HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
t7
I I
—
Date: 1
Permit Number: _
^
r*MNINNONNE"MENWAMBW
Building Permit ApplicationNui 7 i017
LPermitting
Planning and Development Services
and Code Regulation Divisionpartmen
)Building
2300 Virginia Avenue, Fort Pierce FL 34982 Lucie County FL
Phone: (772) 462-1553 Fax: (772)
462-1578 Commercial Rea
PERMIT APPLICATION FOR:
To Select from dropbox, click arrow at the end of line
Pi2OPC75E0 ii1lIPR01lENlENT
Lt?CATIONA"'Yx
e<.„<
k 3
Address:��
Legal Description: LQl[,Q_r.-,c �cA
1bY1C - t)& j Z7- Lc)ZO
Property Tax ID #:13D1- (o03 -
010-4 Lot No.�
Site Plan Name:
Block No. 2.
Project Name:
Setbacks Front Back: Right Side: Left Side:
7'-eGr OJQ� -vz. . Rf)P1GCe_ 04CA pl4woocl. Cze- nail
8tcur� I,, 1 new 1'oly�c�`1v �1�5 �n6WlGy0)erN FC-57-50i- (4ZS.
r)6...z 5V-W- e_GA u'irnp i-ClH&4S•3-R2-Sn51Gkl veG-A
EIHVAC
❑ Electric
"Shutters
QWindows/Doors
0 Plumbing Sprinklers El Generator R/fl Roof Roof pitch
Total Sq. Ft of Construction: 2,rj5(o SgFt.j of First Floor: 2 . 55(o
Cost of Construction: $ I���17 Utilities: L1 Sewer L-1 Septic `Building Height: 1
b$ +,�• ,,. .�..» �� y, `•- x.�' � �,ra.� ,� �v &' _�,� # - 1�t,.k��a
t711V ERLSSE a �v
- 3 �, � ,.<.x.:, r K��a y �' 4 � �?. �4a^,R b" x � `� -�� � Y {�" F'� .�:
. s•'h,-^:v.i�'x`a FYW�,£`, m,f,; i n...,m& ^�r.�.. .,{ ,�z ,�,.�-. 1'.., ;°",e ..
sCC}NRACTOR
=; ..J�:_..., W,.? `� ^»m. ... '� ¢fie: "� .Mn .•:
Name ��_ e_ Ci \\� 5 i
Name: o T�11d2cXa ) • t^,�'�ll
Address: �Dl >C��;���r � •
Company: L(6Y Z&Z-kfS RWC �P;��YS
Address: Cg lol 2 C hcnn_r) fLy
City: 'PA. State:
Zip Code: _'3L19 S1 Fax:
City: 1F_ 6 A ai-e_fce, State:_
Phone No. -}-4 2- 3L1 Z- 7�9 0 l
Zip Code: 34q $Z Fax:
E-Mail: WP_nc%a Ae r. \N\ S ()4ynck:,\. Czrnn
Phone No. �'a2 3Z-is�dS�
E-Mail: I� hid_ ('ol �� .2
1,1- &Jerfrom
Fill in fee simple Title Holder on next page ( if different
the Owner listed above)
=t_)A(3
State or County License: ('�(' -46,
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
RAJIa�Il. INRIVATl7V.= a tee.
ai.ae'�
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
— Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone:
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
commencing work or recording vour Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF (Z.COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of CC --obey- 20 1}by this � day of _�` ��_d 20 by
(Name of person acknowledging) (Name of person acknowledging)
LL �&J —
6/) YOALW Tuj��4
(Signature Notary Pu lic- State of Florida) (Signs of Notary blic- State of Florida )
Personally Known D� OR Produced Identification Personally Known X— OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Sea wmifflD n No. ti (Seal)
SALLY POR SALLY PORTES
—1 ion g G A7625 .;�•. �;4;
* *' My Commission Expires ,# *11
Commission
itRevised 07/15/2014 '� �`'T�r No bAr 15, 2020�,..-`-` My Commission Expires
o„H n���.• vem �.',�a�� �.� November 1 b, 2020Lil
a�,una..
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS