HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLIICABLE 6 FO MUST BE CO____. ETED FOR APPLICATION TO BE ACCEPTEGI
Date: J Z �l SCANNED Permit Number:
BY
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�. St. Lucie County
Building Permit Application
-11anning 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 _4
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 772U i
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Legal Description: U-2)
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Property Tax ID #: 37_1$()t00S70004K Lot.No. i4Ol
Site Plan Name:
Project Name:
Abacks Front Back: Right Side: Left Side:
Block No.
14W
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it
workto e�jer orme un ert is permit -c ec a apply:
[HVAC L_I Gas Tank ❑Gas Piping a _ Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers E Generator 1:1 Roof
Total Sq. Ft of Construction:
Cost of Construction: $ `�`7"oO
E
Name &1717/"e-
Address: %eyOgl 4_)-7,
City:
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
Name:
Company:
State: Address: 226—V /01,0 ;-7
Zip Code: 3Sa Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
City: C-%ari71, State: 11Y
Zip Code: 3 31C;�Fax:
Phone No. 36E= .7 `/ '-2-S216-
E-Mail: 6e?eb &1Y'a,912W1'/ pewy"
State or County License:
it value or construction is >LSuu or more, a RECORDED Notice of Commencement is required.
.'ESIGNER/ENGINEER: —Not AppiCd le MaRTGA,GECOMP Ny: Not Applicable
.ame: Name'
Address: Address:
State: City: State.
.1p: Phone: Zip. Ph ne:
FEE SIMPLE TITLEHOLDER: , Not Applicable BONDING COMPA Y: Not Applicable
Name: Name:
Address: Address:
City: City -
Zip: Phone: _ Zip: Ph me:
I certhly that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representatlon that isgranting a permit will authorlxe the perml holder to build the subject structure
which is in conflict with any applicAb 2 Home Owners Association rules, bylaws or and Cove ants that rtnay restrict or prohibit such
structure. Please consult wlth pour Hama C+wners Association and review your dead restrictions which may apply,
!, consideration of the granting of this requested permit, i do hereby agree that I will, in all wpects, p(06rm the work
accordance with the approved plans, the Florida Building Codes and St, Lucie County Am ndments.
' ie following building permit applications are exempt from undergoing a full concurrency view, room additions,
accessory structures; swimming pools, fences, walls, signs, screen rooms and aCcesS01V use to another non-residential use
....11ARNING TO OWNER., Your failure to Retard a Notice of Commencement may exult in your paying twice for
1proventents to your property. A Notice of Commencement must be recur ed and posted on the jobsite
efore the first inspection. If pu intend to obtain financing, consult with lender or an attorney before
STATE OF FLORIDA STATE OF FL
COUNTY OF N%Nm1 bANL COUNTY OF
The forgoing lnstrqment wa knowledged before me The forgoing ins
this � day of 20 14 by this= day of
I
ame of perso" nowledging) (Name of person acki
1 +
I
ignature of Notary Publla State of Florida) ��JS {Signature of Notary,
ersonally Known oR Produced Identification_ Personally ltrtown,
Type of identification Produced F eSZy -4Ua -'?u_-.S[.L,~ I_ Type of Identification
Commission No.
COMMISSION 4FtS1518
No.
Revised 07/15/2014 L97) 39M15.9 FwWallotmseroce.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATI
COUNTER REVIEW REVIEW REVIEW REVIEW
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jrnA(,S
Ho
iAMI
owledged before me
---i 20__14 by
15tate of Florida) p'105
OR Produced Identification 'm
rCed C47—A - CZ0 - iy •
re"
Na"ALVIS MA
MV COMMISSION
SEATURTLE I MANGROVE
REVIEW RESIIEW
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It�i?PLEMENTAL CC}NSTRt1C Lt'E tAW tNaRM
ESIGNERjENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
.ame:
_
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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.
!.i consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
I. accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
e 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 opl'RordftVour Notice of Commencement.
Signature of Owner/ ssee
Signature of Con a o / 'cense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF
COUNTYOF Milg1'YII - 1�)Ab►=�
The forgoing instrument was acknowledged before me
14
The forgoing instrkment was�cknowledged before me
T
this day of 20 by
this' day of ?11QG�l 2014 by
�. w IzI GoI'iZA u_z_
ame of person acknowledging)
(Name of person ackno a
111,
ing )
(Signature of Notary Public- State of Florida)
(Signature of Notary,�e prid State of Florida)
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification Produced 662A - 000- _N - UnG`
Commission No. (Seal)
Commission No. al)NALVIS MART
MY COMMISSION #F
IIIEZ
1518
�?
018
Revised 07/15/2014 c4o>> sse-01ss FloridallotaryService.
m
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
! ,.' ATE
)MPLETE
lITIALS