HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7
Z�l PermitNumber:
SCANVED
6GANNED
BY BY
L I I-ocleCOUIllty St. Lucie ColjnhRECEIVED
Building Permit Application JUL 19`2015
Planning and Development Services
Building and Code Regulation Division PERMITTi.Na
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Courtt, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
I PERMIT APPLICATION FOR: 60,S 0 4P �A (Z I
Address: -S
Legal Description:
b,de, . F'I *9 4t9 r.
Property Tax ID #: 3 4 1 :5 - Go I - 00 6 5 - 00 6 - V - Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
—Mechanical
Electric
GasTank
— Plumbing
Total Sq. Ft of Construction:
VGas Piping
— Sprinklers
Cost of Construction: $ 2-1 00 0 - 0 ()--
—Shutters
Generator
Sq. Ft. of First Floor:
Block No.
. —Windows/Doors
Roof
Utilities: —Sevver _Septic Building Height:
Mlq�TRAW-F
Name 'Aev-,4411 vx'�'
Name: CA-�:r
Address: 1?191 -�'E Q-(elld
�Y
Company:
City: A&4 V. Lkz�r'
Zip Code: TV'l Fax:
Phone N�qQ 6
— State:
Address: /70/
City: rl. rler"—
ZipCocle: Fax:
Phone No 6 771
State:
E-Mail:—
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License ;2, q 0 1;
I
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
Vag -ar 1�!F
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Ad d ress:
Address:
City:
Zip: Phone
I
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
—Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: _ Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby maae.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. I
no
:e the permit holder to build the subject structure
or and,covenants that may restrict'or prohibit such
de6d 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, s�reen rooms an� a�ccessory uses to an6ther 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 inMd to obtain financing, consult with I nder or an att fore
commencing wGfk or recordi 06j/Notice of Commencement. . �7 7py� -
Signature of Owner/ Agent/ Lofsee/Contractor
SigKaKture of Contractor/License Hdrder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this cML day of;:-T-. J) A 20_J�� by
Oat I �a_� zd_K�r�
this j_(� day of 20 1!� by
(Name of person" acknowledging)
(Name of person ac�nowleclgng)
(STg-nature of Notary Public -'State of Florida
ary �ublic- Statelof-Floricla
Personally Known OR Produced Identification
Personally Known OR Pro d'uced Identification
Type of Identification
Type of Identification
Produced
Produced . . ........
Notary Pubilc - State of Florida
WAHNAINGRA
'I wida
Commission IND. state 0
!=My cooeal�i*
Commission No. res Dec 20, 2018
otary 2013
NVtr 07 es Dec 20
my omm
commission # FF 177249
..... .....
J FF 1772, 49
Bondedthr Na .......
OF
o,ded'�'� qhI1t1o.n0"W
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Kev. //ZU14