HomeMy WebLinkAboutBuilding Permit Application NARY-05-2015 vvT--U��E (01 :46 Pf,� CENTRAL SCHEDULING FAX No. 32126861"
Date-o/n/ 10— Permit Number:
ra c I
Building Permit Application
Planning and De velopment Services -
Building and Code Regulation Division
2300 Vir'glnla Avenue,Fort Pleme FL 34982
Phone (772)462-1593 t=ax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox,.cliclt arrow at the and of line
•�.:lt .I y.. pPl. i',�1, t i1,. j• i., j�'i,i:' i Ufa •.' .i ,"T :�•i7Fti1 i d~�. i+t ?? �'.' 1'bF.l .t
Address;. 1
!regal Description:
Property Tax Ib# I �' '' LotNo.
Site Plan Name: _ Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side:
11,
Nzr' it ¢P' .. j�iF �f ✓ r i., i,1 l�tij;.ik. �1N 1> d. w:r$ h.^k
4 �, �e ai I�,?4. ti •,v� TySn"m i t� '� P S r'�"'{ �f,'�' ul 'Sr�, �. i '('a;" �K S
a� ..11}"li ;3,qd� P t �J� l�k� � ��y�i�W tl:k l�. �IA�� jt � y �`'� 5�; •F Ile 7� P7$i t �`1 ate ,d
rtlona work to be nertormed un ert. is perms —c kFaif apply:
VAC Gas Tank Deas Piping _Shutters windows/Doors
Electric El Plumbing 05prinkiers Generator Roof
Total Sq.Ft of Construction:_ S .Ft.of First Floor:
Cost of Construction:$ gam utilitlestSewer O Septic Ullding Height:
n nt K"'trav R> a 4� P,•.;ro T a vy i o f
" "
rc x „ft .5s`�'erj% 9 �f• 1 l ' x P'
Name Name:
Address: o Compan : , V9P
City 1 State:j—�-- Add r ss I
Zip Code: { Fax' City inf CAstate_1ir'1
Phone No�1�, J�Q` � Zip Code:} Fax:1n z-9-3
30
E-Mail: — -- Phone No. i 1-515
Fill in fee simple Title Holder on next page(if different F-Mail: "� ���� m, '0
from the Owner listed above) State or County License:
44,
If value of construction is$2500 or mare,a RECORDED Notice pf Commencement is required.
MAY-05-2015 TUE 01 :46 PM CENTRAL SCHEDULI-NG FAX No. 3212686138 0
�f rtY§.pt [�p yF l9T`t rx i 1 a yvip�� R� p 6
1�• YN
Iv`S.$'!J t Ear "}`�'� '4x11`.lt � �5{t ;(} t }'• Z i.?tt itt �u �� {} r(�y.�i� `f",Su'�. r =�r,61'.� t�� '?
�i1±5)3GNERJEi41GltEER: T Not Applicable
MORTGAGE COMPANY., Nat Applicable
Marne: Name:
Address: , Address:
City: state: City: State:
dip: Phone: Zip. Phone:
EEE 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.
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 rnay result in your paying Mice for
improvements to your property.A Notice of Commencement must be recorded and pasted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencin work or recording your Notice of Commencement.
f�
Signat re of Owner/ ent/Lessee signature of Contractorf L ense Holder
STATE OUN Y FLCrR1D�- BO STATE£}F FI OR 4
COUNTYOF LBO(� COUNTYOF �.._.
The fo Ding ins gas acknowledged before me The f going Instru nt as acknowledged before me
this day of 20 by this day of��26 fey
ba)ircel IL�' PNO�� r�(Nameof person acknaw edging) person acknowledging
fA
Signature of Nota�ry li
Pubc- tate of F ida) {Signature of Notary Public-State of Fior }
Personally Known x/ OR Produced Identification Personally Known OR Produced Identification _
Type of Identification Produced Type of identification Produced
r� + w
Commission N❑.'C4 �,5� 9 • �Fp 3� Commission NJ(_t12,-6-1 7 r +p C $ PlYme t0E8�@3
M
OCT 28,241 - W61ssloa#FF172372
aoxoao x>wtBu �,i lrew OCT 29,2018
�02tIT$
—� 0,11101+
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW R£VIEW�
CWTE
CO1V1 PLErE
INITIALS