HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 11-29-17 (2)All APPLICABLE INFO MUST BE C06ir'LETED FOR APPLICATION TO BE ACCEPTE / Q�
Date: I I.7-q• 12 Permit Number:
Building Permit Application
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... kl"'.
PERMIT APPLICATION FOR: fZ��vaV�7,�d ANo 1),6A0
Pf C}POSED IMPROVEMENT LO:CATtC}N
Address: 63D I
Legal Description:
Property Tax ID O O O
Site Plan Name:
Project Name:
Setbacks Front Back
Right Si
Additional work to be pertormed un r. this rmit — chec
_Mechanical Gas T _ s Piping
_ Electric Plu IOU _ Sp klers
Total Sq. Ft of Constructio.n:(.' s'
Cost of Construction: $ 90 0. 0 Utiliti(
Name" F
Address: rL
City:* F . F t Stat
Zip Code 34,25/ Fax:
Phone No. t -722^ -3 $9 ^3934
E-Mail: IM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Lot No._
Block No.
Left Side:
Shutters' _ Windows/Doors
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
s; —Sewer _Septic Building Height:
Name: IF LE,QDGf 6&A1 1 =J0-
Company: FWddG _ -)R 20(r5i;
Address:
City: A/C�; S/92Lz Stater
Zip Code: 34gJ4, Fax:
Phone No77Z.-97/-¢.SDS
E-Mail Zkg0O &,7?iV 47-7-, ET -
State or County License C_IIjCO2ZO9 `f'
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
I I tp t: R B ak
S RPt�ME lT1�L CONST111' I�I N I:AW iNFURI
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address: I
Address:
City: State:
City: State:
Zip: Phone I
I -
Zip: Phone:
FEE SIMPLE TITLE HOLDER: I _ Not Applicable
BONDING COMPANY: _Not Applicable
Name: E,r�q t s,Q S,aFgn
Name:
Address: /P.4LEO ,adal k Gil
Address:
City: & PrE a I k
City:
Zip: Phone:
Zip: 54 'Phone: 7ZZI__ 59 — 39,3b
I
OWNER/ CONTRACTOR AFFIDVIT: Application is her&y made to obtain' a permit to do the work and installation as indicated.
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 applicableHome Owners Association. rules, bylaws or'an'd coven ants, that.may-restrict
or prohibit such
structure. Please consult with your Hone Owners Association and review -your deed for any restrictions which may apply.
In consideration of the granting of this) requested permit;-IAo`herebyagree that i swill, 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 applicat ons are exempt from undergoing a full concurrency review: room additions,.''FJ
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory use's to another rion'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
commencingwork or recordingour Notice of _Q etajcement.
`ign; a totes' _ < wme L se seef Cont'r"a was Agee[ -.for O
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ig at ru "Contra er/Licen e_ . o_ Ider ett
STATE OF FLORIDA r- ,
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TATE-OF-FLORID"""
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The forgoing instrument was acknowll d ed before me
g g g
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he forgoing instr ent was acknowledged befor rpe;
this ( day of P, e by
N,
z o z
his day of 20a byLy
I20
T RSA
(Name of person acknowledging)
(Name of pers n acknowledging)
I
(Signature of Nota Public- State of Florida
V
(Signature of Nolq§4 Public- State of Florid )
/OR
OR
Personally Known Produced
Identification
Personally Known Produced Identification
Type of Identification
Type of Identification
Produced
�,
Produced
Commission No. "'
(Seal)
Commission No. (Seal)
REVIEWS....
FRONT
ZONING,.
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
'MANGROVE
COUNTER
REVIEW' `
REVIEW
REVIEW
REVIEW'
REVIEW
' REVIEW
DATE
RECEIVED '
J
DATE
COMPLETED '
ev./2014
1.