HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE;COMPLE ED FOR APPLICATION TO BE ACCEPTED - �/
Date: cal O[ ' Permit Number: �/ ��—0 1)�J
Building Permit Application FEB /2 2017
Planning and Development Services
Building and Code Regulation Division e
2300 Virginia Avenue,Fort Pierce FL 34982 _
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
PR®POSED I ROUEM NT LACAINT,I X N:
Address: 3r181 S. 254h. FT R ERcE El
i
Legal Description:
Property Tax ID#: 2429 444, QW3 0 00 8 Lot No.
Site Plan Name: Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side:
MR90 ► G I � W WO K
ep AID Evsmm6 /G ceCl p o r it
CQN'ST �UCTI® 1 ki 1 1
Additional work to be pertormed under this permit-check all that apply:
_Mechanical Gas Tank Gas Piping _Shutters =Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Imo-' Cost of Construction.$ Utilities: —Sewer' _Septic Building Height:
MN 0
Name z N 402Wf IoR ST� 4-L
C. Name: "RAX60
Address: 70U S Srtolor k, Company: 1,-� LA1 Ck
n .CoA94:'y: c.. I
City: Poku ST. L ��` State: 51 Address: A 9 RoM
Zip Code: 34986 Fax: City: FT'"P►F2CE_'- .,.t`-fi Stater)
Phone No. Zip Code: 340 4S ,�Fax:
E-Mail: Phone No 772'— 979-'C46S
Fill in fee simple Title Holder on next page (if different E-Mail L&Dsc6x Q' se -,q6A . n°&
from the Owner listed above) State or County.License C$c, 125907! -
AT.I.SCA
if value of construction is 2500 for more,a RECORDED Notice of Commencement is required.
i
S P CDNS R� I N U 0
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: n s Name:
Addre Z d o �� �� uJ Address:
City: K. a..., State: F I - City: State:
Zip:�3 e14S'"2_ Phone 3 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 covenantsithat may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for'ariy 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 recordiQ4 your Notice of Commencement.
n
Signat o caner/Lessee ntractor as Agent for Owner Signat re of Contractor icense Holder .
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �
COUNTY OF Loe to
The fS g instru t was acknowledge efore me The for g instrume was acl owledged efore me
this/ of 2QLWby this�y of ' 20 by
(Name of person acknowledging), (Name of rson acknowledging)
.(Signature of Notary, `lic- tare f Flori ) (Signature of Notary
-P 1 c-State o F.lorid
Personally Known v OR Produced ntification Personally Known V OR Produced I ification
Type of Identification - - Type ofli'enill;
Produced Produ eci'�PH� °-i BRENDA J.I
.�= Notary public-state..ot Florida
,ot►HYP�e.,� BRENDNJ. KFFNEY -
• : •e My Comm.Expires Jul 22,2� 9
Commissio f5i*•` �," Notary public; Stat�Setallloiida Com ss
omm.Expires Ju122,2017 FOFr�op:' mmtsston#FF 004851
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"'�.i"`', Bonded Through National Notary Assn.
Commission#FF 00485f
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REVIEWS FRON TM ERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED.
DATE
COMPLETED-
ev.7/2014
III