HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPUr.
.ABLE INFO MUST BE COMPIL'r I C-D FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Ll
SCANNED
BY
St. Lucie County
Planning and Development Services Building Permit Application JUL 0 5 2011
Building and Code Regulation Division PER�,gi-rING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Countj� F_
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address: 290 SW Prima Vista Boulevard, Port St. Lucie Florida 34983
Legal Description: Section 29 Township 36 South Range 40 East
PropertyTaxlD#: 3429-134-0001-000-5 Lot No.
Site Plan Name: — PARISH PRE-FAB SHED Block No.
Project Name: Moving prefab shed already on site.
Setbacks Front Back: _ Right Side: Left Side:
�W�L.W..0 I WVW§ft IV VM1 PUP I I ICU UP IUCJ LI Jib IMP I I IIL�161
E]HVAC - Gas Tank E]Gas Piping
LIElectric El Plumbing []Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ --3(M —
M
Shutters []Windows/Doors
Generator E] Roof
Sq. Ft. of First Floor: —
Utilities: OSevver ElSeptic
Building Height:
A jT
N
t:§WT
Name SkuP krtL#L M.
Name: _73_-:nDX) -F�!.
Address:_9995' N, M�Iifc,0 Ir-
Company: )F Pi,P�l M re 0 1 L--DF,7?-S
city: tc,(N Bov, CIAl'ottAs State: PJ_
Address: I r7 n- kex.� "M C�17
Zip Code: 3*34 10 Fax: 51s 1 -1 -15 9 59 4
City: F'P state:VL
Phone No. Ste ( -7 -15' - 0) 51 L4
ZipCode: 34`itjc� Fax: T-U7,4
—
E-Mail: f9aimsub-ori
Phone No. -77 Z 7 , 0 1 (o
Fill in fee simple Title Holder on next page ( If different
E-Mail: S 0!4 'E ccr--%
State or County License: 0 I
from the Owner listed above)
if VdJUC UP GUnbXrUQion is;-z:3uu or more, a MA-01HIME) Notice 0? Commencement Is required.
L)ESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: e:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: r N6t Applicable
Name:
Address:
City:
Zip: —Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: —
BONDING COMPANY:
Name:
Address:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Applicable
Applicable
St.LucieCount makes no representation that Is granting a permit will authorize the permit holder to build the subject structure
which is In con4ict 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/Agent
STATE OF FLOR�
COUNTY OF aJ4xBF0.C�k_
The Ing instrVent was acknowledged before me
thisip--rdayof JI.Af-4L- 20 (2-by
person
(Signature of Notary Publi State of Florida )
Personally Knc 7OR Produced Identification
Type of Identification Produced
Co 05q - -----------
Commission No.
f-k'9- D"k.CALITTO
h*P'XT!Commiss6#GGV54II52
Revised 07/15/2014
OF FLORIDA
A; 4 Loo'l-F,
The forgoing instrument was acknowledged before me
this � day of ki 1:4 20 a
la- _by
�,OW Vlm�ht)K]
(Name of person i-cknowledging)
Q::�4UAA k�-
(Signatureof Notary Public- StateW Florida)
Personally Known OR Produced Identification
Type of Identification Produced 'I'U I —
No.
31�AREN S. NIEL5
C,,,Mission # FF 1 1
,,. C,,ission FXP
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
R
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS