HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (J
Date: Permit Number:
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Building Permit Application DEC 2 9 2015
Planning and Development Services PERMITT: - .
Building and Code Regulation Division St.Lucie Cc•Tn v. F'
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential v
PERMIT APPLICATION FOR:
PRQPOSED`INPROVEI tN'T LC►CATION
Address:
Legal Description:
Property Tax ID.#: _�L(OUD6Lot No. 3
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Site Plan Name:; : Block No.� I
Project Name:.
Setbacks Front Back: Right Side: Left Side:
DETAIL D DESCRIPTION OF WORK
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CONSTRUCTION IN•FORIVIATIC►:N
Additional wor,to be performed under this permit-check all that appy:
_Mechanical —Gas Tank _Gas Piping —Shutters —Windows/Doors I
Electric _Plumbing —Sprinklers _Generator —Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor: iT
Cost of Construction:$ 1100-DO Utilities:' —Sewer —Septic Building Height:
OWN ER/LESSE;E <s sCONTRACTOR
Name6GName: Irlis�-rr C)-,
Address: Company:
City: State: /=L Address: 7`15,:1 A U
Zip Code: 3 y�;W-2_ Fax: — City: VCN c.��, State: 91
Phone No."7 7Z -:�r3 g -13;7 7 Zip Code: 3��(FL Fax: �—
E-Mail:'A,'r�'1x'-n coir,//50c.& Phone No (a
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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.
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SUrPPLEMENTAL CONSTRUrTION LIEN LAU1/ INFC1RM TION
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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
'commencing work or recording-your Notice of Commencement.
Signature wner/Lessee`/Agent Sig ure of Contractor/License Holder
STATE OF FLORI AA ', ,. STATE OF FLO IDA
COUNTY OF COUNTY OF
The forgoing in5tru ent was ac enowledged before me The fo gin strument was a knowledged before me
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this 2 d of 20! 5 by this Nday ofD 20_[_ y
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(N me of per n acknowledging) (Na a of person acknowledging)
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(Sign ure of N tary Pu c State of Florida ( ignature of Notary Public-S ate of Florida)
L.MOSLEY
Personally Known OR c ICt*hXdiiAt#FF 164026 P sonally Known OR Produced Identification
Type of Identification e Expires December 13,201 T e of Identi is tion-
Bonded
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% p���°•` BondedThruTroyFeinInsumMe800-385 Op dUCed 1.^. ` �� ITA JOHNSON
Produced E _°* ,`�: Notary Public-state of Florida
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Commissi n r .M; Commission No.
Commission#FF 004376
W"I''(' br' °��"`� Bonded Through National Notary Assn.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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B:O U N GARY S U FR\/EY
LEGAL DESCRIPTION: :'ABBREVIATIONS: SURVEYORS NOTES:
The South- 175, feet of Lols,j,, SET = Set 5/8" iron rebar kith
2 & West• 1/2 ?lot 3 in Block 8 1Ye•llow cap marked "PSM 5543" 1 • Unless otherwise noted only plotted easements
INDIAN RIIVER"'ESTATES UNIT— ,1.',; ' FD=Found 5/8" Iron Rebar are shown hereon.
occordi,ng' to:.t,h.e;,plat Ch ereot' ' 'F.F.E.=Finished Floor Elevation 2. No underground utilities or improvements Were
'OH--OH--OH—= Over Head Wires located unless otherwise shown.
oages43r ed in Plot Book 10 3• This site lies Within Flood Insurance Rate fop
pages 43' :X--X--X—= Chain Link Fence
R.O.W. = Riht of WFirm Panel X Vop# 12111CO277J Doted 2-16-12
of 'the Public gay
Records of '0--0--0—= Wood Fence 4. Flood Zone shoWn hereon is on interpretation
St. Lucie Countq; Florida. � FPL Transformer Pod_ by the surveyor and is provided as o;.courtesy.
', ,PL:=Value as plotted The flood' zone should be verified by a
R'= Radius of curve determination agency.
L = Length of curve 5. Bearings shown hereon are based on the Center
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Q Del of Curve
EAS. _ line of Pinetree Drive as being N00'00'00"E
Measured 9
CONC. = Concrete according to the Plat described hereon.
-C':P.= Concrete Pod 6. P.U.D.E. denotes Public Utilities and Drainage
®= oter deter Easement.
= Power Pole 7• All Lot dimensions shown ore per plot unless
= Utility Box otherwise shown.
®= We I I
REMAINDER OFI REMAINDER OF I . .REMAINDER OF
LOT`1 BLOCK 8 I 1 LOT 3 BLOCK 8
Q I LOT 2 BLOCK 8
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CN CD 1.4
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NN 190 00 00 W 165:.00 I N N I J .
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