HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / 9. SCANNED Permit Number:BY
St. Lucie Count
1 EM
Building Permit Applicati
Planning and Development Services
=C-9UQtY,
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
x�-ry- ryr, c.C- x .�-.�R„fw� y _�, r [yy�.w,^ -4r,;r r* � is�Fri'(��,��a4;:, 'y„j �` ��'a s s "��•�g�r .Y.A<�
.. 'i ((��.,�♦ H A Y'Y 'L�Y r N L�CM � � y4lA ..�M1SP; ,
�I �4�C�'11 PIV� E�I G't. a
'«f W-���N Y'r
`
Address: (2
Legal Description:
Property Tax ID#: �%��(Q 19- o1V - LgaV S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
-�n ..��,�,�+a =ski f� ,yr ti n �. afi n `*� �'"'" •�, r- �- t ra, � � .#`'
1Eti�llEDxl E CRi �LV'L3FyWL�RIC $ ag I $F � !1l K, ,
mjr..'K.C.+YL';
n s
Fa«f ,Ro a�....//,/•..Ft.J.."3w.Lb.,..:rf�.NtrWtSr,-f.'i3Fo�4.vk�4sY• ye'`.k;%;?p,✓;1":.:41•No ... 1k...i£'4
;r Qsfd;-ir9. 3 o�GH:r+gl o� AlGo✓cl;.'oh' S ., tip -ta igPar�r�?ey�;
+i._.• s�n`�'�r'p-a:r s4r �rre.atyars-�],x
� « � as 3�s `„�,°'`pr �•8".f? 5n'�'?�'�:�"s �� kw
�'�a."
. ,:..r..'�i',+r'`.A }...., r��.!:^� .A �iE.'. �•r. .....
Ft'� ., ...�: t ., .'+�;,.,. 7�uw.�$±5�;.v. r.:.;f i, savi,�r��x.�^ �" .w.s.�j
be
ACICUtional work to e e orme under t-checkispermit a appy:
F;
❑Gas ❑Windows/Doors
HVAC�l Piping �, _Shutiters
Electric O Plumbin9 ❑Sprinklers Genrat Roof Roof
r pitch
Tota.l:$grfto Construction: S ':.F.t..,dfrFirst Floor:
pp}�
Cost of Construction: $ �"T /� � lb , t 1 Utilities: Sewer Septic Building Height:
pllU EftjLESSEE `� u`'na�
^b +�. _iM JY k
fi �a� rx ,�;
/^ 1 i 1 p' '1 Na'+yl'�'Ji
a+�.Y..�L i14;!)�lcC h�
yp4!QNtT�I�'S.lF•�1 n.�11r,'�rtbr. ...:4'iJ•Yta"�i♦
110
Name e v h 1)
ar O
Name: G \1-
Address: 9 6 SD u C SPN-,. ,r�,6,o
ompany: �- w o� eS�� \
City: State:
Address: '� 0 Z 511 Co SQL ^ 5 -
'(� State:��
Zip Code: Fax:
Phone No, 11"111
Zip Code: Fax:
E-Mail:
^ v-�
Phone No. l t a- - .3'ZO ^ `a LA 1(1(
Fill in fee simple Title Holder on next page (if different
E-Mail:
from the Owner listed above)
n
State or County License: �1,3
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
t
A I'4`Y14A fjve'Yµ W wyye�
SUPP IytENT CONS: UGT�.t�Oe�LitI�F IAI/ir' 1,lFyfi�R11%FATI(?N�.�
RP7Y?`CA,,.'t{r..'Si`3b4aY.%+3"aF"i'$..}EY1`"ii�°�SL.�.kP+•siw.d.x.n'Jt
DESIGNER/ENGINEER: _ Not Applicable
Name: 4 • E
oJOc
`�F 5�
'�,. .. �rLUf ti."•(�e�^.�¢�`.h
MORTGAGE COMPANY:
Name:
�! Not Applicable
Address: 0 Aw e !ie
Address:
City:_ Pfc'ej State: F.
Zip: ly9ln Phone-7221 (7-/Z9—_
City.
ZIP: Phone:
State:
FEE SIMPLE TITLEHOLDER: 4 Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
Address:
Address:
City:
City:
ZIP: Phone:
OWNER/ MNTRAr TnD Aennvnr..__1. ..
Zip: Phone:
--• - • •- ... " . nppncation 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
commencing work or rp�cirdino vnnr nb.r:,e —4: r•....,...- i�
wre or uwner/ Lessee faEfor as Agent fo rwri
STATE OF FLORIDA _
COUNTY OF
The forgoing instrument was acknowledged before m
this�aday of �� 20�,by
,1A n iTa rr(- /l- `�
N ersonmaking statement
Person y Known OR Produced Identificati °
,Type o I e ion
Produced
(Signature of N&ary Public- State of Florida
Commission No. (Seal)
REVIEWS FRONT I ZONING SUPERVISOR
COUNTER REVIEW REVIEW
iev. 8/2/17
,OUNTY OF i
The oing instrument was acknowledged before m
this°�-4jayof J7'7r/Lr/%j 202,�'by
Nam rson making statement
Persona nown j OR Produced Identificatio ? i
Type of Iden i ication ..-_.
(Signature of No Public- State of Florida )
`i j
CommissoNo. (Seal)
J�1 � ,•,
'-y ,
PLANS VEGETATION SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW