HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED.FOR.APPLICATION TO BE ACCEPTED
Date: • 2(�) ice_ Permit Number:
C",
PH-a1 tf'ID n
f4f
BOd-ing Permit.Application MAY 13 2016
Planning and Development Services
Building and Code Regulation Division PEWoiTTiNG
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone:(772)462-1553 Fax: (772)462=1578 Commercief Residential y—
PERMIT APPLICATION FOR: To.Select.from dropbox, click.arrow.at..the.end:of line-
PROPASED IMPROUEMENTLOCATION ' �' �" x t I � _'
Address: 5103 PALMJT'TO AVENM11Xr?IEEC9,, M 34582.,
Legal Description: S61� &--17^4 41F D
Prooerty-Tax ID#:--3
Lot-No.
Site Plan Name: Block No.
Project Name: 5(tACK FZ Sla15NC_e VV(NC)0\/\/ rRT,:PLf%G33Mr-N-r-
I
Setbacks Front_ Back SO M eoM uy Right Side: 101
Left Side: l OI
T
DETAILED DESCRIPTION OF,WORKr _ �} ' � , r � � `
i
lrP�.��l~M NT of �xtsT'INet UVINDOWS WITt{ 1?J�W .:WINDoWf� IN
x tsTl NsiMp o>'�>�!NQS, �D I NT .I�I+ Xfi�R1Osz -r'�,I M
' 1NsTa�TIoN o� tz�MoV��L_� rMl'�GT� tz.�slsrfv� �l'��izl G 'P�ANFI_L.S
iCONSTRt1GTIO:N jNFORMATION ti $ _P_ Y h n
- .._ - x
x _.. _�r
itiona w__ to e e Orme under this permit–c ec .a appy:
HVAC El Gas Wank ❑Gas Piping _Shutters Windows/boors
Electric 0 Plumbing FlSprinklers E Generator Roof
Total S Ft of Construction: W
Q _._.__.:--
_ S . Ft.of First Floor:-,a&(_a)..CA_-�4�_ 25&1
Cost of.Construction:_$. I b b -0 Utilities:0Sewer. Septic Building Height:A
OWNER/LESSEE GOIVTRACTOR t
NameGlit�ITb'lap-� � �'F#�I I✓ S f> +G Name:
Address:510 LMtT(a AVSN(r11✓ Company:
City: fBKT vf]:E(LG� State: 'PL.- Address:
Zip Code: 39'g82 Fax: '17 z• 582_AITN City: State:
Phone No. 2.5 19. 216 VA tgej r.tog,,;;LAO_-- Zip Code: Fax:
E-Mail:_ '%� r r/In:.Ca IM oti 1. G0 P" Phone No.
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,i RECORDED Notice of Commencement is required.
PROPERTY ADDRESS.
5103 PALMETTO AVENUE
FORT PIERCE. FL 34982
LEGAL DESCRIPTIONS
THE NORTH 200 FEET OF THE SOUTH 310 FEET OF THAT PART OF LOT 62•
LYING EAST OF CANAL 71 AND NORTH OF THE WESTERLY EXTENSION OF THE NORTH
BOUNDARY OF OUTLOT 14. WHITE CITY SUBDIVISION. ACCORDING TO THE PLAT THEREOF,
AS RECORDED IN PLAT BOOK 1. PAGE 23, OF THE PUBLIC RECORDS OF ST. LUCIE COUNTY,
FLORIDA. THE SOUTH 100 FEET OF THE NORTH 300 FEET OF THE SOUTH 310 FEET OF
THE SOUTH 490 FEET OF LOT 62• LYING EAST OF CANAL NUMBER 71, AND NORTH OF
THE WESTERLY EXTENSION OF THE NORTH BOUNDARY OF OUTLET (SIC114. BEING ALSO THE
SOUTH BOUNDARY OF OUTLOTS 15 AND 16, ACCORDING TO PLAT OF WHITE CITY, A SUB-
DIVISION OF SECTION 4. TOWNSHIP 36 SOUTH, RANGE 40 EAST. AS RECORDED IN PLAT
BOOK 1. PAGE 23. OF THE PUBLIC RECORDS OF ST. LUCIE COUNTY. FLORIDA.
1
S�SIlPPLENIENTAL Ct�.N57'R�UCYiON,LIEN Lgl�l, INFQRMA�'IQN � � r F � , ;� _
.a
DESIGNER/ENGINEER: _Not Applicable MORl'GAGE COMPANY: Not Applicable
Name:Vel eri'e,, Dek.1e. o N Name:
Address:.51 o3 1:3►(m e-lt A%/e Vi rne, Address:
City: P i e State: P::?— City: State:
Zip: Phone: "772- S 19 . 121 4. Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name:Ghri's o r>h e 'e. rName:
Address:.c5j o 3 'Fklme-ffn Ayekil&r, Address:.
City: fj e rG eL City.
Zip:349,92_Phone: ?72-4-G5-,C>9`2-0 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 tender or an attorney before
commencing work or recording our Noft of Commencement.
s
Signature of owner/Lessee gent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _4 �o,1�, COUNTY OF
�_
The forgoing.instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 11,y this day of 20 by
(Name of person acknowledging) (Name of person acknowledging)
t
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida}
Personally Known OR Produced Identification Personally Known OR Produced:identification
Type of Identification Produced yp_ tification Produced
P KAIZEN S. NIELEN
Commission.No. _rl e r Commission#F001"11U69io No. (Seal)
+ k
My Commission Expires
Jun
e 12 2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE 'MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
iNiTIALS