HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: fJ( 17 Permit Number: / � - ®� �•
IT RECEIVED
Building Permit Application FEB /9 2017
Planning and Development Services
Building and Code Regulatio'ri 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
PROPOSED IMPROVEMENT LOCATION:
Address: P
Legal Description -zS\ard4 lSJ�yJ�QI���YC2.� `tom
Property Tax ID#: f�j _eJU\^yD-lo�"CX7��' Lot No.
Site Plan Name: ; . Blo',ck.No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
—��t -P��;�s Qom•��.mu..,�� c�c�
CONSTRUCTION INFORMATION:
Additional work to e nertormed un er t is permit-c hecka a apply:
[1HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric Plumbing O$prinklers I Generator 11 Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$c���cx�• l�O Utilities. Sewer❑Septic Building Height:
OWNER/LESSEE- CONTRACTOR:
Nam i��"pk�Px . Name:
Address:y6_g � T l � Company. Lbda
1
City: Paechz State Address-(So
Zi_p Code3 - Fax: City State
Phone No,.--I-1--j-• 44-14 Zip Code&M a Fax:
E-Mail_4-A 1 a bT0CQ&.ARA Phone No.'_In -
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License 2t13U5-
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
r.
17� IL
SUPPLEMENTAL CONSTRUCTION LIEN LAW.INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name. k wa- Lo Name:
Address 90 G¢ Address:
City: F -5 \, a State- ) City: State:
Zip:3gg53 Phone:--i'iZ- ?J.s�b- Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
'Name: Name:
Address: Address:
City: City:
Zip: Phone: 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 Hof the granting of this requested permit,1 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 wor cording our Notice of Commencement.
s
Signature of Owner essee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA J STATE OF FL RIDA.
COUNTY OF ,��v��� /s�Gr cum COUNTY OF�r vl -- Cat �.
The for pping instr�nnen.was acknowledged before me The fo�ng instrurr�nt was acknowledged before me
this `"bay of zot�by this day of 20 by
(Name of person c ) (Name of p a7ning)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification �^
Type of Identification Produced Type of Identification Produced ?EC� 19 L—
Commissiori'No. 1113 p&•. I Commission No. ea
Commission
�F I U 3-� �� : Notary Public-State of Florida f f gL11 f :,�►" �;, LIRA URI L
Notary Public State of Florida
%•F dr,�� = Commiss on
Revised 07/15/201 "�FL,�� My Comm.Expires Sep 27,2019 �,, My.Comm.Expires Sep 27.2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVII`EW° REVjEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS �'
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: sue: r 17jt1 / Lo�� . Permit Number: `��- ram•
RECEI
Building Perm' Application FEB 19 2017
Planning and Development Services � ��s ' ")cGq
rBuilding and Code Re ulation Division 1 h
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 ;
PROPOSED IMPR01%EMEIVT LOCATION �, '�`�,� `�t '���, � � �i ; �,_•� ' �``
Address:Llo L 1 ,
Legal Descriptionfae ) -e- ram, �v cz Zio 0(_,_SL__VQLY_C_J 4U9
Property Tax ID#:� �—Jam,—�D-1�"�X�� Lot No.
Site Plan Name: . . Blo'pk No..
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION
4 C IMCEIVED
FEB 20017
1017
!IRONMENTAL
Additional work to be nertormed under this permit—check all t=apply:
aHVAC .Gas Tank ❑Gas Piping _Shutters a Windows/Doors
aElectric Q Plumbing ❑Sprinklers Generator L Roof . Roof pitch
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:QJ Lk�• vo Utilities:11 Sewer Septic Building Height:
_,e:- ,4 t., s . .£ 3 - ^r, e,_ +-1 Y, ' t . � hL .�*.;.e_ t.or. .i.. &13 �� f.t.• a. .rya;
Namtf, Name:
Address:yd� E,S Company. AD
City: X, Stater --Addtreesss:�q la
Zip Code 399a!1 - Fax: City:rt .�I � State
'1
Phone No`l`1�— `1`t Zip CodeNqq a Fax:
E-Mail: dCemm&.ADA Phone No."In
Fill in fee simple Title Holder on next page if different _ E-Mail:
from the Owner listed above) State or County License 2BLo%+b
If value of construction is$Z500 or more,a RECORDED Notice of Commencement is required..