HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 al0 5 Permit Number:
RECEIVED MAY 0 2015
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: To Select from dropbox, click arrow at the end of line v �L
PROPOSED IMPROVEMENTfLOCATlO'N j
461 F_
Address: 14010 e;Z S- (�
Legal Description:
PropertyTax ID#: Lot No.
Site Plan Name: R'7`-/i'147-5'147-5QCs -,C(orn 119 iy Block No.
Project Name: Pa4r/c(/9 E -z-v iz
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRtPI-ION�OF'W,ORK -
l(C fwg U 7 rl�� �`�f) S S� �(z 0- )N
CONSTRUCTIQN INFORMATION
Acla
itiona wor to a er orme un er t is permit—c ec a tat appy:
_ VAC Gas Tank Gas Piping ❑Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: /,o 5 3 5- Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: a Sewer[]Septic Building Height:
OWNER41
/LESSEE ,CONTRACTOR
Name a 4N2 me: c `G' U3 A
.3 tmpany:Address: ,Q�O OCEA n L.I o �L ��/ (
city: �`i=i15�h. State:_ Address: SIS ( S" 47 `}):�--
Zip Code: .3q Fax: City: Fl v State/: FL
Phone No. ,42_`�6p^ `�yS� Zip Code: Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: Wr111,7>
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SIPPLEMENTAL CONSTROCTIONiLIEN LAIN INFORMATION i;
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: 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 thepermit 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 o n attorn before
corpA4P_Qcing wor recording our Notice of Commencement. i
s
S ature of Owfier/Lessee/Agent Signature of Contractor/Licens Holder
STATE OF FLORIDA STATE OF FLORIDA 1
COUNTY OF ���y3 ti-M` , COUNTY OF /v�"c'�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_,4fday of this 15 day of 7 20 ,S by
AMA (ROBERT J CARVALHO —�'� '��
ROBERT J CARVAILH0.
MY COMMISSION#EE183283 �It�1? . MY COMMISSION#EE1832&
r_a MEIFe
(N ( p ( t� EXP RES March 26 2015
Name of p �.person ackn Fioa�a Name of person acknowl d'# ,
ors�rrke.ccxn FlmldaN Darn
(Signature of Notary Public-State of Florida) (Signature of Notary Public- tate of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced )>L Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS