HomeMy WebLinkAboutBuilding Permit Applicationa'-- y
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_ \� 111 Permit Number:l00—I—Q350�
RECEIVED JUL 18 2017.
Building Permit Application C
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: T % i` IS l 10 ('P Seel m (%A -I u-- D2 3 qq,ty %
Legal Description: zmb y — 0 q— DD o — 06>e 40/ b Szz 1 A06NG #114 AS I'7%ll�`
Property Tax ID #: u q 6) y— ao / --rrZ`b Lot No.
Site Plan Name: r Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION.OF WORK
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CONSTRUCTION INFORMATION y
ACClitional work to be ertormed under t is permit — check a apply:
®HVAC Gas Tank Fs
Piping _ Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total. Sq. Ft of Construction: M S . Ft. of First Floor: q
Cost of Construction: $ Utilities: •Sewer Septic Building Height:
O,V1%NER;%LESSEE z�. ,;
CONTRACTOR
Name %Z qrAJTZIIY
Name: t zi//7-
Address: F 22111�,/ 021 11%/�%�
Company: a%%/ G.
City: p/yl/h �ICI*i /�-i � (S� Staterr
Address: ��� lt/ &MAA S'%r
Zip Code:. Fax:
City:. .5y- 4L'&l/- State: Az:'
Phone No. 1r��-' �l�'" b35b�
Zip Code: �/`� �� Fax:
E-Mail: Okla�QICA,' � /,il/. i
Phone No. I U
Fill in fee simple Title Holder on next page ( if different
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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SU;RPLEMENTAL CONSTRUCTION LIEN IAW INFORMATION'
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DESIGNER/ENGINEER: , Not Applicable
Name: 166 7,04/16
Address: E:-t
City: State: �-
Zip: Phone: -
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:: _ Not Applicable
Name: 1
Address: l
City: AA
State:
Zip:- Phone•
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
1 certify that no work or installation has commenced prior to the issuance of a permit.
Applicable
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
commencing work or recording vour Notice of Commencement.
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SigfiMo o Owner/Lessee/Contractor as Agent for Owner
s
Signat ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5 k_ lyc, COUNTY OF Sk . L+x
The fo going instr ment was acknowledged before me The forgoing instrument was acknowledged before me
this �� day of imp 20 LZby this day off �`f 2011 by
\AaAti
(Name of person acknowledging) (Name of person acknowledging)
(Signature of NotaryPu - State of Florida) (Signature of Notary*Public- State of Florida )
Personally Known OR
Type of Identification Produce
Commission No.
Revised 07/15/2014
:ed Identification Personally Known
L l.r Type of Identify
�l N AMARIEGIVE
�SSIO1mbeG622 20 Commission pM
MY ricers
exp1RES: Deco ;
_. _. wWarY publicUnderw I '.
OR
COMMISSION # GG 022023
S: Decem0sQ20
Bonded Thru Notary Public Underwriters
REVIEWS*
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE"
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS