HomeMy WebLinkAboutappi
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p
'Date: '� Permit Number: 0
Building Permit Application pS
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
iPhone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ✓
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: jjpgC% 5o. ,8rr0C(e5rni4A Dd F* �1-rc�p 3gqLt-5
Legal Description: 17 35 q E / OF Al 1& Or 5 i Lz of 4W ��'� - LE55
E Y3o F:T _ (g. -73 /-Icy
Property.Tax.ID #: 0?3i7- J43 — 0005-100-a Lot No.
Site Plan Name: Arie-1 17cu .ca- Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
F]Electric
Plumbing
Total Sq. Ft of Construction:
d AV
Cost of Construction: $ IP D f 3,v
Sprinklers
Generator
S Ft. of First Floor: _
UtilitiestSewer 0Septic
QWindows/Doors
0 Roof
Building Height:
Roof pitch
� ' �l s+^�gr* d}SR T'�t�xah., Akt°'t�."�
`'..NEaR/'LESSEE:
; "t �CIJ'""' �' '-
CONRAO,R�}�T�,o,.. '
j Name jarieI.
Address:.)(o S'a, o G1!.sm i kh -
Name: k r-<!�J
Company: 5o6or l5f\e_65
City: �-r! 2 i e r-u- State:
Zip Code: 3 LALI q5 Fax:
Phone No. 7�2_ g152r 52-0 %
Address: 1 5
City: C4__ State: f—
Zip Code: 3L1g!S2 Fax:-1^I2-' 4(oC,--M7
Phone No.2-77-- W t,,:, 9 2-L-4v3
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: 5rn 501 u os LA6L�,00. Co;-YN
State or County License: 05 (oip
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
;Name:
'Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
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.
1!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.
i
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 your Notice of Commencement.
Signature of Owner/ Lesse n ractor as Agent for Owner
Signature of Contractbrgicense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ,`7�- LuGie,
COUNTY OF S U6,e-_
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this � day of -: LLT�2 20 1q by
this day of Swn e _ 20_a by
�a -F 2-7r6f(acr
K->_ 4- (acr-
Name of perso making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known y,' OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
t y Marie Sarah Music
S y Marie Sarah Mu
NOTARY 121-113L
NOTARY PULILI
( gnature of Notary Public- StateWESTATE OF FLORIDA(Signatur
of Notary Public- State of FI STATE OF FL
Commission No. F>r 912-13-1 Comm#FF912137
Commission No. FFq/Z13? Comm#FF912Expires
Expires 8/24/
8/24/201
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
e
RECEIVED
$ Z
DATE
I
COMPLETED
k
Rev. 8/2/17