HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr I ,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u U U
Date: y115 Permit Number:
r; :.; : -_" RECEIVED AP914.2015
• SCANNED
Building Permit Application
Planning and Development Services 'St. Lucie county
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: To Select from dropbox, click arrow at the end of line Wa11 5
PROPOSED IMPROVEMENT LOCATION:
Address: -���,f N . Wto\, / AlA
Legal Description: a�i,�r^ —14 11h (=Nrr Iss A -u\) _«C,aF, AND Gorr- LDT- i
Property Tax I D #: IL4QO --
Site Plan Name:
Project Name: "z V
Setbacks Front Back:
Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: III
->-rSW t ask Aluminu,-i� L4er-%:' + �orrrvd
Or-4 j U--qI I i pS pu' mrv2R� frwckO
CONSTRUCTION INFORMATION: III
ALIUMUFidl WUIK LU UC CI IUFFIMU UnUUF L111b FJUI ❑]IL — Li
0HVAC Gas Tank E]GasPiping
11 Electric 0 Plumbing []Sprinklers
Total Sq. Ft of Construction: 3.
00
Cost of Construction: $ I SQ d.
Shutters ❑ Windows/Doors
Generator Roof
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name t lav,/,sal Mh15RkrY\
Name: f)tsnr.jr= F-ftnogh--
Address:a�Cp N. +lux W
Company: i
City: �;; - R,irC9, State:7F�
Zip Code:/�9L _ Fax:
Phone Ncy --
E-Mail• Ch�l[_9 �A/cGl�l��c�lr (1 .CJ�ri1
Address: t1f�1= i_
c..r1a . 1
CityAA[ Qlm fgpLh Stater
Zip Code: a34 1_S Fax:
Phone No. col - Cco19 - It,:;(
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: I
State or County License: it-�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE NGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
— Not Applicable
Address: r
Address:
City:W. lArn
Zip: 341LA Phone: ShL—'7q,_3—:ire
State: L
City:
Zip: Phone:
State:
EE SIMPLE TITLE HOLDER:
Name:
-_) of Applicable
BONDING COMPANY:
Name:
of Applicable
Address:
Address:
City:
City:
Zip: Phone:
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 your Notice of Commencement.
_ Signature of Owner/ Lessee/Agent i
STATE OF FLORIna STATE OF FLORIDA� 1 ^
COUNTY OF jr n COUNTY OF iT�ln'1 Gad 1
The for ing instrument w s acknowledged before me The��fo��r�QQi,ng instrument has acknowledged before me
thisL ayof��� 20�y this�dayof AQAI,20aby
plc% 1 Klt $� 6t-SnaQ [). riniER::
(Name of person acknowledging) (Name of person acknowledging )
Notary
Personally Known 1/ OR Produced Identification Personally
Typ . __ . _______ _ _ Type ofld4
MY COMMISSION # EE153(&
EXPIRES December 15 2015
Revised 07/15/2014
OR Produced Identification
mARISSA BATIS�T1�A
dY COMMISSIONS#(JLeT50591
EXPIRES December 15 2015
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
I,
1
COMPLETE
INITIALS