HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1 °)J ' iA
RECEIVE
M
Building Permit Application MAR 0 b 20V
Planning and Development Services
Building and Code Regulation Division i i�'�� ��'``
L
2300 Virginia Avenue,Fort Pierce R 34982 Si. e CM!"'
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential _
PERMIT APPLICATION FOR: To Select from dropbox, clack arrow at the end of line
0*CIGMSIrD tIt1tElE►1
h._.
Address: J.-- f� C. ' V'
t " I es 0Sr- L1-Legal Description: ` I
Property.Tax ID#: Lot No.
Site Plan Name: // Block No.
Project Nance:
Setbacks Front Back: Right Side: Left Side:
a--, -' >. � Vim:l Ga�r,;kv 3 �.a.f Y'+�.'5- •s�.� M'F ys,.. a ....>a jia � v4 - K >
+7, :: � : n✓f _ _ - i � �• �c *•.l}°`5 °'�`"r..•y�h�? tk x�'t`j,F?�. ''•�z.?��r'a">M•G ?3s y s Est rsf>.t
.��3 =���'1ll:E#3�E=�SCRI:R.,�TifJN'`l�F � ��j, ,�'Y.�,�������• ��.�����,���.�.,�� � .�� �, � v�> .�� ��„�� .,�,�.�
-'r-,.,s P r K AK'r ram, � �� _ � �,,,.i�RlLr. �'��ie'� ��`''' , r� 'v^�,•r v.`. _r,�tfi '�zs�ra.`"Y '.�",}x'g-��E i.��„ .a 5z`�•- 5u"� �.5r ts,;�'°'
.�':::t�9'4.wtis..�J,*,.;`..�.:+.4. r�: =`*, _.�`�n,�,c.,F�".4-�'a s,s t' .-.6^`,ro+.s<.,,t, r.:.nm-.fi:.;��.�. r.a,+1..{,4.i_1.-sr<.. 4t��.. �"'.-..��'+��,+;�..o.d�.,A��..J,t'�T,c��.«..q.r3;v.• `A�t�:a�,_a*,��sy.
iR•.f;k„�k rr.;f;�.#+ J..��'-'=t P=`v �..� x4.i'!s�+'r�:`= -" o .i_�'. 0.b;v .,)'`j,r4 rsYnt;� rirkl'�',.i - -�• u!�. JYr.'y h'>^. '?':iV,v;'k +>~r ;+. _i`.. ..� 4s$+5•a' ,=w... ..�u<`s hr�ts.Si
"��,...'5 ( �•a;�}�'_"� �::�'T"�a'f��7y�-r� �1 x.,s•k y,F S"wut�,:r°b�,�}i��*'l rycS§�j4�'�"�+''�iy•�3 a�+F'3is't`i��}tn.}S� ,� 'a+rvs n.:�.'��, ,�,��r,._��s 3e w��y`-.t zr7rz, �a:j�%,��^;4.t�:
ono avar o rme un ert pecan .--c,y.. :.a app y:
�HVAC (--�Gas Tank Gas Piping _Sh�aiters ❑Windows/Doors
QERectric L,+!Piu►nbing ❑Sprinklers �Generator �Ro+of
Total Sq.Ft of Construction: n� _Ft.of First Floor:
Cost of Construction:$ 3 c Utilities Sewer OSeptic Building Height:
Ee Name: ( 2h M
Address: r Company: I jIn a1
City: State: Address:
Zip Code: Fax: city: V@t0-D 0P�
Phone No. Zip Code: �. ,Q'a Fax:
E-Mail Phone No.� 7 z �-Q )d
Fill in fee simple'Fine[colder on next Rage(if different E-Mail: t y
from the Owner listed above) State or County Lkense: U' ,
If value of constructions is Snoo or mare,a IMCOFIDW nonce of Commencement is regi:ired.
REP
SUPPLEMEiTAL CONSRUC1.0[ LtE LA11� lNF3RdA�QN
-- -
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 len a or an attorney before
commencing work oMcording vour Notice of Commencement.
_Sign re of Owner/less ent Signal6ire of Con /Lice TH er
STATE OF FLORIDA STATE OF FLORIDA �--COUNTYOF IJ ir_ COUNTYOFd
( [
The fo otn instru ent was ac howled fore me The f rgoing in ment was acknowledged before me
this�day of 20��y this day of 11JA ri- .20 J ity
J"bj I g, -8 - S _JJ_t C_ A
(Name of person acknowledging) (Name of person a Wedging)
(SignMg of Notary Public-State of Florida) (Signat f otary Public-State of Florida)
Personalty Known OR Produced Identification Personally Known OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No. G" b :�3 (seal) Commission No. 6 :3 (Seal)
Jude A Straker Jugs A.Straker
-Off At. lWYARYPUBU
Revised 07/15/2014 STATE OF FLORIDA STATE OF FLORIDA
Carnow 00033 I Com"GG033681
qgWr Expires 9
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
tNITiALS