HomeMy WebLinkAboutBuilding Permit Application (2) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / �1 e o �
Dater 17 Permit Number: y �'S ® f
RECEIVEo
Building Permit Application APR 2 8 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
)Phone:1772)4624553 -,Fax:s(772)462457:8 BCD�_„,ermaa ?Residerotial x
PERMIT APPLICATION FOR; �j�j(,� gal
P (3Pt}�ED IICPR01/sEM€.ffTf_OATf01 xw CZ 14 L Ck?k4 120ad,
Legal Description: Z 3(1 7-9 6 l t GS5 �� 70 ff -h 3tt amOGy , Ma,4' �� �
OF AfC '2 C yFa V✓o f 164-0t � roes �55 C-Z+4 09C�r wu z-, f 2
Property Tax ID#: 0O Z - DOD -2 Lot No.
Site Plan Name:a/rnn 0k7Gki Block No.
Project Name: (fesiog-nd-t5 5 "/ 41-ajV—
Setbacks Front Back: Right Side: Left Side:
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Additional work to e e o'rme under this permit-check a a apply:
❑HVAC Gas Tank ]Gas Piping _Shutters ❑Windows/Doors
L-alectric ❑ Plumbing ❑Sprinklers ❑Generator z Roof Roof pitch
Total Sq. Ft of Construction: ! / S . Ft. of First Floor: 1 / 1 2
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Cost of Construction::$ 15 DI y 0 0 'UlAlities '. 'Sewer❑Septic �B'ildi.ng'I71e ght:
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01NNERLES " r kfi fGfl�I�RAC ' R t
-. 9 � _ _.bx. 2• rye.,,,.. F .r, z. .
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Name Name:
Address:
p a La4j CZ CY • Company: Prvrech Svcs
City: State:_ Address: 2-OfD G 600-4"*7rZ Cl
Zip Code: � fax: City DCa State:
Phone No. Zip Code: 334-?�2 Fax: TVI 1_70
E-Mail: Phone No. r)(Q
Fill in fee simple Title Holder on next page(if different E-Mail: Pybtcc4l b" 624m-& , G
from the Owner listed above) State or County License: . L V U�� � �
V� 4�d
If value of construction is.$2500 or more,a RECORDED Notice of Commencement is required.
DES Ncafi:4p#a(lcah(e ORTGA6e C0%MPAl4Vd x Not Af*fcable
Name: Finnvold Architecture Name:
Address:8000N Federal Hwy Suite 118 Address:
City: Boca Raton State: FL City: State:
Zip: 33487 Phone: 661-306.4286 Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
;Name: ;Name:
I Address: - Address:
City: City:
Zip: Phone: Zip: Phone:
1 certlfy 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 apphcable Home Owners Assocratioru rult=s;,bylakws"or•.and.covenants•that.may restrict or-prohibrt such
structure.Please'consult with your Nome 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 TO3 OWNEl@:Your failure to Record a-i'ilotite,off'Ce:'rr mencelt`emt 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-Inspettion,If yo;u intend�o.obit;il.n,fiinarad g,consd'it VitK.liendler or-an attorney:before
commencing work or rXording your Notice of Commencement.
9cr .�f-e;�;) 0�-- s
Signature of Owner/Lessee ontractor as Agent for Owner Sign atu re—oVtontract /Lice se Holder
STATE OF FB OR II '' .. STATE ,FLO
COUNTY OF • l��e COUNTY OF Ain e
The fo ing irrstruJ t was acknowledge fore me The for , ing instrument was acknowledged before me
this I day of / r ZO tYby this l day of ` 20 17 by
VO
i'S Cet0!fd-.s �Gc�l
(Name of person acknowledging) (Name of person acknowledging)
-(75-inature of.Notary:Public State of,Norida) (Si ature of.NotaryPublic-State of,Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of IdentificationQProduced u Type of Identific tl n Pro u d
V ' ' Fa
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Commission No. .o`PRV 4U,`,(Seal) KIM A NOTORIS Coimission<No. ° f S t KIM A tOa�S d,
Notary Public-State of FI itla _ , c o ary Public- fate 61 Florida ;
N• JUL: My Commission Expires May 9, 017 �: a� My Commission Expires May 9,20t 7}
�"O11,0Commission '� �''% °''`
Revised 07115/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
l INITIALS