HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 031.')-oll 7 Permit NumbeFf:*
owaing reirmit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PFRMI I APPLICAI [ON FOR: To Select from dropbox, click arrow at the end of line
PROPOSFD IMPROVFMFN I LOCAI [ON:
Address: 5701 0 (�, -, c_ /4-,.) (_ f --_ - k- I? ;e_
Legal Description: )2A 4 ,)3 19 'a
61 C '/-I o IP tJ VL4 o 42
Property Tax ID #: "7-3I a &i I 1 0 0 0 1 -
Site Plan Name: yr 5701 OCC-^!)e AUQ
Project Name: -rl. 9-004-11'
Setbacks Front— Back; _Right Side:
DEIAILFUL)ESCRIP11UNLOF WORK:
CONSTRUCTION'] NFORMATfON:
L-JHVAC "Gas Tank L_jGas
OElectric El Plumbing OSpr
Total Sq. Ft of Construction:
Cost of Construction: $ 5, OoO - o iD
Piping
00-
4,4�ova t-)�I)
am (Generator
S,c Fit of First Floor:
Utilities: L] Sewer USeptic
1�,
4r,
MAR 2 9 20!
PER,MjTT,,,
St. Lucie Couj,,.,.,
7Te7 —L4-7
Z:2
s In Of c-A
Lot No.
Block No.
ElWinclows/Doors
0 Roof = Roofpitch
Building Height:
OWNERESSE
CONTRACTOR:
Nam e
Name: Co�4-
Address: 5-701 Q( A,/f-
Company:
city:— Pork PC67L7 State: L
ZipCode: Fax;
Phone L No. 72) 3-70 -1-71:5
Address, 1-7 710 r- a
City: P-2r-4- State: r L-
Zip Code: 3 14 L-I Fax tvlA-
Phone No. (7-7 0 1
.
E-Mail: Yl�k4v�
Fill In fee simple Title Holder on next page( If different
from the Owner listed above)
E-Mail;
State or County License:
If value of construction Is $2500 or more, a
Is required.
Drs
SCANNED
BY
St. Lucie Countv
1-1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City: State:
Zip: Phone:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Wcsj o� T Inc�S LI_L
BONDING COMPANY:
Name:
_Not Applicable
Address: 5''7a' Avc-
Address:
City:F.
City
Zip: 3 4 cli(-) 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
s
Signature of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF GV� LPL _c_� L_ COUNTY OF 5 � •
The forg ng instrument was acknowledged before me The forgTiing instrument was acknowledged before me
this I' day of JV r' . . 20 2 by this Z 1 s day of Mc —re , 20 1 7 by
0 tn') 3. e__'o e \ ICI G!"4 -, ?=-C�t"-) —)
rs (Name of eon acknowledging I (Name of person acknowledging)
CS#OL�� 1 C&q45J_'
(Signature of Notary Public -State of Florida) (Signature of Notary Public- State of Florida I
Personally Known OR Produced Id tion Personally Known OR Produced I gtification
Type of Identification Produced Type of Identification Produced
Commission No.
(Seal)
Commission No. i!Y �� g �Z S (Seal)
olo
`"•""°vs,
Conumss�m, H FF 209728
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Revised 07/15/20
=
Commission Expdos
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REVIEWS
FRONT
COUNTER
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW -
MANGROVE
REVIEW
ZONING
REVIEW
DATE
COMPLETE
r
INITIALS