HomeMy WebLinkAboutBuilding Permit Applicationa
4
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j(
Date: I�4115 Permit Number:
RECEIVED NOV 2 0 2015
Building Permit Application
Planning and Development Services
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: To Select from dropbox, click arrow at the end of line
Address: 1339q MW anwoed 9l[CWe I f2al►m Cr-hl , IFL 34990
Legal Description: Qi V-e_-loerld LPG to-1- 30 Lo-t 3a, Luv- 377(ple-112)
Property Tax ID #: 44,95-103- b031 - OD0' 3 Lot No. 3 a+
Site Plan Name:
Project Name: To w-FI eh l , Jq-Fsh awn 9 k
t
Setbacks FroBack: Right Side:_ Left Side:
�CAG n
Block No.
yaitionai worK to oe
11HVAC
11 Electric
errormea
unaer tnis permit- cnecK ail apply:
Gas Tank Gas Piping _ Shutters Windows/Doors
Plumbing Sprinklers Generator Roof
_
❑
Total Sq. Ft of Construction:
Cost of Construction: $ 3 ,150.00
S Ft. of First Floor: _
Utilities:DSewer OSeptic
Building Height:
1-0
01NNERd ESSEE ,
� _
u CONTRACTORS r � 11,1 1 0e
..A?rva,�,,,.�.R..°�
NameA16S hot (QV /O tu 1"'I'g
Name: l Q'0.es K_' 6M r�
Address: / 3 Set° 9 B� ci Iu rnad
PL
Company: -C`re 'V>0cCk1 F7Ck&D(vA
City: Pa IM
Zip Code: 3Y9e1 TJ Fax:
Phone No. 9.5 Y_
State:
Address: T35k-0 Corncr tl Cb ak C.i C U6 t L4O
City: FU`(l V1toCC State: FL.
Zip Code: 3�Ags� Fax: 1`12'4U 5 37.S2
Phone No._11`)-. AIDFJ La-1-1-2
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:'AC� W%n@ AVCpOLCk) VQC�ON •coM
State or County License: C13C % SFS4' C>q
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER�ENGINEER: _Not Applicable
MORTGAGE COMPANY: Applicable
Name: SI,�,nCOGS� V�tcb � En9 LLC
_Not
Name:
Address: �31030 5�i"5
Address:
City: WC-AeC State: 1p L
City: State:
Zip:' 3NlLo0 Phone- X I-53Z-g000
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
comb ncipg work or recording your Notice of Commencesaerrt-N
Signatur/ of Owner/ Lessee/Agent
&.IAT-9 OF FLr -
COUNTY OF [�u # D
ST/XE OF FLO I A
WUNTY OF •L-(A-«v
The fo g instr�� Ient was a knowledged before me The forgj�o,in�g instrument was acknowledged before me
this y of M'VVe 20 / by this �T'day of NOV2/n br✓✓ . 20 /S by
JCt_rnysrK.�4_nnY
(Name of person acknowledging)
( 'gnature of Notaryublic- State -of I rida )
Personally Known �C
Type of Identification P
Commission No.
Revised 07/15/2014
Commisslon # FF 90784
%EW)nm. Expires Aug 6.1
Ba"ilhrough National Notary
V" S (t , 2 a-11 P1
(Name of person acknowledging)
h'C40�t Q-nv �__
(Signature of NotaryPublic- State of Flor'
lnally Known
of. Identification Prod
20
Identification
Q�Qarx��ublic - State of Florid
tbiftrhission # FF 907848
My Comm. Expires Aug 6, 201
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