HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: • /0 • 1-7 Permit Number:
F �7F
._ -,. ... ,.r Building Permit Application
MAR 10 201
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 x Residential
PERMIT APPLICATION FOR: n
Address: 2rade6a"'A izD
Legal Description: 6e M C blur•Le n vn S g L I/ P, 474 ad-.d 3 1 2r-74 ofr-a
Property Tax ID#: 23AO 50 I 001 R a 0 o Lot No. a¢3
Site Plan Name: Jr r_ J w a-n S`i�a[31� Block No. .91
Project Name: 'd pw '► n" S�Aglz
Setbacks Front 853 4 - Back:��q,�� Right Side: ;Z q3,21 Left Side:
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&UilrJ -er.T KLfaL 02,.r•, QfV,4 Yi9l4110-niCJ QNh 243 Jr0A4-CLL1-0V_S Sl,r, If
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CQNTRUCN NFO MT101 � U �4�
Add itiona I work to aorme
er
p u naer.tri is permit-check a I I that app y:
_Mec6anicaf! _Gasiank _`Gas Piping "�Shutters' =Windows/Door's .
_Electric Plumbing _Sprinklers. _Generator Roof. Pitch
Total Sq. Ft of`Construction,_. Sq. Ft.tof First Floor:
Cost of Construction: $ 1�0)S0'a Utilities: —Sewer _Septic Building Height:
�` t 3£ " _ „xv T .
01N'IER%LESSE' ° ._ s N IN KIA
CONTRA kk� .QR
Name , T-kwr,avi eyl+erprrMs- g Name: .`�S Fra„ tecraa C4b,,%4Tw($11A Xvo
Address: 55 q 10 Myr-4-11L 9 r'o a Company:T)f,rP .r, c es
City: fT P f't Yti State: Address: '??d'U �1,w,t D,'ha TYYA:L-
ZipCode: 344%Z Fax: City: F-7- State: 16°
Phone No. -7-7-_4 51 e? 171 V Zip Code: 344KT- Fax: `17Z yG3 7$73
E-Mail: Phone No7'72- and "7797
Fill in fee simple Title Holder on next page(if different E-Mail acyl.,Ce"`
from the Owner listed above) State or County License ,4t 19q0,36-J-1
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
.SU�PPl.EMENTAL CONSTR�U�TI:ON LIE=N'. LAW IN'�1=0RMATION: r ,
r�A
DESIGNER/ENGINEER:` _Not Applicable MORTGAGE COMPANY: _N6i-ApplicableN n
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�permit'to do the work and installation as indicated.
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 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 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 our Notice of Commencement.
ISI I' �• � f o�.
Signature of Owner/Lessee/Contractor as Agent for Signature of Contractor/License Holder =°� .`
STATE OF FLORID m<y STATE OF FLORIDA - Q
COUNTY OF s ro�o COUNTY OF
Z ms m z ms m
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Theforgoing instrument was acknowledged before m z The fgrgoing instrument was acknowledged before Z c
this day of 20� by his I v day of M%QR �J:L 20a by �
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o- Nom m
i j C N r1 i C, A,n J
(Name of person acknowledging) ame of person-acknowledging)
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(Signature of Not Public-State of Florida ) (Signature of N ry Public-State of F ri )
Pe ally Know OR Produced Identification onal�Know�n �
OR Produced Identification
sk77;,
ype o Identification Type o
Produced Produced
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
= COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.