HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �O �A /IlV SCANNED Permit Number: / (0 O to • D
BY St. Lucie Count, RECEIVED
t
Building Permit Application JUN 2 0 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: To Select from dropbox, click arrow at the end of line
Address:
Legal Description:
7,yy.
PropertyTaxlD#i: `I�I,�Jf-dl-�C��r/-�I�O - y Lot No.
Site Plan Name: / - \ Block No.
Project Name: Narhod#r K1(�Ge l i �eSfYl'(� Cr?nTt1l (F 1�)
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK;
1115+QIIof clq
of fence
5Lirre(Arloy
Poor arro.
(�onl eperm1J--
CONSTRUCTION INFORMATION:
bona wor to
11HVAC
e e orme un ert ispermit-checka
13GasTank ❑Gas Piping
apply:
In
Windows/Doors
_Shutters
11 Electric
El Plumbing
Sprinklers
E Generator
E_] Roof
Total Sq. Ft of Construction:
r
S Ft. of First Floor:
Cost of Construction:$
�Sd -
Utilities:
_Sewer
Septic
Building Height: h /17rICr
OWNER/LESSEE:
CONTRACTOR
Name Idly- CaV;Tf
Name: 1201141d toIliVer
I �7
Address: 1?, 60 7 Nafbour R C+14C 61Vd
Company: ProCfOi CC%hStlfnl'�Gn CGi�AGl1 V,��
City: PQ /M (/ State: FL
- /��Cl3p �7
Zip Code: 31-1`ICiG Fax: ��,�-3i(P`
Phone No. ?�� 336 3ciao
Address: � OSO L1S- i'{ U✓ -1 7
-- - -- - - —
City: 11s'r( 13et<CA state: FL
Zip Code: 3)gUUQ Fax: R2211: d 1,ft
Phone No. T 7a d3q 610
E-mail; O, Cayif fta hrVCC, d rCi
i
Fill in fee simple Holder on next page (if different
from the Owner listed above)
E-Mail: C� fC II i VPr (U rGC'/ 0✓CC• Cal r I
state or County License: nC
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEIVIENTA4GONSTRUCTION LIEN LAW INFORMATION:.
DESIGNER/ENGINEER: x Not Applicable
Name: Peamd and Lewis ArtMleaa and Planners,UC
MORTGAGE COMPANY:
Name:
Not Applicable
Address: 1295 US Highway one (ard Maori
Address:
City: No,mPalmeeam State: FL
Zip: —a Phone: 561.626.9704
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Harbour Ridge Cauntr Club, lno.
BONDING COMPANY:
Name:
. Not Applicable
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
rommencine work or recordine vour Notice of Commencement.
\t r s
_ Signature of Owner/ Lessee/Agent Signature o on ractbr/Liu nse Holder
STATE OF FLOR AA STATE OF FLORIDA
COUNTY OF S l cxiCOUNTY OF T�i(i%CP✓1 Qf ✓Qf
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1 day of JlS 1J 20 Irby this IS &day of 3cAn R 20 _ by
1 I �w 1i'l/1 % t' )611I Var
(Name of person acknowledging) (Name of person acknowledging)
1/a zu � &-
(Signature of Nc ry Public -State of Florida ) (Signature of Notary Public- State of Florida )
Personally Known K OR Produced Identification
Type of Identification Produced
Commission No. 159 g l (Seal)
o4�0.Y cL�'ir.
- Notary Public -State of Florida
Revised 07/15/2�•; My Comm. Expires Jan 31, 2017
'u,+ •.:,: f:nmmisslon # EE 861169
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. FF)3001(' (Seal)
VALERIE D BROWN
Notafy Public - State of Florida
"•;°;,;,:�'
Bonded Through Ntional
Nolary ssn.
'?;•a,
'
��'�Commission
•.FF 130016
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