HomeMy WebLinkAboutBuilding Permit Applicationk
ALL APPLICABLE INFO MUST BE
FOR APPLICATION TO BE
Date:
Permit Number: I-M - 0364
REE-z-Fafr�
.. • -.11 = 11 1.
NOV .1 4'
Building Permit Application
Planning and Development Services PERNIi i TiN:
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ,/
[PERMIT APPLICATIONj.{��% FOR: To [Select from dropbox, click arrow at the end of line
1 Ril � r"�Ii�V:b"AyC�T]�Tl,•.....::....L t �g s { 445� ;f; t fF.. f z
Address: Or, r-pYfi PICYCC. FL• 5�992
Legal Description: Ineflan Rjyr-/ Wat7eS- Unl -H - DL1'2 2 -o�l2 Ft C}F Ln-r a c7
fin ALL LOT -E-1 I (MAJP 3u I DIN) (QR 2anc7; - 2`1l nL.l
Property Tax ID #: -3 L02,- ( 0 bl - 00-7Y - 01)D - D Lot No. :3031
Site Plan Name: Block No. 2
Project Name:
J 1
Setbacks Front Back: 0 Right
Left Side:
g2lP ffi2
+0 (Y s-
Additional worK to be nertormed under tnis permit- cnecK an apply:
�HVAC 0 Gas Tank ❑Gas Piping _ Shutters Windows/Doors
® Electric ® Plumbing U Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: ? l_0'F1"2 S . Ft. of First Floor: 84D ets
Cost of Construction: $ 1 � ► OC7� Utilities: Sewer ® Septic Building Height:
fOl� yRIwMM
i d 3 i4 Y
Namee hns�q cr(e Iiccol Al ArhlnQ
Name: Mi ke P iI W(1e(2t
Address: � 1 Pi rye T P—C �
Company: _ h DY
Address:IC3D2 S Fi0d
Con -fru ctf m &P aV•
rctl HO LAA -W104
City:ay-t Pi Prce. State:
Zip Code: 3LJ (: i K 2 Fax:
City: R'j Vl,1, I nt I-Uc I e, State: R-
Phone No.-119-2CP3:15 3
Zip Code: 549 52.
Fax: 7'72-2yq-2aOj
E-Mail:C0X_h U+C.VY@G�YY1Q.'i I • C-021
Phone No. _M'Z- 3 ]:J
4
E-Mail: n ll �-e nil lrondn
-:Oq O) O01 • coyi'l
Fill in fee simple Title Holder on next page ( if different
State or County License: C—FlOW
SO (08�
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
' Name: Y h h(C W
Address: RYC
City: State:
Zip: Zuq!!�D -Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: ('hV iS &o MeliSca Chi tME
Address: SC(D k
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name: P
Ad d re s s: (95S` l Q %10 r 1`�
City: 2 � M' On State: FT
Zip: Z2,27L4 In Phone: C: p(n lU-7S NtS
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
commencine work or recording; vour Notice of Commencement.
S
Signature of Owner/Lessee/Con actor as Agent for Owner Signat re of ontractor/License Holder
STATE OF FLOR _ A ,,�� � STATE OF FLORIDA
COUNTY OF�I I i 1 COUNTY OF Co int w ci el
The for oing instrument was acknowledged before me
this day of V.i 20 Llby
ltirame'of peerson ackRovyl dging )
of NotaryYublic- State of Florida )
The forgoing instrument was acknowledged before me
this _, day of N` Obi &Y 0el, 20 _ by
Mike Mi (ando,_-.
(Namrf person acknow)eogipg )
(Signature of Notary Public- State of Florida )
Personally Known _X OR Produced Identification Personally Known Y OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.ffi0fQk Co Q t,, I) NICOLEELLENSON mission No I
MY COMMISSION #GG081 1104 NICOLE ELLENSON
EXPIRES: APR 02 202
ro MY COMMISSION #GG089104
�Bonded through 1st State Insurance EXPIRES: APR 02, 202j
Revised 07/15/2014
a" Bonded through 1st State Insurance
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
' I
COMPLETE
INITIALS