HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMP�_.�UD FOR APPLICATION TO BE ACCEPTED j
Date: kp 0)Q SCANNED Permit Number: `
. / St. Luce County RECEI EL)
Building Permit Application DEC`'14 2016
Planning and Development Services
PER-MITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial �41— Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION:
Address: i $,-90Y Nf. �Pf4'MAuis41-', blVl1
Legal Description: I`Ciitr'QLnael/ - Ux 3 - f- 388 35- Gtyj f~ r'-)- AS MeoStnho
M Cp 44,e. A)tz e,F_S'6 T RAa% (Mite 7c//zz6 ) cka .2fa 22 — /TRo z� iT9Zi
Property Tax ID #: 3Y19 - n i- wo I - 000 - 3 Lot No.
Site Plan Name:
Block No.
Project Name: If _"5 1, Y Lg ZA- t_lt cX-A, rwL
Setbacks Front Back: Right Side:
DETAILED DESCRIPTION OF WORK:
Left Side:
Tv.StaLL f_LAJ- .-C a k"""nw M 3 t3a,�yr 6" NZ coa.� cb -I-(, [AGL of
Rr I?+un ,_le, P_C" PAVoc,, ++ Aftnuep on P" "7 - O
ON INFORMATION:
�Gas Tank [] Gas Piping LJShutters Windows/Doors
Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $ �2L®
S Ft. of First Floor: _
UtilitiestSewer Septic
Building Height:
Roof pitch
OWNER/LESSEE:
CONTRACTOR:
Name S+ Luui ` e4d44g&4Q f.LC
Name: /ylfdWd A lr. A:l '
Address: y(B4 /j).dlFJ,jm ty2
Company: /11 4 'r1J& Ae4'-e ^6 u c
City: Uuxk.leA, State: PL
Zip Code: .33411 Fax:
Phone No. / ISY fig(e (9340
Address: //(,e'75-� sw S,4-
City: `/?S/_ Stater
zip Code: 3t/997 Fax:
Phone No. 7?2- 21r 729g,'
E-Mail: Cal, dl1 d 004 0- aot . f oun
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Aer fkzc, -( M 6 I,G4,0- Gos._
State or County License: oZq S� Q
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTIOtr�1EN LAW INFORMATION: LJ
DESIGNER/ENGINEER:
Name: Coo ?,&Ze 4-6'Nf/INfli
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 3l5" S. 71 G•Ga
Address:
City: PDA* ?6'tft&L
Zip: 34450 Phone:
State: P_
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
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
Signature of Owner/Lessee/C � or as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The fo going ins Tent was acknowledged before me
this f day of l
20 b
STATE OF FLORIDA
COUNTY OF
The for oing instrument was acknowledged before me
this Lday of nab. 20 _LU by
CG`YrteMccoan (l�VYlJ�1ytC Unh
(Name of person acknowledging) (Name of person acknowledging )
(Signature of Notary Public- State of Florida) (ignature of Notary Public- State of Florida j
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.
Revised 07/15/2014
CARRIE MC U*Wis ion No. I CAR�I'1CCUM11
M`GOAWIsSION F=9350 it i.: ;•• • A MY COMMIS&ON O FF97i911
L YOtQFS YnMTE�f O➢. 1919
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
W
INITIALS