HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1 -
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED - - - --
Date: y�aL..5 U4 Permit Number: Ko 6-A io
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
SCANNED
BY
St. Lucie County RECEYVED
Building Permit Applica ion APR 2 5 1, 18
ST. Lucie County, Permitting
Commercial
PERMIT APPLICATION FOR: C (3 z Q�-�
Address:
Fva-+
Residential
Legal Description: 32. 3 `i Hd i NRT M/CT OC y U F-p OF F 3�P FT -
'VA to Yl- OF XW % OFAW%yGYG
Property Tax ID #: 1ri32- 222-(- 000/9 Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front 2S Back: 227' Right Side: /O' Left Side: /O v A)C; ="n•VN5iaN
.TArro %'F-T Meks
Mechanical
_ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 3 S7bt m
_ Gas Piping _Shutters —Windows/Doors
Sprinklers _ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
FOiIUNEiI ESSEE a '` , � u.�
•r. av< ,.a .,., .... ,:m .."."A--R..b.A .�. .&•#..9 .... :
,GO�ITRACOR� `
., .$ _:;. e: . .ram *. cu_*•?'x c._.
NamedvenGAYh,waref64 CC oCOGaWaC!!�ft
Name:LNS
;Address:,. he- t,&m Pala DIAILOL
Company: 4wncoee L L c-
�:,
''City:fl`�z'/�K�a'.. State:6A�sH
,;Zip CoerL`I3o3i3Fax: •,uso��Cty:
�Phone,Na:.s,a
� car
Address-4 ti"�?�
State: FC.
O T•,AI,a C:
Fax:_ 792.69E--876
Phone No 771-2,87-731 Y
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail awngoy'e@ Rrna i eyih,
State or County License 'idGY7
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
Narr
Addi
City:
Zip:,
FEE SIMPLE TITLE HOLDER:
Address:
City:
Zip: Phone:
Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Address:
State: _iqL:u City:,. a State:
=4R'Sft Zip: Phone:
Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
City:.
Zip:_
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a.permit to do 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, Wall 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
commencing work or recording vour Notice of Commencement. /l
�a4t
. 2f�
Signature of Owher/ Lestontrador as Agent for Owner
Signature of Contr ctoi 'cense older
STATE OF FLORIDA I
'
STATE OF FLORIDA
OF �' (3 r)
COUNTY OF Z
COUNTY
The forggjng instru ent as acknowledged before me
The f 1 11 instru ent was acknowledged before me
this �15 day of J 20JB by
this �S"°tlay of 20 1� by
.
(Name f s n ackn wle gi g)
(Name of pers n ackn ledg'ng )
(Signature Notary Public- State of Florida)
(Signature o otary Public- State of Florida )
Person y Known OR Produced Identification X
Persona Known OR Produced Identification lC
Type of Identification
�tPSlX1�2
Type of Identification
quri
Produced \dnC� UVJ�✓J
Produced c1m��A-4tttA
Commission No. C�1�j �(Gin�� (Seal)
Commission No.U�� ,`i (Seal) Wi
Moneiphae
iison Moneiphae
NOTARY P
BLlc NOTARY PUBi
REVIEWS
FRONT
FFLORIDA
ZONIN L4POTOR
I&DEANS
-VEGETATION
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SEA' S
R� /7
COUNTER
REVIEW M t �REVOMS 1
/7f�lEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.7/ZU14