HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COn i, ,TED FOR APPLICATION TO BE ACCEPTEG-
Date: SCANNED Permit Number: l g 10— Qa�;Q
BY
St. Lucie County RECEIVED
Building Permit Application OCT 102010
Planning and Development Services Permitting Da art
St, Lucie County vnk
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential(
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED�IMPROVEMENTLOCATION L.
Address: /U( O 3-CMAV f)kLIVE 'j-0
Legal Description: 1-9h fd eREST `ON011040 WIT 0 ANA I/JMV donnimi 5.a.&I6 rZS
PropertyTaxlD#: Lot No.
Site Plan Name: Block No.
Project Name: (r/4405 eue-rb
Setbacks Front Back: Right Side: Left Side:.
gETAILED DESCRI7"OF'WORK"` '' '
y ,.
�...a__ _. _e_
Zus �l�c� f►7ro c� dF l BA-c664iy
-`
CONST_RUCTION_;INFORIVIATION
Adclitional wor to e orme un
ert ispermit-c
ec a apply: -
'a
=-
-
0HVAC UeGasTank
❑Gas Piping
_ Shutters
Windows/Doors
11 Electric 0 Plumbing
Sprinklers
_ Generator
❑ Roof
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ d1 D6.06
Utilities:Sewer
Septic
Building Height:
01NNER_/LESSEEy
CONTRACTOR y
-
~�'HR��S LL(e-16
,
Name
Name: Mlrie
RuF77t
Address: 1301 Sw ,26/4,S71-57'
Company:
pllqVaefige
City: State: r�
Add ress:12-1ro
(SEF,
JLWe / NV
Zip Code: 3317: Fax`
City:
p `L5a
R666 � XJtLn1 State:
Phone No.
Zip Code:
Phone No.
33#ff Fax: 77�'Sy� 3�47
77)--545 -33od
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail:
State or County License: �2615/
from the Owner listed above)
ifvaiue or cunxrurnon is >zouu or more, a KtLUKUW Notice of commencement is required.
SUPPLEMENTAVCONSTRU,07iurl LIEN LAW INFORMATION, = r
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: I Address:
City:
Zip:,
one:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City: _
Zip: _
one:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
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 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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordine vour Notice of Commpnrpmpnt
_ Signature of Owner/ Lessee/Agent Signature of CJtra4of/0cen* Holder
STATE OF
COUNTY OF OR%IDyl�wjc c /) STATE OF FLORIDA,,,.
c �n
COUNTY OF 1��/
The f r oing instru en fa acknowledge Before me The forgoing instrumnent 1was acknowledgedJaefore me
this day of� 20 �by this ,9 day of l iG� 20 by
ofAr ac n IedRinR ) I (Name of
:r9g
tyreIno
Nbt `bl -State of Florida) (Signature of Notary
yPublbliicc,5tate of Florida )
onallywnp : "�$uce84Hlht4f�Q MMPS Personally Known V OR Produced Identification
Type of Identification Pro commission x FF T88ass Type of Identification Produced
�� •°,`.�`� �9 D ce ber 29, 2018 ;"tiWroy"... MITC Commission No. b Commission No. (22 o�'h'� Nota Pu61ic-State of Florida
'1ded1hmu9h Naeawi NataryA,,
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
O.I
(*�
COMPLETE
(:J
INITIALS