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Home My WebLink AboutCERTIFICATE OF CAPACITY-ZONING COMPLIANCE_, ) OFFICE USE ONLY BP #: D 9D 3 ' D27/��llCo SECTION 15 TOWNSHIP /_ ('J 3/_5 RANGE �n C [/ MAP NO. J7 %JC J ZONING /' /' T � l.. LAND USE O M ("OM LOT CVG % TAZ NO. � FLOOD ZONE \/ FIRM MAP # Qt D (J 1sT FLR ELV MAX HOT i D N CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS I d J 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 P AREA FEE FEE o (RADON) LIBRARY PUBLIC BLD PUBIC BLD PARKS IMPACT IMPACT FEE IMPACT IMPACT FEE CORRECTION FEE FEE GE _SCHOOL _ — ---ROAD - CREDIT- Y N LAW ENF IMPACT IMPACT IMPACT FEE FEE FEE FIREIEMS RIVEWAY Y N DRIVEWAY ADMINISTRATIVE 'IMPACT REQUIRED FEE VARIANCE FEE FEE SPECIFY MECHANIC ROOF _ NON -CONFORMING MISCELLANEOUS V SUBS ELECTRIC GAS LOT OF RECORD FEES REQUIRED PLUMBING ✓ FEES 2�/y DATE SENT TO ADDRESSING: REVIEWS FRONT ZONING SUPERVISOR .PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE 3 RECEIVED I DATE 1 1 COMPLETED tk INITIALS I •'•EPICS^CTSE'ONLY: DATE FILED: � p� PLAN REVIEW FEE. t RECEIPT NO.: -EJ� 6-�� PERMIT NUMBER: CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED yak St. Lucie County Building and Zoning 2300 Virginia Avenue Pie R10 Ft. Pierce, FL 34982-5652 �r 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITYIZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRE 0 G C J ' 2. PROJECT NAME: JI SITE PLAN N G G (n 3. PROPERTY TAX ID #: 70 -I — 000 )," 00 v 1 4. LEGAL DESCRIPTION (attach extra sheets if necessary): WE S, �• 5. PLAT BOOK ( 6. PAGE NO. � � 7. BLOCK NO. _� 8. LOT NO. � 9. - PARCEL SIZE (ACRES/SQ FT.): r� _5L LOT DIMENSIONS: _ 070 x 5�� 10. C04LETE DESCRIPTION Oq CQIfISTPYW7�1 PROJECTOR WORK ACTIVITY: I{ 61 ` ou II. SETBACKS (ACTUAL) FRONT: 00 BACK: 5 D RIGHT SIDE: 5q LEFT SIDE: eta 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) DV NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] RESIDENTIAL D4 COMMERCIAL [ ] OTHER (SPECIFY) 13. DESCRIPTION OF PROP( yy INTERIOR RENOVATION [ ] INDUSTRIAL 14. SQ. FT OF CONSTRUCTION: r I l 2 15. SF. FT 1st FLOOR:�d- 16. VALUE OF CONSTRUCTION: $ i 0 r O 0n 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 SCANNED BY St. Lucie County ,ao, - - - - OWNER INFORMATION NAME: Q ADDRESS:. I sw ti CITY: I l may' STATE: zip; ' ✓ qqo 1 p PHONE (DAYTIME): ( 6r63 ��0� 1 Email: 1Z ftidt0IiAef0 IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: AI ADDRESS: CITY: STATE: ZIP; PHONE (DAYTIME): (_) CONTRACTOR INFORMATION �) ST. of FL REG.CERT # Y X ST. LUCIE COUNTY CERT #: � BUSINESS NAME: NA A ( 6D (44Q QUALIFIERS NAME: ADDRES : AA A FJ(-IIV(- 2 e CITY: a lvlCk STATE: ZIP: J IU 2 p� PHONE (DAYTIME): �I( 4:\_ 5 J— 00-gJ FAX N/tO. 1%EmaiL OA . (OOL ` alt I ` ARCHIT/ENGINEE ADDRES 0 CITY: Gt STATE: PE ZIP; PHONE (DAYTIME): (�1'�I O ' BONDING COMPANY: IV A ADDRESS: CITY: STATE: ZIP: MORTGAGEL^ENDER: cu([% TeuM _ V, ADDRESS: C OD f Ol %t' for) CITY: Jl WN 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. W 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 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. ------------ R CONTRACTOR SIG CON CT( SIGNATURE STATE OF FLORIDA STATE OFFLORIDA COUNTY OF Kato-<r 1 COUNTY OF (YiOC4 0 The foregoing instrument was acknowledged before me this 0) day of fo 20 D n , by V-M L l�2�,mc - who is personally known ✓ or has produced identification. of Notary Tici L. Connors Commission # DD502105 Expires May 22, 2009 The foregoing instrument was acknowledged before me this o')_7 day of r t.,_ .f , 2oP, by{�C,Soc-x who is personally known t',�u_r has produced as identification. TrRci L. Connors seal) 0 tuomm755tt IID302tp5 Expires May 22, 2009 OWWTroy Fain inumn Ina eN355-IDr NOTE: TWO (2) SIGN REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNERIBUILDER, 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 APPLICANTS. For specific instructions see appropriate permit checklist. I