HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:TUB Permit Number: 11 61�4 j(;3Q�
RECEP,'7D JUN 9V 9 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: Window/door
PROPOSED IMPROVEMENT.LOCATION
Address: I
Legal Description:lYk2L'CU - ung t-C yo I L al 66Y-5 13aad /V
!M t2� F �IGr ����- Z3��
Property Tax ID#:- - 3�0.Z6
-7- CY-i(e `X6--3• Lot No. 1.3
Site Plan Name: Block No. Z
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION"OF WORK:
YY ooe- 2 + a4ed ra�rac,�
1)ILVA <22�9a"V- �X 1-4- 0v1(Y c2- fcvl-vl�
Ce Gloufe
CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit-check all appy:
HVAC Gas Tank Gas Piping Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers E Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: �n, p S . Ft.of First Floor:
Cost of Construction:$ /T 7. Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR: .
Name aat d (y lV-S b-vI Ery' o I Name: `l ke= 1r ia-1,
Address: ` C7 i l P_r 14 Company:� -8,e E xfe�i
City: �.2 i�.I'C,,� State: t?• Addre=1Z � ! � rZip Code:C Jq TpG�?. Fax: City: I Zt.[U' _ State: �Z
Phone No'7?2 62, 0-7 q 2- Zip Code: :30 91531-3 Fax:
E-Mail: 1 Phone No. '770 7'S73
Fill in fee simple Title Holder on next page(if different E-Mail: 1 I A6 iey" &PC,
from.the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPCEMENTAL.CONSTRUCTION LIEN LAW INFORMATION"""
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
fT•�— s
Signature of Owner/ essee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF zgoi, COUNTY OF S za ac,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thi$'2,f day of !JM/( . 20(-by this`24 day of Sjn y 4 .20 n by
�gy Ce'__ fir✓ ea k7D� 14 Ag
(Name o pers acknowledging) (Name erson acknowledging)
(Signatu N to -Public-State of Florida) (Signa re of W&ary Public-State of Florida)
Personally Known t"� OR Produced Identification Personally Known `' P oduced Identification
Type of Identification u Type of Identification od
o�T�iry u lic o n �p � ry u is a e o on a
Joshua y�y�ha��leB Albedco Joshua a berico
Commission No. MyCom(tli�sibhGG020879 Commission No. � Mycommi��020879
pra Expires 08/16/2020 ora Expires 08/16/2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
LINITIALS