HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ll '7
Date: _� Permit Number: I (OS 01 ar_�
R
Building Permit Application MAR Q-6 �r3d
Planning and Development Services
Building and Code Regulation Division Fes. •f t c .a
2300 Virginia Avenue,Fort Pierce FL 34982 5t.Lucie t;ouyt�ty, FL
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential �—'
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line S
P;ROPOSEDI P OUEMENTI:OGATION ` zKfi,
Address: Zt7 SO w h i ( ro,i
Legal Description: ( $ ;3q q-0 i�,f `/2. y-j' ) w '/,-I 0-p- SLO r/y
`"4 o-F r'lt; `�q — (ass 1.J 3,0 _ ., ` . ! 6 ilC: " o►� 3 Y(OS-5
Property Tax ID#: Lit F-- / 33 - O D I S - 000 3 Lot No.
Site Plan Name: f - Block No.
Project Name: `1 L'1 - 8
Setbacks Fron Back; Right Sider Left Sid �)
t
3 t
cf
CONSTRUCTION
•,es,... 4.. ._ ...,•�.T :...�.-, .... , u..-x ,,, a.,x ...,s.,. .��....».,s f.,-. ..,,:, i t.. J•s., ?d a-,
Additional work to e e orme under this permit-c ec a apply:
L=IHVAC Ei Gas Tank Gas Piping- _Shutters a Windows/Doors
ErElectric 0 Plumbing Sprinklers Generator L=1 Roof
Total Sq. Ft of Construction: SS S . Ft.of First Floor:
Cost of Construction:$ 114, i f]0(7. f Utilities: Sewer Septic Building Height:
x -
�1NNER/,LESSEE xk r t CONTRACTaRc x E` � ', ,
;
Name J O5-e ✓oLLj Fe r,5 ck _ Name:
Address: Z 13 1 l+VP- �.t,o Company:
�..
City: ✓t t-D Se P e k State: FL Address:',.,,`,
Zip Code: 32-a!6 Z Fax: City: _ _ yam ir. State:
Phone No. -7-7 Z-`7-10" 3(o6 I Zip Code: Fax:
E-Mail: i lW �g,-S Ch @ q tiviGi 6-0✓h 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.
: UPPLEMENTA CONSTRICTION j:IEIV IAUU 1NFRMATlO ` � �rt s $i ' �
e��,,u._ >.F,�:,� .n+ � ,.._,..r.�.-...§� ___._. ., „eTi.,.�{x',�za1�e..,�.f 3m ,�'a,7„.k4}:.9.,..�.ari. ..�s.•.» ..< ,.5're��?xisr.aroa-....,, ..sx.� x,.<.-1�_ . � ta.<.a �s vx ..�:,>1a�''v`. ,n;:.'ax
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: 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.
d
Sign ure Owner/Agent/Lessee Signature of Contractor/License Holder 4
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ., „� COUNTY OF
The forgoing instrument was acknowledged Pefore me The forgoing instrument was acknowledged before me
this j day of K 20 110by this day of 2014 by
(Name person acknowledging) (Name of person acknowledging)
( ignature of Notary Public-Staite of Florida) (Signature of Notary Public-State of Florida)
Personally Known-OR, oduced Identification Pe rso al y,Known OR Produced Identification
Type of Identification ProducedLAS! G Mpe o entification Produced
9l c� 33
{ ; 11111
v o°`�-. Notary Public-State of Florid
Commission No. if �I fission No. (Seal)
•_ 11y Comm.Expires Dec (�,�� ,
Commission # FF 177249 {
di o j
0
Budd thrmylHilfianai
Revised 07/15/2014
REVIEWS FRONT ZONING . SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIiEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS