HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Dd -Q5I Is SCANNED Permit Number: � 5
L , St. Lucie Counn RE/��E1ir,,
Building Permit Application `v FEB
Planning and Development Services n. .
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: 51 9b 13MN III
PROPOSED IMPROVEMENT LOCATION:
Address: S-u
Legal Description:
PropertyTaxlD#: a�o�-3a.�1.. bdd 1�1560-.011
Site Plan Name:
Project Name:
Setbacks Front • Back:
Right Side:
Left Side:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: ` III
4o)-Wi- an��r7�.— new pI4merJ 41dumd, 'rad -•o be butt+
e) 16 ue red ev 11I4--� � L� rr V e cJ Cot-Ylet -p r-
oo���kr,ess-Li110 Aur �iI �IVy Crci�P}S .
CONSTRUCTION INFORMATION:
_HVAC _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing '_Sprinklers _ Generator _ Roof
Tdtal Sq. Ft of Construction: Sq. Ft. of First Floor:
Costofconstrudion:$ -2 3-0 G. (/D Utilities: _Sewer =Septic Building Height:
'OWNER/LESSEE:
CONTRACTOR:
,Name- • dlt ri v✓0 !1
Name: SWC160kipin
,Address:; 3LiO AL D:67 ,. v-r A(,
:company: CJgza,�4.waeCp
u• 2.V( c-
''City; 2 tG e- State:(- I
Zip Code: 3 I� / S c,1 % Fax:-7 72 -Ll(a Li -jei 33
'PhoneNo. %�-2 -`t&44- 5S106 k,.-ss;Zi
�,r�
�O •
NAddress::Io)- 1it%'=1
City: �(Ilr�' -.�'?= LuG'l k-
Co �dec- _
Phone No. i
—State: F-(.-
/ L
"iy3
E-Mail: hdOa PT E 7dtln coivrd� —
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: a o) 64 e ✓l nce i k
c, (0- 21o11. Lo 1i11
State or County, LL gnse: Pc
I arLio 5
II If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.', • II
i•v � 1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
_City' _ - . z. — State:
Zip: Phone:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or Installation has commenced prior to the issuance of apermit.
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 reviewyour 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 vour Notice of Commencement.
Signature of Owner/ Agent/ Lessee
STATE OF FLORIDA �A) COUNTY OF IS-CJ�L
The forgoing instr ment was acknowledged before me
this I day of ^ b �' 20 14 by
person
Personally Known V OR Produced Identification
Type of Identification Produced
Commission Noo V ��
Revised 07/15/2014
STATE OF FLORIDA•
COUNTYOF 21.�)�
The forgoing instrument was acknowledged before me
this 7oday of ,u-it 20_ISby
(Name of person acknowledging)
of
OR Produced
Type of Identification Produced Vy) 2 —
No. •5 1 IZI Q•
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE •,
'MANGROVE
'COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS