HomeMy WebLinkAbout648 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICA77ON TO BE ACCEPTED
Date: �1 a�U� Permit Number: Y) G e6—GG �I
•� �`� RECEI`'-
0 JUN 2 9 2017
___.�.... ,_. ...__ ._. ..._ .. Building Permit, Applicafion
Planning and Development Services -
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone:(772)462-IL553 Fax:(772)462-1578 Commercial Residential 1/
PERMIT APPLICATION FOR:
spROEMTtCl
z r. ..,.. 7. t�..
V .1..
Address: S I o�l 641U%1A 0--- Fwt Pie &fAA-— .r..34q�5 i
Legal Description: Lsr,-;�22 a:C�Le E, Let
Property Tax iD 130 �-•��--►b l I��UX,`'.� Lot N®_
Site Plan Name: 1!.,2A &VA QA�-- Block No. Z
Project Name:
Setbacks Front Badu Right Side: Left Side:
DETAIi_ED DESCRIPTION OF 11UORK M `
C1r7 STR C N"111 PSI
i .Yi ,t �-
ddifionalviorktobepertormecl dare erthis perraait–.,checkan that app :
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing . _Sprinklers _Generator hoof � 1� (rZ,
Total Sq_Ft of Construction: cam¢ &Ida, Sq_Ft of Fiat Floor:
Cost of Construction:$ 9,azow Utilities: —Sewer _Septic Building Height: 10
It
E SEE
� flEll_
F
i Ham Narne-
Address: Company C.
City: State: Address: U-e_
B
Zip code: 3NQSl Fax Citi': I (_'. state: (�
Phone iso- �7s�•.•�� F Zip Code:34Ka g Fax:W4-95sSng34 S
E-Mail: Phone No?7�
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License C CoG.573
if value of construction is 25M or more,a RECORUED Rpotim of Commencement is required.
b U
i
• .. � � "
� i � .y .,
r
A,
ry
,< ..
�� �f \'C•Ll S� FYOi 1�H.Y �] �SiITSiII � 'I �- _? J 4K�-"Y 3 ? 1r., 4,�l
•.,,.' .rY rit f
y
u DESIGNERIENGINEER.- Fdot Applicable a, MORTGAGE COMPANY: _Le'l-Vot applicable �
Name: Name:
Address: Address:
City: State: city: State:
Zip: Phone Zip: Phone:
y
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: of Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: I 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 commented prior to the issuance of a permit.
S��t�_Lucie Countymakes no representation that is granting a permit vAll authorize the permit holder to build the subject structure
&'PNch is in conn; vAthn any appBcalmle Hen m Owners Asada Qunl!e bD4mvs or and covenants that Gnay restsict&T pmhibit such
structure.Please consult;fith your Horne Cv.,ners Association and revicew 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 vAth the approved plans,the Florida Building Codes and St Lucie County Amendments.
a he folio ring building permit applications are exempt from undergoing a full concurrency review-room additions,
accessory structures,n%iimrnirng pools,fence~„�gs,signs,screan morons and awry cases to anonher none-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 rAth lender or an attorney before
commencing work or recording our Notice of Commencement_
__;71 2��
Signature of Owner/Lessee/Agent Signatib4bf Contractor/License Holder
STATE OF FLORIIDA STATE OF FLORIDA
j COUNTY OF S+. L V c COUi Olr S-k. L U c
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of J n .20_n by this day of Zy Y*4- ,204 by
5� d
W L
�- R•v ne ,n-e.
(Name of person acknowledging) (Name of person acknowledging) Ii
I
h (Si-,nature of Motary Puhl -State o€Florida) r j5gnature of INota7 P laft-Stam of Rodda j
Personally Known OR Produced Identification Personally Known OR Produced Identification.
Type of Identification a Type of Id TM
Produced L Produced • 1•. DEANNA MARIE G NS
pG4NNAMARIE GNENS ^-�: = MY COMMISSION#GG 022023
s' • {F My OM ISS10N#GG 022023
Commission 6 ®- 6 ber 16,2020 commis
N f o 5 � December 16 Mq
Decem ,,3F F,, o o v tary Public
Bond dThrI�N°�M P°bI1C Underwr tors li Underwriters
7 i
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REViEW REVIEW REVIEW � REVIREVIEW REVIEW
DATE
RECEIVED
DATE
CONI
PLELED a
ev_7/201-4