HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:— SCANNED
BY
St. Lucle County RECEIVED
Building Permit Application JUL 16 2015
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Commercial Residential -
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
�R-OPOSED IMPROVEMENT LOCATION:
Address:
Description:
I q G Pt (X -t1j -
(DN 10,+ 9 - UeD6 1") 1 Q'IL) a CJLWJ MIT
PropertyTaxID#: Lot No. —
Block No.
Site Plan Name;
ProjectName: U-U"il-) ler/JULM*- Is
Setbacks Front_ Back:_ Right Side: —Left Side:
Ut I A[ LtLJ LJ rat-M r- I 1W'- W1 V V � I %.%
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CONSTRUCTION INFORMATION:
itiona wor to e e orme un ert is er it-c ec
11HVAC I Tank as Piping
a apply:
Shutters Owinclows/Doors
Gas
Generator Roof
Ellectric QPlumbing pr nklers
Total Sq. Ft of Construction:
S Ft of First Floor:
cn
Cost of Construction: $ Utilities:
Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Address: TO &St
C mpaliv vx�
Nz k) ow
City: A State:
Addres
Zip Co de: Fax
City: State:-LL7
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Phone -7-7 g LICO
Zip C,&�- Fax
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E-Mail: 0_,t_y- V,() Lql&n afA
Fill in fee simple Title Holder -�n next page I if different-j
Phone No
E-Mail: �y-kPAYWAUV\ 13b(22CA-30L
from the Owner listed above).
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
F
SUPPLEMENTi AL CONSTRUcriON"LOEN LAW.1 0MATION:,
DESIG
Name:
ENGI
EER:
Not Applicable
MORTGAGE COMPANY: e�ot Applicable'
Name:
Addres
K -rvc[,Lao
(&A,\0 v,
Address:
City:
Zip: ?2 614(-p
Phone-, -7-79-
State'
_QU-1- i�
City: State:
Zip: _ Phone:
FEE SIMPLE TITLE HOLDER:
Name:
"Not Applicable
BONDING COMPANY: ZNot 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.LucieCoun makes no representation thatpis granting a permit will authorize the ermit holder to build the subject structure
which is in cc 171ict with any applicable Home Owners Association rules, bylaws or an9covenants 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 Flodda 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
commencing work or reco;diniz vour Notice of Commencement.—,
of Owner/
STATE OF FLORIDJ�+ STATE W FLORIDA
COUNTYOF ItILL CA-0 ICOUNTYOF S9- L Lu
The fIrEping instrurpept was acknowledged �pfore me
this '-)day of '-u-LLLl, , 20 1!6by
ve.cfty
(Signature of Notary
Personally Known \-"� OR Produced Identification
Type of Identification Produced
Commission No.E_E_�;01,679, (Seal)
GY" MYCOMIUSSWN4EEMY
Revised 07/15/2014 DaVM: AM= 141,20116
The forg9kg instrumeqtw�s acknowledged "re me
this _�5day of '�4ULJ�l 20 -6 by
I
(N f 6 k I d int) LI/
(Signature of Notary Public- State of Florida U
Personally Known LI/OR Produced Identification
Type of Identification Produced
Commission No. E-6- (Seal)
MY COHOWSSIGN # PA
EXPWM: Aupa 14.
REVIEWS
FRONT
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REVIEW
SUPERVISOR
PLANS
REVIEW
VEGETATION
REVIEW
vwywwvv�
SEATURTLE
REVIEW
MANGROVE
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COMPLETE
INITIALS
SUPPLEMENTAL CONSTRUCTION LIEN LAW IN
Not
Name: Tn Ht&CI
Addre5.sq. A-70,o� IQ
City: 1-+ 4/1?,VQ
Zip: ';546J4Lp Phone:
FEE SIMPLE TITLE HOLDER: fNot Applicable
Name:
Address:
City:
Zip: —
N:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: 'NotApplicable
Name:
Address:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
no
:ethe ermit holder to build the subject structure
or an9covenants that may restrict or prohibit such
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
commencing work or reco;;dinE vour Notice of Commencement--�
of Owner/
STATE OF FLOW
COUNTY OF
The f9r .
,gpng instrurpent was acknowledged before me
this t--�clayof '-LLLLLJ 20 _1!�jby
7
:5 k-wLi
(r m of perso — cknowledging) y�
e n a
C
(Signature of Notary
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.E_E_QD1,6 79 (Seal)
MY CO?&GSSWN A EE2On72
Revised 07/15/2014 M- = : Aupv 14,2016
REVIEWS FRONT ZONING SUPERVISOR
� COUNTER I REVIEW REVIEW
INITIALS
STATEWFLORIDA S4
COUNTY OF
The forgooi g instmmeyt w�s acknowledged "re me
this ay of '�/_u 20
�4 by
J&
IN -me of person 6cknowledgint) L_J
of Notary Public- State of Florida )
Personally Known L-'/OR Produced Identification
Type of Identification Produced
Commission No.. E-C_7 (Seal)
4SWMAGSSION00
or w.wm: Augua 0,
PLANS I VEGETATION I SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
JUL 2 0 2015
Environmental Resources
St. Lucie County