HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED }_�f
Date: r� 1 1-t- 111 5(✓ANNED PermitNumber: I I
St. Luce CDunty� RECEIVED
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Building Permit Application FEB 17 2017
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia A venue, Fort Pierce FL 34982 n` St: Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
I PROPOSED IMPROVEMENT LOCATION: III
Address: to /'I- / U luplz J _
Legal Description: 46k) 3so rs/a ] C 101-, Sf—� 7a. wc)_ p 37�
Property Tax ID#: `16 //- S i&/r9000-00(2�1 -
Site Plan Name: P ilr c A / rl SO ti _ 1�SLR_-
Project Name:_ lb D_
Setbacks Front`_ Back: RightSid�LeftSide: In
Lot No.
DETAILED DESCRIPTION OF WORK:
_W✓A� M 1 r To 2.
C�o/x 12-1
CONSTRUCTION INFORMATION:
Additional work tone e orme under this permit -cec a _appy:rs �esp❑HVAMGasTank lGasPiping � Shutteors
Electric ❑ Plumbing
Total Sq. Ft of
Generator Roof ❑ Roof pitch
S Ft. of First Floor:
utilities. Sewer❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name W C(-3
Name:
Address: ;o'//0-,;. OGCjr -7-•
Company:
City: -:�_e,otc-,-t ?Se A`L State: A&
ZipCode:!FV95% Fax:
Phone No. '2 J 3 5'7- 116 (r
Address: 117 A ot-N
C-7
City: t:�h
Zip Code: 3d4 g 3 Fax: N
Phone No. _n Z- - ':Z3z— I q'J
S/tate:2�L
/ A
b
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: 5 u i3 R
State or County Ucpnse: C_BG 1 '2,.f
ma's
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applica le
Name:
Address:
Address:
City: State:
Zip: Phon
City: State:
Zip: P ne:
FgE SIMPLE TITLE HOLD Not Applicable
Name" C
BONDING CO! P : �C _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zi Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
>t. Lucie county makes no representation that is granting a permit will authorize the permit holder to build the subject structure
vhich 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 ffuilding 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 Notipe 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
STATE OF FL #bA STATE OFF O A
COUNTY OF s .ill' fC. COUNTY O V 44 1,11(o E
The orgoing instrumen w s acknowledged me The forgoing instrumen s acknowledged before me
this: day of " 20 by this yL day of 20 LV _ by
Of
cs-- 1 tS—
(Sign Lure ofNot#y Public-Sta a of Florida) (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification `1 Personally Known OR Produced Identification
Type of Ideptification Produced -� 1. Type of Identification Produced J)•L +
Commission No. ,4SeaIVAREN S. NIEL Lim Sion No.
Commission N FF 11 s37 ':�'•;,,, KAREN S. NIELSEN
My Commission Ex ices Commission N FF 115837
June 12 201 8 - My Commission Expires
Revised07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
RE IEW
REVIEWREVIEW
REVIEW
REVIEW
DATE
IO�
7/1t 1 -1
COMPLETE
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INITIALS
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