HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB INFO MUST BFC. OMPLETED FOR APPLICATION TO BE ACCEPTED (�� LJ
Date: 11650-�4
Permit Number: _. .._
Building Permit Application
Plonning and Development Services
$wilding and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 V
Phone: (772)462-1.553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: WppS '�-?-Y- e-
.•r, .r' �,,,:,:;�r�1-'•:'1"`�r'4-",W,'N�;Li;1R,' ^,•a;yti;'Y; :.\,� ,�,.,•.a yr..h:'•+:'yi.'' ,„rum ,rA:�j'+'.I',•,:;ri," };�''.�^:'n
.v,. .,,.,. ,.'i; !,•'�. ;•r'•�:i.a..*r ;w,;,a,..'!'a. ,E.•:n.�: ail,%���i:�,.t ,�);:s; ;.�.,}�,j,'�,A.j.;.;,'."�: ::,h,:..,..� .t�:,rn{.,,ri�ir,,.,w.\;r`i�
j. '•n'11Vir^ :RJ4.16'FfyY'� !�{ ,I�a ��..!r�l�'V 'w;''.h',C,�r,:h rf"S'v�'C rin;a\^.a;N:7:::^h:.':veq� ri.i('., cTl q;.i. .�•r r:::•V.�fi,,r;':'i;.;
.r.
Address° - l
Legal Descrlption:
Property Tax ID#: .� [-2) --705- Q=— QQQ - - Lot No. 2--
Site Plan Name: Block No.
Project Name: eir
Setbacks Front Back: Right Side: Left Side:
e.�,�, car,.+:, ^",'o-•:,�v...•v.,, •4, 'qp^,...n,. rw..,i•19 G'.•4 rfr'yay ,:ti'q;q ,",ik,�..-a v,�lrr.r,r.rr, •.,ri:'¢ii • `:r\•i.,,,rt5:.
..'w.r.,vy-r^`,r ,�.r'•"� ,+ ,',+ \' ":'r-'•�'7":,:r,r� ,.•u,..w.r,..P.yyv. ,r i,.;`•,p p'':�,a f. /;.'r.:;
r •r{w r•"rr<r, •r.,rto iQ' 'lrp'+t,.'{�l .}d �4'r✓, ,':.t;, ";.•, ,, l'i`r•,,;.� "•• ?':•;i
'g :'1�rh n,,, .,:r:'�, J r'y5,. ✓. ,��.r. ;:�•,p) ii;,�r, r•;;�rr';i„;µ;ti,,;.,;,,.'}'i;�i"'�'���ft.. ''•i'.'., . ti�;�;�,'ti:�''•'
i,�"i �'%I:'1,{7•."1t'LJ;�, 'r,GJ.�:i,1;�i?i�Vlr�'rJV' ,��YiK•���':'�1n ••+nf~r?yf�.:'7i'�, �� R:,�.�1.,';:1�!:.,l;i-.:L;"::r:i',.lr.::.:,�,, r ! rN'r:rh;N;;.�� -r�;�:
l,. ., .r xa1 .� �6lv„e ..s.. !'�', '''',',i', :�\;,:,l,y'•: d�: ..r,:`\i;2• 'r„
.d1.'s ,.r ,J.. .�,,,.'� 'r ,d:,, r.a•. ::,•. :N"J�:'•,:,A+:x,IM,�arv58.,�'n;�, w,, tri... hr•••:1',...r: '.i,'ri ,`l .'.r.,
din :r. llc��i o✓1 -,.0 - a �c.L- Mea6oqmeAT5
..r.cUV- -leymnk',. cam. i'b
4'' r-qh aid ZS'7" lov1 51 dp- -('e-nce. ' > kl G a� ` 01 f ono• J"-� e ct ,5
a oke. Ori� kk fi-�r�> ~ sY e o-�' ,� ; ,n i5 Yna� rx ��.+t'.
—�r C_C�h 5 Cst ��
4.,, .V. _ „r.. ..V, 'rr...:,i yr.• '�'..i •.,w:/'.,p,�„•)\�V.' ,.f,,..,x4.!'��`
crr.' ..r: ,:r,.' .,"' .;.� 'ru<!:'rr14\:l,,.;"nf r,", :'rlr: •1�'71"76':. Y.l". ��Vn:,O.r ��t'�
;p.,;2. rpJ,.4.'ry"' 1^�F nrl �:,I'", „!�': .t. l''i." :,1SC'..el•i�:'•::M:\+ „ig.N.,�u4J•�I,"�q.'rs.,nn. ':�h:d
,�
��.�.,,.,\.,.11�", .r.��(,n'�1°l:�'�1�?:, ••'��, ':r'!,�d:•',+If.;.:,r'.k::v';;;�Ylff;„\.,..-�,r r ,,,-r;,., .., :�;�I:T(.,.
n,.. .? "fit r,V,'..,r'". }��r�, 1r:'� r'�Y"` s'1 r\�"':,1•'t7:'•':�. ��;,N.t\.r•r' \,w 1X�"�yb :Y :r;.�"•, •i�:yj,n,_,} '
:a"1' d a ¢ yy •:r>!`�.c. •;ry;i:'j'• •{•. r : �' r,.•,.r,�,,;a.G"4 v£„'� ��,'1.�EON!' i✓C?R�MA� 3IVI:Y•w�';•"J','•7;"9 ^`"h,.:•.sr,y .,g. ,J::.r�''.,'�,:;,,}�.tii.F:, 'r�'><:+r}:`•''r;(-:i�r;, ,ti;;'.?��:�,','rf':'n'";•,• , c '•+'r;;;;;,
,,;, .. ,r. ....,,�,,.rA' J ,, e'' �,.�.:.. ,. e�,?.'re:•ir'.�_.{.�.^�,.'= :`.a rs5•. _f�..ti: .s� .r��l:�,.s.k •'iS.t: , .:^�•.. '+:•.r.:� .r..
