HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: <o o Permit Number:
RECEIVED ]AN 06 2016
_- -.-1 SCANNED
Building Permit Application St. Lucie 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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 5 f III
1PROPOSED IMP11 ROVEMENT LOCATION:._
Address: _'W9
Legal Description:
Property Tax ID #: - -
Site Plan Name: S ve
Project Name: C/J/VII/ L L y E s
Setbacks Front 5s'oN Back: 4W-9•Right Side: 7J-is Left Side: G347
:- .. ._ .
Lot No. SY,
Block No.
Ut�IHILtU UtJI.KIF I IUN Ur"VVUNK:.
GONSTR'UCTION' INFORMATION: - .-
Additional work to be performed under this permit - check -all apply:
®HVAC Li Gas Tank ❑Gas Piping _ Shutters ® Windows/Doors
Electric N Plumbing Sprinklers Generator ® Roof
Total Sq. Ft of Construction: ii5 S Ft. of First Floor• !/fa'� fi%64 49y
Cost of Construction: $ �C/�. C�() D Utilities: Sewer�septi� Buil ing Height: oZ
,;OWNER/LESSEE:m :. "
CONTRACTOR. = ;,
Name M/JR/C S, '*,yly o ZLy
Name:
1710 evySTA�wGT/,0^d
Address: INVE/? t'SJ W,*Y
Company:
bAlA.1 f 4,
City: 7/LT S% LuCi E State:20Z
Zip Code:. Fax:
Phone No. J�gq - J S�-
Address:�c?( sr KAn/Nf/1 HK%y S7�/ZZ
City: Sr!/.,047
Zip Code:.
Phone No.
— State: F
36,"7 Fax:
E-Mail: ArLe'oivp.*LCy.9nL.eavol
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
_t7
State or C6unty
//��einlG
License:
C-
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 1�
� � r
SUPPLEMENTAL CONSTRUCTION' LIEN LAWJNFORMATION:
;
DESIGNER/ENGINEER: _ Not Applicable
Name: �RADLEf� ..i t!A
MORTGAGE COMPANY:
Name:
X Not Applicable
Address:
Address:
City: C State: Joldr.
Zip:<a Phone: A1
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _o0p,v& C g:' vd 49,ZLy
BONDING COMPANY:
Name:
Not Applicable
Address:/ erP6W-
Address:
City: o/17 Sr9 aq: e E
City:
Zip: jj�4_ Phone:l�$ -� 9— .
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 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
N"
_1Sigrr3tu_rJ90f Owner/_ILessee/Agent)
STATE OF hORIDA
COUNTY OF 5,49/1y7— zclel r
The forgoing instrument was acknowledged Ypfore me
thisdayof _ A_c �v»���, 20 IV
by
009 S- C4i1/NOLLy
(Name of person acknowledging )
(Signature of Notary -Pow St f Flori as—
ro' /
Personally Known OR Puced Identification V
Type of Identification Produced 1— Y�
Commission No. b a UN%§)f)ZELAIS
Notary Public - State of Florida
` ' ; • My Comm. Ex ires Apr 13. 2017
�;�
P Commission # FF 006231
Revised 07115 N F Bonded Through National Notary Assn.
OF FORIDASA,yr L!/G�E
The forgoing instrument was acknowledged before me
this Qh day of -:S4n .1
20 A�_ by
Notary Public- State of
Known I OR
Commission No.
01
N°cn, 1 0,
Exv^ # EE
ro __'�nbNa6s
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
i
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
I
INITIALS