HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address:
2L401 AA 1cLn -1C,-bMC�-b1 VU
Legal Description: ��r-ISI l�r�f' ShOteS it►iT I PSI IC4 L1�+12 and nlL�l 2t 2-I F+ t-c�+ 13 Or 'x2
lil -130
Property Tax ID#: I43t.P U01Q07-0Coo- Ct Lot No. I4?L'' _
Block No.
Site Plan Name:
Project Name:-D C Mi
Setbacks Front Back: Right Side: Left Side:
Ing I 1ike r h V z Awr
Additional work to be pertormed under this permit-check all that appy:
✓Windows/Doors
_Mechanical _Gas Tank _Gas Piping _Shutters —
_Electric _ Plumbing _Sprinklers _Generator —Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $��o�z) 00 Utilities: —Sewer —Septic Building Height:
Name:
INarne
ddress:
240^1 A+Irvffic � Company: MrfYi Lrkl f!l'amrise 0� xCya
City: State: L Address: 08 7omaha0k 'Di
Tth
_ 6
�/yy�� ��//�� I Ci Indian �Q��a:<. es�-� State: I'1
Zip Code: WC1�Il�f Fax: ^!I4 city.
��2�5�'q��2 Zip Code: 32937 Fax: 3ZI- 777- LIZ34
Phone No.(rev
E-Mail: NLIA Phone No. 772 337-z14170
Fill in fee simple Title Holder on next page (if different E-Mail: (.u{esshaunr7 ��,� -��"
from the Owner listed above) ! State or County License:
I I
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
.�,>sF_� -' v.c t'.rx_. .�.=o:c�.y �_:c s-�.^�^ :3.�.... .-�St.,.T�-s:c�z•:.a �y.--^� .s-i,Y-*eco ��� '-�` ,� -x- rv". x -
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
in consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING 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 lender or an attorney before
commenci work orrecordinigyclur Notice of Commencement.
S
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF
COUNTY OF OIC' Il'1 CC,1 STATE OF FL IDA rami
COUNTY OF
The f9r was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 11by this d NJ 20 rl—by
s L�
(Na=ro ) m p rso w1e i )
( nat o c tat f Florida) na to of Florida)
rs all O oduced Identification e i R Produced Identification
entificatio d T e I o duced
"dt�,,, Commission No. '` � �
Commis r` BSZIGEr! � U
4,p A ,, MYCO MISSION#FF244655 =�s' � � MYCO�flM fiNIF: R i
+ Qp EXPIRES:June 25,2019 CXPIRES,IuRc `a,;.pI I I
Revised 07/15/201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW I REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
z z Z Z z z z Z Z z z Z Z Z Z Z z z z
O O M 0 0 0 0
V O O O O O O O O O O O O O O G O O N 'A ol 'Al 0)
a o o vi o 0 0 0 0 0 0 0 0 0 0 0 o w M
N V N O uJ O M M O O O O O O O O NN O O N C-4
O O N N
O A El!
O N n M 0
N y'M U O O O O O
ll) M N O O O O O O O O O O O O O O O O
oC�MO vi o 0 0 0 0 0 0 00 0 0 0 a
O 04 O O O O O O O N N N O O N N O L
7
'
m 2o`W Z, m
s U o
gfg u>o 0
H> n
O O ` 0
a
o
W m x N O
�
a } o y F z 0
J
U ~Q W a 3
Q m J Q J Q 5 R
>(J MLN Q Z } O T „
QHLLf eO Oa' J �.
J C'
g� z0 QQ¢
QS N , z QO Q m
p�� : Cf
Q N J act cap y QTS SST':.
(n N O O N NJ 9 (17 N N C O 'y L`.
0 2 C U F }} F 0 7 O m 0) O
p F z w o m m E «m E 0 E a O
Q 'm o ff H c a d 'o w C Uf F L 'O
o o mF oBQ NO w U - v ? Q a `� mQ a o a m v d aoo Baa
CL mm Mat~n :M�j °� E m O E W . 6Q (O c r �
m M U U Z 7 } O 'O C L] F�L I D O C T Y N N
U LJL CL N }' K V Q Z� p a0 L J OZm 0 'L a W 6 i0 y� N pTj d � J J
v g oat I Q o�IL a c 4 O �z� $a y w u' m y Gm ML
O m 0 W N J N U O J U C N M W T Z
LLr N O
O Y Z N F C u U
� U Mn o U) ma O mo m g.
muj 2-0
p m O SL) O m m'..
Mp m 8 W m E m
�ODN U oLU S O
�?`✓ z �� LL lr
J C
iG O
+ 05
LQ F da
X LL E
M 00 0n V7 O N O N O r N
pf G
P 00 T W 00 00 co 00 00 00 1-- r O M M O1 O IO
N m w 'It ? 00 00 0p 00 00 00 00 00 00 O M O DD 00 1:
a N O 10 to Uf m MO N MO MA m N l0 w 00 00 to MO
0 0
0 0
o vi
� rn
M
N
L
�pT �
a U
0 N
H cam
C
O
E
`o
c
m
c
0
�o
v