HomeMy WebLinkAbout1508-0155 BUILDING PERMIT APPLICATIONI - I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLItATION,7' BE ACCEPTED A100 01441cj
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Date: Permit Number:
RECEIVEZ)
Building Permit Apylication
Planning and Development Services V�Ury Ant AUG If 2015
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial — `fi A(deD i a I
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PB01 4
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Address: 41 IN 5 C__4 6 4 P C_ 212 _P Z 6-p- S S ft -'_Y q 2-
Legal Description:. 8 t P- 2 L oT /0 u &:) 5 T T 2N'�Lq_r-1 P- :'-v 64- C-9 TA-FG S1) LA 7- 80()1C
JO
PACE
Property Tax ID #: 3L10Z- 602- 0i26- 000i-F Lot No.
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Site Plan Name: -5-C-*6tA_P(, ODU4C, Block No.
Project Name: -g C-,-A 6 e-A,? E, P%001
Setbacks Front Back: Right Side: Left Side:
DETAILED'WORK
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Additional work
9HVAC
to be nertormed under this permit -check all that apply:
E]Gas Piping Shutters
12 Windows/Doors
Gas Tank
IElectric
Plumbing
0 Sprinklers Generator
DRoof
Total Sq. Ft of Construction: /'Z/OS2
sqr-r Sq. Ft. of First Floor:
Y 09 S Q cw_r
Cost of Construction: $ / _7 0. 0 00. 00
Utilities: 0 Sewer 13Septic
Building Height:
�0- V",
OWNER/LESSEE S, "MCONTRACTOR
[
Name 01413 P-
Name: A 00 Z /3 U T- c 0 64- -,rDJ E CA 1-b-
Address: 4qOLt fC-40"Pc- � -C
Company: b c-; t-k 14-�
City: �q- State: FL
Address: ?6w )(Bt-
Zip Code: 3 V V 2 Fax:
City: g (-;-g A- 9 7_!� State:
6
Phone No. � q 2, 2OL4-3s?6
Zip Code: 3 7-9 ST Fax:
E-Mail:
Phone No. 2z9-'3q,?3
Fill in fee simple Title Holder on next page if different
E-Mail: 4 e I q- ti oi 6 U"' cPe-,,4. czn
from the Owner listed above)
State or County License: CG C 14-14 14- 1
If value of construction is $2500 or more, a RECORDED Notice of commencement is requires.
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SUPPLEMNTAL CONS�TRUCTICIN.�EN LA1N 1FOfIkATION• k =�
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: F=,)C "i
Name:
Address:
Address: 2 1 04- P A-(-m B±1 2-04-,b s 6
City: P a L`1 d State: f t
City: State:
Zip: 3 0904' hone: 3?-/- �?Zy- 03 y 0
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address: I
Address:
City: I
City:
Zip: Phone:
Zip: Phone: I
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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, signi, 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 reco posted on the jobsite
before the first inspection. If you intend to obtain financing, consult wit ender or attorney before
commencing work or recording your Notice of Commencement.
I
i
g ture of Ow er/ Lessee/Agent
I
STATE OF FLORIDA
COUNTY OF Sr-i t vel-C
The forgoing instrument was acknowledged before me
this 3 1 day of 1V L- `/ 20 / f by
i
(Name of person acknowledging)
I
(Signatu a of Notary Public- State f Florida )
Personal, Known r✓ 0 d Id�t♦�fiio�N�
Type of Identification Produces .-- -- -- — ---
Commission No. C tl i Jt ORES Fe6nnry 20.
Revised 07/15/2014
re of Contractor/Lic�nAe Holder
STATE OF FLORIDA
COUNTYOF Sk , 1-Jc �%-
The forgoing instrument was acknowledged before me
this 3l day of .Sy \ y 20 15 by
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
orally Known OR
of Identification Produm
public State u1
16,2016
ion No. '� fro ° Comm. E>{i��SAec 58761
E8
• •� ,, . � y Comm,s nh National Notate
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
RE IEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
13
COMPLETE
INITIALS