HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S-a7 - I1 t104 -�a39
Permit Number: _-
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Building Permit plication
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVED
APR 10 2018
ST. Lucie o� -Z permitting
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end or line
PRQP..OSED .IMPROVEMENT LOCATION:
Address: 1OLQ0 v�C,012s CLIJ-)f ,; 1a. 0or--` SF, l.z,c;>✓ .F� 34��6
Legal Description: `� 5 36 39 W� off' S W y o f S W L yG IVWL % o-'
3
Property Tax ID tJl: 53I 5 ?Q - 6000- —COO -- 6 Lot No.11A
Site Plan ;`Jame: 5}oyu�Q btii Iclinp 1plpi� Block No.UjA
Project Name:��/"ikn. i rc,nsr�a►'�'d�en ;S-%rGae I`rlr,
Setbacks Front 300' Back: IO$ ' Right Side: 360 Left Side: a4
.DETAILED DESCRIPTION OF WORK:
�aWIjV by 36' IorS� by
CONSTRUCTION INFORMATION:
AU2itional worK to IM ne ormed` under
DHVAC 1J Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: l I Sa
Cost of Construction: $ 9�00
OWNER/LESSEE:
* II o pen 54or-ca q t
pur rnri - LnecK all apply: -
Gas Piping Shutters UlVindavvslDoors
Sprinklers 1:1 Generator t V I Roof � 1 Roof pitch
S�Ftj of First Floor: Jf 5-1Utilities: USevaer 05eptic Building Height: f L-
Name btEi9tletl
Address: I(}udG C,:i--Hf R8:
City: Por-` r+. State: fL
Zip Code: S` T36 Fax: /4
Phone No. 35 - 2a 1-yC90
E-Mail_S2 n& r'lc c-04 -s% hrarnS, cola
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: r f1cl5Q Parrish iQ6ierS
Company: er'S CCi►'P2ooz
Address:J YD SIJ ICIp'
City: - c32 ri fnn State: FL
Zip Code:'5a(-,Q6 Fax: �fq
Phone No. 35;t-daI-y690
E-Mail: SCIMQng:LUY'2C.paS+k(,YnS,r_(-)n
State or County License: Cf3c, 05900
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
N8
SUPPLEIVIFNTALCONSTRUCTIQf LIEN LAUV_INFO:RMATION:
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Narne:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Ap'piicable
BONDING COMPANY: Not Applicable
Name:
—
Name:
Address:
Address:
City. —
City:
Zip: Phone:
Zip: Phone:
I nri\.I vn; rtrrIuvi I; application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 dome Owners Association rules, bylaws or andcovenantsthat may restrict or prohibit such
structure. Please consult with your Home Owners Association an�`revie v 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 Quilding Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full eoncurrency 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 your Notice of Commencement_
Signature of Owner/ Lessee/Contractor as Agent for Owner Sin re of
STATE OF FLORIDA
COUNTY OF
The or oing instr nt was icknowledget before me
this day of V- Q 20',by
Name of person making statement
Personally Known OR Produced Identification
Type of identifliptinn
Produced
STATE OF FLORIDA
COUNTY OF_/
er.
T-ne for oing instrument was acknowledge¢ before me
this 9, day o by
p
o 1.
Name of person aking statement
Personally Known OR Produced Identification
Type of Identification
Produced
n� n
(Signature df PWofary Public- State of Florida )
�, _.
: 0. "I Notary PublJJ'c-StateofFlorida
Commission No. _ • .= Commis �t3t567 Commission No. 03
9 My Comm. Expires Dec 1, 2021
Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLAN VEGETATION
COUNTER REVIEW REVIEW REVI REVIEW
DATE i
RECEIVED I
of
COMPLETED I 17l4'�i!r ¢j f
Rev. 8/2/17
SABRA M. LINDSEY
MY COMMISSION # FF 2C
Thru Notary
REVIEW I REVIEW