rtiona wor o e pe rme under this permit-C ec a that apply-
HVAC —Gas Tank _Gas Piping _Shutters __ Windows/Doors
-Electric _Plumbing —Sprinklers Generator _Roof Roof pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 1�, 'DD Utilities: Sewer „Septic Building Height:
- ..m !'. i:. ,•;rr.1;r, ,.a`. �'.rJ•':'!' ,:,:: ':F:' ,i.. _.,1" `'r;,(:•.}7 ;�%;J,e�N:•n,•;?.. ��r�. , ,J�^. .;+.�rn:;::.'N�l.�::`�
.cG^ '!t� 1• � t,f,.. ,� ,J.,,.f•;�'%i'.'•• y'r.;/ieA':,�'`1� :{:"�''
,,,i�.r."✓•,:,,,c¢;f�,,.5!V �I�:..i�, S•r o .i.•� ra•, p..�Nr, :\"';'1,�•..(i .,C,�.. .,1� �i , ^P,,i;1,..,{tigr„!rr.�:�.a;'.,g6
,'r�,:•G.a�,,..a W ..F��?5 !.i '•, /+ I�lri �1L1r.,�,(T\.,;��;ti�.,.rh�r!':K'r;:;..,::h "rG;,Ji �}..•,.,t�:.,`I�;',i:•J.
"�rK�►'9.1.ri tl`�,'.I�I ���JC� yy}: ,v ��rJ ,r� ..i. d'7.°'� d 'ysb'a.,/1•',�►.'r� � .� i .!„1"•'•
iri'.:n.,(••„di �...�L„-,.�.., � ,u{1Lr l\� ,11\, n,9.:V�.in�m�” •.,I��i,�.1.�1•yF°.,:::0�.'�aa•d A.�.,...Pr...,�.R. �A..rte.: :Arn f,oi.4r.,A�alr��f�r7::;:•%'e;;.r4:: y7��.S,':b:.v:..1'r.:`,.`.:f^'"r?e..l��d�:;�'i:°:
Name Name: C a'n
Address: Birf, Company:
City: State: Address:
Zip Code: '�7p� .- Fax: City: i Ie,(- State: �-
Phone No. �� � -�ni�J��_ Zip Code: Fax:
E-Mail:_ _ ._— Phone No. 2
Fill In fee simple Title Holder on next page(If different E-Mail: Oxr%'�(OD-0 mak " Cp
rn
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
1000/Z000In S111d HOOH'IIHIQ TC9TVfLT92 %t13 M19f:ZT 9T0Z/9Z/80
„,r•: .�., 6 '5('✓ .res+•. ..s�'A,c;:•+>;c,fi: '").L'lr'lpC•'J.i,•�b;ii+'.1 •%cv;w;,,?.�,�,.
,.K ,.�,,.•,....�..a,.p..��}r•.5r-.•:-�..�.;r�;r.......,,,;..w;,, ;,.�, ,,i:.,.�^,s '> �'x t �'�” `',A'f;,',t,n.i"�✓,.'��:�9r,� ,� �. �(�:�!;a}.ly'1f..�.�';;i:•,:,:Ci{•,".
116 �a'
� C° r 3Y.r', n4 Ida ii d" p1Y5 53 �. Ir f;:y
d`: ;,'i.,r .h,�,. ,.. �,,:edw�y; ;,� r{i.,;ha.,� �?��r :l .:;;•>',:,..�>:��,..
�, �#` 11 .1,yr.iAnsd: +,y'df•^''t(�C•nu e.i.Y r;61...'i5tih01k.ftr<'.rAJi..l;N1,.,f..,,ti;�F1'.,�'`r,.d�'6•„ .Y.dai,i, ..
„
DESIGNER/ENC�INEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address
City: —State: City: _ State'
Zip: Phone, Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name;
Address: Address:
City: _ City: -
Zip: Phone: __ Zip: rt_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 lender or an attorney before
commencing work or recording our Notice of Commencement.
ature of Owner/Lessee/Agent Si of Cont cense Holder
STATE OF FLO " � ' STATE OF FLORID
COUNTY OF {►2• COUNTY OF
The forgoing inst ent was acknowledge before me The forgoing instrument was acknowledged before me
this day of 20 Iyy this I U day of v-� 20�� by
1
SLuD- TT �a \
Name of pers owl ing (Name of perso know ging)
r
(S' nature of o y Public-Stat of Florida) ignature of Nota Public-Statof Florida)
Personally Known_OR Produce Identification Personally Known_OR Pro ce Identifi t'yoln
Type of Identification Produce Type of Identification Produced u
Commission No. �O � ( ea ESLIE MUEHLHEUSER C mmission No.
LES 14.1"' EUseR
N�ry Public.Sw a%of Flonr a Notary Yuo��' Slag of Florida
Commissionrt FF 163899 Commissions FF 163899
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
f000/C000[8 Sfild NOOH'IIVN TC9TtVLT95 XVa 11d9b:ZT 9TOZ/9Z/90