HomeMy WebLinkAboutBuilding Permit Application (2) ;
All-APPLICABLE INFO MUST BE COMPLETt FOR-APPLICATION TO BE ACCEPTED
Date: I 1 7 / ' � - Permit Number:
Cis rx � �.sslr MP Building Permit A e'�
p lication PEf;N11I r,vG
Planning and Development Services St. Lucie County;, FL
Building and Code Regulation Division
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2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Res.7/intia y
PERMIT APPLICATION FOR:
PROPQS I i 0 NL IN LOCATION•
Address: qac5 n,-ainje— Ave, br-4- IS
Legal Description: on 6 e' 6
Property Tax ID#: 0I — OCR / L d0 —" Z Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Rig/tide: Left Side:
DE JL D � E�SC«aIP I'0 � ORK. -
i
al—
I S '
MWTRNUCTIO INFO AMA 0N.
Additional work to /ee
performed 'under this permit—check a that app y:
VElectric
Mechanical nk Gas Piping Shutters Windows/Doors
ing Sprinklers Generator _Roof Pi ch
Total S . Ft of Constr
q Sq. Ft.of First Floor:
Cost of Construction: Utilities: _Sewer _Septic Building Height:
I
OWNER LESS- CONTRACTOR.
Name Name: k
Address: � Company:
City: State: -Address: LlalM PL
Zip Cd'de Fax: City: 0i crc' State:
Phone ,o. %gid-SZip Code: Fax:
E-Mail: I . Phone No 1 s �
Fill in fee simple Title Holder on next page(if different -E-Mail L�
from the Owner listed above) -State or County Licens _, C -11501 isyl
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
S PP «ON TR '��I 0'N LIEN LAW EST,
ATI N:
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:
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 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.
Signature of Owner/Les a/Contractor as Agent for Owner Signature of Contractor/License-Holder _
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 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 acknowledging) (Name of person acknowledging)
" r
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR 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. 7/203.4
All APPLICABLE INFO MUST BE COATED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: J6- 03 7 V
RECEIVED!
ryv n
F � JUN-'9 9.1010
Building Permit Application Permitting Department
Planning and Development Services St.Lucie Countu
Building and Code Regulation Division
2300 Virginia enue, Fort Pierce FL 34982
Phone: (772)4 -1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLIC ION FOR: j
PROPOSED INPRQ _MENTLOCATION.
Address: XiA. ve
Legal Description:
Property Tax ID#: 60c) Lot No.
Site Plan Name: Block No.
i
Project Name:
Setbacks Front Back: Right Side: L Side:
DETAILED DESCRIPTION OF WORK
Pet.,4,,1 se
e— /l'�
CONSTRUCTION INFORMATION
Additional work to be per orme un er this perm! check all t a app y:
_Mechanical _Gas Tank s Piping Shutters _Windows Doors
,)0,Electric _Plumbing Sprinklers _G erator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Flo r:
Cost of Construction: $ . c� Utilities: —Sewer _Se•tic Building Height:
OWNER%LESSEE CONTRACTOR:
Name • •} Name: 1-0a
Address: Ll 6 o�''"' Ofn Ile A,Z Company: Lo'
„gCity: fC00 State: Address: 4.1 con k Ace,T
Zip Code: 3 Llq Fax: City: jO... &e(e— State: 'e
Phone No. "97.9 C) fp Zip Code: 3LI`3'S_1 Fax:
r
E-Mail: ,- a 1. �;r k,- 5 f/QQ c Irv, Phone No 7 79 .Q G 1.9
Fill in fee simple Title Holder n next page(if different E-Mail_
from the Owner listed above), State or County License 66C i 3 D-2 1 S' �
. I
If value of construction is 2500 orlmore,a RECORDED Notice of Commencement is required.
I ,
I
I
SUPRLEMENTAL CONSTRUCTION UEN;LAtN INFQRiVIAT14N:
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:
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 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.
Sig ature of Owner/Lessee/Contractor as Agent for Owner Signadire of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA ,.
COUNTY OF L'.[/Ld+� COUNTY OF L1JC J�-t
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this&�_day of 2PLN� 20ffby this day of 20 by
K t,A go/ 4- /"/('1h P-)
(Name of person acknowledging) (Name of person acknowledging)
` 9�/�i�l
(Signature of Notary Public-St of Florida ) (Signature of Notary Public- fate of Florida)
Personal) Known �Z
Personally Known OR Produced IdentifiF5S'�
im"- y OR Produced Identification
Type of Identification Type of Identification
Produced 1— Produced
Commission No. (Seal) Commission No. (Seal) 'anu�•�;
D
o
REVIEWS FRONT ZONING m PLANS VEGETATION SEA TURTLE M `;'
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE �- CO o Q m
RECEIVED ° o d
DATE N m<O. „'AZo c
COMPLETED N oX
ev.