HomeMy WebLinkAboutLevine PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1Permit Number:
• Building Permit Application
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
PROPOSED Irr1MPROVEMENT LOCATION:
Address: 3�0� S10(hn r.U- Ff-. P.&ICA .'rL
Legal Description: ai,4I PC 1,-n SID RLr-- Z COT I Z ( Q 18,"id ( 0P- 39 24
Property Tax ID 4: 2H07) --_7I S ' 0017- DD O - U Lot No. 2—
Site
Site Plan Name: r Block No. Z
Project Name: ?{( SLYn,Gn CR (0n5i C_4 -%O/1
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
�
tpicc< 3.5 tt�n lotic SySt-� .
14 See/ S kw
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all j[73[ apply:
HVAC Gas Tank ❑Gas Piping IIIL��—IlJI Shutters Windows/Doors
Electric Plumbing Sprinklers L.J Generator 0 Roof = Roof pitch
Total Sq. Ft of Construction:GG
Cost of Construction: $ 3 0 G S Oo
OWNER/LESSEE:
Namepttir +[,kA C, C 6,if4&Qn4
Addresslt.tnvtse 161Jd
City: t1 /I 7i VC{
Zip Code: 3`'I cl kL Fax:
Phone No. (-nz) X1(1 - SO 1 L
E -Mail:
SFt. of First Floor:
Utilities:SewerElSeptic Building Height:
P f;e
State: �t_.
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
CONTRACTOR:
Name: _D(/L" Y_u7-ut-Z
Company:iHIC. t EV41ing &1e S
Address: 3'-1 � �)f
City: PSL State: -FL
Zip Code: girl A\Fax:
Phone No. ((t-772) b l -L 32-cZ
E -Mail: /, C t -co"
State or County License: 1i ' 1 td 1-1 C Cl l o
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTJON LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
lot 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 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 rk or recording your Notice of Commencement.
ignature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF S}: L V C i Q
The Torgy .ng instrument was acknowledged before me
this '7(//rday of M fn lr . 20 aby
M I -r 1 I ng
� r
(Name o person acknow a ging)
A
(Signature of Notary Pu lic- State of Florida )
STATE OF FLORIDA
COUNTY OF S-} L u C, c
The lfprg1t instrument was acknowledged before me
this Oiday of hn ( b . 20 1 --1 by
(Name of person acknowledging )
� � L9 C --
(Signature of Notary Public- State of Florida )
Personally KnownOR Produced Identification Personally Known OR Produced Identification
Type of Identificatj ruceed Type of Identification Pr duced
Commission No. F-f-� t13 5 LP ( ryt KAREN,). {' WFR
'NS D. CHISHOLM
i� MY COMMISSI FN MEF99g356 I Nor 3S wg, SOM
MISION *FF994356
Q EXPIRES: MAY 18, 2020
FS MIV 1a 9��
Revised 07/15/2014 i4 „omn
Banded through lsl State Insurance I ........v,. ,„ on,d
REVIEWSI FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS