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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ' l"Il7�J' ©Loc)% M maw. �� '� SCANNED .� . - Building Permit Application BY Planning and Development Services St. Lucie County Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential_ PERMIT APPLICATION FOR: I PROPOSED IMPROVEMENT LOCATION: • p. °' =' Address: Legal Description: Property Tax ID #: ~O) -E 9 � /r 1 Lot No._ Site Plan Name: /yFM4-rS 1SI.,�JD Cftbl) Sg C,7_ Block No. Project Name: Setbacks Front Back: Right Side: Left Side: la 't4 g4q�%-' S -V gA&yAyAL jmr- # 1.L FiNjyb Met -AL 6M P&4 4±'Vf-W bag f CONSTRUCTION INFORMATION Is - Additional worK to oe perTormed • under inis permit — cnecK all tnat apply: . _Mechanical Gas.Tank Gas Piping _Shutters a•_Windows/Doors _ Electric —Plumbing _ Sprinklers _ Generator _ Roof AL Pitch Total Sq. Ft of Construction: —4!Li�d Sq. Ft. of First Floor: / 3 SA Cost of Construction: $ �,QQ�.r Utilities:N��Sewer _Septic Building Height: OWNER/LESSEE: ; CONTR CTOR # Name. ,ram•! i? IN d Com'p�ny� ,,�•. '� ' GzWu La'%t/' I Add�ess:� ...% �E �%'�L�S Cd� �%f%ilCIE 117`"ACLI� n 'lj'iai f�9 t,_•�° r� °Lip Code: (7 � Fax: Phone No. Q G 9) Y?I — IJ97 State:iC"'Add�es�ts` £ rMl4d�F HU city b�N� Zip Code: 33y3'6! Phone No 77A — �*/— State:rt Fax: WQ1 �7D7 E-Mail: ;' Fill in fee simple Title Holder on next page (if different-: from the Owner listed above) J E-Mailf,,,0 4-PQ b6�itNd200G:do r'i�L7/. C!�/rr State or County License ('CG /ya %6-:�/ If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPRLEMENTAL CQNSTRt, CTION 1,EN LAW INFORMATION DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: Name: N Not Applicable Address: Address: City: State: Zip: Phone City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Name: ,Not Applicable Address: Address: City: City: Zip: Phone: 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. h 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. Signature of Owner/ Less a Contractor as Agent for Owner Signature of Contractor License Holder STATE OF FLORIDA STATE OFF ORID FFLORID COUNTY OF Mari Ill COUNTYOF /" AC�if\ The for oing instru ent was acknowledged before me The forgoing instrugnt wa acknowledged before me this 2 day of MA rf_ 2011 by this I& day of %�dt C 20 M by GiAec-t (�.,NeHe &ucP UJ4 flea (Name f person ackn wledging) (Name of person acknowledging) (Signatu a of Notary ublic- State of Florida) (Signs re of Notary Public- State of Florida ) / ✓ Person ly Known OR Produced Identification `c Personally Known OR Produced Identification Type of Identifiy�t' n Type of Identific ti Produced / \ b Produced �. Rymed Commission No. Grp 5 3 0"CIP411111111 OrLmummooph"� "MUD Commission No. all 5 f(Sean ankf=0n e 1 PLANS VEGETATION SEATURTLE MANGROVE REVIEWS FRONT ZONING SUPERVISOR COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED L ev.