HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C* �a.Ce �Ai .� Permit Number:
BY RECEIVED
Building Permit Application FEB 2 s 2�16
Planning and Development Services
Building and Code Regulation Division ST, Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential_
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line -bC_%C. k_
Address:2062 Lq9- rL,i_S BLV6 3446Z J 3F'AC.4 J` is 31-I5r4-7
Legal Description: A)C.-7T trc5 ^S cj:�.oa+> >N _ d 9A2 a Et G Z
Property Tax ID #:.y oa - Sb / - CS®6S -OCR0 — y� Lot No. ?.
Site Plan Name:.A/FTTt 0 5 Block No.
Project Name:. H/4z5rE Dc)e,c
Setbacks Front Back: Right Side: Left Side:
dF 170 CA 1AJ CRaV A2.` �caV 11.1 t� 14005Z � • 1 --4:S;-AL4A71 c)xJ
o F 8v,ar F= ; A b1 AC.Er4 T'O ®er,
Generator
Total Sq. Ft of Construction: S . Ft. of First Floor:
c
Cost of Construction: $ _'Ll.00 Utilities: Sewer -Septic Building Height:
OWNER' l:ESSr Ei.q arSra7t*,4r
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Name._LoagAy NAsag
Name: 0,40". �lJt3Lt?�JS�/
Address:.V 4/ C:1yu_��®h, D2)yE
Company:
city: iT?S, oe4 State:
Address:430 iesJ6Y A414AXA ;hA
Zip Code: /r�7 Fax:
city:.4 up"riEt'2 Stater
Phone No. 1a .`% COS
Zip Code: 335K.'& Fax�/O/- 9T�3
&Mail:
Phone No.. AC62) ?yA-- ;U 1CL>
Fill in fee simple Title Holder on next page if different
E-MaiI:CpAArA4 D _S/6aJ A,-%b ccWri?AC?� L
from the Owner listed above)
State or County License:e8C lz 6 // 7A
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: A*G, Wgi.ae4,
-Tmo-
Name: _
Address: ,
Address:
City: FurZ
State: r'L
City: State:
Zip: -Typsq 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 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
commencing work or recording v6ur Notice of Commencement.
Signature Lessee/Contractor Agent for Owner
Signature Co 1151der
ner/ as
of or/License
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF P,,2VK. 8f,4a.y
COUNTY OF lPAtot 16cge,r/
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _7 day of dC4�7i3 , 201L by
this r day of FGA .201k by
Name of person making statement
Name of person making statement
Personally Known IOR Produced Identification
Personally Known bC� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
nature of N ``r ESDELL
g ! Ttt dPA#Q UV
Si
( gnature of Not
- a
=_•+ '` MY COMMISSION#FF146880
; THOMAS TRUESDEL.1_
;_,: �:
Commission No. EXPIRES A"I111. 2018
Commission NO.
MY COMMIS490agFF146886
(407)398-0153 FioridallotaryService.com
',!tOFFo?' EXPIRES July 31,201£i
(407) 390-0153 FloridallotaryService.com
REVIEWS
FRONT
ZONING
SUPERVISOR
KIE
�EGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
RREVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17