HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL ePPLICA7E INF MUST BE COMPLETED FOR APPLICATION TO%E ACCEPTED I (�
331IIA' r, � Permit Number:
7_91 11
\ T I l'15
��S(t lLucie.Cot,nY
Building Permit Application SCANNED
Planning and Development Services - - - Bl/
Building and Code Regulation. Division St. LUt)I13 (:(111nt�
.2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential.
PERMITAPPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT L CATION:
Address:
Legal Description: -L�l !02 35 9 _ O n Stu "j- Yle 9.6GA?A7_
7i• r>t��n -GoHoleo,72 1=7- DIo g1'
Pero y7Tatl :#%: 3�/Vqv—
Lot No.
Site Plan Name:' Block No.-
Project.Name:%
Setbacks :Front--: Back: RightSide: Leff ide:
DETAILED DESCRIPTION OF WORK: now
„.; a
/y" ._ ND
TRUCTION INFORMATION:
OHVAC _Gas Tank E]GasPiping _Shutters Windows/Doors
Electric Plumbing USprinklers Generator Roof =1 Roof pitch
Total Sq. Ft of Construction::of 7 ScFt. of First Floor:
s
Cost of Construction:$ _a 6 O. Pi_Z> Utilities. Sew&ElSeptic Building Height:. 90
OWNER/LESSEE:
-
CONTRACTOR:
Name mG
Name: I_VMA5%E,e
16J(N L,i WC
Address: 14A-R IS Au S,Z9 a L PH o'L
CompanyTA NtaS AAR-1
City: [= % t N 7E.IZC ::.. State: JA
Zip Codae:34 91/-% Fax:
Pho�S Nd JoC / 5 ' %?lo
Address: 3 3 / 1 1-0 Jug7'91
�
/f-k -:- n1 5 '%
City: 1't ;PXeACC
Zip Code3 0 4 -Fax:
Phone No. 7:, ` •l/6Y — A
State:_r_L
YkU
7X-
E=Mail:
Fill:in fee simple Title Holder on next page ( if different-
from the Owner listed above) -
E-Mail: $169S av o fi"DBZ-aSO a,714 A)0
State or County License:
If value of construction is $2506 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE ENGINEER: _ Not Applicable 'MORTGAGE COMPANY: _ Not Applicable
Name: S7in u .uG C Name:
Addressuaen.. N.F&ot�tae v1V,f aoB Address:
City: Bock Z4p A) State: ,r/— City: State:
Zip:, a Phone:l—�8 31L-3ii 3 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Names
Address:
City: _
Zip: - Phone:
BONDING COMPANY: _Not Applicable
Name:
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,
accessorystructures, swimming
g pools, fences, walls, signs, screen rooms and accessory uses to anothernon-residentialuse -
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 -
commencing work or recording vour Notice of Commencement. -
Sign a re of Owner/Lessee/Contractor as Agent for Owner -
STATE OF FLORIDA
COUNTY OF
The foring instr),ment was acknowledged before me -
this ovday of `'_ arc,( _ 20y7 by
LLamb �.
�U s
Signature Contractor/License Holder - - -
STATE O FLORIDA �1
COUNTY OF
Thefo,r ing-instrument was acknowledged before me
this )� —day of - (1' i-oL, , 20 hI :by
n , �
(Name f erson acknowledging
'I I.
--
_(Signature of Notary Public- State of Florida )
Commission
OR Produced identification
#0 P Notary PubBo State of FlorMa
Trade L Lamb - -(Seal)
`� y nNssion Fir047aa3
%?y Expires 01/2512020 -
--
'Revised 07/15/2614
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVI W
RE IEW.
REVIEW
REVIEW
REVIEW
.DATE
COMPLETE
I
INITIALS