HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE CCIMP�c icD FOR APPLICATION TO BE ACCEPTED
Date: PermitNumber:
SCANNEU
BY RECEIVED
& �ft! I St LUCie Count,
I Building Permit Application APR 2 5 2016
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 2�
PERMIT APPLICATION FOR:
"o
Address:-200 N F&M,4r- Ar-� f*7-0's—
Legal Description: C 11,9 N � & 4-o� ql�o S�7 Q W I --
Property Tax ID #:
Site Plan Name:
ProjectName: 15)<Ac", UL96
Setbacks Front Back:
—Mechanical
Electric
GasTank
0-piumbing
Total Sq. Ft of Construction:
Cost of Construction:$ 9MO'
MY41
Right Side:
! 17' 7: -E�ft Side:
permit - cneCK aii-xnaT apj
Gas Piping
— Sprinklers
Q��
Generator
Sq. Ft. of First Floor.
Utilities: —Sevver _Septic
Lot No.
Block No.
Windows/Doors
Roof
Building Height:
Name Akr (S4 V t,
Name: 'Arz6-Li"1-N'9P�0P5LtL
Address: jj9-v-;3 -QL-9 QLjpj�(-Al
C-�
Company: /,/AV-rc)AYf
City: State:
ZipCode:
Phone No. f)-2 L,31 U 9-7(0
Address:
City:
ZipCo'cle: �&?99-L/
Phone No '?� -L 3 ? 0
State:
Fax:
/ /S'
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail 1-4A,,.i)'J` IP lug,/,
69 cw I. Co
State or County License__�-�
OAT
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
"OPMER MI Uffin
T
11 4 SHIEN
RMA11
DESIGN ER/ENGI NEER:
Name:
— Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY: —Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: _ Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 perm19pplications are exempt from undergoing a full concurrency review: room additions,
accessory structure* swim g pools, fences, walls, signs, screen rooms and accessory uses to another non-re§idential use
WARNING TO W Your failure to Record a Notice of Commencement may result in your paying twice for
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improvern n to ur pro st I
I e r I perty. A Notice of Commencement musty/ recorded and posted on 'the jobsite
before the f i st i pectigirl'. If you intend to obtain financing, consriYender or an attorney' be I-
-Mencement.
commenci w korpecordingvourNoticVVET Pr 7., 1
75
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w
nat w Lessee/Agent
License Holder
E 01111�
ST E OF FLORI�g
;CO
2
Ulm
S TEOFF I CIRID
NTY OFm
Ty 0
U,
COUNTYO
The forgoing befo
1�
instriment was acknowledged
this a —day of ?.�W7 20/ (o by
The f9[going, instr^enT was acknowledg9d bef
2
thiso&L 29�L by
day of
6 �� 1. 8p
A
let2�:
pp— 0
(Name of person acknowledging)
(Name of person acknowledging)
e'N64L22
(Sig —nature of NotarOublic- State of Florida )
(Signature State FloVida
of V ar�FPublic- of
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificati
14- -
Type of Identi
I
M=
Produced 011Y_ J2�4
Produced - /)�r
Commission No. (Seal)
Commission No. U (Sea I) -
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 7/2014