HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO:.BE-ACCEPTED
Date: 11 Ia0 ��J "` Permit Number: 15
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• RECEIV _ll 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
PROPOSED IMPROVEMENT LOCATION:
Address: /3 3d 9
gat/
Wood
/OL.
Legal Description: el V er 8 42Ag
C P8
6 7- 36
- %Of 3a (61C 376 6
PropertyTaxlD#: ?03- CO3'7-0cv-3 Lot No. 3'2-
Site Plan Name: --- ow FtV, i Block No.
Project Name: T 6 w - r
Setbacks Front U�ia� Back: � Right Side: / 9 , Left Side: yO ,
DETAILED DESCRIPTION OF WORK:
l N SfQ //a f ivid o P sw%�% raw i, .slaq l (� --L cC a-, !e9,4 ar',n e.✓y`
CONSTRUCTION INFORMATION:
Add itiona I work to be performed und-e-r—IF is permit— check a apply:
E]Gas
E1HVAC Tank Gas Piping _ Shutters a Windows/Doors
Electric 0 Plumbing ❑Sprinklers 1:1 Generator El Roof
F'.L 3r2.
Total Sq. Ft of Construction: Dock 6 7f
Cost of Construction: $ 4//7, M
S Ft. of First Floor: _
Utilities:cnSewer 0Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name I'S<}Awh .a 0W.41G14 i
Name: 7-4:RRy
W I
Address: 13309 N to Ba.y twoocl &L
Company: Podls by
Address: S�'�!o
g aea .Till e.
S, F�a/,r✓'Q; lbw✓
City: State: 4c'L
Zip Code: 3 5/9 yC/ Fax:
City: Intl r• 1` St.
ku, eie_ Stater
Phone No. g S y _ ySf$ , p/7 3
Zip Code: 3 v.sa-.Z Fax: 7 74 ,, 3: 3 7- lal P7
E-Mail:
Phone No. 'L7 a --
3 3.7 . q'7l 3
Fill in fee simple Title Holder on next page ( if different
E-Mail: 'Ojet- 0
dobol"by4 -X-he, Cdn,
State or County License: C
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: /y41^YeS/ Ao e-knea
Address:7er El-ys Ooe
City: 15grt s- 4-u ei %I—'- State:
Zip: 3y9s2-- Phone: 7?a- V6k 5sn9
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _
Address:
City: _
Zip:
Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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
commenciniz work or, recording vour Notice of Commencement.
r/ Lessee/Agent
Contraetbr/License
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -,41 COUNTY OF "3T
The forgoing instrur)gnt was acknowledged before me The for oing instrument was acknowledged before me
this Af day of 1VJJf �i/'�� 2015 by this I day of Nd U 1205
20 �5 by
(Name of person acknowledging) (Name of person acknowledging)
—/
(Signature of Notary Pu Ic- State of Florida )
Personally
Type of Id(
Commissi
Revised 07/15/2014
Notary Public - State of FloQrida
Ry Comm. Expires Di§9�,12016
Commission # FF 125001
0�2at" J l�Iwzh 6
(Signature of Nota7Pub It- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Co m
MARIE E. KNOWLES
My Comm. Expires Dec 16, 2016
Commission # FF 125001
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