HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO
�MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: U " • 1`r SCANNED Permit Number: Izn 2' Q)%':7jy
s = BY RECEIVED
St. Lucie County
Building Permit Application AUG 10 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 f Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line y III
I-PRC]Pnrwi) IMPRnvlz IFNT i l7CATinN% -
Address: )�)4 1\1 Ji_ IJ_Lm i-of-1' ri r Ll' S `tN'f -I
Legal Description: Ef'elaE PO.i>c-
Property Tax ID a: 14Z57-ZZO-0002-000-9 /1H25-Z0-Ol` -5L3 D51otNo.
Site Plan Name:r� Block No.
Project Name: Pt I �r I ✓� t o_rt %y l I Icy-)
Setbacks Front Back: Right Side: Left Side:
'OETAILED-DESCRIPTIONOF WORK:'
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[CONSTROCTI.ON INFORMATION:.
1]HVAC IJ Gas Tank ❑ w
UElectric 0 Plumbing ❑Spi
Total Sq. Ft of Construction: 19 $
Cost of Construction: $
Piping
ers L_JGenerator
S Ft. of First Floor: _
Utilities: Sewer F]Septic
❑Windows/Doors
ORoof
Building Height:
OWNER/LESSEE -
CONTRACTOR:
Name ik. I o i le C,"ilulp,
Name: I)TY14
We1Ji _
Address: a '
r7P e.
Company: Q%'ll l`eya- vl c ✓leer, llLP.
City: 154 PIPf'C;� Stater
Zip Code: 2 ,/ Fax:
Phone No. 46 Z - I5Z2--
Address: �;Sb0 JW'Ir,q e. -bL 9S S
City: CbC� State:iL
Zip Code: 331 ZZ Fax: 5 nl- �133 U17 j�
Phone No. 51P1 -PV- Ie14
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E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: d 0ky- - 2 d UJ(eC rfdJf( -), (-16T-r7
State or County License: 73 O
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
Name:IS{O�CS�J✓�S PC%
Address: N N0)3 ,47me.
City: State: �1t:�:
Zip: Phone: jq&o >
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
/7 Not Applicable
MORTGAGE COMPANY: mot Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Applicable
e the permit holder to build the subject structure
or and covenants that may restrict or prohibit such
deed for any restrictions which may apply.
Inconsideration 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.
1/11
_ Signature of Owner/ Lessee/Agent Sign�at 'e
STATE OF FLO A STATE OF FLORIDA
COUNTY OF C • �C l P— COUNTY CIM-1m fe o_h
The fop o'ng instrum t was acknowledged�pj7eefore me
this ay of L?` 20 L�by
(Name of person acknowledging)
( ign a Y Notary Public- State ri loda )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Commission No.
BELLAMY
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this19 dayof�TJly 20 &� _by
D5a_'31Z_J . WCf+
(Name of person acknowledging)
A1t�- & Li"4
(Signature of Notary P c- State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
MIM70I9
No.- &V_ NOTARY PUBLIC
Expires 9/22f2017
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
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COMPLETE
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INITIALS