HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lI-/.- Permit Number:
RECEIVED
Building Permit Application MAY 13 2015
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:
PROPOSED fNPR®UEM'EMNT @CAl1QN;
Address: //;5- /2464 OvJ, 5-e,15-e4 54e-44 { �. 3/7J� 7
Legal Description: ,/1190/es 2S')uv+d/ 54c. 7
Property Tax ID#: q Dot - 6--0/ -131,2 - D00 Lot No.
Site Plan Name: /l/e7t1Ql Block No.
Project Name: /10r //,)-
Setbacks Front Back: Right Side: Left Side:
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DETAltED DE�SCRI°OPTION OF WOR
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Itionalwork to be performed under this permit-check all tat appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _PlumbingRoof
_Sprinklers _Generator If-Ly_
Total Sq. Ft of Construction: d5-/c/ Sq. Ft.of First Floor: o-�' /
Cost of Construction: $ 1700.00 Utilities: Sewer _Septic Building Height:
Q�111/NER/LE SE=E: N. �` �` k
SCONTR°ACTOR: T 3
_ �t
Name ea We/- S'?A5 _Toc- Name: -5
Address: ` Y1 S. Ocean Company: -zr
City: JenSeq &,uck State: /Z• Address: 46/ A/• f. J-4eAcer S7�
Zip Code: 3%957 Fax: City: Jchs'e4 3e,,,c4 State: FZ.
Phone No. 772--�2 Zig - $4�6 Zip Code: 3119577 Fax: 77;�-132 -.1gy91/
E-Mail: /7� /29aY;/?a Cd eu,-fh/in4 o hef Phone No 77)- )JO `3715-
Fill in fee simple Title Holder on next page(if different E-Mail raW"-'Yn5 �""rA i4 c (�) •C9r�
from the Owner listed above) State or County License 1.2 /9 I
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
05/14/2015 08:10AM 7722322191 ADAM SMITH PAGE 02/02
DESIGNName: ER/ENGINEER. Not Applicable MORTGAGE COMPANY: Not Applicable7
Name:—
Address: Address: 7
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:
OWNER/CONTRACTOR AFFIDVrT: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 'strict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions Y14iLch may apply.
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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_
Thefollowing 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 ormcording your Notice of Commencement.
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORID__ STATE OF FLORIDA
COUNTY OF _._rOUNTYOF_
The forgoing instrument was acknowledged before m #The forgoing instrument was acknowledge O before me
this day ofQ2 4y) 20 by his 1Y dayof/ 20 by
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(Name of Name of fn person acknowledging)
person acknowledging) ?s I I
Cap
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to
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—(Signature otary Public-State of Flo4da Not r Public-state of Flo flda)
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Personally Known OR Produced Identificatio ersonally Known OR Produced Identification t
Type of Identification Produced Type of identification Produced
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.7/ZU14