HomeMy WebLinkAboutBUILDING PERMIT APPICATIONWI APPLICABLE INFO MUST BE COM'. --,,'ED FOR APPLICATION TO Bt ACCEPTED,
Date: __71 10 Permit Number:
SCANNED RECEIVED
BY
it St Lucle(COIJ"
Building Permit Application MAR 3 0 2015
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 Residential
PERMIT APPLICATION FOR:
Address: 2 -A I 0i
7_(mot Yqe_rr,ik-
JR-
F-r FL
Legal Description: . t7u4--c4-
I%&, d a .
i I r% 17- 20'1
Property Tax ID #: 143ic, for9q f)046 AO(3 I Lot No.
Site Plan Name: Block No.
Project Name: -
Setbacks Front Back: _ Right Side:
Side:
;zm6chahical Gastaink Gas Piping -Shutters
E ectric , —Plumbing Generator
Sprinklers p
Total'Sq: Ft of onstruction: Ft;-df First Floor:
it
Cost.11ofton'str6ction: $ _35-0, Utilities: -,s6w,,er Septic
F-f
Na
Zip Code: 34q90
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
�, . -,,Windo1Ais/D6brs-" i ` '
Roof
Building Height: I
� i &D
City: r-Y 551-6-C 4 State: fL
Zip Code: '3144 45 Fax: Zzy 7 qro 3 -2
Phone No--77 ?. 7ol 7747
E-Mail d FFra t vq5 4 1 Ac. 4P a a e'e
State or County License 9,A 9gen t 62- 1
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL iG ONSTRU
N LIEN LAW INEORMATIQN
DESIGNER/ENGINEER: _
Name: Crwl_ 4-- rvlenarcl
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:!gof, "b-iLir t,ja,r-t-
✓+t ,<
Address:
City: Fr !Q-r-crc-4—
Zip: 34gS'0 Phone
Stater
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
1V 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 your Notice of Commencement.
G
& a -
Signature of Owner/ Lessee Agent
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLO _
COUNTY OF lZu
COUNTY OF
The forgoing instrument was acknowledged before
me
The forgoing instrument was acknowledged before me
thiL_ day of MA rC e f 20j,�_by
this�Q day of P2AV_&,Q,= , 20 /y by
1_ 1)
.
Z� , J
(Name of person acknowledging)
(Name of person acknowledging)
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o¢no
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Signature of VotaTy Public- State of Florida
w
(Signature of No6fry Public- State of Florida)
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Personally Known OR Produced Identifica
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✓ �¢
Personally Known OR Produced Identifi
Type of Identification
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Type of Identification
�a
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Produced
ya ':1
Produced
Commission No. (Seal)
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Commission No. (Seal
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014