HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I&-to/q, Permit Number: I1O6
_n
�ob
az =IJUN 0 9 20P
Building Permit Application PEMM-1-TING
Planning and Development Services County, FL
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
PROPOW INPR+OVEMENT LOCATION:
MU U I c 0a. I / I ] .]• C" ✓ V- I L- 1 rut -I l•K W.
Legal Description: 313 00 Zkr PART a ►= S iy FT o Five of 5,C 56 /R l6S.f 6- S/r46T-
L y(� Nay of Fbt_ Z)tSC L1: Qe& A9 Pr aN Li pAsb
Property Tax ID #: a. Y32-•H1i/-0003 -010-A Lot No.
Site Plan Name: ' Block No.
Project Name: J A -ea- r le-ce/yie^'r
Setbacks Front a 98 Back: rod Right Side: ao Left Side: X
amonai work
_Mechanical
— check a
a
_ Gas Tank _ Gas Piping _ Shutters
_`Windows/Doors"
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: oZ g® s•� �h. Sq. Ft. of First Floor:
Cost of Construction: $ - - / _000•% Utilities: —Sewer —Septic Building Height:
OW ISS EER/LEa SMEE:
CON RACTOR:
Name J391AAJ F 6Crb19,0
e: , L AfXrCA660
Address: c% 5 • a�'f i^ S PPa»
Com�ISU?6'91,04City:
�{. Rtx-e State: rL
AddrS.
Zip Code: 3H981 Fax:
City: Ft. PierrK, State:
Phone No.(22; o1/C'8Y5�
Zip Code: 3 9 Fax:
E-Mail:
Phone No 07
Fill in fee simple Title Holder on next page ( if different,
E-Mail
from the Owner listed above)
State ounty License
If value of construction is 2500 or more, a RECORDED Notice.of Commencement is required.
ri
°
i
SUPPLEMENTAL CONST TIO:N LIEN LAW INFORMATION:
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:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby 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 applicable Home OwnersAssociation• rules, bylaws orand covenants that may restrict. or -prohibit such
structure. Please consult with your Home Owners Association and'(Wew 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,,perf&m the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applicationslare exempt from'undergoing a full'concurrdncy 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 Withllender.'or an attorney`before
commencingyprk or recordlog you°r Notice mencement.
Sign Owner/.Lesse o rac or as Agent for Owner••
Signature of Contractor/License Holder
STATE OF FLORID ,
STATE OF FLORIDA
COUNTY OF : O , l i
COUNTY OF
The f rgoing instr ent was acknowledged before me
The forgoing instrument was acknowledged before me
this � day of 20� by
this day of , 20_ by
82I A. A) rjr- #
(Name of person acknowledging
(Name of person acknowledging)
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification V/
Personally Known OR Produced Identification
Type of Identificati
KAREN S. NIF
q ntification
d
Produced l_ �,���pYPUp��
•Commission,+
F t b�
`= tommissio
Commission No. ( =;a nny
• ' June 1
Expires
�WiMmissi No. (Seal)
o .I •
REVIEWS
FRONT �' �-
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
i 'REVIEW
REVIEW
REVIEW
REVIEW.
REVIEW
DATE
RECEIVED
(9 (D
DATE
COMPLETED
ev. 5 2vC,1U.
WO-1