HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit N llsvi>_ 4�)_316
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RECEIVED JUNW215 St LUcie couniv
Building Permit Application JUN 2 4 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
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: )'4 b() 0
Legal Description: "�_rbrj�At V�k R 01
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SitePlanName: 4"b." (2-49a G-09_%-160
ProjectName: 14-wba" Pktjoe "e-7,6C)
Setbacks Front Back: _ Right Side: Left Side:
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Lot No.
Block No.
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QETAIL�EP, DI�SCRIPTION QFW.,0.RK:'-,_
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AclaitionalworKlOijenerrormea uncler inis permit - cneCK all apply: L
E1HV Gas,Tank DGas Piping Mutters Windows/Doors
aElectric Plumbing OSprinklers 1:1 Generator aRoof
Total Sq. Ft of Construction: IC70 S Ft of First Floor:
, '. . !" — IlSewero -
Cc& of'�oristr'u'ciib"n- $ .7-0 -Z35�--76' Utilities.. Septic Building Height:
,QWN,E R/ LESS E E:
CONTRACTO
Name 14-irbaw:'12_4�e Q-4,y CJ-6, T-elr*
Name: PAIJUSAMPSON
A�&ess�.' eJ917, RIVA-
CoT pa_hy:.TLC: EXPERTS
City: State:
Zip Code: �1 c`1 cl r)' Fax:
Phone No. Wel
Ad,dress: 1237-DELAWARE AVE.
Cit�_:.FT. PIERCE State: FL
Zip Code: 3.4950 Fax: 772-466-1655
Phone�N'b-.',1772-46.6-7626
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: keith@ticexperts.com
State or County License: CBC1258197
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirecl.
I I � I - _ .1 ' - I—' I
SUPPLEMENTAL, CONST-RUIZTIGNI'I�N- m, NtbWAiTrON:
DESIGNIN/TENGINEERi _NotApplicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State: -
Zip: _ Phone:
FEE SIMPLE TITLEHOLDER: _NotApplicable
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.
,ethe ermit holder to build the subject structure
or ang covenants that ma estrict or prohibit such
deed for any restrictions % ich may apply.
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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 a9d 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
commencine work or wcorclinR vour Notice of Commencement. I
STATE -OF FLORI�
STATEOFFLOT�
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COUNTYOF X COUNTYOF
The fpqo Ii acknowledged before me The f ing ii t t as acknowledged
�g histrulnent w�s Fbefore me
1 20 by
th s _,,,�Lay of 20 LS-by th S Tday of
Type of Identification Procluced_-�
Commission
Revised 07/15/2014
of person
of Nbta?VI�411c- State
Personally Known _2�J OR Produce@de.A"-tion
Type of Identification Produced E*'
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Commission No.- 9
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