HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICAB INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ¢ q
CA' 1 Date: 9 « I 1
Permit Number: 1-t Oil `1
RECEII'-'D AUG 15 2017 SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line cowl III
Qi¢noJ a} tOn
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
umt
Aarboar icwe - 02n dd/n in iah? E - &1i it /o/
Property Tax ID#: 114/1-709- 660/- DOD-S Lot No.
Site Plan Name: �j Block No.
Project Name: O_htl 'vLd ReXQhhe Reed
Setbacks Fri
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
/Zeno v� Cau.cL h,��lEGce eLLG i nets I couti�(„c.-fn/�s, -��le
CONSTRUCTION
R
VAC LJ Gas Tank ❑Gas Piping
lectric X� Plumbing []Sprinklers
Total Sq. Ft of Construction: �e 5&'h_hreS
Cost of Construction: $ 151000, 00
Shutters ❑ Windows/Doors
Generator 1:1 Roof
S Ft. of First Floor: _
Utilities: —Sewer Septic
Building Height:
Roof pitch
OWNER/LESSEE:
CONTRACTOR:
Name 0 iN eeet
Name: J, &L ch fe/ I-14en /
Address: 5/67 NAM 4 /0/
Company: W/e 7".44tK Cool G c4o t!O )z
City: 4 p/&:'ce' State: Pi-
Fax:
Zip Code: 34K�,7
-I Phone No. 56731 '4 6Sq
Address: ?J 003 62 t HELL Dr Sf6--b
1/
City: ,r em lblw � State: rL
Zip Code: 32q 6 3 Fax: 77 2 -Z3'f- (o48 7
Phone No. %%�-�3'f- 4Q''79
E-Mail:
kreCLI 142160 be,/1.s H,,he
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: i)1htu, / @ W?-5bn"k-dji1dgpire4J.atn
State or County License: .J/1/ & C GG 27�/ 68
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
ISUPPLEMENTAL CONSTRUCTION LIEN. LAW INFORMATION:
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: 2
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name: �)�n
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 holderto 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
commencine work or recordine vour Notice of Commencement. 17
as
OF FLORIDAr
fY OF / )&
The forgoing instrum nt was acknowledged before me
this day of Lb5t 20 (7—by
(Name of person acknowledging ) V
(Signature of Notary Publi t5te of Florifa )
Personally Known OR Produced Identification
Type of Identification
Pe Notary Public State of Fbritla
Commission No. g LindaXftVjtrey
My Commission FF 236629
"+?,,,,off' Expires0629/2019
Revised 07/15/2014
OF FLORIDA NTY OF /mA'm /U1 V94)
The f%9rgoing instr ment was acknowledged before me
this /=�fi"day of 4L4,t 20 /% by
E//LLLGGca� �'��-ter
(Name of person acknowledging) U
kptL'
(Signature of Notary Public- State Florida )
Personally Known /OR Produced Identification
Type of Identificatio _PLojyc�.d- _ - _ _ __
Commission No.
236629
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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REV EW
REVIEW
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REVIEW
DATE
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COMPLETE
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INITIALS
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