HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APP ICABLE INFO MUST BE COMPLET�v'rOR APPLICATION TO BE ACCEPTED
Date: s, �� Permit Number: ,�
i WANE)
t t� Luc can Y St:,Lucie'
Holus Depalowt;
'
Building "f ait"Appficatiogn
Plannlcg and Development Services A 1�OV@d B r /0 -
euildig and Code Regulation Division pp y.
2300 Virginia Avenue, Fort Pierce FL 34982o �t
Phonlp: (772) 462-1553 Fax: (772) 462-1578 Commercial "'R�I�'� J.�
PERMIT APPLICATION FOR: .S
Legal Description:
Property Tax ID #- 'Lid O' (QV Z)
Site Pl�"n Name:
Project Name: CQQTe- F'kF_ t
Setbaks Front_ Back:
Right Side: deft Side:
FT
k No.
S�na� , �.� N�Jyvu\1 .1.0u�nlr�c�l is
ill A_ _ A w' T 1 _ i 1 _
Additional work to be pertormed under this permit- check all that apply: /
�I II echanical _ Gas Tank _ Gas Piping —Shutters V Windows/Doors..
V, lectricPlumbing _ Sprinklers _ Generator Roof iPitch
Total q Ft of Construction: S•�' Sq. Ft. of First Floor: k 135 SF
�0 / n
Cost o,l Construction: $ ��`T.T�V�IJ: 1j2 V Utilities: _Sewer Septic Building Height: I_L ,
OUVNE
/LE�StSEE:
CONTRACTOR:
Nam�e-`�,,.
�\ ��
y i �� 1 S y
Name' iTr�..�..
Add
e`I1. li' U.F: y,Y> i.
ss: US �i,. I
+ ., .. , _ .•.r' /�� 1.-.r }?• 1
Company:
City
Zip
Phone
'� [ZY�. PL 1\CQ' State:
Code: 3-t Fax:
No. `� �0
Address: 1W 7UiZTLE C0VE. rr
City: State: l�L
Zip Code: « Fax:50(PIS-71%
Phone No q'5
E-M 99ail:
Fill i i fee simple Title Holder on next page ( if different
fro rril the Owner listed above)
E-Mail tf&t&
tece
•
t Vitt
/�
State or County License V e 1508
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
-Name: r
Address:
City: POV
Zip:
'. Nam
CiV
Zip
Not Applicable. 11� MORTGAGE COMPANY: Not Applicable
' W Name:
ZEE Sm -Address:
, State: L 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 ofthis requested permit, I do:hereby agree that l,will,'in'all respects;' perform tihe 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 rion-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'an.d 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 your Notice of Commencement.
Signature of.Owner/ Less
tractor as Agent for. Owner
STATE OF.,FLORIDA
�,l I
COUNTY OF � /T• {�/la7c
The forgoing instrument was acknowledged before me
this 1�7day of Q . 20� by
(Name of person acknowledging )
(Signature of Notary Pu ic- tate of Florida )
Personally Knowr nIONGed ldentifi@8teem
Type of Identifica J MADE LA LUZ VELASCO .
Produced i •`:-MY COMMISSION P GG0$0399
EXPIRES NpvembeF 28,.2020
Commission No.
01KA P &z,11
Signature of Contractor/ cerise Holder
STATE OF FLORID
COUNTY,OF"
The forgw.g instrument was acknowledged before me
this day of 20�4 by
(Name of person acknowledging)
(Signature of.Notary Public- Stat of Florida )
Personally Known Pradiirarl Irlantificgntinn�.
Type of Identificati .'i'4 MADE LA LUZ VELASCO
Produced _MY COMMISSION# GG650399
• EXPIRES November 28, 2U20
Commission No. "' ;(Seal)
REVIEWS.'
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION. '
'SEA TURTLE
MANGROVE
COUNTER._,
R'EVI W
REVIEW
REVIEW
REVIEW
" REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. //ZU14