HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONuG�
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: AIL110'J 810I11'ISPermit Number: 03111
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Building Permit Application RECOVE®
Planning and Development Services Pq OO
Building and Code Regulation Division OCT 2 2015
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial_ Residential PERMITTING
St. uc ® oun
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: (0300 S Oce4ry %724vif
Legal Description: 'UA;r&C ✓%Ye C0Jyy A4(jvur 9n/6' -Un//T-P e'--•/ testa
C_ 20 A 4W(rS /)-1 T/Jnd /)-?0 AW0 rr.0 uNoiv f/A� er J-C,14 ✓
Property Tax ID #: SIT Il - 00/ -coot —OOO/ -7 Lot No.
Site Plan Name: irfAl?i tax, 2y&e Block No.
Project Name: ?("4.'r1.Z 926el:7
Setbacks Front Back: Right Side: Left Side:
bETAILEb DESCRIPTION-bF,WORK '£;, :
r sTirrc�tav dr= /u�r.. r -S'cAw;;i &-/ Nav auk 40�z_ Sysrwft")
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CONSRUCI IQN INFORMATION:'
Aaclitional work to Be ertormed under tis permit- Check all appyi
11HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors-
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S❑}� —F-t�. of First Floor:
Cost of Construction: $ -71000 Utilities:rlSewer 1:1Septic Building Height:
OWNER/L'ESSEE. -
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CONTRACTOR:
Name U/JjJ'LE /✓o �N
Name: / 1'
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Address: 403 0 S Oct-} %IrL
Company:"
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City: JF_7✓ &zt State:
Zip Code: 3Y9C7 Fax:
Phone No.
Address: /79J ell a
ran,A._ A17
City: S74icf'
Zip Code: 3W41F9'
Phone No. Z4 Z—rNrri
Stater
Fax:
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: &ff�(
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State or County License:
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nvame or construction is>zsuU or more, a RELCIRDED Notice of Commencement is required.
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SUPP-LENIENTgL CONSTRUCTION;LIEN
LAW INFORMATION:=``
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DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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 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'n your paying twice for
improvements to your rop rty. A Notice of Commencement must be reco a nd sted on the jobsite
before the first inspec rn,P you intend to obtain financing, c s th n on attorney before
commencin¢ work o rec�iuiin¢ your Notice of Commence nn t //
ALYM���
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Signature of Contractor/License Holder
igna re o Own r/ sZ-1
TE OF FLORIDA
COUNTY OF
STATE OF FLORIDA }�a�' LJ
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COUNTY OF II
The fQA ng instru it wa ack ow ledged�lefore me
The fprOn Ong t as cknowleclged f �e me
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this �[o day of 20 by
this day of 20b
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of p rs acknowledging)
(Name of p s acknowledging)
[Name
natur of Notary Publi tate of FI a)
( gnature Notary Publi State of Flori a )sondllyK
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Nof� 6
ion No. bS
Commission ,
.;••>,,a, JOHN LEE TIN
1 „gip, e JOHN LEE TINNEY
Y ; o` �a;•.,
+�. ; `= Notary Public -State
f Florida = • Notary Public • State of Flori
- • = niy oumm. Mires Nov 15, 2018
Revised 07/15/2014
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Commission x FF 155316
Banded through National Notary Assn,
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