HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: �U� —O
Building'Permit App ication JUN °fir=:j•
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lue.ie County, FL
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
Address: oZ
Legal Description: _
Property Tax ID #: /745
Site Plan Name: %fob
Project Name:/Ova
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Lot No.
Block No.
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Additional work to be nej orme under this permit— check all apply:
E1HVAC L_J Gas Tank ❑Gas Piping, _ Shutters Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: .2Y 3$ S F 19d S . Ft. of First Floor: T.
Cost of Construction: $ oZ�-,SOLO ov Utilities: Sewer ®Septic Building Height: /
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Name owl
Name: e,
Address: GU6li ppe_S iia aCir►i
Company,:;
City: Aal�01< Stater.
Zip Code: K2 74 , 3 Fax: —
City: �..- P!'�.�; ..P J ; State:
Phone No. 702 - 979 — A V
Zip Code: ✓ � Fax: %z� S/66 `�J �
E-Mail: `..oi' eo
Phone No. 7%2 — oZ 81
Fill in fee simple Tit a Holder on next page ( if different
E-Mail: 4z aI7 he /se /A cz� 4/a%�• co
from the Owner listed above)
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State or County License: (r2—
If value of construction is sz!)uu or more, a KtI.UKIJCU NOMA! UI wuu Ica MCI Ica' L .—y.... v...
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MORTGAGE COMPANY: Not Applicable
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ity:3,A,-!e,,,,rMrM
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Address: 6v:
City: /� .'fiu State:
P: ��G� __ State:
Zip: 39950 Phone:7U V6
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Zip: -U 7S/ Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY: of Applicable
Name: sgzen P
Name: o
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 apermit`will authorize the,permit, holder tb 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•Amend`ments. ;
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 anotheriiori, residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may 'r'esult 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 firtancing, consult with lender or an :attorney before
commencing work or recording Vour Notice of Commencement.
M
Signature of Owner/ Agent/ Lessee Signature of Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA `
COUNTY OFLyt a COUNTY OF
The for mg instrument was acknowledged before me The forgoing instr ment was acknowledged before me
this ay of -itA-e_ 20 14 by this day of 20 by
Mar r �^ltdsd'&'
(Name of person acknowledging (Name og^
P
(Signatur of Notary Public- State of Florida) (Signature of of ary Public-State',of;Florida )
Personal) Known ✓ OR Produced Identification Personally Known OR Prod ced Identification
Y _
Type of Identification Produced Type of Identification Produc,
KAREN ,S. NIELSEN
(Seal) Commission No.
`�o4Pprava��';iSsiOn k FF 11563
Commission No. - /
ti ANGELAP."HELSOH My Commission Expire
MY COMMISSION 0 GG 02a50T % ;F of « o' June 12, 2011 8�A
Revised 07/15/2014 �� ' '?'i Tim;Il'iNitNo" saw"I
REVIEWS
FRONT
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SUPERVISOR
PLANS "
'VEGETATION"
`SEA TURTLE. .-;-MANGROVE
COUNTER
REVIEW
R VIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
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COMPLETE
INITIALS