HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLE',
,FOR APPLICATION TO BE ACCEPTED
Date: 1 8.a
SCANNED Permit Number: I ti 1 - O a1 (o
By
St. Lucie County
Building Permit Application
Planning and Development Services
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: Re
kce lqt ktr eo,+llcr
Address: -5913 To.br..
Legal Description: 1A � '. 11:i�uelf-E61C-)A&S-C'1n"4
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DP, r 3,6Q3 —c�278a
PropertyTaxlD#:W 6/0-0375 =OOo - Lot No.
Site Plan Name:
Block No.
Project Name: s i nclraa12 Ale'-
s
Setbacks Front ;, Back:
Right Side: Left Side:
1
Aaartiona wor to a pe orme under t
is permit -check all that apply:
—Mechanical —Gas Tank
_Gas Piping Shutters Windows/Doors
— Electric Plumbing
—Sprinklers —Generator _ Roof
Total Sq. Ft•of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $ I1 -g 0 6
Utilities: — Sewer Septic Building Height:
Names Felix r'lorc$Ph
Name: e
(
Address: -6500 S(�orvM�4o1C
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Company:Qorvdrfpr,6 ftC
City:
Zip Code: 3'i u6L Fax:
Stater
Address: 3°l3 I�I.M/ S` &v4Ford h
City: POr� jnY Lcrzc State: Fl
Phone No. ( CC L) 856 -.�69A
Zip Code: 3(49V3 Fax:
E-Mail:
Phone No�g110
Fill in fee simple Title Holder on next page ( if different
E-Mail
State or County License CF=ClI- ?.G
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required.
Not
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip: Phone:
NG COMPANY: _Not Applicable
Name:
Address:
City:
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
commencing work or recording your Notice of Commencement.
2 C 2,C �piL`462
4i/./�
Signature of Owner/ genftJtessee ontractor
Signature of Contractor/License Holder
STATE OF FLORI A
COUNTY OF 1V C ,_e
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledge before me
The forgoing instrument was acknowledged before me
this o_'OL day of (V c)J 20 1by
this 20 day of Ivor 2o3_li by A k be, b o
yel'x povejoh
A1
( ame oon ackn dging)
(Name f p son ack ewledging )
I )fk
;.i
(Signature of Notary Public- State of Florida)
(Signature of Notaryublic-State of Florida )
.' J
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of ]den 'fca ion —` ^
Produced t s �: t h lAL T Ufa
T qeo dentifcatio ti, y V°'dA LT' GC
lip educed Y C
n •;� MY coMR91SSlOq
�? I/Y COMP tot�€3
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" CXPIRE&Dec mbZ
Commission No. � 2-l"I-ZOIS, ?, (g d1) C;.�'�.3ES Deccr•.3Comrfi33io
No.�7&11 meal)
ilny :9 i rmrEa�b@rySOM1i6
FtCr .NGWrYSE
M.0.T11
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014
201