HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPLICABLEPNFO S COMPLETED FOR APPLICA�ION TO BE ACCEPTED
Date: Permit Number:
60ANNF-D
Planning and Development Services Building Permit Application 3t. Lucie courity
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
4 4
Address: -14 30 Z5. N an
Legal Description: Sam '300 1
lar V1, 1(ris Cmdo
YM I -A I UW
Property Tax ID #: 36 a (0 CIS - 00q;t C)CM 9 Lot No.
Site Plan Name: Block No.
P roject Name:
Setbacks Front Back: Right Side: LeftSide:
's. i W-OWMANi
2,
FAW : -0 %, ii I- :" M.Wmi
W
P 'V
Replace-mantTrpqd windows
'IRS:
AaaitionaiworKtoDeDerrormea under this permit- cneCK all apply:
[1HV Gas Tank E]Gas Piping Shutters Windows/Doors
11 Electric Plumbing E]Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft of First Floor:
—5 "n OSeptic Building Height:
Cost of Construction: $ Utilities.. —Sewer
Name a h-A I
--- ---- ----
Name: Richard Chariton
Address: '11420 S.QtVDQ:;1r_
Company: CVaq-��oi)
City: SQ'n &DjC:A State:EL
Address: 16585 106th Terrace N
City: Jupiter State:FI
Zip Code: 3149,!�'7 Fax:
Phone No.
Zip Code: 33478 Fax:
E-Mail:
Phone No. 561-339-7110
Fill in fee simple Title Holder on next page I if different
E-Mail:.Richard@palmbeachwindow.com
State or County License: CBC059351
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
�w
At;W, i li m prA
M �Vc — W�N_
4N ki� M' NINE
0 �R
AMR?
100 -M
X !WMNW�IAH�'M
DESIGNER/ENGI NEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: _ Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
—NotApplicable
BONDING COMPANY:
Name:
—Not Applicable
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. Lucie Coun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in co %ct 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 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 firs in&pectictirrif-yeLlintend to obtain financing, consult with lender or an attorney before
commepeill`!�gwork or recording vbur Notice of Commencement.
— Signature of Owner/ Lessee/Agent
STATE OF FLORTIA STATE OF FLORIDA
'COUNTY 01 + - 1"o �_ � -,P, I COUNTY OF TQ� rk
The forgoing instrument was acknowledged before me The forgoing instrument k ledged before me
this cN: day of -,S-0 v\k 20 L5 by this& day of Ctak . 20 J!5- by
k',o%A,ck.c � C�%A r X + rh\ �
(Name of person acknowledging ) ..(Name of person
of Notary Public- State of Florida )
Known OR Produa0een
Type of
Commission
ir� of Notary Public- State of Florida )
)Iy Known VI OR Produced Identification
Identification Produced
Notary Public - State of Florid
M
y Comm. Expires Aug 10. 201
Commission # EE 120800
Revised 07/15/2014 1
'. 0� I �01
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
MANGROVE
REVIEW
�VEGETATION
0 W NA
SEA fURTLE
REVIEW
DATE
COMPLETE
;REVIEW
INITIALS