HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: SCANNED Permit Number. d 1 — 0 v
BY C'E.C"3V
St. Lucie Countv
Building Permit Application JAN 2 5 2017
Planning and Devefopment5ervices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce. FL 34982
Phone: (772) 462-1S53 Fax: (772) 462-1S78 Commercial ✓ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:.Af}dr�cl�QQ�mIaF,,.
LegalDescription: �t
,
PropertyTax1D # — _ ��. O D ) -Q Lot No.
Site Plan Name: Block No.
ProjectName: ej 1ES i. j—R,
Setbacks front Back Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Ins}ul� (11 S�I�l,.pl�atze 1�D/� Mn_+crmu�� Ccmh s LJirt
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5 2. s H � �,�n u r % �i �M �ls \ w,cks a+L 4
a l P �►o�^, G �► P ,-C (4* c-kUtA UA-
CONSTRUCTION INFORMATION:
Artiona wor to a rme un rt is❑enmt—c e a_app -
GasTank i
Piping
ShuttersnnHVAC
as oaWindws/Doors
Lrnlectric Plumbing
Sprinklers Generator Roof u Roof pitch
Total Sq. Ft of Construction: S . Ft of First Floor.
CJJ
Cost of Construction: $ of (1 Utilities
Sewer[jSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name i.f1C
Name: -)AC, Coct
Address: Cu s:1'1,,rtVa Ra i
company: C� I � c,
e:Mean
Address71g0. 7L clo-i 1 j
City:YlOm $DUA State:.PL
Zip Code: 2>1 tI j Faz: B(�I,-Scn3 %�e� l
city: W My .
Phone No.
.
zip Code: 12a)W I Fax- 3-21-7125- 5273
E-Ntail: r
' � ( � Cs� M
Phone No.
FII in fee simple Title Holder an next page ( if different
E-Mail: C S1h ff
State or{ounty License: MIZOly SSE
from the Owner listed above)
If value of construction is $2500 Or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: —��II
Name: .
Address:
City: State:
Zip: Phone:
reeanvwLtIIll ILL HULDER: _Not Applicable
Name:
Address'
City:
Zip: Phone:
MORTGAGE COMPANY- _NotAppliceble
Name:
Address:
City: State:
Zip`•. Phone:
BONDING
Address:
Zip:
I certify that no work or installation has 'commenced prior to the issuance of a permit.
In consideration of the granting of this requested permit I do hereby agree that l will, In all, respects, perform the work
In accordance With the approved plans, the Florida Building Codes and St. Lude.County Amendments.
The followingbuildingpermit 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
�Ki E. La �0.rj n l
STATE OF FLORIDA STATE OF FLORIDA {
COUNTY OF S1, Luc,P. COON Y'OF ttirZ UR v A
The forgoing Instrument was acknowledged before me
this _�_4 day of M A , . 20 a —by
M
�u �_� -
PersonallyKnown '_ OR Produced Identification_
Type of identification Produced
Commission No..J �494 q (seal)
Revised 071I512034
The forgoing instrument was acknowledged before me
this1'7 day of (}, /tA,t (�.,2,r,�, 20 ,12 by
�fl Gr i Ct L�fLt��1
(Name of rson acknowledging)
(Signatu)a Notary ublk -State o lorida i
Personally own t___� OR Produced Identification
Type of Identification Produced.
(MMELA L KRATZ
MY COMMISSION p FF236E
REVIEWS
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ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
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REVIEW
REVIEW
-REVIEW
DATE
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COMPLETE
INITIALS