HomeMy WebLinkAboutBuilding Permit Application DECEIVED
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AL.AppUcAm INFO MUST BE£OM PLETIM F IA T.0 BE ACCEPTED
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Bate: Z ZI Permit Number.
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1€30i .�Permit filo
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Planning andDdvetia0Mtnt Services
Building and Cqde.Aegul o{i T3ivisiart
2300 Virginia Avenue,Fort Piercell
FL 3498Z" " `p
Phone:(772)462-1553 Fax:CM)462-W8 ,Com ercial JC a R25idetlti3l
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PERMIT APPLICATION FOR: To Select€ro n dropbox, click avow at the end of line
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Address; '� 3 ,o ) CD I
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Legal Description:' �`-�.•-'rc-y-v'`l�L ��C/!�I �ao �o��� t•JaW� nJiv q /� u-"�'- --
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Property Tax ID##: �j'S ZL- (00-7 UC)q(011- d oo -q '� Lot No.
Site,Pian Name: 5'`S�^'' w �e-t 0$ I - i Block No.
Project Name: � !
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Setbacks Front' Back: Eiight Side: Leh Side:
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-am M�r W
l600e-
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than wo o t as — ap -
QHV�tC Gas Tank Gas Piping _Shutters JoM indows/Doors
Electiic Plumbing �Spr klers Caent rator
Roof Roof pitch
Total Sq..Ft-of Construction: ' t Ft of Fiat Floor:
�( Hei ht"-.
cost of Cons ttiori:.$ .Z ? S. - Utilities.
t5ewei L�15epti,r Btsildirsg• g
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Ida : P'-e�sAa-i�t .> . .. -� •
Name o.r+ U�: :u s" t
_jp�.Ct (1/ -Szm Company:�Ii- rs. sreC
State:
Gt ►' '�R��"=' t Address: Stater-
Zi; erode: 3 R y� Fax:` _ -1 e "ca
� 8 fo- Zip (3�8�s- Fax:
_r:.r . Z,... o t Code:
Phone No_ • �'{ (� `t'1 p ,
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E-Nfail: Phone Nolll
. - 'L•€fail: I ^�' L �.(3 P. eatroo..e:®�•--
Fill in fee sirnole Me-Holder on sYexti}gage(�>� e� ECC 15i38417
Sa®tee the Comer rm ed-above) ! Stagy or.Cct�e e:
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f€�{ue s#smns>��e�.is rtr �'a�l�£�i :lei �f .• .��is•req�red.
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DESIGNER/ENGIN Not-Applicable' I YGA EICOMPANY• blot Applicable
Name: rC r Name: .
Ad
d'i-ess: 'l _�= � ° -- z Address: f
City:,, - State: f C"lty: i State:
Zip:: 33'($2 Prone:-. ! Zip: I Phone:
FEE'SI PLE�'LE�OLPE1d: . _'Not Applicable �3Nflt1 G i pAN�I_ �CNot Applicable
Name: Dame:
Address: Address: c
City: f City:
gip- Phone: :i Zip: i( Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
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St.Lucie county inakes no representation that is granting a permit will authorfze the permit holder to build the subject structure
which is in conflict-with any applicable Home Owners Association rules,bylaws o,,and covenants that may.restrict or prohibit such
structure.Please consult wrath your Horne Owners Association and review your deed for any restrictions which may apply.
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In consideration of the granting of this requested permit;t do hereby agree that f!6il1,in all respects,perform the work
in accordance with the approved plans,the Florida Building codes and St.Lucie County Amendments-
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The following building permit applications are exempt fKor n undergoing a full co0currency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING`li..O.OWNER;Your failure to record aj Al6tice of Com>�ner�cemeit esult in your paying twice for
improvements to your property.A Notice of Commenceanent rnusiil�be r rd . and on the jobsite .
before the first inspection u intend to obfairl financing,coast ' len r or atto ey before
commencingworts or re rdin our Notice of�Cornmencement. fI
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Signature of er/lessee(Cbntractor r for Ow er Signature oritractor/License Holder
STATE-OF RI®A !� STATE 0 Lt3RIDA
Cr�UNT"t F e �LC3U 0
The forgo i eat was.acknowledged before me. the. of ! nslxument was acknowledged before rrie -
this 0 20 9 by this d of /�wt z by
Pe43r a caf=1 4-
! Pe2Qr A Cafam U!
(Name of person acknowledging) (Dame of Pt I son acknowledging)
igna r.e otary Pr�bGc-Stu a of Florida) ; { Egriature pf otary PublEc-Sate Florida)
Personalty.K own. x OR Produced ldentrFicatioki Personally IKnowm X OR Produced Identification
Type of identification Type of-fd'tificatioa'Produced
NctatyPubrC ..of
commission No- a� KenM PF98i647_ Commiss10 No � �0f
< iHy ? Kari M Mawbmi
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR VEf�ETATION SEATURTLE :MANGROVE
-COV.NT'ER REVIEW kVI REVIEW ; REVfEW REVIEW REVIEW
DATE
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cnmPLETE
INITIALS ! �i
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