HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPLICABLE INFO MUST BECOMPLETED FORAPPUCATIONTO BEACCEPTED
Date; 712�/2ets�%%L I�SCANNED Permit u
BY
St. Lucie County
Building Permit AppliCa 1
Planning and DevelopmenrServleex
AdIding and Codg Regulatlon plvlslon
2300 vtrglnla Avenue, Port Pleme FL 34982
Phone: (T/2) 462-1553 Fax; (7n)46z-Ss7a Commercial
Permitting
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IVEL!
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I s/ zolS er i
f
Departmrrt
jF&d6hW'p County, F
PERMIT APPLICATION FOR: To Select from dropboX, oilck arrow at the end of line III
Address: 000 N. Rock Road
Legal Description: OR 421-2150 St Lucle County Jail
PropertyToxlD#: by-bUuub35 E/yU (JLittlTo. �
Site Plan Name: Block No.
Project Name:
Setbacks Front. Back: _ _ ^ Right Side; _ Left Side:
Replace Chiller Building Roof Sheets
[3HVAC Gas Tank ❑Gas Pi In Shutters ❑Windows/Doors
41 Electric 0 Plumbing Sprinklers 11 Gangrator 2 R of Roof pitch
_
o .
Total $q. Ftof Construction: S� 6 SCL5. of FirstFlo'or.
Cost of Construction: $ f' �y l Utilities: sewer USeptic Building Helght:
$!� ���St �" �
•_� -} ,,, r ;"S _ems. r._F`�<3 �'�t��G.... ��='�'_+'k.!-�.s'FL..u+'�t
�tyP'+ S 3s. �� ,T,� � 2 S tZS ,.y, � �R�
�:v��C�_�3:Yt 41..�
�I Cheryl
Fort Pierce
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11
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Fill in fee sImPleTitle Holder an nW page (it different•
from the •
1
If value of construction is $250a of more, a BBCORDED Notice of Commencement In required.
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-------- --------
Name:
Address:
city: State: —
Zip: Phone
FEE SIMPLE TITLE HOLDER: ,_ Not AppllCaole
Name:
Address
Zip Phone,
MORreiAeuCOMPANY: Not Applicable
Name:
Address;
City: State:
ZIP: Phone:
BONDING COMPANYt ,_Not Applicable
Name:
Address:
City:
221p:--^---Ph6ne•._
CONTRACTOR AFFIDVIT: Application Is hereby made to obtain a permit to do the work and Installation as indicated.
It no work or installation has commenced priorto the Issuance of a permit
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 florfda Building Colies and St. Lucie Cotldty Amendments,
The following bull ding permit applications are exempt from undergginga full concurreney, review: rgem 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 tnspectlon. If you intend to obtain financing, consul( With lender or an attorney before
w..iwn ..,,..I- np •6� Alnv vnur nln4rrn n4 KI MIMAnrAMGn►_
r
Signature of wner/Lessee] tractor as Agent for Owner
Signature ofCQn tto%censeNalder
STATE OF FLORIDA
Luaec
STATE OF FLORIDA
St Lucie
COUNTY OF - ao-✓ y
COUNTY OF
The forgoing Instrument was acknowledged beforeme
The forgoing lnstrumant was acknowledged before me
tK54 dayof .lac/r _,20f by
thl; doyof .Ildy ,20jg by
f}��1
Name of persopmakIngstatement
Personally Known 14 OR Produced IdemlRnatlon _,,,,_,
Name0akingstatement
Personally Known person OR Produced Identifleation—
Type of Identification
Typo of Identification
Fradviced
Procluucnad
(Signature of Notary Pu Io fldPtill9aS.BCECKEL
tureofNryPµblir State offloriday
��Q@ #fF979475
Commission No,F� 7 :'S Coco s�{q
Co mission No. W Z0'R47 i
y1 Xpir��115,2020
8„t; •"a B4ndadTNu TroyFeln lnturante et03•Tole
ov+"°�a� Notary Public
Alyssa MOd
or
Ex I /1
REVIEWS
FRONT
ZONING
SUPERVISOR
RlANS
VEGETATION
SEA
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
E
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
of Flodda
208476