HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI . 8C5 —0-550 S17K
ALL APPLICABLE. INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
RECEIVED
Planning and Development Services s P@rmftting L;�'Pgrtl,n,
5t.
Building and Code. Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 40-1553. Fax: (772) 4624578 Commercial -.Residential
8GAN
PERMITI APPLICATION FOR:
Y.
Address: i 7 Sj took 1jf Lur,10-J-1 ..ILI f 19-7..
T
LegatDesc!ripiion: _SaL1CteeV s e' La I
Property Tax ID #: '33)1 - So 1-cooq Qgp Lot No
Site Plan N 1 ame., rn ffae4_ Block No.
Project Name:
Setbacks I.Front. Back: RightSide: .3 Q Left Side:
C V: 0 it C de C
C4 n
7- .1 wn I Bw I I I 1c%A U I IUCI LI I M VW [III L- VIeCK all Iapply:
-]
0HVAC Gas Tank E]Gas Piping InShdtters EIjElectric [:]Plumbing Sprinklers G F enerator
Total Sq. Ft of Construction:i
Cost of Construction: $ ,-)5q 1 OM
S . Ft. of First Floor:
Utilities:11 Sewer.ESeptic
F]Windows/Doors
EjRoof . Roof pitch'
Building Height:
Name J, VQ,,Al 11tcl Name.' JUMM I Lfnn rj
Address: 0 6 e JA Ir company: e -t Po a I S
. I
City: -kdA- 0.1edc'e State: Address: Ll I a, e� v
Zip Code 14 01 C I Fax: city: P t 0,1 r Q State:
Phone No. :-7 :20 '3- Ll I S Ll R)?
Zip, Code: - 1, Lj If Ir I Fax:
E-Mail: IA L ica M Sy4 a f gi, Phone No. 5? IS? 7 -2 <73
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�Fill in feezimple Ti Holder on next page ( If different E-Mail;: 1AM&u
I I L-1 q., I q 6,�
from the Owner listed above) State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: Ray Reinhard
Name:
Address: 1ololEaster Lilly Lane
Address:
City: Vero Beaclj State: FL
City:
State:
Zip: 32963 Phone: (772)473-6303
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address:
Address:
City: {
City:
Zip: Phone:
Zip: Phone:
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, pection. If you intend to obtain financing, consult with lender or an attorney before
commencinA v or or recordiniz vour Notice of Commencement.
Signature ofp1her,
STATE OF FLORID
COUNTY OF1 V I . L�,�C,�'fi
I
as
STATE OF FLORIDA
COUNTY OF St. Lucie
der
The foing inst ;1 t was acknowledge fore me The fo oing instru en as cknowledg efore me
thist day of 20 by this � day of 20 by
acknowledging
Public- State
Personally Known OR Produced Idle ntif'e ion v
Type of Identification Produced ew r f I��jmu
Commission
Notary Public - State of Florida
��. �° ' My Comm. Expires Aug 16, 2022
Revised 07/15/2014 5ordec throutih %atiora: Nbtary Assn.
James T. Leonard
(Name of person acknowledging)
(Signs u e of Notary Public- tate or of F da )
Personally Known OR Produced Identification
Type of Identification Produced
Notary Public - State of Florida
My Comm. Expires Aug 16, 2022
Bonded through National Notary Assn.
(Seal)
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DATE
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INITIALS