HomeMy WebLinkAboutBuilding Permit Application 05/05/2015 09:53 7724621578 ST LUCIE CO IMPACT PAGE 01/03
ALL APPLICABLE INFO MU ECOMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �5 �/ � Permit Number: 156
Building permit Application
Planning and Development Services
Bulld/ng and Cade Regulation Division
2300 Virginia Avenue,Fart Pierce Ft 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial.__. Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
` J>s�:1;jlry'?ie, ti ��i�,'-.,vZ w:C':•�,.�5'�$':�`"��(`,�^"),,^,:,.r�a,w^,L�.p.l_.s���,",��Vi4 r:;i.i��4���f�"yL�`-�.=�ua"�l�b.'1 Y mF!'y,.i,,��Sly�.'�,'"CItZ��'!,•��:�a,�1�'ti�3\,H e�� c�:1._;�,�1:1?�.aIr';,V.:r:i-r�K�;1y.,--�µsu �uI' ,p^jt;t,>.r,�i�;,".?5dt:,;,(rWJ��7".�;�i.�t�•v��1K •'�r?,;-{M1
Gry`;
u:
U_._y-LY•'7i, %1140:.1 FF _ ./I r
Address:
Legal Description._ Q
Property Tax ID 9; ) )LV,,,w Lot No,.
Site Plan Name: $lock No.
Project Name;
Setbacks Front Back: Right Side: Left Side:
;.'i' :•..{ 1 , ..:�.....ir ,,.,,.-' pVf.`_...,.y ..., ,,;....N4,, .1 , :,+.m•:['")':`)✓�',,..�,.y7•, :^ir.. •I 4 V.'9,: ��5'.:,. -- '!i{,.•IYIL^`)-'Y;aaBL•_
1 q .e,1.;.•�µ��,�r9,, �I. ,17;yyr ?o'a.a!:.,.,fri�(Lq..r ^r'•id '( .��i.•t�ani;i?•e^ �ru;,, :::r,��-�„ et:d .)ter... �..;
,y -,.5?.,.•�;,v;�i:ar,i! i�:,�! ,:�'i�,'.
nt, , � !li•5. I"
+ ,�' ,, .� �.-''`•: :,a t�ltV �;.� ,4a ��.++,t.,, ��,r_
d,Sitlr:>;• ',itry!fh;aUe ! >a } ,� N .,V r.U:4i;.�+.t,ffia`�'�,r_ k; .!' '1'• & ..ti. !_.� � ._.:•.
%p•x ay,. 5A A �F. t ;� •aW+. �•�.L,T:,,SI.C:_Su3�i, ia',.,- `i4i���i,�u�'�:r id,��i,�•r`r.:7mrra:�i�.L�� ,f��iY:�iy.'..�A•.��:1.(:.�.a11 ;,�`�.t.,.'ti9 t':IJ!i'i'.i{i•
_..�• `S:T .,4a .,.<,:•• ,yy •"'.y;'ii..l;rw::i,.-�-;ncr�4 y'rY�pJGi:'y'.,�.ri.-'a�^da:�.,`I�: ,.a,M1Sfi: ca:w-. �+•.•mIJ;17d.r?:!Ff.-_;:;:::•,•_�n-„ao •i.•I'"t.� „r.,-�.i•:"'!)'�`kRiuel,r..•.
�. � •.''1 ;l.� S'•. T,s-:. ,�.:h � ��,^:�� ',! � _ =,-/ ve. �511h,.;Htlr �{Jrl-11�;�'ti Y,rv,.r. •q-::�:-,T
!: 'F 1 3 �� e 1 +,;. _% •` 4••5,: }el" ,u:.hi tilt u;-. '�4i. ;'
V. .L{J•l`:°%��J, ' 'F-
Fl,:itc_..
�' !i,. ��+, .:-JtV__�r�!�2G:f!�r%..I.�� .�c?;•.11�fi:�y,��"���_`��,--�''-.����:''w�� 8°�"Ff�t�l.'�x'.����;.�'�r��i;E'M�°.:�t�.l-.;.`.-�;.r;.�.:;�;•,2�t•14:C�h2�•Maf � J;.h;�'r`':r.1
trwria work to be erfoRmed under this permit-cliecK all Mat apply.
