HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETtu FOR APPLICATION TO BE ACCEPTED u1 'ice'
Date: I-2YIln SCAN Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
NED
BY
St. Lucie CouiN
RECEV ED
Building Permit Application .IAN 2 8 2016
PERNIMING
St. Lucie County, FL
Commercial P4- Residential
I PRO POSED .INPROVEMENTiLOCATION:. , `
Address: 3300 /V 41 '"Y A-1A
Legal Description: 0 ?,y 1IC'� Gcw:[ Lod T_n wee D!-) nn8 L (-,4 t
f_ 05; 174 i A
Property Tax ID #: 11 &-4�Qcc) - �')ll- O(N-S1 •- ()(NC - I Lot No.
Site Plan Name: /�pp2U-t4 Seq./ /rt ciSe,cKu— Block No.
Project Name:
t
Setbacks Front 3S Back: Right Side: LeftSide:
r7
.�
0
CONSTRUCTION INFORMATION
—Mechanical —Gas Tank —Gas Piping —Shutters
_Electric —Plumbing
rn� Sprinklers —Generator
Total Sq. Ft of Construction: �� 7 Sq. Ft. of First Floor:
Cost of Construction: $ 10,00 Utilities: Sewer Septic
Windows/Doors
Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR':
'° ��.•aa ',M
Name�'� Tr,� �ir,'D Tr:,�FlF�n.l
Name:
dddre3s:�,_5Rc'-,c''i�''C�c�nnti�:Di�t� '�i�.
Company: `
Cityi-TCl��ci%S�Xe State: YL
Address: 3 3/ SarL r7sP "
City: r7 mate: �
Zip Code: 5 Fax:
Phone No.
Zip Code: 3 / ?Y6_ Fax:
411 5-
E-Mail:
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail
State or County License C�/25 SPS�
from the Owner listed above)
If value of construction is 2S00 or more, a RECORDED Notice of Commencement is required.
i
-SUPPLEMENTALCON STRUCTION`LIEN LAKJNF,ORMATION
� . � �r
�
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:•,
City: State:
Zip: Phone
City:"
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
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 Countyy 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 co
ncurrency 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 Commencement.
LO�t /vfc-
J . o
Signat re of Owner/ Lessee/A
Signattfe of Contractor/License Holder
STATE OF FLORIDA J „
[' '
STATE OF FLORIDA� + I
COUNTY OF
COUNTY OF �i �IJ C I4?—
The fo oing instrument was acknowledge f before me
this day L/JCl V) 20��0 by
The forgoing instrument was acknowledged before me
this_ day 20_ by
of _ _
of.
/sa Jq /-4n . .
\r1-0r1
1-D
11Jt k�XaVVNS
(Name of p on acknowledging)
(Name of person acknowledging)
OGZ
�Q�.�Jjcvt�
igna re of Notary Public- State of Florida)
(Signature of Notary Public -State of Florida )
Personally, Known OR Produced Identification
Personally -Known OR Produced Identification
j11le6�151C
of Flodda
Type of Identification .�.
'i} II{I�1{Tw 43 �RArW
:QdIA Moto Public State
+F- lies D u ton
Produced—
`MYICONMISSION 41 FF19E66e1v
-RM
® ommiasion FF 999179
0% 8911312019 (Seal)
Commission No. EXG�alfebnABq 11, 201Y
OiRb
rtiriadloti
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE :•
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.7/2014