HomeMy WebLinkAboutUntitled All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ���
Date: Permit Number: (T)
Ca Li f J Y. RECEIVED
F L 0, R 1 0 R.
Building Permit Application MAY 141019
Planning and Development Services
"flitting Department
P merit
Building and Code Regulation Division SE' 6dFle CAbney
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 . Commercial Residential (\
PERMIT APPLICATION FOR: 12 2
•`l -ate e,/,-)Ly
PROPOSED ONPROVEM 'LOCATIONo
Address: 2-LiS 3 IL.A.t S s-i �b � gteQ-e tL- (3'-1P(5
Legal Description: Pi,s ,4r/MS 3- 3 -t `I . ZS�c, Si c r D� 5 344..E 5- ,r-i 1i rtJ /7e, .rte
fiP c ?tb Ft or uu 3/'t /9 S fr-2 (42.-
Property
4z
Property Tax ID#: (3.pi v l -/yap(( non Q Lot No.
Site Plan Name: 4'Stoe,,v[e- Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
AILED DESCCR PTION @t WORK:
` b
et--vIJLov ANA) blk3 ( � � LaN
CONSTRUCTION [INFORMATION°
Additional work to be performed under this permit-check all that apply:
_Mechanical =Gas Tank Gas Piping _Shutters Windows/Doors''
Electric _Plumbing _Sprinklers _Generator Roof f 4 Pitch
Total Sq. Ft of Construction ,. tx 6/-)0 Sq. Ft. of First Floor:
Cost of Construction: r2L-Isw "`/ Utilities: _Sewer _Septic Building Height: I Sr
OWNER/LESSEEo CONTRACTOR
Name C t•tv-c5 4- =Dcatii Name: (i 41 ( gr-?1 .i&u
Address: 2)-15-3 �n tW4 n�.s 2.t� Company: (' rs-104 t �`(N d
City: Vii' p State:Li., Address: 3) -71 nt_ d Jt o - . ,SLUG
Zip Code: 34-co- ( Fax: City: State: ri,
Phone No. Zip Code: 151tg 2. Fax: 0-la0c"
E-Mail: Phone No '27Z `1
Fill in fee simple Title Holder on next page(if different E-Mail ('A-c ,..1 1(2,1)V:i Z,, u , (
from the Owner listed above) State or County License e ,(6,5533 /1S?-kg
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL C«ONS'TRUCTI®N LIEN LAW INFORMATI®No , ;�
...:.. b MORTGAGE COMPANY: Not Applicable
e
DESIGNER/ENGINEER: Not Applicable le
•
- Name: Ae. .,k )—Cci aNR(_. i jc., Name:
Address: gots pre.aA,.:Az 4,k)6 Address:
City: -0:— .,121.k- c2e.� State: eu City: State:
Zip: gq,G,cZ Phone 772..i-(4-,0 775-1. Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: 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 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 youypr perty. A Notice of Commencement must be recorded a • posted on the jobsite
before the first ',sp ctio% ou intend to obtain financing, consult withle.- or .#i attorney before
commencin: sr, or =cordi : our Notice of Commencement.
ArrW., ;)..--
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contrac or 'cense Holder
STATE OF FLORIDA STATE OF ,
COUNTY OF 3 k -
, ' -\- . COUNTY OF 4k .FLORIDA , veva
The for oing instrument was acknowledge before me The forgoing instrument was acknowledge before me
this \.1day of V`Nciti , 20\ by this day of �4. , 20\i by
SSS'ev -vN (-q6r\-o v. 44t1 -Ire.► v\. C q.s }®vvt u qj
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary P lic-State of Florida ) (Signature of Nota ublic-State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification ,_...,-. '..,.. Type of Identification - z-E "°
1 �.e-0 ., •-„-_ �= VEND
Produced \D _s.,- y . ?,4c�1s a Produced Lam.p° — „ , Re
' NAMhn?� 025 a °I1 a SGV 2'l0'L3
'''':1„'''''''' DENS 00 022 t, ,, flMt1�IS510N 020
Commission No. adv . i ,�- IV( ' }�s'1D'rber16,209 �r, COmmissi0n o S XY2G Decemb,cU( a1 -.
t r: '*' FxF1RES.De ulcu,„3„,niers Il ;.=TydThn lotatl Pub
Fa ;..r=: gande ,
'1 i :e�: Bonded l _...,---,-z,--.10 �,,,r,.....0"'+
REVIEWS FRONT',--. 'ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev. 7/2014