HomeMy WebLinkAboutBUILDING PERMIT APPLICATIO0Ni
All APP
Date:
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INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
O ' Permit Number:
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Building Permit Application EP 4 2n98
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone�1(772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
S
Permitting Department
cunt FL
Commercial Re iclg'_ pY�
Addressl_1_71 01 Er PLe e- F-LA 3Yg,45- �`� kI V_*
Legal Description: Ce4_V-L 4.,,�u�,,,�,v �S'k.l=S �r %
Property
)I Tax ID #: 3 a -1) '7 O 1 o UDl 000 2 Lot No.
Site Plarj Name: !Li 11 i_Im 5 Block No.
Project (Name: 4
Setbacki Front 4 Back: RiAt__�Ide: � Left Side: /OB,'Z
Sri
Haaitioilai'worK to oe perrormea under tnis permit- cnecK aii tnat apply:
I.-M chanical Gas Tank Gas Piping _Shutters Windows/Doors
AEI ctric /Plumbing _Sprinklers _Generator -,Roof Pitch
I Total Sq, �Ft of Construction: yia7 Sq. Ft. of First Floor: 3375 Llvi hdr
Cost of CI nstruction: $ L% 9; G 32 Utilities: —Sewer L-Septic Building Height:
OWN �R/LE=�S�SEE
CONTRACT�tR:
Name
,I 'g-.c r avo S
Name: [iYl.l`L&tL b9 U av, r.es Ga
Address:
12 e& L+,,^ CT
Company: D � Fr&otrSeo (_�nsT rvc4,z,% Tv,,_
City: Stat6:�
Zip Cole: ) ti 5(.G Fax:
Phone IIII� o. J lq 9 - Sib 1
Address: g,�Cad'I-MIC-
City: State: C`L-
Zip Code: 3(4g-'4S Fax:77Z 46S-1373
Phone No 772- 2) %71•1
E-Mail:
Fill in f
from ti
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e simple Title Holder on next page ( if different
e Owner listed above)
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E-Mail CL T-F re", 40. d.e L , ed"'
State or County License 6f5 a g Do 31,.9,1
If value or, construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESI6fQER/ENGINEER: _ Not Applicable
Name: i4wGki tc4vnr-L Xhf-
Address: ^11- AV-4-
City: F-T— qt- vrtc State: FL —
Zip: Phone 460 7?
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: PF
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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. If you intend to .obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement. ftfto.c-
Signature of Owner/`Lessee/Contractor as Agent for
STATE OF FL
COUNTY OF
The forgoing instrum t was acknowledged before m
CON
this day of vik"20 by
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► ln,PAIvnJ—71-N i ��L1n,Iff_rrP
_ PT2
a�N
(Name of person acknowledging)
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/OAppr"
/1.�
•r,7rubIic-State_ofFIor1M6a /
Personally Known OR Produced Identification
Type of Identification
Produced
Commission No. (Seal)
Signature of Contractor/License Holder T
�m
STATE OF FLORIDA �o g
COUNTY OF a m T
wox
The fo ing instrum t was acknowledge, before
this day of 20,�' by
a'
(Name of person acknowledging
(Signature of tary Public- State of FI ida Y
Personally Known k-� OR Produced Identification
Type of Identification
Produced
Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE t COMPLETED "(