HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: r/g2 LaLl& Permit Number: u _.C�
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
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i a a ' �' sp,�,..-.,.e�a:aa`. ., .A+��.Address: l-i CQiJ'1/ � ilk�ivt 4!0_1
Legal Description: f°--D / 02 D
Pt_ulcl 8,
ro ert ax ID#! ' Lot No.
Site Plan Name: Block No.
Project Name: _-
Setbacks Front Back: Right Side: Left Side:
311A[ X 1,. <
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2" mss e_ QPr
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Additional work to be pertormed under this permit-check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_Electric _Plumbing _ pri k ers _Generator _Roof
Total of Constru ction: &,;x 0 Sq. Ft.of First Floor: M/14
Cost of Construction:$ Utilities: _Sewer _Septic Building Height:
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@me (U Name:
Address: x-70:3 _-ry-a--nda A-✓-e Company:
City: F l p,'CC_ State: ` Address:
Zip Code 44tOFax: City: State:
Phone No. (__771)--)" 3,33 " 6 91�5 Zip Code: Fax:-
E-Mail: �Y � C,0M Phone No
Fill in fee simple Title Holder on next p ge(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.
1
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
— Name: -
i
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 our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 201�p by thiszp�L day of 2016 by
(Name of person acknowledging) (Name of person acknowledging)
4igna�iureotary.Public-State of Florida) (Signature of Notary Public-Stat of Florida)
PersonallyKnown OR Produced Identification" Personally Known OR Produced Identification
Y
Type of Identification Type of Identification
Produced Produced
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.7/2014
SHEET 1 OF 2 SURVEY SKETCH SURVEY NOT COMPLETE WITHOUT ALL SHEETS
MAP OF BOUNDARY SURVEY PREPARED FOR MELESIO CHINO AND KETURAH A. CHINO
AERIAL PHOTOGRAPH
PROPERTY FRONT VIEW rnrACE NOT To scnLE
ry'' .Y �-.t ,ted•'yr 2'v z .,
lE;
JUANITA AVENUE
(70. RAW)
20' ASPHALT ROADWAY
FILE COry
NE CORNER OF BLOCK B
N 89'4WOO" M 110:00' N 89'40'00" W 110.00'
FIP 1/2 I FIR 5/8"
(NO ID' _ I - � (NO ID) BEARING BASIS
o i 203 8.
LOf 19 I
BLOCK B I N
to
i
72.9' a ..
#4703 Q LOT 21
LOT W "> N I Two-STORY CBS 1 ! LOCK B
BLOCKPB ' `, I. RESIDENCE r ,
36.2. I 10.4':. 8.•'
I m
34.6' '
. _ SCREENED -
POOL ENlk
CLOSURE N II
'` d LOT 20 plicant has been advised NO structures
J M
b cw ,r T BLOCK B an be erected within ani easement or
0 I
Eig'hlof way un M L proved.
I� WpI cant Initi Iss
cn
5/8
FIP. 1/21 I M 4416"
N �) g•4 0' 10.
` LOT 5 LOT 4 LOT 3 LOT 2
BLOCK`B B BLOCK B BLOCK B BLOCK B GRAPHIC5CAL1✓
BEARING BASIS:BEARINGS ARE BASED UPON THE PLAT BEARING o' t 9 130'30 60
FOR THE SOUTHERLY RIGHT OF WAY LINE OF JUANITA AVENUE.
N°TEs: BASEPOINT' SURVEYORS
PROPERTYAPPEARS 7b BE SERVICED BYFUBLIC UTRITIES. .
ALL BEARINGS AND DISTANCES SHOWNAREPLAT AND MEASURED.
P.U.&D.F.-PUBLICUTILITYANDDRARJAGEEASEMENT PROFESSIONAL SURVEYING AND MAPPING
JOB 8-1512-009 SCALE-1'=30' WWW.BASEPOINT SURVEYORS.COM
FIELD DATE-12103/2015 DRAWNBY-M.W.S. P.O. BOX 691152, Vero Beach, FL 32969
REVISION- '
REVISION. Phone (888).220-6805
� �lillt. 11 REVISION- Fax (885) 219-5273