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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPR VEMENT LOCATION: Address: 192 A �[�DO Q Legal Description: Property Tax ID #:II Lot No. Site Plan Name: a � CTC ' Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: �s�� Z �� s ti�G� &kX ��tiq� c6* e F�c�cC wt_rH 2 - � c�.���r G�-z6 A'o0 1 12" Doobur CA?!5_ Haaitional worK to Ise HVAC errormea Gas Tank unaer rnis permit - cnecK au E]Gas Piping apply: Shutters Q Windows/Doors Address: z-_ /A3auc1 `vim _ Fcr ce Qrtfrv,-C, City: of r erg State: r" -r- Zip Code: �� �L Fax: Phone No. _ n City: PS C Zip Code: 3'19 S3 Phone No. 777- 678 state: ) �- Fax: 7 -77 -SH -1009 - 73 S_g Electric Plumbing E -Mail: Oze .a. (Jecwn z' E'G. Lw • cc State or County License: C-6C-6gS_�+63 Sprinklers F] Generator 1-1 Roof Total Sq. Ft of Construction: Cost of Construction: $ 22'90-0° SFt. of First Floor: _ Utilities: Sewer F Septic Building Height: OWNERAESSEE: CONTRACTOR: Name &l IC Nal V!W� Name: f f Address: z-_ /A3auc1 `vim Company: VG`enx_,,s Fcr ce Qrtfrv,-C, City: of r erg State: r" -r- Zip Code: �� �L Fax: Phone No. Address: OW _Si-� n City: PS C Zip Code: 3'19 S3 Phone No. 777- 678 state: ) �- Fax: 7 -77 -SH -1009 - 73 S_g E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail: Oze .a. (Jecwn z' E'G. Lw • cc State or County License: C-6C-6gS_�+63 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. COUNTY OF The forgoing instrument was acknowledged before me this 20 24^_by I J)# (Name of person acknowledging) (Signature of Notary Public- State of Florida) - i Persai4a Known "_— OR Produced ldent:5caticn._�___ Type of ITe­ntnccabon Produced ---- --- Ca nrnission vo' s t `s�°: {Seal)KIRK ARI KAT2 AAY COMM!ss!ON #FFO• COUElf E v O The forgoing instrument was acknowledged before me this _" :D day of `� '20 by IJ (Name of person acknowledging (Signa` ure of Notary Public- StatF of Florida } flersonaliy- q OR Produced Identification Type of Identification Produced________­ . roduced_____ _, _ Cern fission Na ;;; 4924 n11 a. _. KIRK ARI KATZ Revised 0711151201.4 (467) M-0153 FloridallotaryService.com EXPIRES August t 2. 2G17 (407y 398-oi53 FlurictaFJofaryServlce.cc�rn rW I EViEtA15 FRONT I ZflEiiNG SUPEl?�+'15OR ? Pi ANS tiL�ET TIflN SEA TU F Iv ANGROVE { COUNTER ' REVIEW � REVIEW � REVIEW PEViIEW REVIEW I REVIEW CON1PLETE_. I — SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESI(5ERJEN" G-NEEIR: — Not Applicable I MORI-GAGE COMPANY; � Not Applicable dame: _ lame: Address:. Address: City: _Sime: city: Phone: I Zip: Phon2.- FEE SIMPLE TITLEHOLDER: — Not Applicable BONDING COMPANY- Not Applicable Name: � Name- Address: Address: — City: City: _ —_-..,. _ _._. Zip: _Phone: � -- _ Zip_ —Phone: I certify that no work or instailation has commenced prior to the issuance of a perrriit. St. Lucie Cosnty makes no representat on that is granting a permit_ will authorize the oormii holder to built! the subiect struqure which is in conflict with any applicable Nome Owners Association rules, bylaws or and covenants that may restrict or prohibit such structuT-e. 