HomeMy WebLinkAboutBuilding Permit Application From:Bailey Whittemore Fax:(800)757-0066 To: Fax: (772)462-1578 Page 3 of 5 02!20!2017 10:58 AM
€
P
ALL APPLICABLE INFO MUST BE COMPLETED F611 APPLICATION TO BE ACCEPTED
t
Date: Permit Number:
I
°
RECItIVED FEB 21 2017
Its
Building Permit Applicati®n
Planning and Development Services I
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 1 Commercial Residential
P
PERMIT APPLICATION FOR: To Selectifrom dropbox, click arrow at the end of line J ell,r, n .�
.pRJ -C>SEDIVJF -VV
�i - i�1T
Address:
Q
Legal Description: W (�
E
Property Tax ID#: vt�d� Lot No.
Site Plan Name: t
C�J.� s � : Block No.
® E
Project Name: `��,0` (�t•�' �,o��
Setbacks Front Back: I Right Side: Left Side:
I
14TA1= sL?W5RfPT1C)i ®f WC�RA1'.' 2 4 .
.1.. k i..._. v _ ... <,.�_w: ,i• .f ;, ft �: �t ,<<l ry �y �)t 1 FR_ lf�i °!: G,. Sir _
E
i
Additional wor to benej r orme under this permit-check a appy:
RE
VAC Li Gas Tank ❑ �G s Piping _Shutters a Windows/Doors
lectric Plumbing �.Srinklers Generator Roof Roof pitch
€
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ �-� t(` Utilities: Sewer Septic Building Height:
y''CC3ITRAGQRs `Sfr ui.
G
c Name �A / i'€� ' Name: (14
Address: -�c(j�1` 1 1�c f�l�'7 �I�n� - s_ Company: C.
City: Sate:
9 Address: _
Zip Code: G Fax: City: F0 �?� ce Stater
Phone NoAa 4UR' Zip Code ����5t Fax: (r ,c,
E-Mail: I Phone No. �{ (011.9 JO90
Fill in fee simple Title holder on next page if different E-Mail:
from the Owner listen above) State or County License:
°
If value of construction is$2500 or more,a RECORDrD Notice of Commencement is required.
i
€
3
€
6
From:Bailey Whittemore Fax:{800}757-0066 To: Fax: (772)462-1578 Page 4 of 5 02/20/2017 10:58 AM
5 ?PN� NT G�NSTRtITj( l`LI;E 'fi lUA*T1 uz ;� kr z r r ;
n;l, 2_,._. ....,�. .a:t,.,.at ...r{ �r ,"''.,•;�,,,., v.. n..+.,?r:l ,.,.a ,�'-;. n .....<.:;�„ -- ' .� �r�.5 � { , � .� j 2v E r ",�, yM s A.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: �Not Applicable
Name: Name:
Address: Address:
City: Stote: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 1 Address:
City: t City:
Zip: Phone: i 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 Nome Owners Msociation rules,bylaws or and covenants that may,restrict or prohibit such
structure.Please consult with your Horne Owners Association and review your deed for any restrictions which may apply,
In consideration of the granting of this requested per it,I do hereby agree that I will,in all respects,:perform the work
in accordance with the approved plans,the Florida 6u11ding Codes and St.Lucie County Amendments.
The following building permit applications are exemplifrom undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,sgns,screen rooms and accessory uses to another non-residential use
WARNING TO®ilUlfFi:Your/allelic to Itectsrtt iyotice of Commencement may result 16your paying twice for
improvements to your property. A Notice of ommencement must be recorded andposted on the jobsite
before the first inspection. If you intend to o;tain financing, consult with lender or an attorney before
commencingwork r recordingour Notice f Com_mencement.
1 l
Sig ature of Owner/Lessee/Contractor as Agent for Owns- er Sign o Contractor/License Holder
1
STATE OF FLORIDA i STATE OF FIORD
COUNTY OF_ ; �iJC`t .. S COUNTY OF LOC(O'„
Theing instrument was acknowledged before m� The forgoing instrument was acknowledged before me
thisf rgoday of , 20 Eby this 016 day ofC- r 20 by
S
at
(Name of person acknowledging) (Name of person acknowledging)
I
(Signatilr of Notary Public-State of Florida} I (SignaturePublic-State of Florida)
Personally Known _ OR Produced Identification; Personally Known OR Produced Identification
Type of Identification Produced l Type of Identificp ��atio Produced
soy,,,,Bifem IfQilY 1dICOLI:IiULINSK! C `'° ° Y MMl SIGN I FF'142732
Commission No.r� jSMXVMMISSIe IfFF142732 Commission No.ti * E f Augusto,2018
£X IRE&:Aug s15,201$ s �Q\o BondedThruaudoetftrYServtces
�r'ren �\or Borded'CaruBudgetliatatySettlCeS r4"��-OF4L
Revised 07/15/2014
i
S
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
F
DATE
COMPLETE
t
INITIALS
i
i
i
i