HomeMy WebLinkAboutBuilding Permit Application � I
All APPLICABLE PFO MUST BE COM- ED FOR.APPLICATION TO BE ACCEPTED Date: Pe mit Number: I `.L� 1
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Building Permit Application PutAc khfur,,s
Planning and Development Services St. Lucie county, FL
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:
wR,'R0PQSED iNPROVESMENT LOCATION:
Address: iZD 6 -a YIFLI
Legal Description: SuJ6 � o ' M Vv .,o �.►'•-►�-,5 BIK � Lo^7"S a a��13
Property Tax ID#: It xa Sc)( (00 I 3� 00,9 o Lot No.
Site Plan Name: 146WIn f?-r dam, Block No.
Project Name: i`tCLJhiuy,
Setbacks Front_ Back: Right Side: Left Side:..
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Additionalwork to ed under this permit-check all that apply:
✓Mechanical _Gas Tank' _Gas Piping _Shutters _Windows/Doors
Electric Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor: Lt
i
Cost of Construction:$ 9 ?;, 00 O Utilities: -Sewer _Septic Building Height: i
N R{
Name Name:_Wl i c1y-L D f)Frwm tz1 w
Address: IL410 mur-l-t-f- r �-,�- ompany:, PF-r-za e oStd CAyi, 0'we4 yv % iptll.
City: r-1: P re n tate:_ ddress: RA 4o L•►,eso m e- P iv.- f y?G c
Zip Code: 3%-Iq q,2 Fax: City: ice', Stater
Phone No. -n2 Y I o Zip Code: ';YTYC Fax: 717- 116S' 7873
E-Mail:�-/11(-G pl G Phone No -772_ ,to/—']7q
Fill in fee simple Title Holder on next page(if different , E-Mail e4; rQh('yv�S-�iv1��QoL , C&A1
from the Owner listed above) State or County License ;40031-2.1
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
5�DPP EMENTAL CONSTR�t1CTl�N LI'�Eld LAIN I. F��� RMA�T1,0'�l '
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:, r_WL- Name: P&
Address: 266 p,c.L&Warr ave Address:
City: f i- Pile u State:FL- City: State:
Zip: zyT <-o Phone 772- V60 11-t2tfq Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: XI W 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.
'I- /Z/
---n & 4�� —AIL,
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF CZC A
The oing instrum t was ackgowI dg d before me The for oing instrum t was ac nowledge ore me
thi�day of 1 ( 20 by this�day of 20_ y
(Na of person acknowled ing) (Nam f person acknowledging)
Si re o ubl,'c- tate of Florida
(Signature of '- ubiii�'ta3�a ( ,rY )
1� J'jo, ANGELA M HUFF
rsonally Knbwt�' ����': l`&RedsML&99ifiedt'ro Personally Known'�_� «�Of Biro,ff 4d� o [catro
r state
TYPE of Id ' '� "' "'� "� = Commission�FF 234730 Type o en l l�a.� n��a �, Com oboe of Florida
try Comm.Expires May 27,20i9� mi o
Produced '%'F PO' M r,� ss� n#FF23
Produced J < •,�oF�,��, v mm i 4730
1�� NI IL nal Plot ary Assn.!' <- Bonded thr r-May 27 2019
�.. Commission No. oBliNatioli Assn.
Commission No. ry(Seal)` ��
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REV EW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/2014
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