HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONN
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I (� %�
Date: �unoo ann-( -IS Permit Number: 160'5 -0 a v
SCANNED
OBNNVOs BY RECEIVED
® St. Lucie County
Building Permit Application MAR 14 2016
Planning and Development Services PERMITTING
and Code Regulation Division �., Lucie County, FL
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
wPROP05ED°.IMPROVEMENT
Address: 4�we; AIELz eF "'40, &-gr pic_aG�, jc-L
Legal Description: S'• 290. 33 "OF Tf10A1d91 / &0 71A_ IWY2. O,- rA&F "W Ak DE it6E
Ale 4 0,0 p& Vc % 'W5 T//E EI.fT 54 ' /• 66 ACRIFI1
Property Tax ID #: Lot No. _
Site Plan Name: AIIA Block No.
Project Name: /VIAL
Setbacks Front — Back: — Right Side: Left Side: =
Rr -ROOF EXe,I71^V6 AIIAPirv6
HUanlUlldl wuin w uc en ui uieu wwei um Pennu-arecrc du apply:
OHVAC Gas Tank �GasPiping _Shutters ❑Windows/Doors
11 Electric 0 Plumbing¢�� 05prinklers1:1 Generator 9 Roof
Total Sq. Ft of Construction: �' �fOJF Sq. Ft. of First Floor: JF
/�
Cost of Construction: $ 2`'J, 0aD BOO Utilities: _Sewer Septic Building Height: /b Q
OWNER/LESSEE,:
CONTRACTOR.`,' _
Name 114141I Af 6l CO.; 666
Name: R/4//990 A4
DUlj- COrVST¢el:Pie N
Address: 4e& Peotu /$h
Company: DOUGLAs
D4111-ir
City: 1!s4Q7 PE,a�F State:YL
Zip Code: 3 60 Fax: 772-4165-7665
Phone No. 772 - �/ 833�i
Address: F O • 4e:IoJ9ib
City: iCoAX PleuF_
Zip Code: 3i��f
Phone No. 772 ^ A&-Ai`,'�1
State:
Fax: 772-465-7665
E-Mail: ri@tf & ✓keYz if. com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: YPYiP_J� /kYl�ii
l//r CDirI
State or County License: C6G.O/30�f
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
M
Name: PAUL !�I/�LGE/ /NG•
Address: /A7%t �/LT/1?/ ff ..SU/TE
City: O State: F4
Zip: Phone: --772-7orp-?j 2
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: ,rA.L1F dl Oi9/.i�E2
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name: /1111i
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: &14
Address:
City:
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
Vs
_ Signature o Owner/ Lessee/Agent Signature of C tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S� LUG/E I COUNTY OF .SZ: LUG/E
The for ng instrum nt was acknowledged before me
this2sdayof AM# 2011by
a476�Ea Q• AA1 yT
(Name of person acknowledging)
Commission
Revised 07/15/2014
ed ROGER A. PRIEST
Notary Public - State 01 Molloy -
My Comm. Exq� Wov 7, 2016
—l;ommissiod #``��''�� 217267
Bonded Through National Notary Assn.
The forgoing instrument was acknowledged before me
this day of M..4,fa 20 C—by
A(5�'fzA W- P.�iEfl
(Name of person acknowledging )
'4"' 4:
(Sig t e of Notary Public- State of Florida )
Commission No.
Public - State of FI
im. Expires Nov 7,
mission # EE 2175
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