QHVAC as Tank LGas Piping _Shutters E Windows/boors
]Electric
9p,umbing OSprinklers Generator 0 Roof
Total Sq, Ft of Construction;__.. T Sq.—Ft, of First Floor:
Cost of Construction:$ � � L,�, __- Utilities; Sewer USeptic Building Freight:
6F'1.011;
r; �. _ .Fl... ...I> -�a)�,,.,_5'n arc,:re:m:'- n• +51.ti e- _— 'a• - - .-)
q� .�'.,.3__au Crj r ai S•. i4 � :uh�'`"�` "!h? .Ir'��.'I _ ^,•P.1V:i1•
-�' - - f�8::d%.. C$t�„ 5 1 I..,,i.... ,. .n._ ^x•'L'•T`ZL 1",Y
L.,�'.1 "3')iCX•' -,; ;,-•`' SG•u,b�txl ,.cs •.1! 1, @a f I �:: --a:; >'1"-•„�,k..,.a J. r.r
:`•`-�YY , .`• ,L7i� -•+��':.. .t.:, 11�:�'arL�.r.�..4.a-.•-,,.�,.n..%h r,�• }}cc�� .,i.;; ..M'! �,.�.v�frLl.d'i.:�:�_G?�:t�.. ..�:. �' ..1.�
v ` ''°�.. '.J.,. .+,,,.+. ..,.•ftia'r' �ql. a#ti.-:•�•. „.i'.0 �r..e,.,r;_ 1•�l!�t, (.��:'�'r _.,t,..•;o;?¢r-..rr:r.1: ral..�i,s.,.6, i�1 f I
I..F?.�� il,!ti•..t�.:;��,r•r.,- -,5. 1:1•aerel•'fs.��Ld ?, $,,,',,, 1,•.d•� Jc{4_:.-� rF�`...,•.;M..,,:rF.a,, 1�7�'e• F,sy��-� 7
Name ('j' �w Name vr^
Address, 5Ar.__. Company: _Cafi.n Q�Hk,_�rio,
City: ') ftR, State!F�_. Address:�� h „
Zip Code: -_�"�..� Fax; City: RDA State:,
Phone No. �'I, l Zip Code: —1±_ Fax: 11-900
E-Mail: Phone No. JI-L Aly q,4 _ _
h
Fill In fee simple Title Holder on next page(if different.• E-Mail:' M' Jnr++v+H b�nkr�,mti •� �v� :w}�-+
a '
from the Owner,listed above) State or County License: Cr+ �yLBUI
FP value of construction is$25ou or more,a RECORDED Notice of Commencement is required.
P.00/Zoom YVA f?7,:n'r c-rnz?enicn
05/05/2015 09:53 7724621578 ST LUCIE CO IMPACT PAGE 02/03
IRI1 R'9 'tbi: k�S°•{_3 Y,+';, h�+=L Ch's' otT "'4.
4 � ", •1�Y4 N P A''. lea.�' 4T. ,y�,,��.� .f.l.
� d ' '{ �' :k ~�(�'.' r �'+;^.t:._..y�,,, % 'k7 C'' - •.:•.d�
t'• N m1 :«°1„$ fr. "'; .xdx�.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: y Not Applicable
Na me: Name:
-Address: Address:
City: State= City: Stets:
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 thepermit holder to build the subject structure
which is in conflict with any,applicable Nome 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,perforin 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 roams 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 lendler or an attorney before
commencing work or recordinfy our Notice of Commencement.
Signature of owner/Agent/Lessee Signature of t'ac or License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged me
14 _"t-
this day of 20 by this` day of�*,`)A u' 7o by
(BECKY TALOOT ;
(Name of person acknowledging) (Name ackntW P)oy os,201$
,r,1 'wr`�sa.0iss cc,aam
(Signature of Notchy Public-State of Florida) (61gnaturVf Notary Public-State of Florida)
w
Personally Known __OR Produced Identification Personally Known "FJ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No, -- (Seal) Commission No... (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
B04/Soot XV.4 52:OT cTnr:/CA/cn