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 FC 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 I
PROPOSED IMPROVEMENT LOCATION: M
Address: cse_ba 3 � q e 2_�
Legal Description: �r_�e5 &� 46va-gid Ix
Property Tax ID #: 2 �.l�_i -5-69 DOZY - t5oo-8 Lot No.
Site Plan Name: Block No.
Project Name: - `-
st ,r
Setbacks Front ier Back: _`9 Right Side: A Left Sider
DETAILED DESCRIPTION OF WORK:
u
- cnecK a
HVAC Gas Tank ❑Gas Piping
Electric ❑Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ ?� 700 s'
appiy:
Shutters
[]Generator
SgFt.j of First Floor: _
Utilities l _l5ewer—Septic
Windows/Doors
Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Address: _IR6�f g9c5z3 31
Company: "4c t"
City: 1 u State: ++
Address: ZiClll
Zip Code: _, qUZ Fax:
City: ?S` State: Fc -
Phone No.
Zip Code: ?Yf Fax: 772 -e7V /0v 9
Phone No. 111 R 73 ST
E -Mail:
Fill in fee situp Ti, Holder oiKrRW4o�gK���liffer nt
E -Mail: ed -,e , c J f -o- a r7ka ,4a
from the Own Nst% atio�j�o�lM�ss;or +�Fro41r�2a
State or County Licen
X
b`<`_ bP,XE'4RF_S Au�lris'. 12. 2017
?r ,
11 varus u1 wnaU 95-sptSeU4 Ice or commencement is re ulrd4,-' °'
'rFnraS' `` X?iRES ArrtliSt12, 2017
(A47j 399.0153 Ftond.040taryScrvice.com
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
_
City: ' State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name: I )
Address:Address:
city: ._,_.._..,_..._. �
City: ; €
Zip: Phone:
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 thepermit 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 your Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
-.
S
Signature of Contractor/License Holder
STATE OF FLORIDA v STATE OF FLORID
COUNTY OF C: E COUNTY OF c
The forgoing instrument was acknowl edgedLbfore me
this day of '7 , 20 y
(Name of person acknowledging)
z1vf
(Signature ofNotary Publ c State of Florida )
ynawic 0177roduceF Identification
P
T�ie�Q�°(�enitif�IuL�TZ
Nir19�' CC)ts4 '9 �SIsJ�r! #FF044924
Cisron Ne "' ft?. 201 7 (Seal)
{�oz� sse visa FlarazimOlaf
Revised 07/15/2014
The forgoing instrument way acknowledged before me
r
this qday of C_9('
. .4— , 20 by
(Name of person acknowledging }
(Signature of
p'A Y KIRK ARI KATZ
Personally Knc 4m
Type of Identi c'" tpn 0 uc
l�7j �� nr yS icc. m
Commission
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
GEN"D•
LEGAL o�—sCRTPT_CN
-E-;'E"_=1^tiry uT 25 SHEET_ _ C7i 2
P=PE F?AA F -E'4 7 ''i'.jhl;RO!N .STATES OF LOP4G'WC)O'0 s
D_ Cu`a
SO --SQUARE PLAT 80 -OK 25 PAGES 27 27A
hr:OR! T.=FFP- 5A_Nr LUCmE C3UNTY, FLORIDA
Ltt,�7 tF PLAT .11
=-AST /t i _0'
—ST ; ] r 7' 5 830 22' 43" 10. 10. 7' ,
SET m5 R AR �t � I�7.00' _ r ��� ;�_�
;P rL °4002 0,• aG sC SE �S RESRR ' f
rRO'SEO `rim ' �� i
L` CAP ifLa46102 f
�' �i I
24.3' I PROR SED
_cT
Pa�el� Y
LO i 2v -
~ j
�f RLSi `CE 2380 SC �* `�
VACANT
3AR
a
2 00 S✓ -T T ARE
LE
-O i.c
TY
N c
yLB,, ! Fv7 =5 ? r
ti J
S R=251 22.3" ND- A5 REt3AR =LI:Y
FvD. pCa--o2°;^IF3 S Bea ??= G cASEIMENT
i1.53'3�53 r=?=.13'
�l U
s 3hc i : Pavem: n
., L4 L I ;rtei- Q n I c 2 SE i h A-111 E
��-- SSE' 223 88 n� �aaNcrtll
{
rN�
SCP v/! HAcEL'vCpp URNS SND ?-7N�?L g DISK
�J�� �L�Srr ! 291 f4.�aU,S
AN ASSU ^FD VA,v'E F S 33° v : � c €
CP. T'h SCU ,� I v� riA7EL 2� �;'
;C C DRIVE Sfi1C G�ARTNG 7g . i I�
IL 'n. _ a+_AT OF RECORu_ � � v !.EVATTUNS BASED Ohl EE.�C;�AiiC I
SETBACKS, Lt)CAT(C31�S G1Ti'E 1A C3,BYcf
REcoRa PLAT.
S TO BE VERIMED By CONTRACTOR
F?vt ?an & Topc SurveyBa:ndary survey 1 rev. Are ;y.G.V �Fo m Board Survoy 0---pis-Suiit Survey GEiw. Are Aa,&,f, s
D.. 1925 nata :)-Dgad C--Calcul&tod XExistinrj irsde Pro-?rorntlan bistancx n aAasru7gr Dr4Tanc ra F3af D st�ncs
ALL BEARINGS OR ANGLES ARE BA5EO ON RECORO PLAT, UNLESS GTHERWISE NOTED.
Ti-iE SURVEY OF THE i'i"IQPERiY SHOWN HEREON IS itJ
_LANDS SHOWN HEREON WERE -T A3STiACTEO FOR
ACCORCANCE WITH THE DESCRITfION EURN€SHED BY EASEMEFTS AND/OR RIGHTS�1=-C1:OF nf:CCRq. IE
CEFMFY714AT 'DIE SURVEY MEETS MliVIMUM?4`G NJC AL.
STANDARDS SET FONTH BY THE FLORIDA BOARD OF LAND
SUHVEY�S, PURSUANT TO SECTION 472.027 Fi.G�RDA STATLT't5. }I
NC gf-AFICH OF ;'HE PUBIS fiECORDS HAS BEEiv MADE BY THIS REPROI}',1C C)N iNANY FORM, i5'�C)ii1BtTED- gEgq}� g ��� 0�' i
7FFICE FOR ACCURACY aR ae,sslows. ALL CORNERS UNLESS O FI�R�w�G s n rte, r 6®r