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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPI,_,_'D FOR APPLICATION TO BE ACCEPTED Date: Permit Number: SCAn a-06 b / Iv BY PA/l St. Lucie Count, BuildingPermit Application 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 v Keslaentlal PERMIT APPLICATION FOR: AL:uMlnfuM F65vir4s/ldw,> DIWF. Ck065006R . ",+ . ..." -r ..........:."..... , . ..,A...,,,..., . a ... ^ < s .. _ .:c: ,R � 3 �. p..,:..a Address: .2yeo /VoR'7/ A1/4 f Imi, Pfoc2ns 1, FG- 3y9,�{ / Legal Description: Property Tax ID #: N23" FIRS - oOey -'GOOD Lot No. Site Plan Name: Project Name: M6W FI- 4YS Setbacks Front Back: Right Side: Left Side: ss tiv;A 2�1'' LFt C2os�Sov/L42 P0k Pt4W9 �9. Block No. _Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Cost of Construction: $ & Q Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNER/'LESSEE:, ., CONTRACTOR: 'Name 1ARr�lM' FG�4T5 LLG - Name: Al. 50t /0 [°r L5 Address: o`Z%% �OU/iL'-PD//U�!/(/��9 WAS/ $m I'J 6 Company:,-a4457TT-1--J5W/5 .Address: lotj C�orUSipJ.�T/O.cl BOX a23yG / City: 9 State: �[, Zip Code: S��q ` o Fax: Phone No. City: one No Fax: ,5`61-333-a?Y64I State:%�L, E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: §YnT1 /t wl$C©ALSTi�Tl6UG� �'M/�tl Cv/N State or County License: GGC 16-Q 7S'{V If value of construction is 2500 or more, a RECORDED Notice Name: ' '8CLh1yKC-.8me ¢,5iOLD4Rp/lLe Address: /7l7 /ntr7iAN i2lyl�i2 S4lA 020I City: y'zp_j� B,rA-Gt/ State: FL, Zip: R296D Phone:77J-77D- 96,A7, FEE SIMPLE TITLE-HOLDER: Name: Address: City: Zip: Phone: Not-, MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone: COMPANY: XNot Applicable Name: _ Address: 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 vour Notice of Commencement_ VIP I � t &� Signature of Owner/Agent/ Lessee Signature of Contract r/L' ense Holder STATE OF FLORIDA COUNTY OF pck\ rr bt CkC Yl STATE OF FLO�tpFy 1 _ Q COUNTY OF 4-Cl Yh 1 Y'7R --- The forgoing instrument was acknowledged before me this ��Oday t= CbN�_ 20� by The for oin 'nstru e{ t as acknowledg fore me of this ay of ���� k! �Q 2y Kr�Shr� mo-rShrnll p�� -� ,C) (Name of person acknowledging) (Na. of a on acknowledging ) (Signature of Notary Public- State of Florida) (Sinat of Notary Public- a of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification _ Type of Identification Produced Type of Identification Produce 1 11 T Commission No. EE 13W1 °I (Seal) _ Commission Not Y—`o����y� SrATEOFFLORIDA Camel! FF124360 .KRISTINAMARSHALL Expires 5/19/2018 REVIEWS FRONT mission LEE 136)79 P ♦� .� �(� 16 NS VEGETATION SEATURTLE MANGROVE COUNTER IEW REVIEW REVIEW REVIEW DATE RECEIVED I �� DATE COMPLETED icv. //LV14