HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABfLE INFO MUST BE COMPLE�FOR APPLICATION TO BE ACCEPTED WNW /
Date: 7. Permit Number: r
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Building Permit Appli018
Planning and Development Services Bu►ld►ng and Code Regulat►on D►v►s►onartment
2300 Virgin Avenue, Fort Pierce FL 34982 lit �L
Phone: (77 ) 462-1553 Fax: (772) 462-1578 Commercial Y°
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PERM IT,APPLICATION FOR: 10 6r m l-e- ;F&m f LY I&s r64,ulet
Address: _1i I (01 '06 3 L' t 2 �,�, (1-cQ axn ` R.D Ex- Pity 3 Y, - ,(_�
Legal Description: to i °I ., LuICei U+& ., a _<y9aj A5jdn +6,0 e)&t v-KeO." r`4
Property Tl11x ID #: 2 23t. '7t)D OOOq 60o - 3 Lot No. 17
Site Plan NCI me: SW cm R �s,^� � a Block No.
r
Project Na„ e: 2tivi CLe S,-ate,-,
1Setbacks it Front's I$ Back: Right Side: 166, 03 Left Side: 70 ' 7Z-
0 t9rns.
Additional worK to be pertormed unaer tnis permit- cnecK au tnat apply:
"ehanicad•• _'Gas Tank- ~ ' _ Gas Piping —Shutters. " ` - Windows/Doors
. El I tric Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq: �Ft of Construction: 9 7 W i¢c S'r Ta7-Q I Sq. Ft. of First Floor:
Cost ofdl nstruction: $ 3 80 G 4o• Utilities: _Sewer Y-SepticY Building Height:
I!I '
OWNER/LE=SSE
C®NTRCl'aR:
Nameive t1iNogm Jr- a; v%
Name:jPra-r,ce5
to
Addre►7�
City: I _State: Vic-
Zip C�I'lde:. o�� r! Fax:
Phon I
Company:
Inc -
Address:29tja )-y"e
savne_ f,,r,R
City: �- �`c.,rt�e
Zip Code: 3 4,9Y �_
Phone No�j�1
State: �'L-
Fax: 7712 Ll6 S `7 b 73
`7 % 9%
�INo.
E-Mai M
Fill in lee simple Title Holder on next page ( if different
from he Owner listed above)
E-Mail ° Pr"ez,,, -_-a
02 a6L. Gn1^'i
State or County License 1?.62-
9vo 3621
If valuelof construction is 2500 or more, a RECORDED Notice of Commencement is required.
lJ ° L ANT L C o NSTR
I0 L EI�I W I
ya " MA tON:
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY: L---Kot App, licable
Name: j�,rc,de.e) etmet gmdern
Name •" - r '
Address: Lhrj �n ,., i 4ve_
Address: , ,
City:15 ar f-
State: _L
City: State:
Zip: 3Lgq Phone-7'722Z7
A2- R
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY: Not Applicable
Name: WA!.L
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
161
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. If you intend to obtain financing, consult with lender or an attorney before
commencing woy* or recording your Notice of Commencement..
i eL ioOwcter/ L ssee/Contractor as Agent
Sig attire of Cogtract License Holder �o•.
STATE OF FLORI
STATE OF FLORID ..
COUNTY OF
COUNTY OF Xcia
a Ns
F I
The for oing ins was acknowledg d bef
by
I
The forgoing in nt was acknowledg d before "'�
day by
this�day o 20M
�� W
this o 2Q/
��!�� �
£`fix
�TRi
(Name of person acknowledging)
a fO
(Name of person acknowledging)
-(Signature of Vary Public- State of Hod a )
(Signature of Nc6dry Public- State of Florida
Personally Knowp-"-- OR Produced Identification
Personally Known -� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
V,EGE,T-ATION ,
SEA TURTLE
MANGROVE
COUNTER
RE E
REVIEW
REVIEW "
-'REVIEW'
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/2014