HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APIPLICABLE INFO MUST BE COMPLL . .�J FOR APPLICATION TO BE ACCEPTED
Date: ,1 Permit Number:
77
RECEIVED
" SA) IT "V' 6 mit Applicatio JUL6 Go9s
Planni I g and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Ufrginio Avenue, Fort Pierce FL 34982
Phon k (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
FPE I`T APPLICATION FOR: 'To Select from dropbox, click arrow at the end of line
PROPIPSED IMPROVEMENT LOCATION:
Address 6ZlLf A'<kory Dr. r4. !-ienee. FL 3 NW'dz_
Legal DI scription: 'modi" R;Ve FSk+e5 Urn; Di - 3 S2 Loj- )S
wr<ct 3y 02s nr 33 bZ- I53o
Propert Tax ID#: 3y�Z-(o0i� -r7N5S -000-3 Lot No.
Site Pla i Name: Block No.
Proiect Name:
Setbac4 Front q 5- Back: 14 � - Right Side: '340- Left Side: 3 0'
DETAILED ED DESCRIPTION OF WORK:
6-, l J -FjoeideL Roo n 0^ ax;s+P�S �o.-,��� t� r,��+� 3
ally o_4 Roves d
CONSTRUCTION
INFORMATION:
AUditio�
❑HIAC
tal work to eiej r orme under
L_IGasTank
this permit -check a that apply:
❑Gas Piping L=1Shutters
DNindows/Doors
❑El�ctric
—
❑ Plumbing
— g
S rinklers ❑ Generator
❑ p —
❑ Roof Roof itch
— � p
Total Sq
Ft of Construction: Z Z $
5 . Ft. of First Floor:
Cost of
onstruction: $ 1 00 0.00
Utilities: 0Sewer ❑Septic
Building Height:
OWN
�I LESSEE:
CONTRACTOR:
Name
Address
City:
Zip Codil:
Phone No.
E-Mail:
Fill in feg
from the
Lea^,,rtMocom. S
Name: leis :S' 17ekke,- �..
S21 tjfskotv Pv
Company: 'Precis iJ.t g4 scree.., 11-rnc.
Address: 2IRDSD I\J,E. T -efe.
State:FL
3qq $22 Fax:
TIZ- b4- S3S2
City: ()k'ee(,61oeZ State: FL
Zip Code: 3g972- Fax: '363- 7b3 -53w�
Phone No. 7 7 2 ^ 370 -
�1 (YQA L
simple Title Holder on next page ( if different
Owner listed above)
E-Mail: Crcjc ke(- i( l0 O CaD ) 4W0 .CAS f
State or County License: 5144 45-3 66
If value op construction is $2500 or more, a RECORDED Notice of Commencement is required. 11
SUPP
�EMENTAL CONSTRUCTION LIEN LAW INFORMATION:
I
DESIG
Name:
Addres
City:
Zip:
ER/ENGINEER: _ Not Applicable
lor,do, ,n 12e L. L
MORTGAGE COMPANY: Not Applicable
Name:
: 1/0S6 'r4;J,cr,� 1 f�: t —5,4e_ 4-M
Address:
State: P-a-
13 qS0 Phone: 01111 - 3` 7 - Sq 61:>
City: State:
Zip: Phone:
FEE SI
Name:
Address:
City:
Zip:
PLE TITLEHOLDER: /Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
11
City:
Phone:
I
Zip: Phone:
I certifythat no work or installation has commenced prior to the issuance of a permit.
St. Lucie Ounty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is n conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structur . Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consi eration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accor lance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The foll luring building permit.applications are exempt from undergoing a full concurrency review: room additions,
accessoi structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARN NG TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impro ments 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
comm4ncing work or recorftg ycir Notice of Commencement.
n A /I
Signatu
as ARerft ffor Owner
STATE OF FLO I A STATE OF FLORID
COUNTY OF — COUNTY OF �—
The f^^or,,oing instrument was acknowledged before me The forgoing instrumen was acknowledged before me
this day of _TLA_V\-J 20 LSby thisay of� k ` 20 by
I
(Name 0 person acknowledging)
(Sig( atd're df-Motary'Public- State of Florida )
Persona ly Known OR pro }��g
Type of entification Prod , PwY `�;'J-- ARY ANN H
p . a e of Florldi
�� •P Cc lWon # FF 202265
Commis (on N ' My. Expires Mar 17, 201
Bonded through National, Notary Ass(
07/15/2014
(Name of person acknowledging)
(Signature of tary Public- State of Florida )
rsonally Known OR
pe of Identification Produce(
mmission NoF aace^
n v
'I MARY ANN HdOD
Wry Public - State of I
Commission # FF 202
Bonded through National Notary
REVIEI(U5
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPUTE
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INITIAL