HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONfAV og'-6'
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: PermitNumber: ~Jj0—C)d3
RECEI`.' I OCT 02 2015
SCANNED
Building Permit Application St. Luce County
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 x Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line1Q *,'z t
Address: 6375 S U S 1 , PORT ST LUCIE, FL 34952
Legal Description: MODEL LAND CO'S sm OF SEC 15 36 40 BLK 2 LOT 2-LESS RD RLW OF US 1-
AND LOTS 3 AND 6 AND LOT 8-LESS W 33 FT FOR RD AND CANAL RIW- IN NW 114 (MAP 34/15N) (39.00 AC)
Property Tax ID #: 341550100210004 /� Lot No.
Site Plan Name: j�11 Aro Art, PC_�G Block No.
Project Name: 4Aetra A2P0305
Setbacks Front Back: Right Side: Left Side:
[DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION" INFORMATION:
Additional work to be Dertormed under tispermit—check all apply:
DHVAC 0Gas Tank E]GasPiping fn Shutters
Electric 0 _
Plumbing Sprinklers Generator
Total Sq. Ft of Construction: 160 !E�20 FT Sq. Ft. of First Floor:
Cost of Construction: $ 7�%� Oy Utilities: Ln�Sewer Septic
Windows/Doors
DRoof
Building Height:
ODUNER/L-OWN---->CONTRACTOR:-----
-- —i—
Name T—WWlemetro PCs
Name:
79
i I
Address:1300 Concord Terrace
Company: &�Ls aC�rJ
,�
c—lec') nL Or FL • �-NC_ -
City: Sunrise State: FL
Zip Code: 34986 Fax:
Phone No. 561-748-0302
Address: /65?/ 05F%'o)X 1-7'�CR
City: Ills Iz
Zip Code: 3 % /GJ
Phone No.P/�
State:
�1
Fax:
E-Mail: hvaldez@rgpartners.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
State or County License.
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLE IVIENTA6c6NSTRUGTI6N LIEN LAW INFORMATION:
DESIGNERANGINEER: —
Name: NoYV n
Not ppffcabfe
5hH el d
MORTGAGE COMPANY: x Not Applicable
Name:
Addres : S J M
6
Address:
City: L_-HDA I
Zip: _ Ph.one: I
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Name: 1p 1
Not Applicable
BONDING COMPANY. x Not Applicable
Name:
Address:
D zoo
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 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 wlth your Home Owners Association and review your deed far 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 accordancNwork
pproved plans, the Florida Building Codes and St. Lucie County Amendments.
The followinrmit applications are exempt from undergoing a full concurrency review: room additions,
accessory strmming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNINGR: Your failure to Record a Notice of Commencement may result in your paying twice for
improvemur property. A Notice of Commencement must be recorded and posted on the )obsite
before thection. If you intend to obtain financing, consult with lender or an attorney before
commencirecordine vour Notice of Commencement.
_ Signature of
Signature of Contractor/License Holder
STATE OF FLORIDA ` STATE OF FLORID}1
COUNTY OF �(e M COUNTY OF fY
The forgoing instru nt was acknowledg fore me The forgoing instrument was acknowledged before me
thi�` day of�gp, 20J by this(% day of 20 /! by
_L Z, " al dD I (��?yz �LZJert¢ l %
(Name of person acknowledging) (Name of person,.Ae(Cnowleking )
State
Type of Identification
Commission No.
Revised 07/15/2014
(Seal)
of Notary
Type of Identification
Commission No.
CgjSep$yion a FF 110250
My Commission Expires
April 07, 2018
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