HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONa.l
ALL APPLICABLE INFO DUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1L� SCANNED Permit Number.
r��xrr BYSt. Lucie County RECEIVE®
E30ding Permit Application Planning and Development Services .APR 2 9 2016
Building and Code Regulation Division
2300 Virginia Avenue, FortPierce FL34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Re:idenfial
PERMITAP.PLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: S 7 -(4-fS1 12-
LegalDescription. a�,'P-elrnlei ( M
PropertyTaxlD#: ( lQV Lot No.
Site Plan Name. Block No.
Prof eOBName: _ _ ice/
Setbacks. Front -Back: Right Side: Left Side:
DETAILED DESCRIPTICiN,OF WORK:
OT
sgns.
CONSTRUCTION INFORMATION: YYtC Q mCLrE 1QC S M
rK To oe eriormea unaeruunnu us Pe—GaaeGK aapply.
Gas Tank ❑Gas Piping _Shutters
0 Plumbing []Sprinklers 11 Generator
Qwindows/Doors
Roof
Total Sq. Ft.of-Construction: S Ft, of First Floor:
Cost ofConstructiorc $ lgoa opla5l Utilities:Sewer E]Septic Building Height:
OWNERjL�E{SSSrE::
Name
CONTRACTOR: John P701 e_sVj'
Address:,
City: State
Zip Code^. Fax:
Pone No. '
Company:
Address: Sral
_
Q�
City: __State:
Zip Code: 11 Fax: -
PhoneNo.7 e UU Jc�� ����
E-Mail
_- _
E,Mail:
j- —
Fill in fo airctpre't ttc IpaPdce cif text €Sage (if different
fr�rn Eiu•. fYwd ar lis :c.tl xbo®e)
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State or County License:
Fr` talue of consiT attio!Z !s $P!Xg or mare, a-REECORDED Notice at Commencementisrequirea. —
0
SUPPLEMENTAL CONSTRUCT16114i;tLN,C.AKiligfo�POAIIoN:,-
DESIGNEWNGI NEER: - 15ot Applicable -
Name:
MORTGAGE COMPANY: Not Applicable .
Name:,
Arjdresi7-7
Address:
City: State:
City:. SI State
Zip: _.Phone; �;i
Zip:
FEE SIMPLE TITLEHOLDER:. —__;Not Appllc6Blii!:,.,.
DING COMPANY: Not Applicoble:.
Name:
N5Me:
Address:
Address:
city
. . . . .
City:
Zip: Ph6ne:
Phone:
I certify that no work or installation hqs c?,mmenced pA6R6t0A)is6aAce of p perrhif...
St. Lucie Coun IN I urd,
makes no represe ntation khat is granting a erroit will aut rize thegernilt holder to build the subject str
isinco ict Ourners Association rules, by awsor covenants.thatrTiayorprohI
which with any applicable Hoffie an, restrict prohibit
structure. Please consult with your Home Qwners Association arid review your deed for any restrictions which may apply.
In consideration of the granting of this re4yestedpermit, I do kreby agree that I will, in alffespects, perform the work
in accordance with the approved plqns, thii Florida tiullding Code; and St. Lucie County Amphdrirtents.
The following building permit applicatiordpre exempt from undergoing a ful I I concurrencV review. room additions,
accessory structures, swimming pools, fet4ses, 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
improv.emeritsto Your property. A otice of Commencement m6stbe-recDrdetd and posted 66 tfiejobsite
before the first Inspect �edd to 64t financing, lenclator art attorney before
n -consultwitb
commenc1hp work or recording vot it Notice crl"VornmencemeA.
2J"
is
SI re of owner/ Lesiee/Agent
- V
e
115U�a�� f Cxinti-actoY/License Holder
7ZEOF
87ATE OF FLORIDA
COUNTY OF rIQ -e V
FLORIDA
COUNTYCIF
1.
Th f ofing Inst ument was acknowledged -before
e o ledg beforerne..
this dayaf 26 y
The for o ng nstruivientwas acknowledged before me
liis day of Pti-nYr 20 ik by
i,parm� of person acknowledging).
persona f e
(N nra Cknowledighig)
(Signature of Notary Public- StaiWF1--;
on
ISignaturecifftlotary Public- StaNdtYlorlda)
Peisona Ily Known -�/L 00roduced 1.1antificatior)"Ll;i . ,
Personallyk;.uwn N/ ' -ORProdude.diddntificati'o.6--.Z:-,
Type of Identification Produced
Type 01,1dentification Produced
•
Commission No
m I N
eLLC kee.
Revised 071
'REVIEWS
ANGRONE
EV11%-
DATE
COMPLETE
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