HomeMy WebLinkAboutBuilding Plans (2)OFFICE USE:ONLY: /� /�
DATE FILED: 3oa I
PLAN REVIEW FEE: RECEIPT NO.: PERMIT NUMBER:
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
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�-� St. Lucie County Building and Zoning
2300 Virginia Avenue, n
�OR10Q Ft. Pierce, FL 34982-5652
772-462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
1., LOCATION/SITE ADDRESS: 3J ji/V GLE pew, �T ,Ai�,te-E
2. - S/D NAME:�L0AeLgv p,*s TX yet SITE PLAN NAME:
3. PROPERTY TAX ID #: ;?340 9- - G ® i4 - 00// - p00 Z
4. LEGAL DESCRIPTION (attach extra sheets if necessary): z
,OF T/1.RcT 3,>r GE,t,S Gv[ y o7 � iT /9^-D LastE ,300 •cT �0 f�2 9-c) �dR 1.ZSjd'-oZ�l
5. PLAT 6. PAGE 7. BLOCK 8. LOT
BOOK 7X I/3— NO. q. NO. NO.
9. PARCEL SIZE: ACRES/SQ FT. LOT DIMENSIONS
10.1 DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: .2"i✓Sr4GG
11. ,I SETBACKS (ACTUAL) FRONT: B BACK: RIGHT: � LEFT:
'SIDE SIDE
12., TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [.a ---COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: 10?y10 Q!/i•���--6
14., Sq. Ft./CONSTRUCTION: 3 ty 15. Sq. Ft. 1st Floor:
16. VALUE OF CONSTRUCTION: $ 6 g 00• J,O
The value of construction is used to determine the amount of permit fees to be assessed. St. Lucie County reserves the right to question and/or modify the indicated
value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction activities. If the value is $2500 or more, a
RECORDED Notice of Commencement must be submitted with this application.
SLCCDV Form No.: 001-02
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OWNER INFORMATION
NAME:
ADDRESS: 3/ s-- 4 f/VGdt' ,,a.
CITY: `T /�JE�GE STATE: ZIP �� SL�14L7
PHONE (DAYTIME): vZv email:
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER:
CL v OE SG`/ ,SR/� G 4-t)6 A411SP-1t06-
ADDRESS: L� o I l//�i�-Y4Swa-e— 14) !'f o`ZD I
CITY: ?5;r STATE: ZIP
PHONE (DAYTIME):
CONTRACTOR INFORMATION
GGc,.
ST. of FL REG./CERT #: 6g c D 0 / r3 8 J' ST. LUCIE COUNTY CERT #:
BUSINESS NAME: C iQ (% r.✓E dY!/1N v F�� Tv�¢ :nr G CO. Zisrc
QUALIFIERSNAME: /GTOy ! C'X10,
ADDRESS: /T/8' C'�.�.yNEGsiOE ,Ord v�
CITY: �-% F/ STATE: ZIP "K7.; .0 2--
PHONE (DAYTIME): (/3) moo?/- 6o27 f FAX NC('�j_Tj X. W P/3 email:e/1pCP 440;0Ze--
ARCHIT/ENGINEER: Al:::2 2 p� ` E�l� oe V T/
ADDRESS: r/ f47 W. CGS FTo yy
CITY: �10 STATE: fL ZIP
PHONE (DAYTIME): �S Gt�
BONDING COMPANY: N/�4
ADDRESS:
a
CITY: STATE: ZIP
MORTGAGE LENDER:
ADDRESS: --
CITY: STATE: ZIP
IMPORTANT NOTICE: When a permit is issued and it is. not picked up within 60 days after notification
it will be voided and returned to you by mail.