HomeMy WebLinkAboutBUILDING PERMIT APPLICATION09/14/2016 11:45 7724621578 ST LUCIE CO IMPACT
09/14/2016 18:03 56179542
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ALL APPLICABLE 1 IFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 'MAC j1,.r,. 114lu �-? "(J i
Date: SCHNNELi Permit Number: , ('0
BY
St. Lucie Counts
Building Permit Application SEP 14 2016
Planning and Development5ervice5;
Building and Code Regulation Dlvrsfon
2300 Wrglnlo Avenue, Fort Pierre FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line II!
Address: %?Ji0 LSS 9&. 3_ 2fil17S ' L-kX-AS
Legal Description:
_ 3
Property Tax (D p:
Site Plan Name:
Project Name: I
— Sol —
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
�n+sTAUAvtor� aF Gay cal CkITI.LFD_ rosy aes cT�,n(-� enac.>n1��s . �lseusse.0 w+t1,
�tSNS EXPM1NbZ AND WAs-T'oW Sb —'V"b. 'T1E L7PUWIJ -E2ftTA%L. IIKAcb1+e3s WAS
uuaG� MA�Tt,F'- w-ter,6t SL.G�'�tO.O�}iSl SE,sr �y tOs
b� irffi I7e7+++/1 ►D&MI s, tD2rr.60Akts Per-- OA sirs uf"Gb., iiAA3i6PS Aa VEfbl iD
Gas Tank as Piping Shutters ❑windows/Doors
0 Plumbing ❑Sprinklers 0 Generator Roof Roof pitch
Total Sq. Ft of construction:
Cost of Construction: $ SAD
S . Ft of First Floor.
Utilities:nSewer Septic
Address:, Rb3o FAA
City: ]a2gy- 5ta L-. State: -C-t-
Zip Code:-Y"!Y7_ Fax:
Phone No.�1(:7" i)$hp-3�1to2
Fill: in fee simple Titie Holder on next page (if different
from the Owner listed above)
or m9m a
Name: _
Company:
Address:
Building Height:
City: L oxAhA'rc* 6 State: rL-
Zip Code: 33470 Fax;
Phone No,!'Sbozz, - r7'Z8el
F.Mail: LED pGTC7eAe � -tFatl C.oNi
State or County license: LAG l �17o-i
09/14/2016 11:45 7724621578
09/14/2018 10:03 561795<1
ST LUCIE CO IMPACT
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Name: —
Address:
City: Stater
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City
Zap: Phone:
MORTGAGE COMPANY: _Not Applicable
Name;
Address:
City State:
Zip: Phone:
COMPANY: _Not Applicable
Name: .
Address:
City:
zip: Phone:
I certify that no work or Installation has commenced prior to the i5suanceof a permit.
St. Lurie Counttyy makes no representation that is granting a perm t will authorize the ermit holder to build the subject structure
which N in rem list with amr applicable Home Owners Association rules, bylaws or ans covenants that may restrlct or pro},rbit 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 permi4 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 concurrenw review: room additions,
accessory structures, swimming pools, fences, walls, signs, scream rooms and accessory uses to another non-residentlal 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
Signature of er esse Contractor asAgentforOwner
signature of Contractor/License Holder
STATE OF Fl. COUNTY OF f�;D/h7 �L'Q C� OUNTY OF� STATE OF O !Y �/1 I
The for in instrur�+nt wa acknowled ejJ efum me The forgoing instru nt wa acknowledged before me
thls/yday of �d P . 20/L by this day ef�� . 20 /�r by
(Name of person acknowledging) : (Name of person acknowledging)
���
T(Slgnature of Notary Pubic• state of Florida )
Personally KnownWW�t�
eI
Type of Idt ficatComm.ExplasAu
Commission No.COM1599110 N FF
Revised 07/1512014
Known
Type of
Commission No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS