HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: t:!r/2• 1-7Permit Number: /
• .r:,. RECEIVES',
Building Permit Application
Planning and Development Services MAY 1 9 2011
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: Other
-PROPOSED IMPROVEMENT LOCATION:
Address:]y2q (&R&LS PLAa POQ7 57 WC16 F(., 3z&aC
Legal Description: 644cE2 16A AT VF_ RESEUL UJI 12 (oX-.371(c-1 qe7)
Property Tax ID#:_33 22 - 561-6015. 600 - Lot No.
Site Plan Name: 04-re"1 'gesiD NC.c Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
74JS7A L 2"K(Z`, Remt &/AIFa&60 r-Dd
0 U(2 J(.+GI f(() - ) �Oe in / �✓��v e�
s
CONSTRUCTION INFORMATION:
Additional work to be rtormed under this permit-check all that apply:
�HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers ElGenerator [] Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 22-00-00 Utilities:In Sewer O Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name d r0_7 f3e70.J Name: Ryan Figman
Address:7142c/LAIJQEL5 PeA&C Company: Apex Pavers & Pools
City:&JX/UClE State: F�- Address: 725 SE Lincoln Ave
Zip Code:3gf ft- Fax: City: Stuart State:FL
Phone No. 7?2-2-33-g393 Zip Code: 34994 Fax: 772-5101
E-Mail: Phone No. 772-419-5151
Fill in fee simple Title Holder on next page(if different E-Mail: jscalise@apexpavers.com
from the Owner listed above) State or County License: 23896
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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
commeUing work or recording our Notice of Commencement.
s
Signatu of Owner/ essee/Contract r as Agent for Owner Sigriatufe of Contr ctor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF AP_((/J COUNTY OF }P-71d
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this M day of �'( 20 �by this(�day of i-1Aq 20 11_by
�4d^J 2y Fi6MAiJ
(Name of person acknowledging) (Name of person acknowledging)
(Sign ure of Nota Public-State of Florida) (Signs r of Nota blic-State of Florida)
Personally Known OR Produced Identification '� Personally Known **� OR Produced Identification
Type of Identificati n P (03 SS/_gWO Type of Id
;'.�:• JULIE M SCA " JULIE M SCALISE
Commis Ltif1 INV�. gglpN#a 20 Commissio o IiAAA ION��r�4020
EXPIRES April 08,2021 EXPIRES Apri106,2021
Revise 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REV EW REVIEW REVIEW REVIEW
DATE
COMPLETE I It j
INITIALS