HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEThu WR APPLICATION TO BE ACCEPTED
Date: 5�$\�� Permit Number: \`�
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CnMAY
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Building Permit Applicati 0 8 2 119Planning and Development Services SCANNOBuilding and -Code Regulation Division BYounty, P_ermltting
2300 Virginia Avenue, Fort Pierce FL 34982 UCI@ �OUili�/
Phone: (772) 462-1553 Fax: (772) 462-1578 Commer%ia� Residential ✓
PERMIT APPLICATION FOR:
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Address: 33A AV*- i`r Do-rce •(=L- 34982-
LegalDescription: ReCJ'iw&.'PdLM S/D Gir 9 7,21 /TO�lT.13T��)�,
) .:q 0 �4 — 7!V 05a, 5 �7
Property Tax ID #: Lr,2 na i A 000'L Lot No. ry /iL
Site Plan Name: TPw, o-ld), d- #,-dr4 6 ' Cct rro) f Block No.
Project Name: leai1 iLrcr,Q e. e_
Setbacks Front 1 S9 $ / Back: 83 •3 Right Side: 13 / • 9 / LeftSide: S9, 9 /
17 6gfT
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permit-
e_ 3 Rwd fL SA-R' w a 6 -va
P-Mechanical _Gas Tank Gas Piping _Shutters =Windows/Doors
✓Eleatic ✓Plumbing _Sprinklers _Generator —Roof SI12_ Pitch
Total Sq. Ft of Construction: 2 y q Lf Sq. Ft. of First Floor: /9loS
Cost of Construction: $ Y26S, 000 Utilities: mower peptic Building Height:
OWNER/LESSEE;:" '
CONTRACTOR
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Name i rma Hw 4- i4<.dr4 0 V
Name: /➢1 1' CAt_f L 17 i Fra r, ces W�
Address: 33 a
Company: 17 i �Fra_c.,e eS 111 Crn��f wcl �+, 1 vim
City: FT Q i er a State: F`-
Address: 122 r/li ",'G
City: F I f' ' e ra2 State:
Zip Code: 3 W 12 Fax:
Phone No. •77Z- -370 87Za
Zip Code: 3Y1?Nr Fax: 772- tIGS 7873
Phone No �1-72_ 20l -7-7fl
E-Mail: +Im • Co,n
Fill in fee simple Title Holder on next page (if different
E-Mail
i CF ra n Co n t i n [ rn- a -a) , e0"1
State or County License 99 gqd o 342- I
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
?SUPPLEIVIENTALCONSTRUCTIQN LIEN LA1�V INFORMATION
DESIGNER/ENGINEER: _ Not Applicable
Name:S+e.re- I.-,C4uSi Ly fn A �vvQ � �
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 13% SE (�[aren r Zvi
Address:
City: Fr t .r -� State: Fti
Zip: 3yA'Jz Phone -i-7z -725-6L/65
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _ Nat Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address: V
Address:
City: R
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 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
commencing work or recording r Notice of Commencement.
Signatu a of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLOIPIRA
COUNTY OF
COUNTY OF 3 . ►-Uc's Q'
The fgrgoing instrument was acknowledged before me
The fodrgding instrument was acknowledged before me
this _ day of 20�by
this _ day of VVTl 204by
%-,On4 -\ v�ees�a
��e�dt<� ��T4anC�3Gd
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
(Signature Notary P lic-State Florida)
of of
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
L-
Type of Identificati n-----""t':
Produced l
Prod aIeNAMP
Commission NoA<rdQ1Zk,0-a,'3 (Seal)
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Comm s_ b O $rr 71 m??e $nJem'=(Seal)
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DATE
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DATE
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Kev. //2014