HomeMy WebLinkAboutBUILDING PERMIT APPLICATION[ -
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED @
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Date: PermitNumberRF—C- ,91 r—
BY
31,
s Lucie county MAY 2 2 2015
Building PermitApplication PERMITTIM3
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I�p Lucie Coun% PL.
Planning and Development Services O
Building and code Regulation Dlvision
2300 Virginia Avenue, Fort Pierce FL 349a2
Phone: (772)462-1553 Fax: (772)462-1578 Commercial —/-- Residential
PERMIT APPUCATION FOR: To Select from dropbox, dick arrow at the end of line
Address: Seems F4�VbE2 f2eAE>
Legal Description: Uai1 eweoD Pareyr.+t% 12 A r31)L- 17!Er Loi2s l ? 2
Property Tax lD #: 1 %?3O 1 (OL5 O I (::'l -7 000 - Z— Lot No. I i 2-
Site Plan Name: Block No. 1-18
Project Name:
Setbacks Front Back Right Side: Left Side:
Y.�-A
mona wo to rm un er permr[- a app .
�HVAC Gas Tank �as Piping Shutters Q
Windows/Doors
Electric 0 Plumbing Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ 3['Jb- Ittilities:Sewer OSeptic Building Height:
Name h✓tC
Name:. JeLO
Company:
Address: Iy4- W. ThA+r 17AIK CtV a
City: T p. I r— State.
Address: 0 3zi^J'
city: ci-G2 State;—r--/
Zip Code: S3*SLS Fax:
Phone No.
Zip Code: 7fg Fax:772- S1,77
E-Mail:
Phone No. 2- f Pi6 5r
Fill in fee simple Title Holder on next page (if different
E-Mail:
State or County U'o�ense:e8 #- FS I S� 2
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEE/R:1 Not Applicable
Name:AtCR1>c./
MORTGAGE COMPANY: _
Name:
Not Applicable
Address: oo
Address:
6 �L
City: Fcri' Ptcv- w State: 1=
Zip:7gakSo Phone:-nZ4,vLA7e
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: _Not
Name:
Applicable
Address:
City: `'
City:
c
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con ict 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
Signature of owner/ Lessee/Agent
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF k- uo1:%� COUNTYOF � �J'nJJP
The fo ing instrument was acknowledged before me
this \\day of ff�— A _ 201-'5:-by
Personally Known OR ProdU,ced idde cation
Type of Identification Produced ?T
Commission No.
Revised 07/15/2014
(SE9)C DAVIS
b NOTARYPUBUC
Caron# FF108235
Expires 3/31/2018
The forgoing instrument was acknowledged before me
this _ day of .20 _by
person
(Signature of Notary Public- at&of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. .AL
CONNIE N
Notary Public - S
z My MIM111. Expire
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c,?a Commission B
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
of Florida
129. 2016
209535
Notary Assn.