HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /7 Permit Number: / L)P7.
RECEIVED
Building Permit Application FEB / 1 2017
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 `X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line no101rt1S t
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PROPOSED IMPROVEMENT LOCATION:
Address: �1Q88 Planfallon LaV-S DhVe POI'- St LUCK, Fl, 3NQ8l
>t- Legal Description: Reserve- PlQ-Yl'�'GL-hor - Phage SA Loi
Property Tax ID#: l`5'?Q -e)oJ" 0Q2-L4-��" L4 Lot No. I
Site Plan Name: -4Awsch Re,316mc _ Block No.
Project Name: l-l(r-s .h Sithe Ice—
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Rr_mOVe anCi repiaCe (11-5) Si ng l,C Hung ) (8) Fixed ;
( _.) I-lovizon+G.I. Roller, (4) Slid '
�I �sS . r 1
(and (3) PIGS-F IPro E ntry doors .
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit-check all 1_1appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric. Plumbing Sprinklers E Generator E] Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost`of'Construction:$ 54,400 ..00 Utilities: _Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name_Jose h+MQLY,14l..l' d)_ Name:
Address: -IgBs Plo.nfi�ibn L.DKes .QYiyc Company:1l'I 10QQ,L.3 '
City:_ Pnrf.St•LueIP State:FL Address:3510 sl: [_)we 'AWv A^
Zip Code: NCI (o ,., City:_
State:_ L
Phone No. 441 "' a :r Zip Code:_ _?)4Cl,9 1 Fax: Za(o -01-464-
E-Mail: Ir11{a.eb a;,z ,i nr, amaRP nor-in Phone No. -772 2-9(9- OL45 9
Fill in fee simple Title Holder on next page(if different E-Mail: nPrmi t5.al�S�eros anarr�0 -corn
from the Owner listed above) State or County License: l ci31e
If value of construction is$2500 or more,---a RECORDED Notice of Commencement is required.
/1
SUPPLEMENTAL CONSTRUCTION LIEN. LAW INFORMATION:
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:
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 andMsted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender a attorney before
commencing work or recording our Notice of Com
xz' -.:s
Si ture of wner/Lessee/Contractor as Agent for Owner nature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID/�,
COUNTY OF IYr�arf in COUNTY OF f�aYh7r
Theor oing instrument was acknowledged before me The for cling instrument was acknowledged before me
this day of 20 ?—by this day of JA4LA" 20 by
(Name,of person acknowledging) (Name of person acknowledging)
(Signa ure of Ndtary Public-State of Florida ) (Signature o otary Public-State of Florida)
Personally Known OR Produced Identification-/ Personally Known - OR Produced Identification
Type of Identification Produced Q L Type of Identification Produced
�'��, KELLY WIDMAM, Commissio N """�., KELLY WIDM/�
Commis o .pj II11 4 �eal�.
• ro �;
Notary u -State o �r7da ;=o� ,��.: Notary,Public-state.of Flo ida
Commission#FF 929255
•. ••- _J* ;•_ Commission#FF 929255
."' oc M Comm. xpir M Cornmr.Expires c q,
'�E ` , nded through National Notary Assn.
Revis 0��' /�01 %% :� `` Bonded through National Notary Assn
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE- MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS