HomeMy WebLinkAboutBUILDING PERMIT APPLICATION?q
ALL APPLICAB[E INF M BE C°PTTit FUAP LiE ' ON TO BE ACCEPTED 0, -11 s
st.
Date: LIS
BY
$(,Prigti�riber:
FEB - 9 2015 St. L ucle ie
Public Works County 1
513UT1U rfgrlPeYmit Application I
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 X Residential
PERMIT APPLICATION FOR:
PROPOSED IIVIPROVEWNT LOCATION: .
Address: 7!4L�
Legal Description:
Property Tax ID #: � � �� � Lot No.
Site Plan Name: 9' Block No.
Project Name: S �D u�t d1c�Dl9iin ilJYh!
Setbacks Front Back: Right Side: Left Side:
i .-
DETAhLED DESCRIPTION OF WORK:'
c�r� E r r + � u.� (✓ 2 16 , -31 ��, Z� 16) sra
'CONSTRUCTION INFORMATION:
11HVAC UGas Tank F]GasPiping UShutters
Electric 0 Plumbing Sprinklers Generator
Total Sq. Ft of Construction: JfC%a S Ft, of First Floor: _
!/�
Cost of Construction: $ �T`� 6 Utilities: _ Sewer E] Septic
❑ Windows/Doors
Roof
Building Height:
OWNER/LESSEE: f', ':
;CONTRACTOR:'•
`.�7
Namep
Address //� ��' .�Ge([t�i �rr++--""��= �Q
City ate fz LL-:
Zip Code: 4 Fax:
Phone No. ���-Z — 710 63
Name:_.
ompany?2LW
Address: 2,3� i3 a
S♦�JE s%
City: Cif li%ta
Zip Code: '? Q
Phone No. Jr6%_
State:_P__l__
Fax: ) -;z2—2675z-731t
6Z �✓ i^ Z9
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: 6L"o, C,,_,a
j Er_ 6� G/ Maas 691M
State or County License:
/ ✓ G
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. C_� I — '__�
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PESIGINEFVENGINE
Name
Addrasa:
Not Applicable
! a
. �
MORTGAGE COMPANY:
®:
teas: _
Cltyl
Zip: Phone:
Not Applicable
State:
City: ate;
lip: Phone:
FEE SIMPLE TITLE HOLDER: Not Appllcable
Name:
BONDING COMPANY:
Name:
Address:
City:
�LNotApplicable
"j
Address:
City:
Zip:
Phone:
Zip: Phone:
I cartify that no work or Installation has commenced prior to the Issuance of a permit.
w l do County mak no repreeentatlAn that Is rantin a ermlt W111 ini jortze the ermit holder to build the subject at stare
willc�r Ic in c[onflict WI any Appplicable Hnme tlw� rs As�}}oefatian rules, bylaws Gr an�tavenanis trial may reA�nct ar pr hf61t such
structure, Pisase eonsuitwith your Hnma owners �esotlation and review your Zed for any restrictions whlrh may apply.
In consideration of the granting of this requested permit, I do hereby came that t will, In ail respects, perform thework
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 panic, fanets,wells, signs, screen rooms and accessory uses to another non•residentlal use
ire to Record it Notice of Commencement may result in your paying twice for
A Notice of Commencement must be recorded and posted on the Jobslte
intend to obtain financing, consult with lender or an attorney before
SI aturo of lease gent
STATE OF RIDA
COUNTY OF
The forgoinglnstru t sacknowtedgao� reme
this, I —My of ��� 10 L>Y
Known ✓ OR Produced Identification.� _
gnatur roc
STATE FLO A `
CQUNTY OP
The forgoing Instrument as acknowled ed a me
this -J-(-liayoft,70 _-by
Type
person
REVIEWS
FRONT
ZONING;
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
.COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
- J
COMPLETE
INITIALS
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