HomeMy WebLinkAboutCERTIFICATE OF CAPACITY-ZONING COMPLIANCE/15 1Z/ oW
OFFICE USE ONLY:
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DATE FILED:
PLAN REVIEW FEE:
RECEIPT NO.: 757b
1 L /
PERMIT NUMBER / I DOZ ' I��lD
CONCURRENCY FEE:
RECEIPT NO.:
CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
SCANNED 2300Virginia AvenueBY
Ft. Pierce, FL 34982-5652 J K.-l.u/rJ LL11
St, Luce COunt / 772-462-1553
DC
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
I. LOCATION/SITE ADDRESS: 2601 Grav Twia Ln. Fort Pierce. FL 34981-4986
2. PROJECT NAME: LVshon SITE PLAN NAME: Lyshon
3. PROPERTY TAX ID #: 3405-801-0018-000-0
4. LEGAL DESCRIPTION (attach extra sheets if necessary): Twelve Oaks Estates Lot 18 (0.32AC)
(OR 3391-2473)
5. PLAT BOOK 6. PAGE NO. --- 7. BLOCK NO. --- 8. LOT NO. 18
9. PARCEL SIZE (ACRES/SQ FT.): .32 AC LOT DIMENSIONS: 98.51 X 140
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
Foundation Stabilization
it. SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE:
TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
�(] OTHER (SPECIFY) Underpinning
DESCRIPTION OF PROPOSED USE:
SQ. FT OF CONSTRUCTION:
VALUE OF CONSTRUCTION: $ 75,556.00
15. SF. FT 1 st FLOOR:
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 6/25/09
OWNER INFORMATION
NAME: Gloria H Lvshon
ADDRESS: 2601 Gray Twig Ln
CITY: Fort Pierce STATE: FL ZIP: 34981-4986
PHONE (DAYTIME): L7�2 201-5784 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:
PHONE (DAYTIME):
CONTRACTOR INFORMATION
ST. ofFL REG.CERT #: CGC1519214
STATE:
BUSINESS NAME: Certified Foundations. Inc.
ZIP:
ST. LUCIE COUNTY CERT #: -� U W D;? �
QUALIFIERS NAME: James J Collier
ADDRESS: 1306 Banana Rd
CrrY: Lakeland STATE: FL ZIP: 33810
PHONE (DAYTIME): ( 8663 859-3889 FAX NO. 863-853-8593 Email: cfi@cfi-1.com
ARC W/ENGINEER Thomas H Fisher
ADDRESS: 4509 George Rd
CITY: Tampa STATE: FL ZIP: 33634
PHONE (DAYTIME): Lj_� 496-9634
BONDING COMPANY
ADDRESS:
CITY:
MORTGAGE LENDER
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.
r
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 RVIPROVEMENTS 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.
4CW & ILIJ:i73
STATE OF FLORIDA
COUNTY OF Polk
The foregoing instrument was acknowledged before
me this I'%_ day of 20 f q
by Ta,H.esCo l/Le
who is rsonally known r has produced
OF FLORIDA
Y OF Polk
The foregoing instrument was acknowledged before
me this / 3 day of 20 /
by n n t o S �\
who is pe
onally kno + or has produced
as identification. as identification.
Sign ature of Nota Signature of Notary
•:Q4"s KATHLEEN S. MORISSETTE „+, ,
Com P.�ON # DD91(Co • s oR�VOKATHLEEN S. MORISSE?991
MY COMMISSION # DD984966
�•; EXPIRES August 14, 2014; EXPIRES August 14, 2014
407 395-0153 F1ondaNu10ryS0N1W.= ,,,,
IAP 3960153 FlontlallotaryServica.com
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 WELL BE REQUIRED FOR ALL OWNERIBUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.
OFFICE USE ONLY BP #:
SECTION
TOWNSHIP
RANGE
MAPNO.