HomeMy WebLinkAboutBuilding Permit Application ALLAPPL:ICABLEINFO MCISr BE(X>jMPLEM F ORAPPL.ICAnON TO BEAD
Cate: a�IT1T Permit Number:
RECEIVED
Building FLrmitiication
�' APR 2 9 2015
Hanning and Development Srvices
Building and Code Fegulation Division
2300 Virginia Avenue,Fbrt Fierce R34982
Phaner.(772)462-1553 Fax(772)462-1578 Commercial FWdential
PEWITAPPUCAMONFOR To Select from dropbox, click arrow at the end of line
PFM:)iM VEMEN'TLCC'AMOM
Address: ,l r7 �tl1s' �o ll'4 4 A
Legal Desca'iption:
Property Tax 1D# - s J' - 64 0.7 - -3 Lot No. .'
Ste Elan Name. Block No. 7�
Project Name:
Setbacks Front Back: Right Sde: Left Sde:
-AiLE3]DEM9FMON OF WOW
tori wflr a e e orm under Iffispermi —crieckali ma appy:
CIHVAC HCes Tank ❑Gas Esping 1-1 CGenerator
Slutters LlWindows1Doors
CElectric IzPlumbing �EPrinklers Fbof
Total Eti. Ft of tG�nstruction: Ft.of First Floor:
Cost of Construction: - �: fl`�a Utilities tenter 9wptic Building Height:
CVB:;YL� C ONTPACTOR.
Name :57Z,- Ntme: S�'`:
Addrem 6O f 4ei.0 c,x-Z,!g.& C)mpany: (57 c- e-S r S
aty: Elate:e Address: �+ s �D �' ►-. �"
7pObde: 3 'Y1,T3 aty: state-
!r No. -7 7..2- .5' .7 moi "tea J- Zip code! 3 r,� Fax 919- �gaa
E-Mail: l-honeNo. -7
Fill in fee simpieTitle Holder on next page(if different E-Mail: je-oT e r,,`r
from the Owner listed above) Sate or County License
If value of construction is$2500 or more,a F800FCM Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Ad d ress: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Dame:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 our Notice of Commencement.
—Signature o Owner/Lessee/Agen gerfffure o"f Con ractor/license Hofc��
STATE OF FLORIDA STATE OF FLORIDA i
COUNTY OF
COUNTYOF SW Lr�cf`
The forgoing instrun•ient was acknowledged before me The forgoing instrument was acknowledged before me
this `'d of_ -"ice} ( 26 1`j by this ,> �tday of 20 by
.
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(Name of perso acknowledging) (Name of person ac how edging)
{Signature of Notary Public-State of Florida) 04nature of Not ry,Public-State of Florida)
Personally Known V/OR Produced Identification Personally Known �___OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.), (Seal) Commission No. {S al
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Revised 07!1512014 lelnnog y aiuuog %8�dj ;��� 'rra. `wrw.AARCnNo7nRrcem
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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