HomeMy WebLinkAboutBuilding Permit Application t.
ALLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE A CCEPTED
Date: (o Pe mit:Nu _
4U@ Wga2daQ .5UP4!WJ;Dd
Building Permit.Appl catic n 8102 0 Z Nnr
Planning and Development-Services
8411ding and Code Regulation D►vlslon
.2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:.(772)462-1578 Commercial
PERMIT APPLICATION FOR* 'To Select from dropbox,click e rrow,at the end bUline
aPRQPQSED IMPROVEMENT LOCATION.
Address: &Q& C iv 1.» S7
Legal Description: e_ 6! p"3
Property Tax ID 8 __- _ i . $ N- 2,•.DOhB'000 Lot No.-_
She'Plan Name: x L U Block No. _
Project Name: ..
SetbacksFrontes . _Sack:�Right Side: lL ft Sider
�DETAILEOtiDESCRII?TIONOF VIIORK• '
De mov64 ,J att 'n dt-►oe
;CONSTRUCTIONINFORMATION
Additional work oe orme under is perm -check a appy:
IDHVAC flasTank ❑Gas Piping LJ Shu errs 'Windows/Doors
UElectric Plumbing ❑Sprinklers []Generator Roof Roof pitch
Total Sq.Ft of Construction. y. g2 5 .Ft.of First Floor:
Cost of Construction:$? ,.foci- o� I IJtilities:QSew r ElSeptic- Building Height:
01NNER/LESSEE f»,:, A "-CONT OR
Name-3' E.df Sa%6-e r Namei
Address: 34o 1 P.Cr -Font Trra; _ Company: '
City: Ford W*,e AA. �State:-()( Address: V
Zip Code: '71#109 Fax: g 7t—SK L-.72.%d City: State:��
.Phone No., .3 Zip Code: 34.Ti H Fax:7 7 1-!'78 -H'S0S'
E-Mail: Sei f fr&,% . to • Phone No.'77Z-7B vO
Fill in fee simple Title Holder on next page(1f,d(fferent E-Mail: @ 4 QR S6i
from the Owner listed above) , State or County License: 4
If value of construction is$2500 or more,a RECORDED Notice of Commence ent is required.
gt'IPPI; Elri iV7°�L(C�NSTF U C10N I:fEN LAIN INFCJRNIl� I_
- _ - :
DESIGNER ENGINEER: _Not A plicable MORTGAG E COMPANY: Not Applicable
Name: 1M.A. C fsov,&& Accoc. Name:
Address: t% S6 Qcckft Slyt. Address:
City: S4-uaet• State: FL. City: State:
Zip: Mckillo Phone M•27.3 - SaL-' Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDINGCOMPANY: , 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.
1 certify that no work or installation has commenced prior to the Issuance of a prmit.
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 o 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 will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie ounty Amendments.
The following building permit applications are exempt from undergoing a full co currency 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 Commencer ient 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 sul wit nder or an orne before
commencingwork or recording -M Notice of Commen ent
I "—�XVrl L�L
Signatur Owner)Lessee/Contractor as Agent for Owner Signature o ntractor/U n Holder
ST TE OF FLORIDA STATE OF ORIDA
COUNTY OF COUNTY C 1F Lia A, n
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 32:�day of SL I vt Z ,20 )�by this i i da of ����- 20 K by
x'120 �er' i� Ca �� vi Abi-C-16J-u
Name of persorymaking statement N ai ne of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced , Produced
(Signature f Notaff I .. (Signature c f Notary Public-State of Florida)
State of Texas z�arat�, LAURAJ.COLWELL
Commission No. vT };� Comm. 202)
s 02-16-2022 FF Mrd 7y .�����. COMMISSION 90'
( f}? Commission No. S���r
Notary ID 129708440 ae EXPII1ES:A;M6•
���50@ tIISPrat
REVIEWS FRONT ZONING SUPERVISOR PLANS YEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COiu1PLETED F T
Rev.8/2/17