HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /)
Date: 7-/ 7 �� Permit Number: OV� (�3
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Building Permit Application PerJULJUL
g Department
Planning and Development Services st. Lucie County
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 IMPROVEMENT LOCATION:
Address: 617 Ale ///er Jia,; -ei 13ecc4 /!GL- 3 x/9\5 7'
Legal Description:�L 1%lef l.� .G.17L • < �'Z`'�� ` Y5-.2)
Property Tax ID #: yFQ,? - 570/ ` OF11/- 000" Lot No. Z5'5-
Site Plan Name: zVe'11/f1 Block No.
Project Name: D'575'
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
C om 1G e re-n o tC /r1�9;/e `j rn e cl�r el
CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit-check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _ Plumbing _Sprinklers _Generator _ Roof Pitch
Total Sq. Ft of Construction: 4021 Sq. Ft. of First Floor: d22
Cost of Construction: $ 19049." Utilities: 'Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name/YI c_ a / , a tr%C�a_ /darn/ems/ Name: AIJijJA
Address: Ra CaJfle R Company:,"m ),' x'-4 /30L,4� Svc. i'ic.
City: State: 0 l Address:
�
Zip Code: y�3`/� Fax: City: State: /C:2•
Phone No. �Dy' y��/- 05-2 7 Zip Code: .3yy5 ' Fax:772-)-3) -2191
E-Mail: Phone No 771'2-0- 375'
Fill in fee simple Title Holder on next page ( if different E-Mail 4Gl'i t"_r " AA;'7c P yaiea • C-0rn
from the Owner listed above) State or County License G86 /25-/9,7/
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: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 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 cp recording o17
A"Al
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor icense Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF �r� L_oc —/ COUNTY OF 3/ ULiY
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�day of A�1 ,204by this Z day of )1 2014-6y
(Name of person acknowledging) (Name of person acknowledging)
zol�,� — X r
(Signature of Notary Public- ate of Florida ) (Signature of Notary Public- ate of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification - Type of Identification
Produced '>L— .��':'NotProduced
Commission No. (Se Commission No. (Seal
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REVIEWS FRONT ZONING # R PLANS VEGETATION SEA TURTLE Amu
COUNTER REVIEW 2 N
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REVIEW REVIEW REVIEW V
DATE '" d rn o' z 00
RECEIVED �� G)o c N m 0
DATE oX�! T, N�.w< p
COMPLETED N�.w_0211m ^'
ke—v. 7/2014
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