HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1� Permit Number:
T-b
kilm 5LQb 1 — 0436
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 Hof line
PROPOSED IMPROVEMENT LOCATION:
Address: 94)5 1Q,wak-,ni fj(- • �--7t 3LtaLlq
Legal Description: �� Pi �� cShDd���—�i I - l� 'Z�I� OF /o► 21 AS I Vas 01.
'Iam4ra u. 044 /ql;l /15 Z2
Property Tax ID#: IR36 -too- aQ!1 0 S ' Lot No.
Site Plan Name: Z\oCXkR Block No.
Project Name:
Setbacks Front �Q2 Back: Right Side: -7 Left Side: 1
DETAILED DESCRIPTION OF WORK:
j � X 2 0 col osed See[ bw-U1-111q OrL
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
❑HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
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Total Sq. Ft of Construction: y bo S . Ft. First Floor: .3(1081
Cost of Construction:$ � u3 • �S Utilities: _Sewer Septic Building Height: Z..
OWNERAESSEE: CONTRACTOR:
Name C Name: Lt,r�2°S P4�
Address: 9015 7a9'1> qr// d Of, Company: oo-S G&La_�-2
City: VT,, AerCe_ State:r::�f AddressA z5&-
Zip Code:11?)4qLP Fax: Cityz3Vfkt State: FF—
Phone No. k9pkAl 33M Zip Code: !Fax:352 4&R-1113
E-Mail: 0C. '�'1 PhoneNo.,f
Fill in fee simple Title Holder on next page(if different E-Mail: ® .
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/FN1G_ffINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Namae6.4d IM5 IhMflfwName:
Adores-$$ IU -yt'dw Address: wt 111, 1
city. State: f t- City: State:
Z i Q 0 Phone: $LQ '7, uu Zip: Phone: 1
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name: i )I n
Address: WNAAddress:
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 restrictio(ns 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 1posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work gr-wxording your Notice of Commencement.
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/_/11/yu A'4" 4�
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Sign a of Owner/Lessee ontrac as Agent for`owner i atur o Contractor/Licen Hol er
STATE OF FLORID ' S E OF FLO A
CO OF �� G1 COUNTY OF bfBQF /02, 1
The for oing instrum! t was ackn wledge efore me The forgoing instrument was acknowledged before me
this Mday of 20.L'�y this(&L day of )VOL 20 L1_by
s Auer
(Name of person acknow a ging) (Name of person ackn wledging)
IT]
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( o ublic-State of Florida) (Signature of Notary Public-State;of Florida)
Personally Known R ra i Personally Known L" OR Produced d ti c
T ica Nall,,ro uced NGELA M HUFF Type of Identification
\11 Np pV ff \\list..
f Notary Public-State of Flor a ��`�P"A�; state o1 Fiodda
Commission Iyo. " Commission f� Q730 Commission No. a, .° Notary
+N." - +Q,; Fly Comm.EdQires fb9ay 17,2®99 = • e My Comz�Irec Oct 12.2018
`'+,;oF,��� gandedihraughlVatilfJaryl� l. , '%s+� dr�`'�, Commisslon#k FF 132509
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Revised 07/15/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE 6L- ,t
COMPLETE �`j rl
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INITIALS
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