Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO nnusr BE COMPLETED FOR APPEIcATIoN TO BE AccEPTEo �I Dare- J1 Permit Number: © Q A 9 REC 119 .:•� J � Building PTrmit Application MAR 14 2016 Planning and DevelopmentSe►vicL-s ! PERNUTTING Building and Code Regulation Divisian St. Lucie County, FL 2300 Virginia Avenue,fort Pierce FL 34482 Phone;(772)452-1553 Fax:(172)46Z-1578 Co nmerdal - Residential PERMIT APPLICATION FOR: To Select from •ropbox, dick arrow at the end of tine �n tlt�llzR�flaf� '' _ Address: s7e)ss v l I,U 5 S Legal Description-yib- 6roU�& C'�aIr►dxxviin4lit S� � G —(J!n -h �.. Property Tax lD C)o 0's . Lot No. Site Plan Name.- Block 'I Black No_ Project Name: l-"pj ap-�nf V Setbacks Front Back: Right Side: Left Side: ::............. .. ` .. . . .n N..;..... ...... ... .S..:rl:,':• �Slyj�irf�:cy�:::.-�a.'� - :T�'- �:f�.• - -j:.Gfy'i:'. !y, ' iu � -.. ..: }.1 .5S,�•..��qq��.yy����': t.J,..:...._:.•.y�.._:.•.L:...„.,::i<L.i ,:1: ,.i.^�:"�' 17�;. 7,,�Gw•.SF. •n• • , ...,.,:-:_.,.-•,. •....:,... ,.,..•.� ....�, ,-..�rC_ .. ..r•. r�..:�-4......c.w :`s,'.:'. ..:%-1i.^:_�;,.;i:::�::ti~ wj:•�;: :�;�i?, sem.. , -7 kC0 • .:...� _� _.,...5:;:88::1•';:r.:f•i'i::::��:":::: .....-•.:( �....y..�•:i;i:�::_::" - _::c;Y;f;::-, Addit - - ,i• :��:;`= tr;: i'Ger,:f;�•,^`.:;,.::;,<%�ra•sa��c,�.:�:i2_.,. _..v, _.+.... ..... 1, .., ...... .o-,� ...a,,.. :. ,r',. :.�.,f..,�_v...,.�.. .w''�, -C�r:� ^;3.._✓:.:S::c•'i:i:%:d:Yi:;.=:: ..__..... ..�.. .L.:._::$.'..s:..r.:'�... ... ..:....... :.�•4:51; ._'Y••_ ::� io• + work•'Co e e.orme under this permit—check W1 appy: �'` `HVAC Gas Tank UGas Piping _Shutters fl Windows/Doors 11 Electric Plumbing Sprinklers Generator El Roof Total Sq. Ft of Construction:_ SFt.of First Floor: Cost of Construction:$ 33, o`� Utilities:,n Sewer U Septic Building Height: _ -5:,,.,..,...-„S:':-::`:: .�.;e.;...r,,,,.;..._.:::..:::: �t9^�” �:l.":• ''.9:...i•.�t>+ C:iGsS:: &0Z nµ:4:::: -.'�.'•:..k��k�.•?�f!. ..1.. ......'::}.:}..•i<l M*5:;,,,,.:•� \�J 141 ,I l-ai'�... ..L'�:'.�.i..'S:w .:1�::::_:: ^� .....'.•:...,.�r.� 1 w:k s•:.:_a. -� ......, .�,:�:G.{.5;,,•...s.`: e :lLe:•.r:'; - 'p,'r•.:`: .C4 {'!m Ivaco oL Name: r) Address: 5” t'yI r,S r ei Company: City:_r- l SP1,f c�'o, State: ✓( Address: 223 G -)rLa d- rea J Zip Code:�^L � Fax: ` .-Q.'�Z� city-10State: Phone No_�39 G—CP`-7 zs— } _ Zip Code: Fax: 73!3 —9za E-Mail: "C7�rl��YlC.Z1/IY7aCr,,&C0M Oe ' Phone No_ Fill in fee simple Title Holder on next page(if different' E:-Mail: QOM S S MQ nn Cd CdECoYiCG� a from the Owner listed above) State or Courity license: C14C.. b �2e6 If value of construction is$2SOd or more,a RECORDED NoScia of Commencement is regeired, �• �1}.jY �j. 't�j;,; -.;i�?'citp_k=•�. `; :t:�= :,1•-::_ ''f':i�.'i::.'i�•: !'.° :'t^ .3 ;a: 'aFY"••'1'.1/'f'�.EV. ;.. �5,'�-".�y�a�a'��i�;;:::f.:.• . ... •...., .. .-..r..... ... ..�_..'�.:.._1. :�:,.P: ::e:.,:<.:,-,,;;:r.•t.,r,�,. �i�&`.'-:' `��.c,.. ,..c_o7c::,' tir .i•".•i:i:'-�;�:_ .,,...::�•,u....••.. �„..n...,.,. •.. :. .., ,..r.-.,.�4���IM3:: "rcu: „?r�.i>ii'°'•c ...a: ......,._._. ....:... :>ii DESIGNERIENGINEER; _Not Applicable MORTGAGE COMPANY: �Not Applicable Name: dame: Address: Address: City. State: City: State: Zip: Phone- - Zip: Phone_ FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Marne: Address: Address. City. - City: Zip: Phone: Zip_ Phone_ i 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 u'ldergoing a full concurrency review.room additions, accessory structures,swimming pools,fences,walls,signs, en rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a N ' e of Commencement may result in your paying twice for improvements'to your property.A Notice of Cam ncement must be recorded and posted on the jobsite before the first inspection.-If u intend to obtain nancing,consult Wth lender or an attorney before commencing k or Tetayour Notice of Commencement. 111-4, , _ er( e / gnt II SiSratuo ra4-r Halder 77.;SignFORIDA 11 STA 5T M13A CO l•Gl CO OF J" The fo in instrument was acknowledged before me The forgoing instrument was acknowledged before me_M this day of d f`.C) 20 �bi` thls ��day of 20 _L4�_by (Name of person acknowledging) (Name of person acknowledging) (Signature of N&diry P lic-State of Florida) I (Signature of Apia ublic-State of Florida) Personally Known ✓ OR Produced identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. 111Fz �t?g (5eall Commission No./125D 70' (Seal) Ga11 H. Gentle Gall H. 0111ft s'�}tYP ay £FFC83fOS _ WWWAVOMMIXim RevisedU711 /2014 TnRY oar REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SFA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS