HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLEC FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 0' Permit Number:
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Building Permit Application FEB ? 8201
Planning and Development Services PER.10ITTINGSt. Lucie County, FL
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
PRtJPQSED.11V1PR01/EMENT LOCAT1Q,Nk?, �
Address: 9900 5' ck.o .l HIy
Legal Description: hC_pVrVA UovIT y/y A?VO 0^.10/V 5M*0&>E-
/At CpWmryy a&MLmEf �0�2 329/ -1'9tiy
Property Tax ID#: AJSdZ-SD3-C vyy-Docs- Lot No.
Site Plan Name: �7�-{'r_PR G;V11 Block No.
Project Name: //,�
Setbacks Front (�/K Back: LV Right Side: Left Side:
T �
DETAILED DESCRIPTION OF WORK `
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W
S- SLrain�G/ars � n.6
wll/ ,A�pdw �� 6X 5, 7I/V6 /7
CNSTRUCTtfJN INFORMATIQN
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Additional work toe nertormed uncler this permit-cheCK ail that appy:
HVAC Gas Tank []Gas Piping _Shutters Windows/Doors
11 Electric ❑Plumbing Sprinklers 0 Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ )� 35b Utilities:cn Sewer Septic Building Height:
OWNER/LESSEE ^^ CaNTRACTOR
Name 19:�l',�g� Name:. M/G
Address:d�t UN fir& 'i'►ZL_ Company: 6y
City: TK_7_ V l LLA&E S State:JF�— Address: 7 to IVW r- &
Zip Code: 381(4-- Fax: City: S As-� State: rt=.
Phone No. t'o(y) Zip Code: 3N 19'K Fax: r,.q Z
E-Mail: Phone No. (2lZ- 00CcO
Fill in fee simple Title Holder on next page(if different E-Mail: McC-(+*0r- L #N 00v'
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SIPPLEMENTAL CQIUSTRt1CTl0N fiLIEI LAW INI* RMATI(?N a
tea• �,, s.. , .,. _ , . ,r' �. _
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: 5 NC-OASr ALlMilVaAA 6?VbVN e:
Address: 1360 Mrw• ,r,' No,2nf SZii l IQl Address:
City: C - Stater City: State:
Zip: 33-7(,r} Phone 7Z'?IS 37 -q�=) 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,fen walls,signs,screen rooms and accessory uses to another non-residen ' I use
WARNING TO OWNER:Your fa'.
a' r to Record a Notice of Commencement ma suit in yogr p yi wice for
improvements to ou/ec
per/ Notice of Commencement must be re red nd //Yey
the jobsite
before t st i peu i tend to obtain financing, consult w' I d or before
comm ci rk or r Notice of Commencement.
s
Si natu a of Owner/Lessee/ ntrac r as Agent for Owner Signa o ntract'r/LI en older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_-4qT C9r` /.4-7 COUNTY OF -!�;?T.I- -)C1,1C=
The forgoing instrument was acknowledged before me The forgoininstrument was acknowledged before me
they of��� 20/-
,,'—by th i � aSi of � 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signat of Notary Pub' -State o F orida) (Signatu're--of-Nota ry Pub't:-State ofFlorida)
Personally Known �OR Produced Identification Personally Known -"""OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission No. (Seal)
.PY.. ANN td.GAUN IOND y..
MY COMMISSION N FF 173907 A" Psi�, ANN M.GAUMOND
Notary Public Underwriters EXPIRES:December 7,2018
Revised 07/15/201 ' x6 Bonded Thru Notary Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR. PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
CO M P LETE
INITIALS