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; will, in all respects, perform the work in accordance with the approvers plans, the Florida Buildin.0 Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pooI5, fences, walls, signs, screen rooms and accessory uses to another non-resmential use WARNING TO OWNER, Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notil e of C©mmencement must be recorded and pasted or; the obsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Cornmencernent_ Imo' s I _ Signature of Owner/ Lessee/Agent Signature of Coniractorji_icense Molder i I I i ��-r_'M rs[ r -a saDrt-vA COUNTY OF The forgoing instrument was acknowledged before me this 20 24^_by I J)# (Name of person acknowledging) (Signature of Notary Public- State of Florida) - i Persai4a Known "_— OR Produced ldent:5caticn._�___ Type of ITe­ntnccabon Produced ---- --- Ca nrnission vo' s t `s�°: {Seal)KIRK ARI KAT2 AAY COMM!ss!ON #FFO• COUElf E v O The forgoing instrument was acknowledged before me this _" :D day of `� '20 by IJ (Name of person acknowledging (Signa` ure of Notary Public- StatF of Florida } flersonaliy- q OR Produced Identification Type of Identification Produced________­ . roduced_____ _, _ Cern fission Na ;;; 4924 n11 a. _. KIRK ARI KATZ Revised 0711151201.4 (467) M-0153 FloridallotaryService.com EXPIRES August t 2. 2G17 (407y 398-oi53 FlurictaFJofaryServlce.cc�rn rW I EViEtA15 FRONT I ZflEiiNG SUPEl?�+'15OR ? Pi ANS tiL�ET TIflN SEA TU F Iv ANGROVE { COUNTER ' REVIEW � REVIEW � REVIEW PEViIEW REVIEW I REVIEW CON1PLETE_. I — HAZELW00D DRIVE — . — (60' R/w) — — .. , 20' ASPHALT ROAOWAY BEARING BASIS S88'22'43"E I FIR 5/B" (NO ID) vl �o �a 8.3: ONE STORY GEIS RESIDENCE w n SCREENED — — POOL ENCLOSURE - 0 FIR 5/8" � FIR 5/8" FLAT LIMITS NO l ES nnor rH7 f n ���1c„ F� ro �r .ssF•s�crn nr r,u.x'.rc t>T1r.+rr — ,'ii•5P.7NC5 rt?lJ :ii57'r1.�Gti5 SND AW ARE RECORD A:".D UVEAS.',-Prrl UNLESS Ufii F,,lA''R;F yl:.!'�JLi4G511iie:L.RSuJ[,!'OILf'EcORJPL.lIRVGFUR IriL SO:IFHii;2LY.41G!i:'Uf V"AY!,'".'E JOti y - 1605 Qjo Know O.S/111116 . Y 4 Now, ow, I c. D.R'l:.,aa , PsWso:'- PROFESSIONAL SURVEYING AND MAPPING FF'v,srov Rrvsrav 3306 AVIATION BLVD, VERO BEACH, FL 32960 FLORIDA BUSINESS CERTIFICATE OF AUTHORIZATION NUMBER LB 8912 Phone (772) 925-2250 00.00 xr0 N8$'22'43'W 22.36' FIP 1/2" FIR 5/8' PC(NO fD) (NO ID) T� P _ • Q vi I I h r. r� 0 FIR 5/8" � FIR 5/8" FLAT LIMITS NO l ES nnor rH7 f n ���1c„ F� ro �r .ssF•s�crn nr r,u.x'.rc t>T1r.+rr — ,'ii•5P.7NC5 rt?lJ :ii57'r1.�Gti5 SND AW ARE RECORD A:".D UVEAS.',-Prrl UNLESS Ufii F,,lA''R;F yl:.!'�JLi4G511iie:L.RSuJ[,!'OILf'EcORJPL.lIRVGFUR IriL SO:IFHii;2LY.41G!i:'Uf V"AY!,'".'E JOti y - 1605 Qjo Know O.S/111116 . Y 4 Now, ow, I c. D.R'l:.,aa , PsWso:'- PROFESSIONAL SURVEYING AND MAPPING FF'v,srov Rrvsrav 3306 AVIATION BLVD, VERO BEACH, FL 32960 FLORIDA BUSINESS CERTIFICATE OF AUTHORIZATION NUMBER LB 8912 Phone (772) 925-2250