HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEri `
Date: (e • SCANNED Permit Number: A 6"2-0
BY
St. Lucie County RECEIVED
111111111111160110111111110 Building Permit Application FEB 10 2016
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: Sign I_ -I III
I PROPOSED IMPROVEMENT LQCATIO►V: III
Address: ;U ✓J i k-tAr i/OW-0% ui�l % YUC T �C IAJ�.(Ak IrL 7� ���
Legal Description: 31i'0 /01 - L 0a " ono -I
I
PropertyTax lD #: ' , I�" V7t� dl ovv--7• Lot No.
Site Plan Name: 'M `O—W �04) � Block No.
Project Name: —AM1�\ VV\\LJLy
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK: III
\ham\�, c�s�r�tie._�r SAC
alt'e6L-
I CONSTRUCTION INFORMATION: III
LJHVAC LJ Gas Tank UGas Piping
11 Electric 0 PlumbingSprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ CQ q9)
Shutters ❑Windows/Doors
Generator Roof
S Ft. of First Floor: _
Utilities:liSewer 0Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name k 1"nn—k-pam LLC,
Name: V-k0V1 Y S
Address: Xr0 C,,,+
Company:\Sf
City:0 AnDcll CLrWOQ L._q Stat
Zip Code:'6 11402 X:
Phone No. 3 G / Per)
Addre s: \
City: ILVt� State —I,
Zip Code: as ok D Fax:
Phone NoY {U .'
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:.
�""
\'3f..at s\ 1nS a CLIA . (t)m
State or County License: OM Dnr\ () I.DLi q
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. ( Y3 E ti
SUPPLEMENTAL CONSTRU
LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
v'Not Applicable
Name:.
Name:
1—
Addre�
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
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 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
a
_ Signature of Owner/
STATE OF FL
COUNTY OF
The forgoing instr nt was acknowledged befo
this day of 20 2Lby
(Name 6f person acknowledging
ie)`D N a�2
(Signature of Notary Public -State of Florida )
Personally Known OR o e Identification
Type of Identification Produced
Commission No. (Seal)
Revised 07/15/2014
STATE OF FLOBIDA
COUNTY O A ILIh,
The f o�fi instrument was acknowledged before me
this 1 y of��1 AJAAA „ 20 t tl by
(Name of person
(Signature of NotWPublic- State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No. E
EE1OM
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