HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a 1D Permit Number:
c` RECER'S-D JUN 0 7 2017
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Caws
PROPOSED IMPROVEMENT LOCATION:
Address: -7199 S LAS R W
Legal Description:-'--+ "Ci C- i!3 Z, .5(-o 14 D 6UL Z F� 11141- i)C W E_' &[ Ll LY I
W L(QP SCC R.kA1\4 SELL 11L(-I SD W �>_lw LI S10 FT TC) ?C) 13
Property Tax ID#:3414 f5ol-1908 --3910 Cl Lot No.
Site Plan Name: �G,����%nT� (.fin+f �1 CI Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
PRy)GC< 3+0ti pGCJ' (A�C' wjl+ ic�i1 Y-ob, , wl S Y—w k-e6\+C_(7 I`+ SP-er•
Lc ke �0( l; Ke Ckeol ,tDwf.
CONSTRUCTION°INFORMATION:
Additional work toe performed under this permit-check a appy:
&VAC E] Gas Tank r:JGas Piping _Shutters L]Windows/Doors
Electric ❑ Plumbing Sprinklers 11 Generator F] Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ � �•3 s uo Utilities:n Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name [LQ'Qk'-f—np FL FGSI- cocS �eC�i lam/ Name: ft
Address: Company: IA F(Drde
City: 64 0-,)L StA State:l�Ay Address: S(5 I V I l ,•
Zip Code: 11 J_3`- -0 2-clFax: City:PS t- Stater
Phone No. C-1 LQ `4 y L 50-7 Zip Code: 3 9 (4r Lf Fax:
E-Mail: Phone No. (-77?� flZ_ � 2_0 `2.
Fill in fee simple Title Holder on next page( if different E-Mail: �J CC 2 ,x+otlt� c� C O . COr-►
from the Owner listed above) State or County License:Q y9 i X S 1 GI Gj (D
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL C®NSTRUCTION"LIEN LAIN-:INFORMATION;; =
ZESfGNER/ENGWEERr Naf Applicable MORTGAGE COMPANY: �>47NotApplicablel
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"worlaor installation has commenced prior;to the issuance of.�O 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- OWNER:Your failure`to Record a Notiee of Commencement"rnay 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.
C s
_Signature of Owner/.Lessee/Ag nt Signature of Contractor/License Holder
STATE OF FLORIDA " STATE OF FLORIDA L�
COUNTY OF �I L(nC_k. -,c COUNTY OF JJtt.. C(
The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
thisZ day of 20 LZby this ay of v ,20 by
(Name of-person acknowledging) (Name of person acknowledging)
(Sigriatdr_6dfANotary Public State of`Flond i I (Signatur:e:of.Notary�Public-Saate.of Florida.)
Personally Known_ OR Produced Identification Personally Know 014radured Identification
Type of Identification ProducedType of Identification P oduc d KAREN D.CHISHOLM
?i °n My COMMISSION#FF994356
SPRY!UB
Commission No. _ M ISSION#FF994356 h MAY 18,2020
� '
SCommission No.
:MAY 18,2020 Bonded through 1st State Insurance
Bonded through 1st State Insurance
Revise.&-0—7/15/2 0.14
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS