HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCE-`-) ,
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Date: Permicmber:
SCANNED
RECEIVED NOV 05 2015 SB.Luce County
Building. Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-i578 Commercial Residential _
PERMIT APPLICATION FOR:
Address: ce V CU cJr
/r /c �t z4 �A V)
Legal Description: i A
PropertyTaxlD#: [aL 6,0S' o 066 -000 S Lot No.
Site Plan Name: A-114 Block No..
Project Name:
Setbacks Front Back: Right Side: Left Side:
G/i !C o✓ 7r�v� 7` - f{O sic
itional work to bepe rme under tispermit-check all that apply:
_Mechanical • _ Gas.Tank _ Gas Piping $Shutters — Windows/Doors
Electric _ Plumbing —Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Q) J A utilities: _Sewer _Septic Building Height:
Name r'l i a_ _�-r- - �S�h�OS'.-�- -
Name:_
Address:_7.2 S 14%Ce V%ev e41"
Company: CORd7z4
City: el " li�ciee State: Al
Address: 4.234 Ilesir
City: CV, ' ' v•., " State: �Y
Zip Code: 3 V i R/ 9 Fax:
Phone No.-7 72 - 6 83 3
Zip Code: `/%y6 Fax: e/6I'6�53
E-Mail: �% :.:
Phone No.
Fill in fee simple Title Holder on next page (if different
E-Mail: %-D!y!:
State or County License: e e 3 /Sad
from the Owner listed above)
1.6,C & .z 03
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City: AV State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: __ _ Not Applicable
Name:
Address: r
City: f V /
Zip: Phone:
MORTGAGE COMPANY:.
_ Not Applicable
Name:
Address:
h
City:
State::
Zip:. Phone: '
BONDING COMPANY:
_Not Applicable
Name:
Address:
City: -
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain 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 concurrencV 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 Commenrrempnt-
Lessee
STATE OF FLORIDA
COUNTYOF Sk, Lvc%Q
The forgoing instrygqi�entwas acknowledged before me
this 5 day of N OV 20.)L5 by
Vv-,o-,r^-, 5 S k o 6i c
(Name of person acknowledging)
(Signature of Notary Public -`State of Florida )
P G�VECj51 F�Ot\ ��
Personally Known OR Pr91 nt3tiL�a%Ige.2
Type of Identification Prod L is
�,,!!� N0 (. , m.
Commission No.t. ��claep`LMY,,Lg
REVIEWS FRO � ZONING SUPERVISOR
COUN ER REVIEW REVIEW
DATE
RECEIVED
STATE OF FLORIDA
COUNTY OF Si..Lvci�
The for oing instruTent Was acknowledged before me
this day of .f� O�) 20j5 by ,
Thow.a:S Sk
(Name of person acknowledging)
(Signature of Notary Pub is -State of Florida)
Personally Known OR ProducedXon —tib'n,,,a
Type of Identification Produced BEN
l� *b`• Ndromfs#EEa aayI
Commission No. " .:
� M9 _:MSS
N �a
PLANS VEGETA A TURTLE MANGROVE
;EVIEW REVIEW REVIEW I REVIEW
LCOMPLETED 1 I I 12. 09h I I I