HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �• L7 Permit Number: i 7P. D(41S____?Y
-
Building Permit Application RECz—NVD
Planning and Development Services NON /2 2017
Building and Code Regulation Division i� Y
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
PROPOSED IMPROVEMENT LOCATION:
Address: kS50H 1(-,iAky \t6MY, CA S1.WCie-, FL., 34cA81
Legal Description:- Prero Acres Vow_ to ( a. 0 $°t Nr_Yo(z. ir_,QR`2101fl •248S -1"��
Property Tax ID#: Lot No. I
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Q Jkz -V au 0_�f and (-e foo-F TV11 ngl-e_5 I
CONSTRUCTION INFORMATION:
Additional work toeperformed. under this permit-check a appy:
HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: -4 j I 1 S . Ft.of First Floor:
Cost of Construction:$ �Ci cJ Utilities: -Sewer E]Septic Building Height: !L
01NNER/LESSEE: CONTRACTOR:
NameJAICJMCI Benet ems QC Ck k(e- 6�na-Nneno, Name: : ", _k Zi,mCne�
Address:\$5ocl a\,Ii_ C.r. Company: -TT axNWI-tin S�_A i\dus
City:%A- 5I--WCA-C State: Address: d"15t-t\ SCJ k-.P� P1
Zip Code: 4ACiT'4 Fax: City: State: ��-
Phone No. Zip Code: 3�0 3a Fax:
E-Mail: Phone No. `5(ol -8'SS -(0W9
Fill in fee simple Title Holder on next page(if different E-Mail:_-tn.�p T T a ualt�ubu� \c��,� �h. Cur--%
from the Owner listed above) State or County License: CC.C-t 3a q`ZGS
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: �,T C��1G�/��i v�d��s - /nc Name:
Address: Address:
City: et- cL Stater_ City: State:
Zip: '53 Phone: .5G l— S 7k 44?_cY Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _ of Applicable
Name: Piht2/ j� C1111-ee Name:
Address: r Address:
City: City:
Zip: 34R2-7 Phone: 7-72 4ZI _54-15 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 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 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 ins tion. If you intend to obtain financing, consult with lender or an attorney before
commencing w q recording our Notice of Commencement.
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0'0_� s
Signature of Owner/Lessee/Contractor as Agent for Owner Sire of Contrac or icense Holde
dLA�,2v SNA--fir-`�/A
STATE OF FLORIDA STATE OF FLORI A
COUNTY OF 971 0 6 COUNTY OF
The forggng instrument was knowledged before me The forgoing instrument was acknowledged before me
this ay of C g� 20 JJ this day of20 LL by
e_t_+A157 0 IR2 6 H19 i N-F7"t1;L Ks I, Anne ne-z-
(Name
(Name of person acknowledging) (Name of person acknowledging) \ EH ��V/i/
\�oPN • ��
(Signature of otary Public-State of Flo ' a) (Sig ature of Notary Public-S ategf F ) o ••
Personall nown OR Produced Identification 1--� Personally Known OR Pmm,-cdd IdeoO i n _ Q=
Type of Identification Produced FL hi2/yjr;kS JjP_c-�1tC Type of Identification Produced �2�.e a- r<`'���•
Commission No. t-UMmissi No. �••p�
ROMAN CLARENC YNOMPSON
' /� 11�
a?ra • 1111111 t 1111 �
r PuwIc S •.nt ftOrid�
a• Commission 0 FF 946174
Revised 07/15/2014 %, ,•• 'My Comm-Expires Dec 27,2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS