HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLET=In' `�'OR APPLICATION TO BE ACCEPTED �-
Date : V Win_ Permit Number:
SCANNED FRECIIVED
t , �, ;.. n BY
St. LLudeCountj 20i8
Building Permit Applicnri-
Planning a! d Development Services
Building an,, Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (7 2) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMI FAPPLICATIONFOR:
PR PO 'ED [ -P. RO EM a',�LOC TION:
Address: I L&Qe, FL. 3Y 1Sa-
Legal Descr ption: �VW T �. W.L 5�-o o D
�r
PropertyTgx
ID #: ,3c/11- Sly- 0047 --D00- 7 Lot No. a�D
Site Plan Name:
Block No. 15-
Project Na
II e:
Setbacks
Front Back: Right Side: Left Side:
mpllliw,
�r'�.��,+t�`.,f'i"��„�:is�?1�.,.lL�at:5:tii�L.t,,.-?a1'i:t". xl.! trail .��•L2?_i'� �•:�':r �`.'!�l:i_3—Lv:•�,r..;�,a.,......:
/vov.E �'� F,r'S,'.'r F to uft o �C ti ;� sl / 3 6<r T;-�- r�
over ra,� -S.$, 0 98 - �" �G l %6 ys> N3
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CONSTR JCT1:0_N.INFORMATION;
ems..
ition wor to a per orme un er t is permit - check all that apply:
_Me anical _Gas Tank _Gas Piping _ Shutters _ Windows/Doors
Ele - Plumbing _ Sprinklers _ Generator Roof
itric
Total Sq. of Construction: at fce? Sq. Ft. of First Floor: am)lo
�lt
Cost of C (,Instruction: $ _T7 �'�- oo Utilities: _Sewer _Septic Building Height:
Name: evt n
Name q'e-y-yklI '^
Address' la(ob S'E VY��ll,.i`T4 LJ
Company: S}-cue_ FYD6A-�a--�oo �ny ,�}c-.
Address:D.
CityState:
Zip C041 : �Lt933 Fax:
City c ��- (,Lcue:' State: PLI
Phone II o. 111 - 3s-q - A IV/
Zip Code: ;�q(j 93"- Fax: 11a- 3 36 - ff s- i
33L - 3 990
E-Mail: I'll MARK 1,16111e^l—
Phone No 112—
Fill in fee simple Title Holder on next page ( if different
E-Mail &- J�OA4d / e �- hr�-
State or County License O-U L ad- (Pq aD
from tF�l' Owner listed above)
if value o Ilconstruction is 2500 or more, a RECORDED Notice of Commencement is required.
LI'PPLM?E-N LO-N=S
!®` ' LIEN LAIN
INFORI\/Ix
TI®;N:
d a
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not'Appl'rcable
Name:
Name: L.
i
Address:
Address:
i
City:
State:
City:
State:
Zip: 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 th ' _ ion. If you intend to obtain financing, consult with ender or an attorney before
Comm cinR work or recording your Notice of Commencement. �
• F. J
FSig a ner Les e/ •' ctorzasFAgent for Owner
r/Lice a Holder
STATE OF FLORIDA C-'"
STATE OF FLORIDA
F --o e-t
COUNTY OF (LAOA
COUNTY OF iNA
The forgoing instrument was acknowledge before me
The forgoing instrument was acknowledged iiefore me
SRu
this Af day of 20_IX by
this o?Sday of 20by
(Name of person acknowledging)
(Name of person acknowledging)
(Signatur of Notary Publi , State of Florida )
(Si 0ature of Notary Public- tate of Florida)
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
FF 9'757 p `Y vc>ary Public State of FI
Commission No. =o .al�
,orala F'rantantoni
ri&Pm ission No. f �� 1 S o�°"Y aI�otary Public State of
�� _ armela Frantanton
Q My Commission FF s7
My Comm�ssian FF 975
3 �? 05129/2020
oQe
�� Expires
REVIEWS
FRONT
ZONING
SU RVISOR
^OX41S
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
R-e—v.7/2014