXNO.77a 33y S6)�C Email: troots��r« nUsasiQ.co� ARCHIT/ENGINEER: HR O if I Kb a H t'lz i ADDRESS: "72.6S L I�JSe ck&e—le. CITY: �PO(Li 5A- STATE: ( ZIP: 34,tS 2_ PHONE (DAYTIME): 7[7 2) 466 - sra Q BONDING COMPANY: d\J 1 n ADDRESS: CITY: STATE: ZIP: MORTGAGE LENDER N I 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. } i i t f 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 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 COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. OWNER OR CONTRACTOR SIGNATURE STATE OF FLORIDA �yy� COUNTY OF / t t The foregoing �instrument was acknowledged before me this n^ day of20 /3 by c&Jt'G oww who is personally known _ or has produced as identification. l - d ?/L(r%tKge�r� Signature of Notary CONTRACTOR SIGNATURE STATE OF FLORIDA may,,, - COUNTY OF / / I &rvl The foregoing instrument was acknowledged before me this -2 day of ®!l7"6 WA,' 20� by �'A 41� GUCi wr z who is ptEsonall _ or has produced /� /��/ as identification. L(i]/LLtu P _lG! Signature of Notary Commission No. CE O763al (Seal Commission No. 65 �1� 3o I (Seal) :�ugGc_ ATHENA E. STEINBERG * * W COMMISSION# EE 076301 EXPIRES: April 10,2015 NOTE: TWO (2) SIGNATURES ARIe I1 V*W% ATURE 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 ' * MY COMMISSION t EE 076301 For specific inptructions see appropriate permit c'lheckUSIL EXPIRES:Apri110,2ot5; '"�� 9adedTrva audgatNolay s l)pCi F<� I OFFICE USE ONLY BP #: SECTION TOWNSHIP RANGE MAP NO. ZONING / LAND USE LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # ^ J v� 1 sT FLR ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC LOT SPLIT LOT SPLIT Before 1/1990 After 1/1990 REQUIRED APPROVED REPORT HABITABLE RADON PERMIT CODE AREA FEE FEE (RADON) LIBRARY PUBLIC BLD PUBIC BLD PARKS IMPACT IMPACTFEE IMPACT IMPACT 'FEE CORRECTION 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 VARIANCE FEE 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 COUNTER REVIEW REVIEW pXVIE REVIEW REVIEW REVIEW DATE RECEIVED v DATE COMPLETED INITIALS i t I ! ! I I I i I EXIIIBIT `A' Begin at the Southeast comer of the North %2 of Lot 272, Amended Plat of Aetna Park Subdivision as recorded in Plat Book 7, Page 41 of the Public Records of St. Lucie County, Florida; thence run West along the South line of the North '/2 of Lot 272, approximately 212 +/- feet to an existing fence. Thence run North along the existing fence line approximately 90 +/- feet to the South edge of an existing unpaved drive/roadway. Thence run East along the South edge of said unpaved drive/roadway, approximately 212 +/- feet to the Eastern boundary line of the North '/2 of Lot 272. Thence run South along the Eastern boundary line of the North %2 of said Lot 272 to the POINT OF BEGINNING. Said property lying and situate in Section 10, Township 36 South, Range 40 East, St. Lucie County, Florida. The 30 foot +/- wide North, South drive from center drive (approximately 90' North of the South property line) to drive at traffic signal, approximately 22 feet East of roof edge of lease building is to be shared by users of the property immediately West and North of lease property described above.