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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: SCANNED Permit Number: BY wr'`; w Ui St. Lucie County RECEIVED Building Permit ApplicatiONAR 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 a� Residential PERMIT APPLICATION FOR: PROP • SED tNP OUEMENT LOGATI©N: Address: 029 1 et ` _2_ n AK,I J `D'i Legal Description: ooi-er Re-er eoy-ja Un tT` 102. Property Tax ID #: ( L (ne Li e906 2_ l7d D 0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: LeftSide: + �"•"' T�nSf-.II i iQh t/L_LtLt1d_y i�—✓n,n� � '17nn2 Gas Tank _ Electric _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 3 5-6 _Gas Piping _Sprinklers _Generator Sq. Ft. of First Floor: Utilities: _Sewer _Septic Windows/Doors, Roof Building Height: OWNER/LESSEE: CONTRACTOR Name pe?r" - 4 hors P-46e..,i Woci�.r Name: iy,,ek&a - 9etSw Address: LtQIIY -yW LWO e9rdle Clrc(Y company:aNtYsw City: yr\ ' lrl-v State: FL Zip Code: �I'f Reiy Fax: Phone No. Address: 5`S (40 tome ,Sarn-e pin-e City: f i PfYrc Zip Code: 34efgr) Fax: Phone No 'a' h. 20 1 -17 4 -1 Stater E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above). E-Mail & I Fn,_A e nn S d- f n (R 4oL . e d yr State or County License 12 (bagoa 362 t If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUP LEMEM• L GO U MO LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name:d'nox m-ei7a al _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: Se& A�t Address: City: F, 2T-ir-64-" - Zip: �3y4 5-o Phone 2- State: F%_ 4Go '7%51 City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Address: Address: City: 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 b commencing work or recording our Notice of C encement. 0 �m »oa, Signature of Owner/ L ssee/Agent Signature of Contractor/License Holder ice® d m 1 6 m STATE OF FLORIDA mN A STATE OF FLORIDA gos 2- COUNTY OF �� z COUNTY OF The forgoing instrument was acknowledged befo mg- g The forgoing instrument was acknowledged befor aye this,jbdayof %Y�-I� 20L$—by y,,,o this�day of 20[,�by �t q. <a (Naaam•e of person acknowledging) \ (Name ofperson acknowledging) ��/l�lfn- clia (Signature f otary Pu/blic- State o lorida ry Pub Signature ofjl}bta�ryrP/b is -State of orida ) )C1 Personally Known V OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. //2014