HomeMy WebLinkAboutBuilding permit application AL1.APPLICABLE INFO MUST BB Cd PLETED FOR APPLICATION TO BE ACCEPTED (�
Permit Number - O "
Date:
Building Permit Application
Planning and Developmenr Services
Building and Code Regulation Division
2300 Virginia Avenue,,Fort Pierce FL 34982 Residential x
Phone:(772)462-1553 Fax:(772)462-1578 Commercial
PERMIT APPLICATION FOR: Window/door
"ca'U,=hrG:. i'k�i,�6}'•t)'G'ti if�l,•`1't 4v1St'dF ,t�5`sf:C�' .4 '.� .i:f�`��5:'��.Ri., .�:.,t��a,i.,:�o
..�. ,;�t .. S;'
{f, {s�, ?.,t• iwci �� m,1St —v. S� J..zntz'x.2;yt„1,;
]pip$ PI OUE�'I#:;r`0 '0`A-TI:Q ,, �,xa„';,+, 5.,..,r •:. a,:
Address. qZ 71L
Legal Description: \ MGn �^ l
a
Lot No.
Property Tax ID t ;
Block No.
Site Plan Name:
Project Name:
_Left Side: ?`
Front_ Back: Right Side:
Setbacks --� '
•t_es��: a::rtaiSka77M.ce-�vieiri=;,ti�,ls�.r INS
\.u: tUe, �`: N,
•ant ..s,Lr ~,,'i:v52; .�:<+t'd+•f .2 a�}iiM. 6.1.,af.,, ®r 071
r„ .t, -,i','.1-'1.5.,(? , ro� 1. -. r.a
,.r. ,] ,(: �,a�{\ 1.1._„ ,c, d. ,,; 3sx„-
5_ ? B«}•::`C?draft , 1 l�,n a4 5 ,2„ r., 2 r.k t'•S 4 J ,e to.i:::
1 ,e..Y.,0,9�>i.. ,r,Sl �,+, tRv��.,.. ���k,le'V7�S;5'.oit.,�ilc1�,;S��,•tl�,
t t.• I� ��It��.�.!.1 Y.�.4'�. }� �� f'Jt
�-�� ti
�a,�.`:�,rd�ar.<.:>,tr:a�o�t>'.a:-•#:• fi L�:eN.,���,�.l�ry� ti�T,e+�:;�..,,.,. t � r ;..:
W�hc1G i_ 21 0 S t�'C rr�
isr-n::'•;9,";^..v.
,riy�.�.yplw4:•,'FLA'y)I" • 1 i,Y;'r:]:i:n�,-fi%V<-�'•t1s`t:.•R'-:,.S.d-;.=r;.a.riL,.�;�i a 1f re\}�,>H,,2�t',;L,,::-ti'r�,.,.J^.7^7L,:-.'-d;.,.,,Ct,-=.;_,S)`1.I t;i!klP,54q,:3y,_;,"'f.;•G.0Y,-:,4�j�,.�i,ti}".4i<d'1},;.'I,f`:i��.yy'„iInf:P4))f.r�'J-�i{�.L?,iH,.u,'�.,_�',�PN\...,.a'7,��1l:r�h-�,tXt5-a�4„3t1�1.,a':f;i,c�rn'.�i-�{.Mir?'i.:w"lyri'�;,J,o•�.r�7SiS„$-"jti_,,11`'f.P.,.1t^1k'r,%i;•,-N,!(_<{.Jt.uST�Tj-r\.7�.NiSU,.¢y.s�'.I>t:4�!'Sl.`t,,Fi�:+tS-��{.W�',5n�{tl1.a_j.,.(1+�;l:..c'i>�S”.t'
rJ .104!1!4
:C %1 �C7itd•y \ t,J
•
t '+ C 'Y• 1: :{ 'Bt,,i,a •`,;"-�,,5����.ai,l. 'b: �/''\�' 4.•.� \�I.,� �'+„ys'�.;!),��5�k>;'Y�'�,: �a,>�.).!��.;� 1�>;:.a�T.fiM�L.r.,`_'J, l '::•'::
;��. t� '.C�T!'O:f�t�' :�M;ATI'O:N; .,� �< <>•:��:,;�a:�.4.��..�,.�.z.,.::.F:,,:.:,,.r;,':,_., +: r,;.��., �.j•.��,
�t,ona wor to a Orme un ert tsperm�t–c ec a app Y:
�HVAG �.Gas Tank ❑Gas Piping
Shutters aWindows/Doors
Electric Plumbing
Sprinklers Generator Roof Roof pitch ,`
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ l�{��
Utilities: Sewer Septic Building Height:
- itgr,lijy"F;��`c�C:>=�;:��e�,��S u�1�'�iyS.'yr{11'C�P�;,�v4`^rtfC"1211:�,���{y:t"•
.Z,', ^tii:;is EB c'Ya ', _r'. y:�'S.�.s:�4,,,,y,...:Ce.a: .Vv}i�,1•, <{,tel. ,.,S c.•,v%1•.I t�3r:�,a f'3;v
