HomeMy WebLinkAboutBuilding Permit Application •
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION.TO BE ACCEPTED `
Date: ,3/2///49Permit Number: `60.5 ` (5
Recerito
ca LI i .i T MAt
F L o R a r �. • 9 2010
Building Permit ApplicationpoiThlitln
Planning and Development Services 8t;LuceCOu RY eqF
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:
PROPOSED INPRQVEMENT LQC4Ti0N .. r
fe $ ��� i
., 4.
Address: /2 F 0 / orate 9 R .4'-'{ P , C.'P€ P 3 ep3
Legal Description: 9 3 39 del 41 it/E- ev,/ of w Y2 of 8 (. Y. 07(4,4,-.)"yo,-P
ye/ ar (/.511 opG)or(s-r0 -/770'
Property Tax ID#: ,2309 -3,2z-' 0002-0ac/7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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, � _•..,ae "t,. ,":.�.....,. --,.�._�...r.M.....r..v �....�_` ... ,m<.R....£ ,4,k;;;.‘
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®NSTRCTN NFORMAO
Additionl work tobperformed under this permit-chefiallhapply:
_Mechanical _Gas Tank • _Gas Piping yhutters Windows/Doors
Electric _Plumbing _Sprinklers _Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ ��y if .vo Utilities: _Sewer _Septic - Building Height: 02
OUV$NER%LESSEE " t C iNTRACTOR `
WAP'gra" z.3. .># �� "p r
Name % M/1 �YJ ie � , Name: .41/114.1
Address:
! I C
Address: X2/0 O OVA age. 44,y • - Company: C /00 " �,, i ems/ -,' �J 'f'1
. City: /Cjr (,7 fe State: F Address: ,6 2 3. - `v -z
Zip Code: 3 tie) qj Fax: A7' / City: 4 Cite State`/
Phone No.7 7G2- //tis--6g3.- Zip Code: 3 Zl9 VG Fax: 772-c/E/
E-Mail: /1//4 Phone No. 72x1 - 4/6/// //,( /
Fill in fee simple Title Holder on next page(if different E-Mail: c�i�, ��c,(� '6. Q /4-4d c7, /11
from the Owner listed above) State or County License: 5CC/3//S- S&J
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPREME w ,re v. ...' f,r: Wii� " ,. x"H I,y, ;4%.T'.,t �+. . r,., ,,, 3 �, ,I� *- , 4,£M: : "-9. k #,,
N AKONS T;RUOTI:ON LIEN L.A INFORMATION o4 � - 6
'R +^' &^'4 ,uti'r('^,a�.-rr"f`i oFi,''fi g.", 'h# ' :.s . a _ ,.iVi :. .?" ^, -, ? c 1'it `�"�a.fro.-`= t; lt):t, �,... .*'-1
DESIGNER/ENGINEER: y Not Applicable MORTGAGE COMPANY: V Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: V Not Applicable BONDING COMPANY: KNot 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 withany 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 thisrequestedpermit, 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 recordin: . our Notice of Commencement.
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•-•°°';,,,
Sig ature of gine ' Agent/Lessee ignature of Contractor/License Holder
STATE OF FLORI A STATE OF FLORIDA n
COUNTY OF at- L ..tie- (XCOUNTY OF - f`e
The for oing instrument was acknowledged before me The forgoing instrument was acknowledge.6 before me
this, day of ( , 201a by this day of NCC---( , 20 lby
1 CD'c.S c%_k,�t` t If OKI'aS -t,b'c Cr
(Name of person acknowledging) (Name of person acknowledging)
.-Altlak(1 4t10411 li,64fOrki' (684-/ ///-1
(Signature of Notary Public-State of Florida) (Signature of Notary Publi State„gf, cic a ,,.., . _. - "
PµY F„Bi/, S SAN A. EN
Personally Known OR Produced d i •c �.u... '.-rs ally Known F •,o...` . nf Florida
' " Type f Identification Prod�l'.:-F1''
„ `' ' h49111154QrStnrp
Type of Identification Produced � (,,� 0. YP - is¢inn #FF 231072
CG =* '° otary Public-State of Florida Cr— /f i/;FpFF.? My Comm.Expires Jul 28,2019
Commission No.T a3��c� `.a�:'e;�l� m ,fission No.I t� °ji' '
Commission#FF 23
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1 ';;r o oec My Comm.Expires Jul ,8,2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.7/2014