HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 5 Permit Number: \ 5 O I -0Q 13
SCANNED
Building Permit Application St. Lucie County
Plan
ping and Development Services
Building.and Code Regulation Division,
2300Virginia Avenbe,.Fgrt Pierce FL34982' -
Phone: (772)462-1553 Fa'x:(772)'462-1578' Commercial Residential
PERMIT APPLICATION. FOR: To Select fro.rri dropbox,:click. arrow at the. end of line
PROPOSED IMPROVEMENT LOCATION:
Address: zbA Y "R D
Legal Description: -
Property Tax IDth 3 yD'3 n/ 92- ii9 l :Lot No.,
Site PlanName: Block No.
Project Name: `�h�i)61 C �.✓ rC.r tier /mil E/ origin Si
Setbacks ' Front -Back: Right Side: Left Side:
I CONSTRUCTION INFORMATION: III
UHVAC: UGas.Tank , U6a,
UElectric- Plumbing EISpi
Total Sq. Ft.of.Construction
:Cost of Construction:$ -
mi — cnecK all LOdj� apply:. . .
Piping." Shutters ' ❑ Window's/D'oors
nklers - E Generator Roof
S Ft. of First.Floori
Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
-Name Cny7-e, Pnn iOPC,;Aep; �__
raRiii/ 519�✓1 '
Address: " 3 HST /i/ ir�ral w;b .y Rid _.
_Name:
Company: -
City:'. 1&,7 State:.'..Address::.
Zip Code: Fax:-'
Phone No.
City: /.rJP_r 4,41 &;44 - State:/ . .
Zip.Code; 33 L!D 7' . Fax:
Phone No. Soh / `8D Z
E-Mail: J� iYIA !� /�.�P.P�i�i,!/3.✓S.CD�i
E-Mail:
Fill in fee simple Title Holder on next page ( if different ,
from the Owner listed above)
State or County License:' 6,S19 062•o l Y Its? '
If value of construction'is $2500 or more,.a RECORDED Notice of Commencement is required.: - -
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable.. . -
Name:
MORTGAGE COMPANY: Not Applicable
Name: _
Address: .: .....:... _ : —
Address: "
City: State: .
Zip: .:.:. _- Phone:.
City:, State: '
Zip: Phone:':.'.
FEE SIMPLE TITLE: HOLDER:;-.." .Not Applicable, :.
Name:
BONDING -COMPANY: - _Not -Applicable
I Name:.. .
Address:
I Address::...
City:
I City:
Zip: .: Phone:
Zip: Phone:.
I certify that no work'or installation has commenced prior'to the issuance of a.perrriit..
St. Lucie.County makes representation that is granting a permit will.authoriie the permitholder to,build the subject structure
which.1s in conflict with any applicable: Home Owners Association rules, bylaws oran covenants thatmayrestrict _orprohibit such
structure. Please consult With your Home Owners Association and review your deed for any:restri&lons which may apply.: -
Inconsideration of the granting of this requested permit, I do:hereby'agree th'at,l 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 memptfrom undergoing a full concurrency rev'iew:,room additions; -
accessorystructures, swimming pools .fences; walls, signs, screen rooms and accessoryuses to -another non-residential use
WARNINGTO OWNER: Your failure to Record a Notice of Commer cemen4 may Fesult:iu 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 our Notice of Commencement.
Signature 6f Wrier/Agent/ essee : ' Signature o Contractor/License Holder
STATE OF. FLORID STATE:OF-FLORIDA!�
COUNTY OF 1 Qlrr :.. - 000NTy OF' : - (. G I M ct�� ,.
The forgoing instr=ent was acknowledged before me .The. forgoing instru t was .a'knowledged before. me-
this-Z day of J GnU a,' </ 20 .1,-.bY this day of VC+ V 20_1.A by
ha e ` a:..� LNe `
,(Nam of
vwledgin � :(Name per n ckn 'ledging)..
(i n tur Nola ublic- State, of,Flarida),'_' (Sig ture:o.Not ' Public- Stateof Florida.).
Personal) Known onally nown x o u 'd a ti cation
Type of Identification rod e - �.'."' 'ANDRIA M. SCHEELE Ty ' of identification Produ-
Id-Ri--StY92ECE
Notary Ppbllc- State of Fla da �
1L- Public - SUh of Flod
.Commission No. 'J=' / e 14j�mm. Expires Feb 27; OM mission No. - •� I j m, Expires:Feb 27, 20
Commission 6 EE 1680 Commlailon 0 EE-166071
. '�%�°f,°,t° Banded Thmo06NatlorW
..--.
—Revised 07/15/2014-.-
REVIEWS. FRONT- .ZONING iSUPERVISOR `.PLANS :. VEGETATION _ SEATURTLE
W: W_E - :MANGROVE -COUNTER REVIEW': REVIEW::' REVIEW. REVIEW REVIEW,.: REVIEW...
DATE — I —
COMPLETE' '-
INITIALS'