HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � r'-/n� —60 3e17Date: Permit Number:
Building Permit Application•z,
Planning and Development Services
Building and Code Regulation Division eco
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
PROP
Address: Neje f, 11 kx\ 121' l✓r , �C��c t �� 7V � ..
Legal Description:
Property Tax ID#: 37y2 - 6009' 05 7 - 04!-57 / Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_ ___ Back: Right Side: Left Side:
DEEDTAILDESCRIPTION OF W0RK:'
v✓r zo I
Additional work to be pertormed under this permit–check all tat appy:
_Mechanical _Gas Tank —Gas Piping _Shutters Windows/Doors
Electric _ Plumbing _Sprinklers _Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1, Utilities: —Sewer _Septic Building Height:
Name w') X Name:
Address: 6'/01 '9 flti er Company:
City: r t!r(. State: Address:
Zip Code: Z Fax: City: State:
Phone No. -771- 211) Zip Code: Fax:
E-Mail:lkt 5 ^,,,i i i6e A /'��' Phone No
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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
commenc#ik work or recording our Notice of Commencement.
na0 re of Owner/Lessee o tractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLOR STATE OF FLORIDA
COUNTY OF �GlLG COUNTY OF
The f ing instruirt was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20�by this day of 20_ by
e � 3RUAY
/ame of pers ack1mwled ing) (Name of person acknowledging)
V
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Commission `,�;wJ6�e,, KAREN S. NMIRVISOR
Commission No. (Seal)
of lorida-Nbbtary
Commission #GG 207
i A~� my ro,
" una 12, 2022
REVIEWS PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
BOUNDARY
•. •Of 03/16/2018 • Order#:1000023334
6100 PALM DIVE, FORT PIERCE, FL 34982
25.0' #f
IBUILDING
SETBACK
I LINE�(PLAT�)
' I LOT 13 I 4 AERIAL PHOTOGRAPH
SCALE:i"=30 I BLOCK 68 (NOT TOSc"
1a_ I p LOT 31
a.
= z I N90° 00' 00"E I FENCE z Iz BLOCK 68
o I 125.00' 0.1'N i a x
0.0' —
a? FENCE
I 44.9' a' o' 1.0'S
0 23.2'
o I
r
0 I o
a r 25' ( o 'v, 0
8 p 0 I M v w LOT 32
F 0 COVEREDCOVERED wBLOCK 68
SCREENED p
Q 0 18.9' LOT 14
BLOCK 68 43.8' o
d a O (�" RESIDENCE 13.1'. 37.5'WELL
Z DRIVEWAY 16 #6100 v TO HOUSE 0
55.2' �
263A .0' ti WATER ^ 26.2'WELL -
�— 'I PUMP c*i TO NOUS U-1 cli
30.0' � o S90° 00' 00"W 125.00' o
0o I oar
to I
lay
o' i + LOT 15 I LOT 33
BLOCK 68 I BLOCK 68
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-ALL ANGLES AND DISTANCES SHOWN HEREON ARE BOTH RECORD AND MEASURED UNLESS OTHERWISE NOTED
PHONE: 561.508.6272 THE APPEARINfj qN THIS D ENT
f .. WASAPITHORJZED BY
I FAX: 561.508.6309
rJ C :y.: . +MC L
LB 8111 K.�
SURVEYING, LLC. M 2880
5601 CORPORATE WAY, SUITE 103 WEST PALM BEACH, FL 33407
NexgenSurveying.com ��