HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPUCAB E INFQ1 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTD E
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Date: �I , J 1 i SCANNED Permit Number:
BY —
St. Lucie County.' ^^-
Building Permit Application AFZ 3 �e
Planning and Development5ervices i '
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
St. Lucie county, FL
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: Hay-6olAy Ad4Z- Pla+y-
1361-1\;'4)
Property Tax ID #:� //L 1 - - p If - p D u
Site Plan Name: HAS u i kr_ AC
Project Name: 4arb0H! A;. (go Board Wa11L
Setbacks Front Back: Right Side:
Left Side:
Lot No.
Block No.
I DETAILEDDESCRIPTION OF WORK: III
CoA5-1TNc,, A wooc(cr 6mrdwa.lk
-ta a r%aiuve.'tya l I .
wv+ic6. Connects or. e-A
bvardwuJk
CONSTRUCTION INFORMATION: III
LJHVAC I J Gas Tank UGas Piping
Electric 1:1Plumbing [ISprini
7 Total Sq. Ft of Construction: ✓ 0
Cost of Construction: $16, !Roo r J n
Shutters Windows/Doors
Generator Roof
S Ft. of First Floor: _
Utilities Sewer 0Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 1 ayloour RAp
Pn A
Name: 0 0us <
Addressja0O NW "%about "Ldiy allid.
Company] A )SOVfe
u
OM C®rp
City: Palr" C"}y State: FL
Zip Code: 34990 Fax�7MI 1 133G-19 S 7-
PhoneNo.r7-72.)573-&04do
AddressAY81SCGrO4der
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City: 4,4-
Zip Code: 3`/9'9%
Phone No.77.a D-516 a��s
Fax�771
State:rL--
Vl-1�5/S—
E-Mail: fl Veepc 0- hrycc . VK5
Fill in fee simple Title Holder on next page( if different
from the Owner listed above)
E-Mail: C - e-A
State or county License: C/3 C 0.3N
99y
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
Zip: C, Phone: 71D0 c,ZS
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: 64ot Applicable
City: State:
Zip: Phone:
BONDING COMPANY: _,�.XotApplicable
Name:
Address:
Zip: Phone:
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.
r S
_ Signat of Owner/ Lessee/Agent Signatur ntracto /License Holder
STATE OF FLORIDA�, \
COUNTY OF sT Lk .�X-'k'g
The f,o,rg.�oing instru en was ackriowledged�afore me
tt�s��ay of , 20 J�;;,by
of person
Personally
Type of Id(
Commission No.
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF (�
The f rgoing instru ent was acknowledged before me
this 1idaaJyyo\fAK-0 ^�20 _IS: by
A
(Name of person acknowledging )
1
IT) J/
(Signature of Notpfi Public- State of Florida )
Personal ication
Type oft Qflgn P
n
• :p EXPigE9: April 12 2016
Commis 9 ttC," 3nMttt ihm Naery r" llnde g I)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE41461
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INITIALS