HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTE6 t
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Date: Permit -Number:
MAR 11019
Permitting Department
Building Permit'Application St. Lucie County
Planning and Development Services -
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential t/
FPERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line BY
PROPOSED IMPROVEMENT LOCATION: Lucle oun
Address: pn F- EASY sl-RFF-T FORT PIFRCS FL. 34982
Legal Description: LOTS �OJiND 70 BIOGK 15 /A1D99NRI0E?E$r47-E5- (V/F9 fILC9RD/A14 77bT#F)7A7-
'TJLiefi9 ASRFeXAFD /N )1TejDk' /D 99654%OFTNERIBGILti aRO5 OFST. X197 OA17yrtaI A,
PropertyTaxlD#: '�TD?^�04'0032-�0-D Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIP/T'IONN OF WORK:
" 2 CO.rcrG�� fO ✓.r ✓/7-� o �/ Ci NZ j�e�a, ZS o .r l�ru ..�..r s l �.T/S�rT CC.o t<. a ,mil d
CONSTRUCTION INFORMATION:
Additional wor to orme under t-checkispermit a appy:
�HVAC MGasTank ❑Gas Windows/Doors
Piping _Shutters
_ Electric FJ Plumbing Sprinklers []Generator E]Roof
Total Sq. Ft of Construction: 911/0 S Ft, of First Floor:
Cost of Construction: $ � 5 � z o D Utilities: _Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name JOHN J. qNDFC<tN cJR.
Name:
Address: I22 E. EAST STREET
Company: �% 3
City: rar f!/ERCE State: FL .
Address: //7 0��aA //nn fit.
City: or -7i r7Lc_c - State: �L
Zip Code: .34V 2 Fax:
Phone No, 772- 6/7 W6u
Zip Code: 3y`I'�°1 Fax: .•/ I4
E-Mail: PFTE,4NDE,f* eO rd#40. G41
Phone No. 772-S77-OI G (o
Fill in fee simple Title Holder on next page (if different
E-Mail: S 4gE1or ,c--
State or County License: e3C /2S'93�3Z
from the Owner listed above)
rvaluef construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY:
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not
Name:
Address:
City:
Zip: Phone:
Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not
Name: _
Address:
City:
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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordine vour Notice of Commencement, i
r,e,-- L
_ SignatuMof Owner/ Lessee/Agent
STATE OF FLOR�IppA d
COUNTY OF ,?1,�r��
The fo ing inst ment was acknowledged before me
this day of ! k AXA 20 Eby
Rnp ,t'_
(Na e o person acknowledging)
FLORID
OF V, a
The forgoing instrument was acknowledgeUefore me
this\X day of PDQpp)& .20 J"�Lby
(Name of person acknow dging )
(' at re of Notary Public-S to of Florida)
Personally Kno OR Prog,duced Ide tification Personally Known OR Produced Identification
Type of Identificati Produced 'c L Type of Identification Produced
QjkRr Kelly Molloy
Commission No. II NOTARY PU ISlOmmission No.
o sSTATEOFF ORIDA �^"•"`'• LASHAtINAI'i MIRG
2ComndfG _`'�• •�'',"t MYCCMMIS&0N#GG275060
ete Revised 07/15/2014 Expires9/18/2022 �•�'.-.:�: e
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS