HomeMy WebLinkAboutBuilding Permit Applicaiton t,y r1/4./ ALL APPLICA L INFO
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,
Date: i - - letC9 `.. J
Permit Number: 0o��
COUNTY -NJ':
•F L 0 R L D •Ii
Building Permit Application ,90
Planning and Development Services
Building and Code Regulation Division A' ✓9�O AGF®
2300 Virginia Avenue,Fort Pierce FL 34982 st•<% It
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Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re/g't '6 IaI
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSEDIMPROVEMENT LOCATION_ , 3 r y , , *
Address: ir1CI 5f Qlcckka C
Legal Description:(&\VC,C PrirY-
ert
Pro
p Y Tax ID#:344 I q -55 v Ol
3
-iocx) -2 Lot No. j
Site Plan Name:5 4*CAI C., N;,:kt-N,
Block;No. .) 1'
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED`DESCRIPTIOO I,OF WORK' g,m 3" r `
. i. . i.. .;lit.:"` ' -Y,. . c% ., �, _ yf. r .�r > ..�- Ffs n l f_
.#.;F��. ....;lv_>J ._ �.L-.�.,�Jz-, s.,+;>. , .-_�.:, �'...fiu f�,.��� ..i..!;,.�-:. � ,,,ai 7 .��`e�1? �.��..,.:f�T1.�•�4rf4.<
C.r1C3Q-OU c0C1 C nCJ 3.L..e Cir. e.--
CONSTRUCTION INFORMATION '
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Additional work to be erformed under this permit-check all- apply: �" E
HVAC L_Gas Tank nGas Piping 1 Shutters f�Windows/Do
gcs
El Electric ❑PlumbinEl
g Sprinklers Generator n Roof
Total Sq. Ft of Construction:q t uction: S . Ft.of First Floor:
Cost of Construction:$ of Pi 5,OCD Utilities: 1 Sewer OSeptic Building Height:
ht:
OWER/LESSEE. ,YF� i m"; ` r ; F , y , r A 4 t - �_ !
�-,..V.-:-...-,-.1:5.3._�.�h.0_34W,t,,._1 .1: .<t 1 7 . ..,`� :CONTRACTOR #. 0 y� f M T: r--R'
Name �52." '-f-/� � - �' - -�- t• -S. .,�-...::m�� ,.�-�,�.�,ct.. ;�.
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i,rzc-y Jm, Name:.._jL_u•rir���-iX:i.ri,r, - q:;cal cic'e
Address: ben{ Gfe i.( Oiui e., Company;—J, -
,
City: t✓o r f Pi e.rC t, State: F( Address: 6 Lt ip tl —7 Tfi ('/-1-- A;
Zip Code:3 qq,R3 Fax: City: I.0 & " k 0,-C c'C-'i o L� State: }=`-
Phone No. (,,.3gs-a62G Zip Code:SLI I D-- Fax: 5 L i . -.-,(5-5*---efo 5 9
E-Mail: Phone No. 57_,,t- f5-.`5-'S.- 4:-/0 5
Fill in fee simple Title Holder on next page(if different E-Mail: r.z Q_c.,(.Fi`0, ,/rtitr43rc)uPFGn1
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from the Owner listed above) State or County License:rs L &, e 0: 3 t.
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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'�=~� .alathreaa`~ ag~'~glliV- ---�&
DES|GPUE0/ENG190EE0: ___Not AppUc@U|e MORTGAGE COMPANY ___NotAoplic8bie
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not BONDING ��G�����: Not
�_. ___ Applicable -_-_ Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance ofa-permi1 _�'
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 requestedperm hereby that I will,iall respects,perform the wor
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
improvementstoyourprmper�/. ANoticeofCornrnenuennentnnus1berecordedandpostedontha 'obsita
before the
first inspection. |fyou intend to obtain financing, consult with lender or an attorney before
) commencing work or recording your Notice of Commencement.
,
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_Signature of Owner/Lesse A'gent e,^`'ture �ontracton/Ucen,eHolder
STATE OF FLORID � y� A' �QArEK�FFL0R / /_
COUNTY OF -�/ ' .�/�u~i� COUNTY OF ya/fry) �l
) Theforgoing instrument beforeme The o|nginstruTentvvasacknow|edge fore me
' this .�� day of ]y1�� ' '2O /-3 by
41L• ine �� `5
0&e--11A4 � ��
(Name of person ackn (Name of person acknowledging)
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/ \.)0 _____.-
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( '!'aturenfNotary Public-State of F
| hd�/ (Signature Notaryu—' r-
nfRnhda)
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Personally Known - r Personally Known OAProduced Iden��caton
Type of\ en���ti , ��@ ^���mo o|Florida � Type m*|uenunuanon Produced
.
Comn'eion*GGU*O1sO ^ mwo
Commission
Commission No. m � MyCmnmSomN»U:t^9'2Ouo'!, CommissionNo' uvcuw&A
wpF�mos
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sxmnsS:April 12,umm
il'e-Wc, Bondpd`������ms
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
' .
DATE
COMPLETE . ' _
INITIALS ^