HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0y*T16an19 Permit Number: 0Ci
Building. Permit Application.
Planning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (172) 462-1578 Commercial Residential %
PERMIT APPUCA,TI0N FOR: otcbgr:
PROPOSED �1 iMbVEMENT LOCATION:
Address;? M9JTE1 BAN EST
Legal Description:. �Td9/TOJIJ4Nkk4A.,, bN�E9�
. Property Tax ID # 1414-591 701.099I Lot_ No.
Site Plan Name: AFANjSH 1AK0 9 Block No.
Project Name:
Setbacks . Front:140: Back: 92' Right Side: WW' Left Side:: 'fig ''
DETAILED DESCRIPTION 0 F WORK:
. .... .
DIRIVE-WAY - I2X04 AN912YI1316
THE DRIVEWAY DONNOT BUTT UP TO TEE MOBILLE RO E
CONSTRUCTION INFORMATION:
Additional wor.k to be nerformed under tis permit —,check all app y:
�HVAC.. Gas Tank - 0Gas.Piping _Shutters Qwindows/Doors
❑ Electric ❑ Plumbing Sprinklers EIGenerator El
Roof
Total Sq. Ft of Construction: 999 S Ft. of:First Floor:
-:Cost of Construction: $ 9., 9.�9 Utilities. Sewer -Septic Building Height:
.OWNER/LESSEE:.. ., `
CONTRACTOR:
NameiW,tgn,g§yk49tN999RP9,�-TtL9N .
Name: MAiir L�YLLI-EIiNI. .
Address:§999 9yTH tU W 'A §V"ITE-1492
Company: WYN, NE[P/ L®' W=W, 9t AITO0.
City: OJ §T l' State: ALL.
Add ress: M 0OWN 02 Imo• I AWIT�€- 42
Zip Code: 49§2 . Fax: �(772) M-700
City: PL0J; T.W, LLU_O,, € State L
Phone No.02),970-5.511
Zip'Code: �,4 521, ,� .. Fax: 2) §70-7
E-Mail:
Phone No. ((77-)A7L- 0
Fill in -fee simple Title Holder on next page (if -different
E-Mail:
from the Owner listed above)
State or County License: 090
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN SLAW INFORMATION:.
DESIGNER/ENGINEER: Not Applicable MORTGAGE.COMPANY: x_.Not Applicable
Name: Name:
Address: Address:'
City: state: !FL City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x- Not Applicable BONDING COMPANY: X .. Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
1 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 Horne 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'irispection. If.you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement..
Signature of Owner/ Agent/ Lessee .
Signature. of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF sT.:LUCIE
COUNTY OF:ST.-,UCIE
The forgoing instrument was acknowledgegL„before me
The forgoing instrument was acknowledged before me
5�'T&7+�9.
this+�day of S'tY�7'F7A6E�Z .D 4"lby,
thisR!tlay of 20,31D by
MATTHEW LYLEMVYNNE
MATTHEWIXIEWYNNE
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of NotJ& Public- State of Florida)
(Signature of Nota Public- State of Florida )
Personally Known x OR Produced Identification
Personally Known X . OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. —
DOROT YANN BASKIN
Commission No. •"''p.' .,
- �. - ,Y.;, OROTHYA IN -
; MY COMMISSION # GG 030 145.';
'. ;.; MY COMMISSION # GG 030145
r;
Bonded Thru NotarycPublic Underwriters I�'F�3 s�Z �� Bonded Thru Notary Public Underwriters
Fwvssed-(D7d>l
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION .
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW,
REVIEW
REVIEW
.REVIEW
DATE.
:COMPLIETE