HomeMy WebLinkAboutUntitled ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S/2€01 Permit Number: 1 V)S- - 1)* 1 7
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Cfou r\rrY REceiveD
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Building Permit Application 1444Y 272010
Planning and Development Services Permitt
ng DePa
Building and Code R6gulation Division St.Lucie r rtment
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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
Address: - '''Yt WI
Legal Description: ...cA. 1 t..i,ti t.' 6 aP,e-le:it) ,441-/ / -1-.2 G.0 71,1 01.0,77/e. -ex ei-r.A7v-
Property Tax ID#:,,,,3%?6, N2 /h24: -000 -e Lot No. €1)
Site Plan Name: Block No. i 4 3--
Project Name: Ma,/)il ejtr4
Setbacks Front Back: Right Side: Left Side:
Aellipt., S e/4-101 )041 do I Af c kvik. -'
f7-;-Tg•;;--::77-7": '.,',- 7_,,,-:_:-.,--,-7.-
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..itio-na—wor to-
..-47 -oinie-• _"tin.a-r-.1 iiOriii if—6 k a 1- appy: -,
EIHVAC ` I _I Gas Tank EGas Piping A. hutters7 Ll Windows/Doors --..
E.Electric I:I Plumbing Sprinklers rl Generator ri Roof
Total Sq,Ft of Construction: SVII of First Floor:
Cost of Construction:$ 2J' ' q a Utilities:I 'Sewer ri Septic Building Height:
Name o eipA A 1Y2 enfl4 Name:IZI•ivta.,r (1.'44>) 6
Address:, 8 to si et,n jidoey ev-cl Company: Co 4.0.,/,rh..zre,v, go,1,04,472:he,
City: Ade/ (.4,4. 4 Le 4-(7. State: ri Address: 6.2a.‘ ,r/.. et,
Zip Code: Fax: City: 1-7/. A •-4-e, State:he
Phone No.021/9-tap '/J Zip Code: -3 y-, ,6 Fax:7 72-4411-06 E-Mail: Phone"."714 Phone No. 7 7.2-ia/-011/‘
Fill in fee simple Title Holder on next page(if different E-Mail: rip em. Sktio re- a)414.-0 Co- i'-.
from the Owner listed above) State or County License:,(ce-t 3 ats-ls-2,J2
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: ,CNot Applicable •
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: .Y Not Applicable BONDING COMPANY: iknot 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 your Notice of Commencement.
rMIIIIIIMMIIIIIMI1C
_Signature of Owner/Lessee/Agent . - 4;,--,1. gnature of Contractor/License Holder. :•-.,5 N,;
STATE OF FLORIDA'
STATE OF FLORIDA 1 +:.z *a.��
COUNTY OF SI-.LUUe. COUNTY OF -.VI ICJ f 1
The forgoing instrument was acknowledged before, .n g p,
The forgoing instrument was acknowledged,19e . rin�.�� g g g �� .� �
thisa - day of CY)(13- , 20 b a,g:tc thisaq day of,lj }C _.. ,20 1g, by 1
1 v i
ofperson acknowledging "2 a Name ofperson acknowledging in ) 1 �; El x'
(Name � g) { � g
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4--CAC A M L OP C 1)0 0 0 ' U2t-a I
(Signature of Notary Public-State of Florida) ,✓"(Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification 1 Personally Known OR Produced Identification
Type of Identification Produced 1..O(1V€j , Uull1 I L Type of Identification Produced .s .1 'y ! a '
Commission No. CSI) vas i (Seal) Commission No.GIvlI t,OD-St • (Seal)
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Revised 07/15/2014 - -
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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