HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI I i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:. -I S PermitNumber: 150_1-01Q�l
SCANNED
RECEIVE 0 JUL 0 8 2015 BY
St. Lucie Countv
Planning and DeveloomentServices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Legal Description:
Building Permit Application
Commercial k Residential
't 1
PropenyTaxlD#: /3/4- qll-000q-060-2 Lot No.
Site Plan Name: /95/4,,n /-/VV.S4.W Block No.
ProjectName:
Setbacks Front /go Back: /0 RightS!de,. /V Left Side: A;,
fig,,pl.'e7' 7�/, Plec -es 'P/
01
—Mechanical
Electric
ZGasTank
— Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ FM 9X�
— Gas Piping
—Sprinklers
—Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof
Utilities: — Sewer _ Septic Building Height:
U "T'=V! VMM
ffl �00. �'W M RM -
"'115 C, W 'R
Name— 1�-/q Z!1,
Name; L2
Address: 73/1 -r.'A"e &WZ S.;t4
Compan
City: A7 Aer,_, State: L-'l
Zip Code: �05'1 Fax:
PhoneNo. -2-27- doP� ,9-546
Address: 3
City: Aete-e State..-1-0/
Zip Code: 3 $j A2 Fax: 2 2 z - �g f-- k�w
PhoneNo. -)7D7 -633 -075/0
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: 14116, /1171 4 ARga"', W, n"
-
State or County License: 602
67 7d.?-r7j
I
If value of construction Is 2500 or more, a RECORDED Notice of Commencement Is required.
�g,
R14,0460F 1
DESIGNER/ENGINEER:
Name:
Not.Appllcable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address;
City:
Zip: Phone:
State:
City: State: _
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _NotApplicable
Name:
BONDING COMPANY. —Not
Name:
Applicable
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.
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 concurrencV review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
TO OWNER: Your failure to Record a Notice of Commencement may result In your paying twice for
?nts to your property. A Notice of Commencement must be recorded and posted on the jobsite
firgiWection. If you intend to obtain finanpWg,—c0Rsu1tfflitK1enc1er or an attorney before
Lessee
OF
The f Ing instrumeq was acknowledged before me The forgoing Instrumerit was acknowledged before me
this 09rdayof -J'L,/l 201!Cby I this __?'day of �'- / ;z 20_IJ7 by
Hle/a_Z1 — 'Y, I / IC4 /,,
(Name of person acknowledginif) (Name of person acknowledging r
(SI&nature of Notary Pdblic- Florida) (Sigriature of Notary Public- St6te of Florida
Personally Known ILEY
OR Prodi ricatIMICHAEL "IMally,:nown N/ 01 idem%ML M
M
Type of Iclutification Produced MYCOMMISSIMOMMMO tifloationProduc MYCOMMMI—ONTOM111
EX2P1REZS July =18, 2010 July 18, 2DIC
EXFnRES
Commission No. BgL$ ;V64V issio : No A5LO,21 =30M153 (Se2ggg!��.
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