HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE CON 11FD. FOR APPLICATION TO BE , ACCEPTEC!
Date: Permit Number: /5-07 038.
SCANNED
BY
St. Lucie County
RECEIVED
Building Permit ApplicationJUL 21 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
Address:— 7 fzck 4,j le III �,t C-
Legal Description:
Property Tax I D #: 20 1 1 c9c> c2 -1 Lot No.
Site Plan Name: Block No.
Project Name: e,--L, ei-
Setbacks Front Back: _ Right Side: Left Side:
W-C W C C9 -7 C.--C_ �- (_ C'\J / /�;' 'l! _k0k I � '1 1 -7/1 C",J -14 1 )
—Mechanical GasTank Gas Piping — Shutters
Electric Plumbing Sprinklers — Generator
Total Sq. Ft of Con�fruction: 9PJ0"$ Sq. Ft. of First Floor:
Cost of Construction:$ gb.�'0(90 Utilities: —Sewer Septic
—Windows/Doors
Roof
Building Height:
10W N E I @ E-S S, E
Name-0-) er-7 X bu
Name: ---Thz elr-e tA/,
Address:— 60to I /\/Ly I S�k Atl-f
Company:D% ,Q Wi 11 (,1 -) Old
City: lmk&,r- State.F�
Zip Code: S'KJ -7
Phone No,
Address: -� oi 4z� dz-v)
City:. I V 91 -�ru StateEL
Zip Code: Fax: 416
Phone No (7 1 (,� *2
E-Maik g=Ql -Z- d
Vel LV&L�,
Fill in fee simple Title Holder on next page if different"
from the Owner listed above)
E-Mail M(A rl--� 'OL, f-1 3
State or County License C &C i E; -o qqS
1119
If value of construction is 2500 or more, a RECORDED Notice at Commencement is requirea.
[S-WP,iLlE,K4,E,N]TfA'LI[C-ONSITI U ARLIENI!
,�Q�JIN
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DESIGN ER/EN GIN EER: Not Applicable
Name: Cool(�4_rl'L-L�
MORTGAGE COMPANY: Not Applicable
Name: '-4
Address:. W66.Dtt.tA., -eA-i--(
Address: 1/y Alf-%
City: 1�- Ir- 4,7 1- State: T-
Zip: Ph one
City: -State:
Zip: — Phone:
FEE SIMPLE TITLEHOLDER: _NotApplicable
Name: fit
BONDING COMPANY: —Not Applicable
Name:
Address:
Address: A )_1A
City:
City: v/
ZilS: Phone:
Zip: Phone:
OWNE CONTRACTOR AFFIDVIT: Application is hereby made to obtai n 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 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 recording vour Notice of Commencement.
Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIPA
I STATE OF FLORIDA
COUNTY OF COUNTY OF C-�N
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this "�L\ day of k 20_S��, by this.�k� day of,�A,, � , t , 203& by
f P
Name ot Aper 9
L. BRIDGE
Commission # EE 834731
-Mes September 13, 2016
ir,
(Sionatur Or FTOTTua7
Personally)(nown t/ OR Produced Identification
Type of Identification
Commission
REVIEWS CFRONT ZONING SUPERVISOR
OUNTER � REVIEW REVIEW
PLETED
Personally Known I J OR Produced Identification
Type of Identification
Commission
PLANS � VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
J.'