HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 7 a�
Date:,.,_ �_ 9_ f Permit(dumber. � V U 2;
SJ 7,z I
_ RECEIVED
Building Permit Application FEB 112019
Planning and Development Services
Building and Code Regulation Division
2300VirginiaAvenue,Fort Pierce FL ST. Lucie C nty, Permitting
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPUCATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION
Address: rf C n ` fi rev C_ ,
Legal Description: 5 4-K CS h l tc e,r R-,(V,Y 0 5
I �
Property Tax ID#: �� ! ' �il1U� Lot No.
Site Plan Name: a tv ✓-& .4-F Block No.
I
-Project Name' k
Setbacks front Back: I Right Side: Left Side:
DETAILEDADESCRIPTION OF WORK
rtC, GC P 4Ir 6 d n C.1. S_
CONSTRUACT_ION INFORMATlO _ _
A itiona wo toe e orme" under tis permit-check all mat appy:
[]HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
Electric Plumbing OSprinkiers Generator Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
4
Cost of Construction:$ a06 C� I� Utilities: Sewer El Septic Building Height:
OWNER/LESSEE :CONTRACTOR
Name h� W' Yl 4 Name:
Address: L c-49(/" 1 Company: 1 r roc Pi-L
City: ' (r_//'C.P— , f State: L:. Addrei�4avc_e,
to F �c 6f a
Zip Code: Fax: A j/9' City:_ State: PC-
Phone No. Cr Zip Code:,3'(ff 5>- Fax: 7 7 a- tf6rr-r-70
E-Mail: Phone No.
Fill in feesimple TitlHolder on next page(if different E-Mail: ce ieclr qa__f
from the Owner listed above) State or Coun •cense:
If value of construction is$2500 or more,'RECORDED Notice of Commencement is required.
f
DESIGN ENGINEER: NotApplicable- MORTGAGE COMPANY: Not Applicable
Name.
Address: I Address:
Qty: 1 State: City: State:
_,..__
Zip: Phone: 1 Zip: Phone:
FEE SIMPLE Tn LE HOLDER:- ' 116tApplicable BONDING COMPANY: Not Applicable
Name: Name:
Address: ( Address:
C IRY• I Qhr.
Phone: I Zip: Phone: .
1 certify that no work or installation has commenced prior to the issuance of a permit
St Lurie Cou makes no rep on that Is grantft a permitwill auth:> .e the permit holderto build the subject structure
whidm�In a=Mct with app6ble Home ONmers on nde bylaws or and novena is that may rester or prohibit�rdr
structure.Pieces aorm�mit your Home Owners Association and revmew your deed for.any ons which may apply
In consideration ofthe gran ft ofthis requested permit;I do her eby agrw that I wilL in all respells,perform the work
in acwrdance with the approved plans,the Florida&Mding Codes and St Lucie County Amendments.
The fb1lowinglaillding permit applications ar*Pxemptfiom undera ft a full concurrency re4ew:room additions,
accessory strums,swimming pools,fenced walls,SWns,►screemroonand accessory uses to anotheruse
WARNING TO OWNER:Your failure to Record a Notice of Commencement nray r�esuR in yourwaaying tw!ke for
improvements to your property.A Notice of Commencement must be recorded and{costed on the jobdte
before the first inspection.If you intend to obtain financing oo It with lender or an attorney before
commendn work or recordin yourNotice of CommenceMe
7 r -
/&- - Z�L —Z
Swiatirre of Owner/Mwtj Lessee Swu mre of Contractoi/ticense Holder-
STATE OF.FLORIDA STATEOF TORIDA
O } �1
1(',!�COUNTY
The forte Instrurgm vim adarow!__r#gbreme Th 'mstrum was admowtedge`d�beftreme
tWs_- -dati►vf 20eT -�-� �-B�r b1►
(Name ofperson adomowledgt»g) (Nanmofpersonadamwiedging)
(SW ature of Notary Public-State of ) (S%pftre of Notary Public-Statie of Ronda)
Personally Known ✓ OR Produced Identification Personally Known OR Produced Iden
Type of IdermWkdIon Pwd aced I Type of Identification Produced
Commiission No, Commission No. '
=o"�YPua;,Sta�t�e of F orida-MgEarSP Public v• "'1 ,pG°` StaE orlda No eLSp N
• 7�8'� .rte _# ,W
fPk"`� M Commission Expires =' P�`, te -207484
o'r y i �ry Ofpk�`kt iviy Cc7rnmission
Rev�d0T/15 �u" June 12, 2,022 u„m Expires
..-June_1?, 2022
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REVIEWS FRONT ZONING SUPERVISOR_ PIANS VEGETATION SEATUKft.E MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW - REVIEW
DATE
COMPLETE
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