HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INF►O1 MUST BE COMPL ED FOR APPLICATION TO BE ACCEPTED ' I
Date: �'A� 1 Permit Number: ^ 0 `-t
RECEWED
Building Permit AP
lication FEB 2 3 2017
Planning and Development Services PERMITTING
Building and Code Regulation Division 5t. Lucie C unty, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 ommercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: 1
Address: 7 �Qfd ticg' 4 /p./.F45- ���Ca�/7
Legal Description: X CJ% .� , [ All e-
Property Tax ID#: �"'//- //- (a r7t7- Q U®�� Lot No.
Site Plan Name: Block No.
Project Name: '1 _ c��t�
Setbacks Front 2 7.3�` Back: 2 S � Right Side: /0, Left Side: 1_101A.1 10 DW,-91-c,W
DETAILED DESCRIPTION-OF WORK: cft)l\f t7��1 /-70 /61PA
03
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CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit-check all apply:
1]HVAC Gas Tank []Gas Piping _Shutters dows/Doors
Electric ❑_Plumbing Sprinklers Generator _Roo Roof pitch
Total Sq. Ft of Construction:2-fOf s 1'46(- �LS . Ft.of First Floo. :.2 P C) �'- fn 9
Cost of Construction:$ ��oac), yb Utilities: _Sewer _Septic Building Height:z
OWNER/LESSEE: - GONI"RACTOR: `r 4.
Name HIV .1 /(, Name:
Address:} e!!!&G1� Company:
City: -_fzfWfrP1 ✓S�r�''�� State:,�L- Address:
Zip Code:,19/9._ 7 Fax: City: State:
Phone No. / -,;70, " `/,2 i 7/ e7Z Zip Code: Fax:
E-Mail: Gt!e�OIi3' r1!'�/i'C�NG///.'+ �'�- Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAV1/ INFORMATION'..
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: —= - nr� Name:
Address: Address:
City: ® State: A"/ City: State:
Zip:0497,ePhone: — O 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 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 inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
/M
J s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF V-, I V G I 'C COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20/�by this day of .20 by
(Name of person ack dging) (Name of person acknowledging)
i
Signature Notary
y Public ate of Florida) (Signature of Notary Public-State of Florida)
onally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.Ff bLlidg
mmission No. (Seal)
SEAN MANN
NOury Public-State of Rod
'��� £•° My Comm.Expires Jun 22,2020
Revised 07/15/2014 „�;,;;���•' Sond�d through NaNiondNol�fy an.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS