HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLE' r FOR APPLICATION'TO BE ACCEPTED'
Date: Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 .
Phone: (7-72) 462-1553 Fax: (772) 462-1578
Address:
Legal Description:
RECE•I'"�D FEB 4 9 2016 RECEIVED
Building Permit Application
. - . .. FEB - 9 2016 .
Commercial Residential
Property Tax ID #: ° ��� 3 2 -S-00 �4�7 -�}�- Lot No. .
Site Plan Name: Block` -No:
Project Name:
Setbacks Front ___% ® Back: _IqO_.O Right Side: Left Side:_': '
_�'d ^V� Windows%Ddors7 1%Mechanical P�GasTank, Gras Piping =Shutters
I/Electric _ Plumbing_ I/ Sprinklers _ Generator �oof
Total Sq. Ft of Construction: Sq. F.t..of.,First Hoot,:
Cost of Construction: $ 97 % , Qeo Utilities: •Sewer —Septic Building Height:
Name 0 O-5 C. Cf- *1" 1LAaAoS /MSi72!E15 Name:
Address: '78 2 3 l�S T� �k� Company: CDf� %iL6_at �oi�
City: AI Z A Y1 J I—Ak �' 5 State: rL Address: J 50,. rV w F'E'PEk qZ. I*WY
Zip Code: 33 6% 6 Fax: city: ..5 r V A A:r State:.
Phone No. 3e5 %% Z266 Zip Code: S q q g L Fax:
E-Mail: Phone No 77 2 p is-% q
Fill in fee simple Title Holder on next page ( if different E-Mail 11JAA Bi/GL° I (E 6071?c:1A-67, /v.E
from the Owner listed above) State or County License C& & Q f -70'7 3
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
GINEER:
Applicable
Address: S7.,5'0 Al. Ai W S A LaE
City: iA91n1 A1VQ AA5A0_ V State: FL
Zip: 3:3a5�4 Phone gSy 2iY&-22-0'a
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not -Applicable
Address:
City: State'
Zip: Phone:.,
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work andinstallation 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 authorie 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 resuit in your -paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the fi s inspectyJoon. If you intend to obtain financing, consult with. lender or an attorney before
commenciiork or fecor-ding ;our Notice of Commencement.
77,
Si a ure of Owner/ Lessee/Contractor as Agent for Owner
Signature Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY'OF
COUNTY OF
o .
The fAgoing instr meet was acknowledge tl before me
�f day hctnP. 20KO by:
The forgoing instrument was acknowledged befo S �'
this` day of. ��
�' � 20± by ems'
this of
-
pa
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�N
(Name of person acknowledging)
(Name of person ac nowledging)
(Signature of Notary - State offlorida.)'. ,.' ; ;,
(Signature o tary Public- State of lorida )
Personally Known OR. Produced iderdification,w
Personall 9, �. nown OR Produced Identification
Type of;ldentification narinon Bayer
Type of IdentiF at' n. Al
ProducedFLXAli/Z Zl. '.,1 N013ryPUbIIC
Produced
State of Florida
Commission No. lY MSSION#FFjr
MY(�b
Commission. (Sea
l)
Expires' Ma 5 �r. .
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
.COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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Rev. 7/ZU14