HomeMy WebLinkAboutpermit application -1mom
All APPLICABLE 4INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date: -I �— 1 6 Permit Number: .oa 1-11
J7 J-
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:
PROP®SED UNPR7OVEMi N Mom!O'N.
Address: . AQk
Legal Description:
Property Tax ID#: INA . Y01 , OW l• OW3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D'ET LED DEQ CRI TIONOF WORK•
=@@UTLR'1CTIO,N INFORM TION:
Additional work to be pertormed unclerthispermit-c ec a that appy:
_Mechanical Gas Tank _Gas Piping _Shutters Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof
Total Sq. Ft of Construction: ^7 ( Sq ' Sq. Ft.of First Floor:'
,ao
Cost of Construction: $ Utilities: _Sewer -;Septic Building Height:
NER/LE=&S�SEE; C* TRAC 0
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J{..+14T, I7! It. r yrs
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eitys4�Nm� � ';F;I`.C� State: FL 1A
Zip Coders��r' Fax: City: State:
Phone No. -1'70 - 201- 69 (D/2 Zip Code: Fax:
E-Mail: 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,a RECORDED Notice of Commencement is required.
lJF'PL AL C*ONSTEt'llOT1 LIEN L INFO'' M TIC?N•
DESIGNER/ENGINEER: ° Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
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,perinitto do the_work and installation as indjcated.
1'certify that ng work or installation,has commenced prior to the issuance_,ofa'I ermit
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 mayresult in your paying twice-for
improvements to your property.A Noticeof Commencement must be recorded and posted on the jobsite
before the first i spection, if ou intend-to obtain financing, consult with lender or an attorney before
commencin rk or recor aur otice Commencement.
Signat e o Owner/Lessee/Contracto as gent for Owner Signa ur of Contracts Li ense Ho der
STATE OF FLORIDA / STATE OF FLORIDA
COUNTY-6F COUNTY OF
The forgoing instru nt was acknowledged before me The for Ing instru ent as acknowledged before me
this day of S�� 20 ll(v by this < day of�— .20_Zfo by
A&q(q &IOIL4
(Name of person acknowledging) ( ame of person acknowledging
(Signature'of Notary Public-State of Flori ) (Signature of Notary Public-State of Florida
Personally Known ' OR Produced Identification Personally Known OR Produced Identification
Type of1dentification AAeatssaC Type of Identification
Produced - NOTARY p/P�roduced C
Commission No. , STATE OF -Commissiio+n No. Wr�
O°m"s C'oC'v Cx� cit.' STATE OF FLOPE>�s ul ,rM
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION,
COUNTER REVIEW REVIEW`, REVIEW REVIEW SEA TURTLEd MANGROVE
DATE ` REUlEM, REYIfW
RECEIVED
DATE
COMPLETED
ev_ ,
Q
( C
LEGAL DESCRIPTION: SURVEYORS NOTES'
Lot 257 of 1. Unless otherwise noted only platted easements �(
HOLIDAY PINES PHASE II-B are shown hereon.
2. No underground utilities or improvements Were
according to the plot thereoflocated unless otherwise shown. yl
as recorded in Plat Book 20 �.
3. This site Lies pithin Flood Insurance Rate Mop �
pages 12, 12A through 12E of the Zone X. v� �" V
Public Records of St. Lucie 4. Flood Zone shown hereon is an interpretation �.� C
County, Florida. by the surveyor and is provided as a courtesy.
ABBREVIATIONS: The flood zone should be verified by a 'J 41
=a
(*)=Not verified by field measurement determination agency. —{�
Value as plotted & field measured F.
5. Bearings shown hereon ore nosed on the Center
F.E.=Finished Floor Elevation line of Eagle Drive as being S01'37'50*W ,J
SET =Set 5/8' iron rebar with according to the Plot described hereon, J (1
yello capmarked.'PSM 5543 6. P.U.D.E. denotes Public Utilities and Drainage u
MS=Value as measured in field g Easement.
vinm OH--7 Over Head wires 4 7. All Lot dimensions shown ar'e per plat unless C
X—X—X-= Chain Link Fence otherwise shown. �{
FD=Fqund 518" Iron Rebar
R.O.W. = Right of way �J .-
0-0--0-=wood Fence �C
Q= FPL Transformer Pad
PL=Value as platted
R = Radius of curve
L = Length of curve
= Delta of Curve r
Q Site Benchmark
AS. = Measured
S.F.=Square Fool ��
CONC. = Concrete
C.P.=Concrete Pod
®_{Vater Meter
1= Power Pole
= Bell South :J 7-
0=
®=We I I J
LOT 258
o
N 89'29'27" W 123.61' 99
SET SET
0.63rill,
FEN 1.0'IN GE c33.69' C • 26.84'62.70' a I
O I c N
O
M W 1 STORY CONC. BLOCK N CD a
a 20.00' 26.32' rn 1 pp
CONC. ¢ as
M
CN _ I PATIO ,3.30 -3= rn
0
v p f rJ
C> Q I c c l
r C01�C DRIVE r o I
o z 33.90' 42.70' o
J
o I
U I M 29 I
a0 m
FD.
FE E 1.5'OUTSIDE SET
.�' .._. N89-29'27"W 121.85'
r
LOT 256
J
1
f LAST FIELD DATE:8-18-11
ASBU I L T SURVE Y
J Certified to:Jesus S. Trevino & Barbara A. Trevino
Group One Mortgage Inc
5201 Eagle Drive Community Land Title Insurance Company
Fidelity.National Title Insurance Company
SCALE:1 ;=30' t I ant i c Land Designs I hereby certify that the survey shoNn bereom is true and Correct
and is based on actual measeurements taken in the field. This
DATEr"8-18-11 of the Treasure Coast survey meets the I,fininvsn Technical standards of Chapter 5J-17
751 NE Jensen Beach Blvd. Jensen Beach,FL 34957 Florida administrative code.
Moiling Address: Di mall si nedb James +'*}mvic sr
P.O. Box 1421 Jensen Beach, FL 34958 A.CesiroJr. �t
11-0374 (772) 398-4290 ALD5543@poil.com James A; DN:cn=James A.Cesiro Jr, ,
i.o=Atlantic Land Designs
DA REVISIONS theiC,ou,
edmail=ALD5543@gmail.o .T•mrerF. -
Cesiro J" n.'=Ds
Date:2011.08.22.07:30:22 tt `cima;��" `•
.. -a4•00Fa.lL'u\F.VJN.
NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC SIGNATURE
AND AUTHENTICATED ELECTRONIC SEAL