HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO M ST B CMPLETED FOR APPLICAW',:N TO BE ACCEPTED /
Date: Permit Number:
"r'1'r""�' SCANNED
--
—, Building Permit Application BY
Planning and Development Services St. Lucie Countv
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ar Residential
PERMIT APPLICATION
PROPOSED IMPROVEMENT LOCATION:
Address: g5go(lnmereiaL(1,1y:01R, ff- Pierre(' jk 311451
Legal Description: f' n( If 2i.3 r)LoGlC iCIAI(>S u//h/cdrJZ/YZLSiY(4 I!Perk llnrl—1 OOC
Property Tax ID #:
Site Plan Name: Block No.
Project Name: p1709.55m(Are TPc Carloou) M to cr AdI1stkvmt
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
aadttiau a� COuwP9 +c' "15kin3 IDOii in�.
GZe� P lannlna4beV ProecF Fde# MNsI' 6z615 4973
CONSTRUCTION INFORMATION:
Itlonal worK to (ee orme under tispermit-checka apply:
❑HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electric ElPlumbing ❑Sprinklers Generator ❑Roof
Total Sq. Ft of Construction: 2010$
Cost of Construction: $ 402?Z[n. m
S Ft. of First Floor: _
Utilities:li Sewer ❑ Septic
Building Height: d/-2.719'
OWNER/LESSEE
CONTRACTOR:
-Name- - L1- Y--1?tro-h1C - - - _ -�
Name. -
—P,—
-- g -
Address: r7ACQ-C=rneiV1ttLL-Ciocie.--
-Company: - -
- -= AO(? -
City: Fl- PLNp-Cp- State:
Zip Code: 3LIQ551 Fax: % '
Phone No(?U) 40-
Address: ED, lbo 61569q4
city: Vero I,JP. ak State:-ta-
ZipCode:159965 Fax:172 GJM14-9(D5
Phone NNW -q 73 - &RY67
E-Mail:Berle, e-rin9g Di PSStt(P.^Drn ,torn
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
D , e
State or County License: C
_%l ei CQ
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
_
Name: 2QAJA tflasboName:
Address: 75' XAJb14WKtVMe bk I fo, _ 10 Address:
City: State: City: State:
Zip: , 91aI7 Phon 77�) D -c ci Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 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
cornmencibg work or recording our No ice of Commencement.
Sign re of Owner/ Le see/g gent
Signa4 re of Contractor/License Holder
ST TE OF FLO ID4Q ///
STATE OF FLORIDA
C UNTYOF n�� (JiniP,
COUNTY OF I,ncLe oxR1nyc))
The forgoing instru ent was acknowledged before me
this _#day of 1JGZ/. 20j&'by
The forgoing instrument was acknowledged'befoie me
this day of Tin ( 20[E7 by
N�I{tiwlel Vane Cress
. P mltj
(Name of person acknowledging)
(Name of person knowledging )
(Sign"01316f Notary Public -State qfZorida)
(Sign rN tarye to
_--Eerson*-Kn=n
O&2rnducedidentifir-ation-�
=PersonallyKnowa� = OR:Producedldentification
- —
tion FL_DY_l V74h� n��
Type of Identification—_
- 27-
nriaaecr
NOT DA
FLWiIDJt
Produced MMY t�T�
NOTARypUBuC
Commission No. STATE C1SPR1DA
. Cm=* FF MW
PDATE
Co molt FFOdX M
78
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
Q
v QII-
DATE
COMPLETED
ev. 7/2014
All APPLICABLE INFO MUST BE COMI, ED FOR APPLICA 0 BE ACCEPTED;
x+
Date: Permit Number:
Application
Building Permit
Planning and Development Services
Building and Code Regulation Division
23W Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITAP_PLICATION FOR:
Address:
Legal Description:
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
p Y
AaaItlona wor to a pe orme under this permit —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: $ Utilities: _ Sewer , _Septic Building Height:
S
Namec:� „Ss :; ,• ,::., :, ..
Name:
Address: r
Company:.
City: : ,y .:+, .� „ a `, `s J State:
Address:
_
G'
Zip Code. Fax:
City: State:_
Phone No.
Zip Code: Fax:
E-Mail:
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail
from the Owner listed above)
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.