HomeMy WebLinkAboutSUBMITTED PAPERSOFFICE USE ONLY:
DATE FILED
PLAN REVIEW FEE: RECEIPT NO.:—=1--�- PERMIT NUMBER:
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
2300 Virginia Avenue
Ft. Pierce, FL 34982-5652
772-462-1553 e Yni�D
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APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
1 LOCATION/SITE ADDRESS:
PROJECT NAME: /� 041 f sGES SITE PLAN NAME:
3+k PROPERTY TAX ID #: ,3C) - -rDlir - O ! 3 ,17 -
4. LEGAL DESCRIPTION (attach extra sheets if necessary): Cogal Description -
TROPICAL ISLES (OR 2786-2163) UNIT F-15
S.
ra
PLAT BOOK 6. PAGE NO.
PARCEL SIZE (ACRES/SQ FT.):
7. BLOCK NO.
LOT DIMENSIONS:
0 COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY:
:Tl a SETBCKS ACTUAL) FRCO�
12, TYPE OF CONSTRUCTION (Clie
NEW CONSTRUCTION
[ ] RESIDENTIAL
[ ] OTHER (SPECIFY)
8. LOT NO.
RIGHT SIDE:'- JaA LEFT SIDE:
lG rG� fQ�
all appropriate boxes)
[ ] EXPANSION/ADDITION
[ ] COMMERCIAL
1 DESCRIPTION OF PROPOSED USE:
[ ] INTERIOR RENOVATION
[ ] INDUSTRIAL
ir4s SQ. FT OF CONSTRUCTION: ��� 15. SF. FT 1 st FLOOR:
or'
VALUE OF CONSTRUCTION: $�'
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 arc 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
RAN�FORM!AT ONE
NAME: 10 el & ZSA4=zz L-..a , 6'"
ADDRESS: G s n c�
CITY: STATE: 4 ZIP: CTY AO G
PHONE (DAYTIME): L_) 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): L�
CAIdTRACTOR_IiVFORMATTI0R1
Uf
ST. of FL REG.CERT #: j�fGG J!!617 29 ST. LUCIE COUNTY CERT #: c%� 4?
RTTSTNESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY:
STATE: ZIP:
PHONE (DAYTIME): U
FAX NO. Email:
ARCHIVENGINEER:
ADDRESS:
CITY:
STATE: ZIP:
PHONE (DAYTIME): (�
BONDING COMPANY:
ADDRESS:
CITY:
STATE: ZIP:•.
MORTGAGE LENDER:
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.
CERTIFICATION: L
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 D.AOPY OF THE CONSTRUCTION LIEN LAW NOTICE TO
THE PERSON WHO PROP,T ,TY IS SUBJECT TO ATTACHMENT.
_.OVAER OR COTqTRA WSIGNATURE
STATE OF FLORID '-
COUNTY OF
The foregoing instrument was acknowledged before X
me this R. day of 20��
by G� J7� V
o is personally known or has produced
1 VA . /Y/Y"7 .l ,�%/ r � a tikatiI,
Signature of No
Commission No. (Seal)
CI •
O
d
Jvda
CMto m
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CONTRACTOR -SIGN
o
STATE OF FLORID
;51�, `�
COUNTY OF
The foregoing instrument was
acknowledged before
me this day of
20/
by
who is personally known
or has produced
M• /,4-- -&/"
as identification.
0
j W Commission No.
2�y
.MST
P
(Seal)
NOTE: TWO (2) SIGNATURES ARE REQUIREDVFOR
ATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILDING PERMIT AS AN OWNSHE OWNER MUST PERSONALLY APPEAR,TO SIGN
THIS APPLICATION IN THE OFFICE LIFRONT OF THIS APPLICATION.
OWNER BUILDER AFFIDAVIT WILL BE ALL OWNER/BUILDER APPLICANTS.
For specific instructions see appropriate permit checklist. E
OFFICE USE ONLY Br 4:
SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
LAND USE
LOT CVG %
TAZ NO.
FLOOD ZONE
FIRM MAP #
1ST FLR ELV
MAX HGT
CONST TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF REC
Before 1/1990
LOT OF REC
After 1/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
��
HABITABLE
AREA
(RADON)
RADON
FEE
PERMIT
FEE
LIBRARY
IMPACT
'FEE
PUBLIC BLD
IMPACT FEE
CORRECTION
PUBIC BLD
IMPACT
FEE
GENERAL
PARKS
IMPACT
FEE
"SCHOOL
IMPACT
FEE
ROAD
IMPACT
FEE
CREDIT
Y
N
LAW ENF
IMPACT
FEE
FIRE/EMS
IMPACT
FEE
DRIVEWAY
REQUIRED
Y
N
DRIVEWAY
FEE
ADMINISTRATIVE
VARIANCE FEE
SPECIFY
SUBS
REQUIRED
MECHANIC ROOF
ELECTRIC GAS
PLUMBING
NON -CONFORMING
LOT OF RECORD
FEES
MISCELLANEOUS
FEES
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
Q�
(Parcel Id#/Legal
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
�aue,n- /1, Faar u)el/
Property Owner Name (Please Print)
Property Owner Sr ig ature Date
STATE OF FLORIDA, COUNTY O
ACKNOWLEDGED BEFORE ME THIS ` ( %�j DAY OF _C� 20 �
WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF/yOTARY PUBLIC V &TYPE OR PRINT
COMMISSION NUMBER
SLCPDSD Revised 08/24/2010
(SEAL)
I
P�OP� BOO ���p61159
M �-pp ee `N p b`6 dew
Boe��h�N�
5�D
EXTERIOR CHA_'l GES TO HOME
APPROT AL RE01-EST
DATE:
NAME: LUG i— Y` ��l PER�([T
ADDRESS.-��2i/7 / �ifq t U r CI LOT
PERMIT .APPLIED FOR: FL RO&M SCREEN ROOM CARPORT ROOF
of
UTILITY ROOM AWNING OTHER ZB
ALL ADDITIONS MUST BE ATTACHED TO THE HOME AND MUST MEET PARK
SPECIFICATIONS. ALL ADDITIONS tMUST BE .APPROVED N ADVANCE BY THE PARK
OFFICE. ALL VENDORS ,AND CONTRACTORS MUST BE LICENSED BY THE STATE AND
COUFITY .AND MUST SHOW EVIDENCE OF INSURANCE. FURTHERMORE. ,ALL ADDITIONS
MUST COMPLY WITH LOCAL ORDINANCES AND BUILDING CODES. :ANY EXTERIOR COVER
ON PATIOS MUST MATCH THE SIDING ON THE HOUSE.
DRAWING ATTACHED FOR APPROVAL
(MOTE: ANY CHANGES TO YOUR SUBMITTED DRAWING ,ARE NOTED BELOW).
CONTRACTOR'S NAME:
ADDRESS: 2%5r /G � /—" % a L
COPY OF LICENSE: PROOF OF I N S Ul RANNCE:
-I
COPY OF STATEI,COL� TY' PERMIT ATTACHED:
WHEN W"OR-K IS SATISFACTORILY COMPLETED. INSPECTOR WILL SIGN PERMIT AND A
COPY" OF APPROVED PERM[T MUST BE SUB-M(TTED TO THE OFFICE.
COMPLETED SATISFACTORILY: DATE:
APPROVED BY: �. DATE: 2,
.4PPR0> TD: PURS . "T T LOCAL ORDLti: VCESA!'Y'D CODES.
APPROVED WITH NOTED EXCEPTIONS:
THE FOLLOWING CHANGES MUST BE MADE PRIOR TO COMMENCE:MENT Or' ANY RK:
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