HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLL , cL) FOR APPLICATION TO BE ACCEPTED
Date: 2-(? 1 t.�q SCANNED PermitNumber:
BY
St. Lucie Goi iritv
RECEIVED
Planning and Development Services Building Permit Application DEC 13 2 1 016
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucia County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Sign
,PROPOSED ENT--�
IMP-119VEM J 7 00CATI(Af-
Address: /0 7a�l� 5, aS h4w ��
Legal Description:
Property Tax I D#: 3cllcl- 5-61 - sboq -Zko- 0 Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
tiE I DES,'
'RIPTIOWOMO
Remove existing wall sign and install new sign. Connect to existing electrical.
CONSTRUCTION, INFORMATION
F_1HVAC [_� Gas Tank . as Piping
OElectric E] Plumbing RS * klers
J2, n
Block No.
S h ut ters; Windows/Doors
Generator Roof
Total Sq. Ft of Construction: -_ '1 " - A.�) J Scl ]Ft of First Floor: —
Cost of Construction: $ 1�/, Me 67 Utilities: Sewer ElSeptic
Building Height:
Roof pitch
TOR:
Name/_/��
Name: 1014A41-RD 7aV&IeL
Address: 6Y(,-1 S�—
Company: .0064 &��6
City: 24(6rl� State: ZY
zip code..- zy-2--p- Fax:
Phone No.
Address: A61(e lelk'o�r' XdA. 4/
City: 6,*e6--o State: 0_-:7t_
Zip Code: 3:F,773 Fax:'�
Phone No.. 7- fr?
E-Mail:
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail:
State or County License: AEV_13_W7--Z6
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
L)tbIrjNEIR/LN1C3INLlElR:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY: Applicable
Name:
—Not
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 propeAv, A Notice of Commencement must be recorded and posted on the jobsite
before the first inspqaro�n. Ff yo_ulft�tencl to obtain financing, consult with lender or an attorney before
eW6_�� s
as Agent for Owner Sigriature of Conttacto//License Holder
STATECIFFLORIDA STATE OF FLORr
46��,
COUNTY OF COUNTY OF '0
The forgoing inst acknowledged before me
this _�� day of !�2a.s , 20 LG by
re of
of Florida )
The yfing instrument was aeknowledged be ore me
this day of 20//,5, by
12tcoo-AD Z?�eZeP,__
(Name of person acknowledging)
re of Not* Public-,Ztate of Florida
Personally Known OR Produced Identification V/ � Personally Known OR Produced Identification
Type of Identification Produced Type of IdQQ "t, n P
r,�duqecl,
�NOA CHAMPITlea I)
y ii r'C
Commission No. (Seal) Commissi '�v
M Comm. Exp
I C, I mi�' E'1'
1 101
�Kl 0 K1101 OCK.
KAR
6 37 . ...... M.1.11 A FF 09
.
--Revised 07 My Commission Expifes
Commission#FF 115
/15/2014
June 12, 2018
U.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS