HomeMy WebLinkAboutCERTIFICATE OF CAPACITY-ZONING COMPLIANCE/
-� ,'t=- +t--r.. a� —5: r�"�Ygf-'• -'- .. a �
,. "•k n. at? + 3 s -.✓. 2� . € d `sue
k�� 5. r .•rya,. S f Fj��.+'i 2vy .xi' �5��'+0
-.+',•i _.•�.._ ..fit'�x-.r,'J.-a^..r'.S'a...c�.1..%�Ja •z_:?�.:v..._...�:'"s
�G�•`✓4::��,
-c3 "� � �'r�-v:
h. "`=i Y.r_
r—�+r�r
� €SY� Y`
y
fa�`�r5'z�,...'ufilz`N
.�"rsizF..��rJ�
�,-='x.'5.. .',�%� �•'
� a� > "F �`'�3-.'����Yr
.r fie+ x`a�,J �-; � t r . ,
n"t�.xS�`S•..„z"�yi ..�� »�
z�r
v� d.- �. s�-,"'"�:r'7
-<.� k."..r�r-3c
���.ns F-�„14
i.f I� 'c 7,:.�
yr Y. �F' "_.���
i � � �.
,..y. .��
HABITABLE
i
t r •
t. .
i
PON
IMPACT:SCHOOL
�_SCHOOL
�'-
IMPACTFEE
®-
TOTALPOLICEIFIRE
MISC FEES
ADDITIONAL
�®
•
PERMITS
REQUIRED
{:
� # �
•-+
-s.
§ n-'�•c`'4Y
�.,; �
4t- LA
3Y-�-��,��`.,�
r i. `'a i�rd-.= <�`�2I0-'1,3Y;11'-i
i''sS"��v� -.`E �.�'�'r"' c rK �. �.�- 1 : _ v�
yi`
� •• ��
•
MM__�_Niglio
• t'�
FA
DATE FILED: c�%•(o
PLAN REVIEW FEE: _/ -OL5 RECEIPT NO.: ' PERMIT NUMBER: Q oa - d ,f A
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
ALL FO MUST B�E�CO COMPLETE & FILLED IN TO BE ACCEPTED
St. Lucie County Building and Zoning f3
2300 Virginia Avenue
oR�o` SCANNED Ft Pierce, FL 34982-5652 /Sc -
BY 772462-1553
St. Lucie County
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
1. LOCATION/SITE /ADDRESS: 015J -SO l ( rtkI n1 irS Fy t6,tfw
2. SAD NAME: /ySITE PLAN NAME: /"/72S T y! ue A CG/tt M e&'e &X
3. PROPERTY TAX ID #: a 3//- 41Y 3 - 6 O Gy- ao o- 9
4. LEGAL DESCRIPTION (attach extra sheets if necessary):-�
5. PLAT 6. PAGE 7. BLOCK 8. LOT
BOOK NO. /Y2 33 NO. NO.
7tia�5o • q�
9. PARCEL SIZE: ACRES/SQ FT. O LOT DIMENSIONS 6 3 p / X / / '7 0
10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY-xY/f�/��.
9u.S�=/r}c r✓9RCG{�LcS s— /3urc��.vG %3 - Gw/T' o3
II. SETBACKS (ACTUAL) FRONT: [j BACK: py� RIGHT: p r LEFT: q /
---�— 0 SIDE / -� SIDE / s
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
NEW CONSTRUCTION [ ] EXPANSION/ADDITION
[ ] RESIDENTIAL [ ] COMMERCIAL
kcJ OTHER(SPECI17Y) f��72ytr-/T-
/Z �cQt fi eN il-L�
13. DESCRIPTION OF PROPOSED USE: /w� rsHoccr�s v-
14. Sq. FtJCONSTRUCTION: .D (D ,Sf'f % 15.
16. VALUE OF CONSTRUCTION: S Sbo U
] INTERIOR RENOVATION
o itJ
Sq_ Ft 1st Floor: 5-0-0 $j F
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
OWNER INFORMATION
NAME:
ADDRESS:
WN-69
PHON]
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FELL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER:
ADDRESS -
CITY:
PHONE (DAYTIME):
CONTRACTOR INFORMATION
STATE:
ZIP
ST. of FL REGJCERT #: Q3 e- O V y 1 (. a ST. LUCIE COUNTY CERT #: a-kG S
BUSINESS NAME: C C r - A 'L
QUALIFIERSI AME:
ADDRESS: M 7 5 �4iKJ S /3 r Lr'L c J GLJ� Y
CrryW)g �CA(4-tK STATE: "?Cc_ ZIP
PHONE (DAYTIME): S/) ��email:
t
ARCHIT/ENGINEER:
ADDRESS: SJ
CITY: &--94
PHONE (DAYTIME): (C6.t ) 776 — 6 // 0
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER:
ADDRESS:
CITY.
STATE:
0V.1
ZIP
ZIP
v
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, ETC., not otherwise included with this building permit application -
The following building permit applications are exempt from undergoing a full concbrency review. room additions, accessory
structures (all types), swimming pools, fences, walls, signs, screeri 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.
em, AT
TE OF • •
•�UNTY OF
The foregoing inst��u!ment,7 acknowled ed
b�yfore J thi �I'rdhy of I>eC , 20�by
C� eJ1= f who is personally
known to me
t,gY P B De: .i. ' iiL rra
1, �e N..,.,Type n
wnozf
eBondit-1
"-*eran:g_inc NDa5&
CON TOR SaGNATURE
STATE OF FLOPDA
COUNTY OF A , j_-L)C. -e
The foregoing in ment? as acknowled&ed
ore lme (lrjsay of UeC , 20AS by
IC }� who is personally
known to m
t� Pia Debra .Guerra
e� Commission # 1)1)268474 p
ZQN@r& itE£1W8W v I 6
Ewa Bonded Troy FW-InsTanW.IM aeo3n_ S
(Seal)
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUH.ING PERMIT AS AN OWNERfAVILDER, 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.