HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr-
N
i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED s�
Date:. t S SCANNED Permit Number: 17
BY
St. LUceCounty RECEIVED
Building Permit Application MAY 22 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: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION: . , II
Address: /D7%� ..f,Cl �5.�• 3f/95�
Legal Description:
Property Tax ID #: / — 5e D _ 8 — Lot No.
Site Plan Name: Block No. i
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: III
CONSTRUCTION
UHVAC LJ Gas Tank UGas Piping
Q,I�ectric 11 Plumbing ❑Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 14 6 JrD� O
21X la
Shutters ❑Windows/Doors
Generator 0 Roof
So. Ft. of First Floor: _
Utilities: Sewer Septic
Building Height: /G e '*
OWNER/ ESSEE:
' CONTR' OR:
Name
Name
Addre
Company:' u ,Ae r
City: �, State: a
Zip Code Fax:
Phone No. 'J � —7 3
Address:
City: State:
Zip Coder,/ 9 4 tip Fax: Y
Phone No. -
E-Mail:
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
E-Mail: /1-, Ns 1 �-o %d, l}
State or County License: p,9 /j"J
It value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMEN CONSTRUCTION LIEN'LAW"INFORMATION:
DESIGN ENGIN ER:
Name: J
_ Not Applicable
y
MORTGAGE COMPANY: _ Not Applicable
Name:
Addre s:
Address:
City:
Zip: 3 4 3 � Phone:
State:
-� - / —Jil
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 rer rding your Notice of Commencement.
_ Sign re of owner/ Lessee/Agent Signature of C ntractor/License Holder
STAT OF FLORIDA e1 STATE OF FLORIDA
COUNTY OF COUNTY OF mac,
The forgoing instrument was acknowledged before me
this 5day of� 20 !!�_71ry
_Person own OR Produced Identification
Commission ovk,,, Notary Public State of FlWda
--O,—itaeietLamb (Seal'
My Commission EE 159114
Revised
The for oing instrument was acknowledged efore me
this day of 20- by
(Name b person acknowledging)
. � ):�_ J, "
(Signature of Notary Public -State of Florida)
sonall OR Produced Identification
Commission No. oy`" Notary Public St opponda
ie L Lamb��e�'/
My Commission EE 159114
.v
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS