HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� • /!7, Permit Number: ( yl S"'
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REGEOVED
.. .. .Building Permit Application FEB 2 4 2017'
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential y
PERMIT APPLICATION FOR:
PROPOSED 1NPROEMENT QCA�TI�O,N �`
Address: S7I i'UW Wo I/ be.ry^ L—IV�
`Legal Description: V_`k.)aK- P144— Il o l-0-r 1 (oA-3,3 S J—1(03
PropertyTax ID#: ��3� "��T�— dU 13—OOC y Lot No.
Site Plan Name: �"Ovz' 1���,p Block No..
Project Name: SC�wait'�"�''
Setbacks Front Back: Right Side: Left Side:
D TA�ILEkD D CRfPTION QF Will
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541.
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AdditionalworK to be performed under this permit—check all t at,app y-_
J�echanical Gas Tank _Gas Piping _Shutters _Windows/Doors
�ctric Plumbing _Sprinklers _Generator _Roof
Total Sq. Ft of Construction: 1000 Sq. Ft.off First Floor:
Cost of Construction: $ ( g U 00. Utilities: ✓Sewer _Septic Building Height:
VOWVERjE�SSET 41VTR q?�OR.",:7at _.. _:*x* _+"�'a rc;M ?...t _._ .n,: ... ,.
Name Anne �twq/ Z Name:
Address: 2SI( lV'w b gtv Lj�Mq 1, Company: � ��?2��� i� L S�
City: ()CJ;i 47 State: r� Address: I a Z 1U LJ I Jfo view S7—
Zip Code: 3YIi 9 O Fax: City: Poa � S (— L,,-uB Stater
Phone No. 2 0•-2 92— 3 00 O Zip Code:3 Y q ?3 Fax:
E-Mail: Phone No 73Z-3 S1-33o0 33 1�
Fill in fee simple Title Holder on next page (if different E-Mail °.���0 5� 5 Q 1 Sau4l.kzl'
from the Owner listed above) State or County License 'Z°12g
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
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S�IJ�APtEMENTAL CONSTRtUrvT1'®N LIEN LAW I.NF,QRMAI"10.N:
64
DESIGNER/ENGII EER: c Not Applicable MORTGAGE.COMPANY: Not Applicable
Name: �4 A W o Name:
Address:2o St ode&.,. 8( Address:
City: 24viii=f State:- City: State:
Zip: 3499(a Phone :M-2'W-"Ll-+ Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 fo'r any restrictions which may apply.
In consideration of the`grantirig of this'requested permit, I do;hereby agree that I will,Iin 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
comrp.qncing work or recording our Notice of Commencement.
Signature of Owner/.Lessee/Contractor as A e r .,Signature of Contractor/License Holder
STATE OF FLORIID AW. STATE OF FLORIDA
COUNTY OF a X�y "COUNTY OF - a
z m�m
The forgoing instru ent was acknowledged be 4;M The forgo!ngJnstrume was acknowledge befo
this ay of 20 b w g thi day of 20 by Q z
�- A i'pn N--•a
/•//�/�'] �(�f�', yip �O V
CON
N
(Name of person acknowledging) (Name of person acknowledging)
f
(Signature of ary�blate o Flori a) (Signature of Nota ublic-State:o Florida)Personally Known Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Commission.No.;-. •(Seal) Commission No.. (Seal) -
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014