HomeMy WebLinkAboutBUILDING PERMIT APPLICATION (2)i'
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: ou vim'
SCANNED
BY
St. Lucie County'2
Building Permit Application T,% "14
Planning and Development Services St �ucQD®p4
Building and Code Regulation Division �Oq� eht
230 1, Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 'IX—
1
PERMIT APPLICATION FOR:
PR.fJ.POSED lNFROVEMENT LQCATION
Address: -7��
Legal Description: /A9.4PO4 R 40r- 9,47 (1,fyXG. AiFXA)
Property Tax ID #: 2%�l S' ^ lvO.S^� pO�L - 000 -•7 Lot No.
Site Plan Name: Block No.
Project,'Name:
i e
—Setbacks�Er_ont - - - _ Back: Left -Side.
QETAiLED DESCRIPTION OFWORK:,
a_
IMV �/J2SU6 0 <"FA
CCaNSTRIJCT.lON lNFORmATlON
Additional workto a pe ormed underd this permit- check kall that app y:
Mechanical Gas Tank Gas Piping _Shutters X wV 'down/Doors
/ Electric _X Plumbing _ Sprinklers Generator i�Roof Pitch
Total Sq. Ft of Construction:. 34 1000 Sq. Ft. of First Floor:
Cost of Construction: $ yre "-- Utilities: Sewer _ Septic Building Height::38/
01NNER%LESSEE .` - : :;
.z
.CONT,RACTOR:. . _
Name ..W ,OJfr � / %A
i ,0
Name '
Company:
' ��/Z
J &(, Ems..
S ''
Address': /E% ,"14`- G�Uy
City: 2% �,�/>a�/rQf%��
State: �`-
Address:
/ S.
L w
Zip Code: Fax:
City:
Va-q
,+L"e, State:
Phone No. 9✓` - ���
Zip Code:
Fax:
E-Mail: G/1401Vli0GT/.04
e4i
Phone No
• 6^ 1
AY 040
Fill in fee simple Title Holder on next page ( if different
E-Mailr����/L
C'
i/LVGT/0A)• LD
from the Owner listed above)
State or County
License
e C6e di.3 y�
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
S,UPPI:EMENTALWNSTRUCTION I,I,EN LAWit;NFQRMATI4N ;;'
DESIGNER/ENGINEER: _ Not Applicable Pp MORTGAGE COMPANY: � ,L Not Applicable
Name: 0e'� 4 01,4 Pr#.) Name:
Address~• y/7 Zew f10�- Address:
CO. ;?All? State: City: State:
Zip:, 3.y!�96 Phone ?7L _Lv7_ 8Z58 Zip: Phone:
FEE SIMPLETITLE 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.,lf you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of wne Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder.,
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 59DWPeK0'
COUNTY OF '59Q P-XCQ
'The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _q_ day of !•VV i' 20 IDS by
this 4 day of : V NE 201V by
1-hvkv.5 iT. W%1kex-
"[homto N. µNW
(Name of person acknowledging)
(Name of person owledging )
(Signature of No - ate of Flon a)
(Signature No ry P lic- St too lorida )
Personally Known - OR Produced Ide ti is t'o
Personally Known_ OR Produced Identification
Type of Identification ' MARGARET A MURRAYType
`�
of Identification
Produced ..,
� ISSIOM#"GG09025�v
Produced :?' MARGARET A MURRAY
.
.!� • • EXPIRES June 29, 2021
'= MY COMMISSION 9 GG09025S
Commission No.. � (Seal)
Commission No. • .- EXPIR45ea)� 29, 2021
,.
REVIEWS
FRONT
ZONING ,
SUPERVISOR
PLAN
VEGETATION
SEA TURTLE .
MANGROVE
COUNTER
REVIEW'
REVIEW
REVI01
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/2014