HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONC unty
Building Permit pplicationFRECEIVED
Planning and Development Services
Building and Code Regulation Division 2 9
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R s$64ntWount , Permitting
PERMIT APPLICATION FOR: TuSelect from dropbo ,click arrow at the end of line �� a
PROPOSED IMPROVEMENT. LOCATION:,
Address: 20 Xj- &'..f PL --9"Pe 00Wy W "I?T PIC9C0 1 t-re, 3`/902,
Legal Description:.L. d �^' // , LAG 0 C /i %� C 0 �Ti "L'Z,
Property Tax ID #: 2 - D - D 0 10 00 di Lot No. J/ .
Site Plan Name:, Block No. _A
Project' Name: '
Setbacks Front -17 9' Back: ! S` / Right Side: / O Left Side: 7.
DETAILED. DESCRIPTION' OF -WORK: '
ft T
,ydo-7" . aY e,#11 Q 1 11W CAI? ROajs . �- I ,sToft : 0 /3Y s���
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit - check a apply:
Gas Tank Gas Piping I Shutters Q Windows/Doors 1]HVAC
Electric 0 PlumbingSprinklers Generator a Roof - Roof pitch
Total Sq. Ft of Construction: 7400 S . Ft. of First Floor. %
Cost of Construction: $ r -Utilities:ewer Septic Building Height: / y ,
OWNER/LESSEE:
CONTRACTOR:
Name 77&61f/il S f1 /� G� S"
Namei sy ee-ir / 0 R
.S "'05
Address: 7 6 2 S` S PL '4kA f f AMC-
-Comp ny:
City: E_R% �/ eR(GF State: L
i
Address: GAG S' S US
/
Zip Code: �I / ��Z__ Fax:
City: F% /0/ealrli
C
State: '
Phone No. T j 2 - 3 Z y Z 2 -
Zip Code: 39f go Z—
p
Fax: ZZZ ' V66 V4
E-Mail: eAPX, %o/i IV115-45/1,4/C G O//
Phone o.
Fill in fee simple Title Holder on next page ( if different
E-Mail: lv 4/ 5 QAIT R//i( S&C-0-5 . C G k
from the Owner listed above)
State o I County'License:
If value of construction is $2500 or more, a RECORDED Notice of Commenc ment is required.
Address: " r
City State:,'?
Zip: Phone
:Address:
�::. •: State:
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.
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 Home Owners Association -rules, bylaws or and.covenarit's 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
rnmmcnAna uninrir nr rarnrrlinv. vrii it Nntira of CnrYirrlpnr_ement_
Signature of Owner/ Lessee/Contractor as Agent for Owner..
Signature of.Contractor/License Holder`
STATE OF FLORIDA : _ ... .:r,. _.
STATE OF FLORIDA,
COUNTY OF Is ar . L 0 C.
COUNTY'OF "
The for oing instrument was acknowledge before me
1
The forgoing instrument was acknowledged before me
this a•day of Y'v\ nt'� . 20 by
this day of . 20_ by.
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced L V1 L
Produced
(Signature of Notary Public- S
IVENS '
(Signature of Notary Public- State of Florida )
NAMpR1E .
Commission No, R°� co . co�N!ssl ,2020 ;.
-
Commission No. (Seal), ,
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REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE .
MANGROVE
COUNTER
REVIEW,, ,.
REVIEW
REVIEW
REVIEW.:
REVIEW
REVIEW
DATE.
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RECEIVED
DATE':
COMPLETED
Rev.8/2/17