HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: e C . Permit Number: /& 0
RECEIVED
Building Permit Application -
Planning and Development Services AUG - 9 2016
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: To Select from dropbox, click arrow at the end of line
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PROPOSED(MPROU�EMILO�CA1`�101�,���al�,r�,.����._��.,}�. }a: �,, H��r�ra'az.���;r
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Property Tax ID #: 14A16 " b�C9��� — OP 0 I- Wn 7 Lot No.
Site Plan Name: P-19S<<ds/%'�; Block No.
Project Name: I,LJSl:�aS1!.`e
Setbacks Front IQ e Back: _,; / Right Side: —,Z_ Left Side: _� J
0,EU9 S io&JjE FAMI V /?,4S1 d kJC_6
Jd*it' nal work
L"_IHVAC
��,,yy
LdJElectric
to be ertormed
Gas Tank
Plumbing
under this permit — check an
[]Gas Piping .
❑Sprinklers
_
apply:
Shutters
Generator
endows/Doors
Roof
Total Sq. Ft of Construction: �'%2 Sq. Ft. of First Floor: 10 2 a
Cost of Construction: $ l i ' Utilities: —OSewer 0Septic Building Height;L dJ
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Address: s9si tb.k
City: ;i; �(--- S�ate: A_9z
Zip Code: _ ��3ftS,! Fax: Cgna
( Phone No. [� �' S2 �R
E-Mail: 01*21/ c CUM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:
Comps
City: ir^/</0 -State: i L'
Zip Code: � � Fax: 277 ?4i- 343')
Phone No. 4111 C3
E-Mail: 12uemc A/ efol, cam
State or County License: —C.6cd fax
f value of construction is $2500 or more, a RECORDED Notice of Commencement is required:: II
is
9-i
DESIGNER/ENGINEER: Not Applicable
Name: IDS[
Address: A 6 79-- 13:2
City: 5p 4_5 iA State: X1
Zip:, )!%�_1_J_ZPhone: '22 S �i�! "[XV_C4 _
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
— Not Applicable
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
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 l 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
q
ncin workorrecordir
V
of Owner/ Agent/ Lessee
Notice oT Lommencemen
er
STATE OF FLORI[ ,� AIM& sS ATE OF FLORIDA C�
COUNTY OF d I;L'�Q COUNTY OF (Q(/�
The r ing instru t w acknowledged efore me
this — day of 20 by
Personally Known,_ OR Produced Identification
Type of Identification PrQdi
..,_ p; KAREN LAVERA ---.
Commission No.-
yjyyy� [noires October 4, 2019
1!, A¢;:- __.,..+.T— Fain inulame 00.'IAr+101/
Revised 07/15/2014
The fo ging instru nt w s acknowledge efore me
this day of 20y
(Name of perso acknowledgin
(Signa ure of Notary Public- State of Florida )
Personally Known teooe'00011 Produced Identification,,
Type of
k; Comrnission P FF 2A4834
Commission No.:. (S al)-
?'''_�>: `r xoires Uc over , 2019 rr;
Bonded Thru Try; Fain Insurance 80038i701+;
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
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INITIALS
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