HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLE w_2 FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Bluiiding Permit Appiica$i®n BY
Planning and Development Services St. Lucie
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I�I
Address: _?$O5/ _.4n W_<VY/a/ 25'I
Legal Description:
Property Tax ID#: //2W-502-Gt09--f
Site Plan Name:
Project Name: rXgAc COAST fA= FAIVI<
Setbacks Front Back: Right Side: LeftSide:
.rjVSii{GL 1V41AQ3 AMD VEA/T/L,477101Y 5f/STe%�1
onaiworictooe errormea unaertrnsperm¢-ci
HVAC Gas Tank ❑Gas Piping
Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Lot No.
Shutters Q windows/Doors
Generator Roof = Roof pitch
Sq. {- [--]Sewer[]
of First Floor: i
Utilities: LSewer Septic Building Height:
OWNER/LESSEE ;F ,.
GONTRACfOR
'' h:<
Name 7re,cr me_ Apod c'pi1sF.
Name: AN,2eeAV AWIW/IVI,'k� it
Address: 305/ fldM51,- j 25T,, T-1.
Company: 41,e FLOG!/ 7;29 A44im .T.HG+ .
City: Ff• Peace Stater
Zip Code: 5f6 Fax.
Phone No. (-7?� L/�% 3065,
—
Address: //3SS //3 AVE-
City: LA tUo State: A--L .
Zip Code: 5 3778 Fax:
Phone No- /379
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
_C7?7)7Z?-
E-Mai1: agtarf,,/.,d 0�a% f/O�SA�e/o ISJIS. COY✓/
State or County License: Cmd - /29D3112.
i
IIit value of construction is SZSao or more, a RECORDED Notice of Commencement is required. II
`"SUPPLEIVLENTALCONSTR,U_CTION
LIEN L'AUV'INFORIbIATION' _ � Y+y
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _
Name:
Not Applicable
BONDING COMPANY: _Not Applicable
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 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.
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF COUNTY OF Prrnzl(aS
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this -7 day of pe'c_ 20 L4-by this 7 day of pe_G 20 /k by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida)
Personally Known �< OR Produced Identification
Type of Identification Produced
Commission No.Er 2- q 7 2- Sy (; bo PARSONS
y P.�Jly Flodda
mComEVku7 p19
Revised 07/15/2014
Personally Known X OR Produced Identification
Type of Identification Produced
Commission. No. FFZ5172SO (( 11�0
No.
241250
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
- _1 1, ,�& -
ALL APPLICABLE INFO MUST BE CON11�c�TED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
St. Lucie Countv
Building Permit Application
Planning and Development5ervlces
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
PROPOSED IMPRQVEMENT
LOCATION :,
Address:�f-
Legal Description:
Property Tax ID #: /4eg 9 - 6-e2- 4k5L7 q - Lot No.
Site Plan Name: Block No.
Project Name: COAST fDd/f i3,+{rtlK
Setbacks Front Back: Right Side: Left Side:
DETAILED bESCRIPTION,QF 0611KS
2)VSrALL AW946 AVD VRrA1T/!-4r1,0& 5YSTEM
-
CONSTRUCTION iNFORfV1ATr..ION :,,=,_
,
All
�I�tiona wor to e e orme under tispermit-c ec'a apply: Y"?
allVAC �
Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors
Electric Q Plumbing Sprinklers M Generator EIRoof u Roof pitch
Total'Sq. Ft of Construction: $ Ft. of First Floor:
°
E]Septic
Cost of Construction: $ _ 27 eOO, ° UtilitiesSewer Building Height:
OWNER/LESSEE=-' CONTRACTOR
�.
_
NameJ{�t�t5tf/e Foo 8,�, Name: ,¢NlJ�P�Gt/ KO/Ll/M!k
Address: 30S/ JJI�LISf�%a ZSTy V-/. Company:- Al/e-'Ieez/ i5MCIA414sm, -Dlar
City: • 141,ehz State: Address: //3S , //3 AVE.
Zip Code: 5 L Fax:' City: `A)Wvo State: F'G .
Phone No._T 4eJ2- 3a3�f Zip Code: 3 3778 Fax:
E-Mail: Phone No. _ 279% 7yI- /3 %?
Fill in fee simple Title Holder on next page ( if different E-Mail: iA/I 2a%Y %OAS /S /b%S COW
from the Owner listed above State or County license: CMG°- /25431p2.
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: _ Not Applicable
Name.
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day Of 20 _by
(Name of person acknowledging)
(Signature of Notary Public -State of Florida )
Personally Known _
Type of Identification
Commission No.
Revised 07/15/2014
OR Produced Identification
(Seal)
STATE OF FLORIDA
COUNTYOF P/ rt�liLc i
The forgoing instrument was acknowledged before me
this 1 S day of /(/Uy 20 ' by
'21r eAJ til /Co rvt tK r !L—
(Name of person acknowledging)
(Signature of Notary Public -State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. i'r .2
[Irl]
of F10 MV
iy7,201f<
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS