HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dale, Permit Number:-17p 7' C) i
RECEIVE
�!
;ar��'�;}a)'�J• Rr��('tirASrr l�A4� �!:: pjT
' fl:W:�1V1'Y�J,ccin..rnc�s=:d1'E4`4A'G�tettT'.:
Building Permit Application
Planning and Development
Building and Code Regulation Division
/f Virginia Avenue,Fort
Phone: 462-1553 Fax: (772)462-1578 'Commercial Residential
■ ■ ■ • • ' - -
• • • •• •• • • of
,n t rcl ' v,t t ,: r� ta: �,,2 � 3 , ,.rr u,;i.7? r �' ..T:- ', >lr9-'F�t Inc ,tx?my,2�rGyT'' >'T"-•�" ' �r?''`t 1ir'r,,
Legal Description: I
i v .ra-7t s. t ..tr§>�•r �u,. r i1 r��'I �t ,�l :.�'[',v } f1.1�`(,,J �"t1ta�' ��,, ,.1,...ti �i r�'3 �f.�' �,t+f„s J t '.,r::: + ��'..r t t I�. � {
+'k+�1"A�7r"1' 'rtf't,"�.nsutnC ra:J:�,.. an,- s 1t.,rr1 p n.,. .i}ty�. � t) ..._+Y71 r � ('.. 1.5:�_ij:T'�).F.1t... �rdf „t ., 1 .,1. ..�:..fi -1h,�f.{..•`{ 11� ��i. l 4'7;t�}'r�2
.7',�cl+�)x1 1�5 S(7 itk aa c 1'U�1+J ri^}}I St IJ."a:f'l�tt,':a:.,�74ri'ws}.�yiCIh�111a'S1'^r.(d_nVi!"��1,�.!�1�6L���'��{j 7xaFylE}��1{�'rf���rli)Y...,u,i�31.��{�`(..�`}i,.�?x�Jdlf:.a'li.[fi?�r�n..��6•r.,d.:�,is r.,1.1!Gf.11i{§�?t-f�1�.�,R 1.e 1Vf•..�!.�.�f,.lt,.....161.k bYlc.l{1,I IF r I E,-t...._.zb
..}1w1..�,...fr3lflSdr..�,••�5t..1:.nL.,r�r�„Ytblrv_.r.,-J..
•j (0—n i / '
Site.Plan Name: rBlock No.
Project
Setbacks • •. Side:
- n R .r ..,•tt,.., r2.1:;1 Vi � �7?7_'-• �r - .,�.c�%,.i._•_ �' r^.,�7'�i1T{ .af'x�i l�x 1 '..l f�t�--A f�l��I.r ry 1'iJirY'
fr-u.,. j_7 ...51. u.t.:.,1, v..,�_(-x,,u,l,.jt r{. ,r..r.1�,. !- x. ., .. -.. 1..... r .'7 r,,,:f,x-. irk .-.. ` ^l��`E I^ ')q.�3-,,,+ .,. la rrl'x.•r }j},:.'-i+.T .':. �r.4•W.r
r•.� .,��l.,, �.I�'i.t„ ..��. R4 ,t#I :�.r7:, ,�rY;,.P irn .t �rafl: A,r> t �• 4 .3,.st�ril±I�� E1,: ,1 ,,.}.��.�,,..,r_{iF {�rx LGt*1 Ft�t,r:l,i} } .,,�.
rf.,,.r„+r.. >a5• .. r,.�.(f.�.,...h}},--,•. 1d�1 ,,�et. •I..Sr Ir :r, ,-•,G1'!'�yr77f:,�,..;',Frrrj.�V. [1 ,i...:1fr(�r 1�1�CTi�'.if1.1�1�.}}73 .Er�{�(I'` r.ti1,11 }1.5�.,,:,x:�.C. .,.. .,r(�1...:_j_.r-h�l. Rd:r..e,�
;?7Ser„rr�arsll.:a��..irl c:^wr"i�.b),,..a 9lxt�o,.l,,t t,w1 ;y,1.��. {�,,.. 2,,e,. t0.0�ti. >]r r'•.1:pa,'�r.,{ .rur.l.,r�,.a'�i* 1�Z.. Ff,#}i}�L,-}r,},}„,: �,r:'1'.•,�;Sa ar,a{I u�:.:..i,r;1v�['e rl
,j...n 1 �11 � � q�•,, ,a;;.t r �rti�^, 1 Fr[IS'hr '�"tp a;w4t�, 3y+7l. 2a �l*'=t t ll cZtr,litlJl4 ,,�. -,i�=-:-.n.�,a,�,ay:rlr'.�,. r�.r_�auN.,!„R'tr�h::_..r.,�:
W t{,.1 s�Yt �.r�r5 1!'1 r�7 4x �,�lC �h t ,.::. � 'i. � i};�,.r4.+,nk113ur•r.:1,U1'�rn-r,�,”�V..riS.,•..nir.,5;<.7....,.,.av1..x..rilalw._n..,:....3'',Y,..a:a'::.�...t<. •'.::_.-,..
