HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR'APPLICATION TO BE ACCEPTED
Date: 2- Z —) Permit Number:
.<,_...111111111111h RECEIV-:D FEB 23 2017
Building Permit Application
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line, C
PRO,ROS,ED IM,PROVEMEtVT LOCATlO"N:`
Address: 1 070 ( 3 oC f&-, (br. Lo�:+,- K(z
Legal Description:I��n�"t,t�e QcJ d -Tno--(n 9.iJ-6— IncLQ-F $LQf (DE
Property Tax ID#: 4511 -51 Do(vq — on o -3 Lot No.V a�?_
Site Plan Name:(( Block No.
Project Name: L- &s o S o
Setbacks Front 'Back: ,O Right Side: Left'Side:
DETAIL ED.bE5CRIPTION ,OF WORK:fleav-
AN N + 3
13s �
EcONSTRUCTlOIU INFORMATION,:
Additionalwork to be pe o'rme un er t is permit-check all that apply:
HVAC _Gas,Tank _ Gas Piping i Shutters _Windows/Doors
_Electric _Plumbing i Sprinklers _Generator `Roof Roof pitch
Total Sq. Ft of Construction: n Sq. Ft.offlrst Floor:
Cost of Construction:$, Utilities: —Sewer _Septic Building Height:
IP
OWNER/LESSEE:
CONTRACTOR:
Name S iCV L�2 L0 G,SS O Name:
Address: 10761 D ' l o 63 Company: f%,- -&nO.
City: S L State: Adclress:N ;✓ wWj aR:r i�,
Zip-Code: `�9 Fax: City: PS L.- Stater
Phone No. 77�,' ��/Z� �Q C� Zip Code: 3`-KN Fax:
E-Mail: Phone No. ( 1-7Z0 BSIZ 32-UZ
Fill in fee simple Title Holder on next page(if different E-Mail: 6 (,,.Q of- cp o
from.the Owner listed above) State%or County License: A�II . `'1 CI (D
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
2617
SUPPLEETAL. iV
r�11> a u txFaR � �o�
Not:A,pilcable- Not Applicable,
DEStGNER/ENGtNEER: P iBAORTGAGE COMPANY.
tame: Name:
:Address Address:
ny:.__
Stater - -. City:. State,.
Zip:. Phone; Zip; Phone-
FEE SIMPLE TIT1E MOWER: a> Apphcaile " BQNDING:COMPANY; - Not Applicable;
Name: Name:
Address -... Address:
Clty:. - 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 ppermit:will authonze the'permit holder to build the subject structure
01ch is in conflict with,any applicable,Hon O OwnerS�AS 1ation.rules,:bylaw's or:and covenants that may restrict or prohibit such
structure,,Piease consult With your Home OwngrsAtsociation:and review-your deed for any restrictions which.mayapply.
In;consideration of the granting of this requested permit,I da hereby.agree:ttiat 1,wilt,,in all respects,perform:the.work
in accordance vikh-the approved plans,:the Florida Build'irig Codes and St.Lucie County Ais endments..
Tha.followfng buildtn g permit applications are exempt from undergoiog:a fufl cancurrericy nsvtew:rooin.addittans,
accessory structures,'svvimming pools,fences,walis,stgns screen rooms and:accessory uses to another non-residential use
WARNING TO.OWNER:Your failureto'Record aNbtfm of Cornmeitcement may-result in your paying twice far
improvements to•yourproperty.A Notice of:Commencemeri.t:must be recorded and posted on the jobsite
befr?re the first inspection:,lf.you intend'to obtain financing,consult with lerldr or.an'attorney before
_commencn 'Work or recordiri our Notice of Comrilencement. .
_ I+J 5
Sig ure of Ow s ontractor as Agent:or Owner ['Signature of Contfactor License HoioTer
STATE OF FLORID — STATE OF FLOR' A .
COUNTY OF . L.icC i e - COUNTY OF ti�cre:_
- -
The fo o'ng ins`tru t"was acknowledged before me The forgaing4ristrumerit was acknowledged before.rite
this. -;�Z.0 ,17 20 Ljbr this122 pf R16 _ .20 t7 by
(Name of;person.acknowledging;) _ (Name ofpersonacknowledging)
(Signature of.Notary Public-State of,Florida.' {Signature of Plotary Public-State of Florida
Personally Known QR Produced identification - Personalty Knovrn'_ OR Produced lde0ification
Type of tde»tificatian Produreii _ - f pe:of identification Produced
Ci3MMISSli3tt,rt
Commission No. a eaIL��R S mmis5ion;No. { KARITiD-CH
aPiES MlaYie,=U W OMPIG
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Rea-i-xt1=0 t 15# 01-1
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION 'SEA TURTLE MANGROVE.
REVIEW COUNTER REVIEW REVIEW REVIEW ' REVIEW - � REVIEW
DATE ,.
COMPLETE
INITIALS s )