HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 51 aA$ \5 2 0 1 5 0 5 3 0 Permit Number: 5O 5'C `13
R'` RECEIVED MAY 2 81015
Building Permit Appl c�� an � 'e (-eole" Planning and Development Services
Building and Code Regulation Division BY 5
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County n
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential d`OL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal
Property Tax ID #: t�{a _70l' in(py "IM' & v Lot No. n t— Ig
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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itiona wor to e e orme un ert ispermit—c ec a appy:
�HVAC � Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric Plumbing Sprinklers _ � Generator Roof
Total Sq. Ft of Construction: _ C)9
Cost of Construction: $lap
' S Ft. of First Floor: _
UtilitiesSewer DSeptic
Building Height:
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Name V I(
Name:
)WWJUSLWIL I'Lt lt.Q
Addres 1p 114.y) J
City: (R tC t _ State:
Zip Code: Fax:
Phone No.
Company:
&
Address
{
City:
Zip Code:
Phone No
, 4 fit. u S�t/at+e::_� /
(.D Fax: �7'c�7�Y T
t�
E-Mail: CoLpa k lu
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: J104 cmvw
State or County License: �
1t value of Construction Is �,ZbUU or more, a RtCURDEO Notice at Commencement is required. Mm. " " """
St.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: °vL a�1 \5 Permit Number:
RECEIVED MAY 2 8 205
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSEDIdMP,R0VEMENT L0CAT10N:
Address:
Legal Description:
Property Tax ID #: lJ ��a� 701- Lot No. )$ "r IQ
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
AILED DESCRIPTI0N'0F:WORK:
1,64 ,u U, 060-0- gC)o en C11"
P.1 C-NC, +0 I3L atsv b!j ALL AA&,b e E(QC-ivlc (sLd, i
CONSTRUCTION„INFORMATION:
Additional wor to 13a nartormea unclert is permit— checK a apply:
OHVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
0- Electric Plumbing Sprinklers E] Generator E Roof
Total Sq. Ft of Construction: 4)
Cost of Construction: $
S Ft. of First Floor: _
Utilities: Sewer ElSeptic
Building Height:
,OWNER/,LESSEE:
x
CONTRA • OR:
Name' v Ydb;
Name: Z)LASWULWLS
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Addresp j� f},y1
Company:
/L
City: (Q tCA _ State:
Zip Code: Fax:
Phone No.
Address
I
City: K - Vuj C.-2
Zip Code: (D
PhoneNo�`F
S't/at/e:: —l^
T Fax: �I7a7�Y i �N
E-Mail: QpLpai-L
�T
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
q
State or County License:
(�900
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
S,gnEMENTALCONSTRUCTION LIEN LAW INFORMATION:,
DESIGNER/E
Name:
GIjNEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Addres .
IZ- l4a
Address:
City: &JCJ State:
Zip: Phone: _
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
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
_ Signature of Owneent
STATE OF FLORIAA;
COUNTY OF -t'
The fojgping instrure_ntwas acknowledge fore me
this o� I day of 1 Y gam 2015 by
Personally Known _
Type of Identification
Commission No.
t
Revised 07/15/24
-State ofForida )
OR Produced Identification
Iced
(Seal)
IAEg MELISSA C. BLANDPORD:
My COMnngSJON o EE2olsrt
EXPlltES: August 14, 2016'
STATE OF'FL
COUNTY OF
The f r oing instr�{�,entt was acknowledged b5pre me
this da, 1' " ` Z1 .20 —!—thy
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
1 5o5 -oy34
(Seal)
MY COMMISSION d EE2U3'
EXPIRES: Aug= 14, 2016
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