HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLE i to rOR APPLICATION TO BE ACCEPTED
Date: �l `[rT_ SCANNED Permit Number: I qua`
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
BY
St. Lucie County
RECEIVED
Building Permit ApplicationFEB 04,2ols
Commercial
Permitting Department
St. Lucie County
Residential ✓
PERMIT APPLICATION FOR:
PROPOSED INPROUEN-1 L®GA IION:
Address: 9%00 S. 0Cec1A br'tve UAly"A- 7-D( Te�,le., Qecleh r-L
Legal Description:
Property Tax ID #: ,
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
Rem,ad2k'tAg z�q MctrA-e.r' bc.�l�roOM -Aew c0b[nei CO�.r'tertoP.
Sllowe..r[ rile '�taa � rzee.rrec� lig���'�replace¢xl;rY bvlb,�
2 Swig cSn@rCFliA�low ve�kaee 't'rck^ry-r'.A
_Mechanical _ Gas Tank _ Gas Piping
✓ Electric ✓ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 130
_Shutters .—Windows/Doors
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Cost of Construction: $ 30 00 0 Utilities: _Sewer _Septic Building Height:
MR/LESSEE;
CONTRACTOR:
Name 'Te--ram
Name:
Address: 9(aoo -,�z �oe.enn Dr
Company:
City: � eAa'eA i3-ea'.a.11 State: Fe
Zip Code: 3`f 45-"7 Fax:
Phone No. ' 71-7 - L4 Lf *2 - 3 a 3 Z
Address_:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: c--66i;,T 1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
S §Pafi EME M TAP CONSTRUCTION flll ENUMN'WilNfl
# RMg 11- ,
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: ✓ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ✓ Not Applicable
Name:
BONDING COMPANY: ✓ Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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, 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
commencinga work or recording vour Notice of Commencement.
cAm'
'Signatu a of O ner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDAS�i . ,, e�
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The for Ding instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 7day of�w 204 by
this _ day of ,20_ by
Jqu RN1)h uS
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced A- D L—
Produced
(Signature of Notary P ic- State o
Si nature of Notary Public- State of Florida )
EL EN
Commission Nd>�' "Q State of Floritle-NoQ�U61
n No. (Seal)
qy P Commission # G
My Commission
270079
Expires
REVIEWS
FRONT
ZONING
SUPERVISOR
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.