It�a,J, ;,.uf.,�_�4,s,.s l�o:,!,,:.,.:Id�'_.ra_t:,,:'�:�,�rtae�f'._...Si„r..'f�'rl,.�^CW. h.,l.,y...... L,�hx _ _ _ - •'_.._
a;yrrr..rrx. :.k:`_a. ti.. r-... ik..�(t"+IIIIfC 5-ctzU ,..C,g
i3. rzL{r 4 x,•ECJ G =•h4 Raju 4'� tom.. ;.r5RE.,to 1 f•-•rl?! I..;f:,S•!•.r,:ki'7 '.j 1"�:t;�x1 .:5 .,,_t5 11a}.:'e•.1::`=
C-1<taF ,,,1.f,. e v4:t v. .,.a'.•.+'yi-s.:: }�.. :i1a}40,, ,{ SHE?tfy, 1 } }tl� liu , �� I
al.. q.,..r. ..a.f ,...r.V�;�.wc ..•«.hcSi,Ri.. I , t �a:ar .`-�.C �t, 1.,- ".11,.ya��ri- ail
n•.:a� rri•1(s-I."'1 'g.."{ ,•:L }'le i�.�,`( ,a e.11.'C'1 "F"�i]I"li .if )'ono+tier,
r�Y�1Srd...I1t:4t�u� rI(� Jfj.,.,1�r(!j
F",..P'"ir�,� �t�2.5.E.:lay t^ r!l,fa.,r.._C7:.;ftxlv�...1.s.r,7u. ■
Additional wol K to up performed under this permit-
1-114VAC Gas Tank FlGasPiping ■ ers Windows/Doors
TotalOSprinklers
aElectric Plumbing Generator Roof
. of • ■ of ■s
A ■ ■ -
• • • • �,1 - -• s •
.., z,,,. '."Zt ,...m.,,r - -- �qrx,- {-. •as. .sSc it;C F)i.p:- r ar
s:.r:z' nl :'r�f"SI• .7«t;7._. ..,.S R;.' ',c.. r. t cr 3a ["'ly[�r. �._
i ,qf.,r.�r.�r}lr :u,,..,i��✓rr.7'st�r r 1.11 yy�1� �t(r� l;lrl i; Z., �J( S Ind.. -'•th>CE=t a.1 9- '1 V). •�._1....z}av � X11 1 )f r
)"�:{},�, g f�� U,rr,.F T< ( ,t; „7111 .y,a}{}:1 r r{I r �i' .F `-'.��a"!`�•.-.rtr.ft.t .11:
Sl�f>a I:��.1ry k a 7!1�u c{�,,..t I�,},�,. �.1•_IS. t �� �t'b} 41 'f! �•,r'�-t 1 �.1, �.rn �C 4��'r:r>��aii't�f:;.rl..z..i.,._.,lL.y��'::',:,3.�'�:':...J>�r�„r:•�,}v:
u'ia.. tffa,:9{. ?-u:�.r�lr>>1_.Z l.:f hrm xif:kSe-l� .f s4..,H. rla.ilvl.t.,�r»h ...t,.aru;> r _ S?{rGTfw
mail
- • -1 . ,
14 . . •
I MIMI="
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 Countymakes 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
commenciniz work or recording your Notice of Commencement-
s
SignaWre of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF f
COUNTY Our, ,--I a_k_0__
The 10 ping instrument was acknowledged before me The forgoing instrument was acknowledged before me
this'RAOday of 20 L'--Lby thiS.22±day ofd�b A .20 0 by
� U h LLrL JA I I I (Lifn :huLf-&ur_,
(N e of person acknowledging) (Name of person acknowTedging)
'(Slgiiat.ure of Notary Public-State oftori •a (Signature of Notary Public-:State of Flor
Personally Known Produced Identification own _�OR Produced Identification
0 Personally Known
Type of Identification Produced Type of Identification Produced
Commission No. XXID-41/6. Commission b
NA MinUF NA OREN AAF
Notary Public-state jJ flarida
Notary Public-State----- — at Florida
ay Gill�;; 'Ommiss # 7967.
Revised 07/ Ally Comm.Expires Fab 1.,2020. . my Gomm'.Explces
fab 1.202
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS