HomeMy WebLinkAboutBuilding Permit Application i � a
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?LLIICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J
J131j f 2-01- Permit Number: I
oRECEIVED*
Building Permit Application APR ®6 2017
Planning and Development Services
% Building and Code Regulation Division
f 2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: (-iLoa 4 E'Y,ekgwe_ Ck Y-de, Q0y f a LLLC;� I FL 3 9fa
Legal Description: Lat the. [me' 04 e- Re—se ry , Gt, 0 d i Flan
or l O- btev eel -PI v- �S s 19 I q p F
Property Tax ID#: 3 3 a a - 900 - 00 to- QCO- 7 Lot No. r7
Site Plan Name: �he ►CAWJe DA fie, e 5 e-V y Block No.
Project Name: �/11
Setbacks Front 5n_a5 Back: Right Side: -66 Left Side: 444.5
DETAILED DESCRIPTION OF WORK:
6'I r I-e- rim I,
.CONSTRUCTION INFORMATION:
��itiona workto e performed under this permit-check a apply:
IJHVAC �- Gas Tank Gas Piping _Shutters Windows/Doors
LJ Electric LL-Plumbing Sprinklers Generator El Roof Roof pitch
Total Sq. Ft of Construction:
nnJ�J''1 b1� s �a S . Ft. of First Floor: 51
Cost of Construction:$ r�! r16 00 Utilities:ZSewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Namemt W Mrs Name: IUn ek ern ynvyi P_
Address: i Alee-rose- CDu-!eT Company: n0..kV, c n o_u.- m me-s
City: Ar f Q 10 4s C? Stater Address: q W e;-:57. OCea.I'ti
Zip Code: I I7&6 Fax: City: 'Sbkc�L-I- State: FZ
Phone No. SI(6 a g(.p l q-a 9 Zip Code: 3+'1'P-1L '7
Fax: 7a a1Qag0Q,,
E-Mail: 4 no k e Ls k_'i SyMzon .Yl et Phone No. `7 7.-� • Q) O- E43 S
Fill in fee simple Title Holder on next page(if different E-Mail: MTelrni'► &f? P-r kc)m c s •Cow,
from the Owner listed above) State or County.License: CC-)C. tP-soot
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
JAW � •�• \1
SUPPLEMENTAL CONSTRUCTION LIEN LAIR/ INFORMATION:
DESIGN ER/ENGI..�N��EER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Alk SIIUC�-1rCsI /l �'hee—r pi Name:
Address: 03'2 t—�70_t4 allf(o Z3 bi- Address:
City: 1oycL.,rn2 State: f L- City: State:
Zip: 290S` Phone: 39 J—600— O(o `/ 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 far 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
co encin work or rec ur Notice of Commencement.
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Sign ure of bwn er/LesseefContractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIft
COUNTY OF. S� • we i e_ COUNTY OF 0 1 , Iu Cl
The f oing instru�peR was acknowledge before me The forgoing instru ent was acknowledged before me
this day of {� E°fi2` 20 Lby this day of ��<r(i�i- 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notar ublic-State of Florida) (Signature of No Public-State of Florida)
Personally Known OR Produced Identification V Personally Known . OR Produced Identification
Type of Identification Produced rI Y4- ) Of Type o en i ication Produced
Commission No. * WCO I N#FF970715 �CQINMISSION�RFF970715
Commission No. * *( F!!Nf `QT EXPI E . rch 13,2020 �e EX IRE$:March 13,2026
� oFf�oO BOndedTlwBudgatNote7S0Mcaa rFOFF ftWedlhm 1kX19lN0tRy$W4=
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE f
COMPLETEbl
INITIALS
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