.{.a".ry+,:;,-i'�:'SP4,;tK,F}�I3.,„Y,;)r"i,.XJt'.�'",1s;;"�'•�s 0,,S"(.�;.�i.`t;'S?.)�..51:S:•ir,.t—,('.i,.,7,7.,y�:t;L�.,...-^i%'.'';Name:
Name Name Company:
'.►a�F::1�TH�t,��1.I LL.•o;,l!C
Address:
c,Lti�}{>):_,,.!.�,y.c!t,c�'3�t,1k:e,.i�. Ec9+�,._-''d�,1i.`�"�`�.n��°?i41ti1e,�,v��Ty_Li i�",t�1,a3.`„,„r�•�a:��'1,y,'
t1,iSc4n„-h14,i,c,i..".t.;.;i.;.i 3•7•S^..t�f)�il\....i.
!:
�c State:��– Address: $044 SW 42 ST
City. I`
Ci City, FORT LAUDERDALE State:FL )'
Zip Code: G LN fax:
'-N Z ALZ`1• 'L7. -— Zip Code: 33312 Fax:
Phone No Phone No. 954-884-8500
E-Mail
Fill in fes simple Title Holder on next page(if different E-Mail: PERMITS@FHAPRODUCTS.COM
State or County License: CGCO61890
from the Owner listed above)
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I.
jc
i
LC /L # BL9LZ9tiZLLI Ol ;WO.I�; 69 94 OZ-tiZ-90
,,,.,• •..,�::,',a�.a:n'Hv ryr.0Jc; :�:y,:,..'.yar., - _i-'h
i. iSv 9 y y a: 'J.,.ga'— .44nm(' "rt,<i\(c5§J#b:�9�., a .:5��„
f'.e.� '`k Mu' i,>h' Nr; •,3a, y w,� .,
Sl1 PLE. `EN7 .'L,GO:NSTRU, ..1:O�M[E- f:' 'r ,,� . , r,�,f +;�' `.,
111!''l�N��O:R:MAT ���, �u_ aj , � ,'r�.��u. �, r
��u ar'. t •A�r �,4. �� Xj . ��,
rt•,.�S;�,,,r.�_r, ,1;,.. a.., r t �,., �a 5i.,;y',.;r..r., •{4, k, z.<� r %�1
ttL�9-9.,w;xu.�P ?�1.:,:/'Yc„al1,<��.l,t'.,
DESIGNER ENGINEER: x Not Applicable MORTGAGE COMPANY.• Not Applicable
:
Name _. N
ame:
Address: Address: _
City. State City: FaRTLAUDOCIALE State:
zip• Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER; _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:soca$W429T 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..
wh ch is in conflict with any applicableiHome OwnerstAssociation rwill
esabylaws or and covenants that build
ay 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
commencing work or recording our Notice of Comme ce eit.
Signature of Ow /Lessee/Contractor as Agent for owner Si at o tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 44 w+6veft COUNTY OF c 1 W(,te
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 11day of r- 20'�w by this i�-Dr1,�._ 2070 by
Name of pe�making statement �ame of pe son making statement
Personally Known OR Produced Identification Personally Known OR Produced Id�r��+ '�ation
Type of Identification Type of Ide ificatipn o%% �10Z
Produced Produced./_ ���°�`�P -NORtijq l�i�°�✓
• tiq�SSiON � ��r.
�,+,
{Sig a gpen> IoliAAU t or i a tary Publlc-Slate Of Flory syaso.. !
�i MYQMMISSION#GG7, •q I14
P
Com . • �rRs_►uiy_g2.2o21Seal ommission No.
' t
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
f
f
is
r:
LE /Z # BL9lZ9trZLLl 01 ,uloaJ' 69:W H-tZ-90