HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMVL I'e. ED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 17OS im 0 R
SGANNEU
BY
St. Luc' rniin+, RECEIVED
Bui Wing Permit Application
Planning and Development Services MAY - 9 2017
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial L Residential
PERMIT APPLICATION FOR: AFT i_:iz -v HE FRC71-iwMW1VN1'1J* AAMes
Address:
.1
Description: 3 5 1 e5� J
Property Tax ID #: UJU, I — u UJ — p' Lot No.
Site Plan Name: Block No.
Project Name,
Setbacks Front Back: Right Side: _ Left Side.:
MUUlLlUlldlWU1KLUUt!Pt!lJUrineU unueu mis permit — cneCK all mat apply:
—Mechanical _.Gas Tank Gas Piping —,Shutters Xwindows/Doors
Plumbing Spr*inkiets nerator Roof Pitch
TotaI=trucion Sq. Ff.orlirl`i_F oor:
Cost n: $ Utilities: I Sewer I Septic Building Height:
q R/(ESSEE:
C R
P,NT ACT0. Al
Nalrnei�
NarnW�'
Address: We(;
Ud (;L—
Company: '��ny: 3 �, � r
r1p <
C - ka.c:h
City: 1,/"0, State4��
F
ZiISz Codeb:'.
Phdne-NI' - 771 A
Address-�� V. 4graj
City: �VIM=3 107—Statue:_
ZiCe: Ft.
pod
Phone No 74.2- Z-f 7K
/ / —
E-Mail:
Fill in fee simple Title Holder on next page (if clifferent•
from the Owner listed above)
E-Mail all
State or County License
It value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUPRLEMENTAL,CONSTRug, LAW INFQRMATION
'
.. ,LIEN
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: �
Name:
Address:
Address:
City:
State:
City: ��
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address: A I
Address:
City:
City:
Zip: Phone:
Zip: Phone:
QWNERf 6hfTkgc'r463t 4t�oyrT,.-i6pliistion:sfhere6y made:fo blitain a'petmit Fd ho the work and installation as indicated.
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 firs inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin ork or recording,.your Notice of Commencement.
Sign m•of,Owner/ Lessee/C ntrac7pr_ds-AgpnLfor Owner
ofkton6tract6r/Licrense Hold
Si n2OF
r'�{ •j;
STATE OF FLORID/� 1
5coirn
STA FLORIDA ��11�n�
COUNTY OF %UC1Q
COUNTY OF
f�elQ
instrument edged before me
The fo day
this � day of 20� by
The fg5going instru was acknowledge by me
this � day of 20 / by
210
2. l /yW /�/�
O/k
(Name of pers n acknowledging) Ydyg roo
(Name of person a knowledging )
Nor
(SikpatiTrepf Nota Public- State of Florida)
(Signatu of Notary Public- State of Florida)
Z
m ° 01
Personally Known OR Produced Iden ifeagod
0
Personally Known_ OR Produced Identi ication--
Type of Identification y Q m
Type of Identification
X 3
Produced
Produced
H a,
n/�//��' 5f I)iv
Commission No. 1.71..1 c�
�3,
Commission No. / O,
-r5
o o m
x
(Se Ija 3
(Se m
r'� • . N r! O N
N V7 R m
p m T
� o
N N O y
REVIEWS
CC n.
I". IhlG SOR
PLANS
VEGETATION
SEATURTLE I$GR E
COUNTER'_ REVIEW REVIEW
REVIEW
REVIEW `
REVIEW
REVIE
_
DATE
1= t (—
RECEIVED
'IC�17
DATE
' (,
COMPLETED
Rev. 7/ZU14