HomeMy WebLinkAboutBuilding Permit Application To: Page 3 of 5 2015-07-20 18:52:31 ,(GMT) 17726733383 From: Maritza Ramirez-Carpenter
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; ?•Z.0. Is- Permit Number: sdi —43.,M
�f>lii»
WA
JUL 2.11015
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 3498.2
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: ?,6N E- I- ti 'C) I=' ►e -€ �=L .S 141 - -
Legal Description: i�E'tX tt:: �{ t�:�F -�, Vt.,t S�� �'a 1
Property Tax 1D#: 13 a _ Co O O 14. - 0 O O - Lot No.
Site Plan Name: Block No.
Project Name: IE•t:�� e' %IC;�Y►Cr QCs 46:{( � L<c:_tai � .��:'.c��r
Setbacks Front Back: Right Side: Left Side:
r•w S{ sr 2 zx ,r r{i rl.;, K ..n„,r i.'".,.a G y (r
14 ' -3
4. ,
-'� '�{'�`�A srf+�r a�.� F a�
4 sTMz.4
'hk cik r -t1\, tiF r '*N'3-f # .�s`ass „t..' -fi �y
S'" ' ',� Ir - l< ..'.
Gam„
rtiona wor to a pe orme un er t is permit-cneCK all tat apply:
_Mechanical _Gas Tank Gas Piping T Shutters Windows/Doors
_Electric L/Plumbing _Sprinklers _ Generator Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ Utilities: _Sewer .Septic Building Height:
=tk5��'G Fti ,c r- rr74 -
Name z 1 c>�` _s E 4� Ct.('J 1 Name: I K 4i'd c' S �U V3
Address:'S,' ( �7 ��!fit L��9�rt� Company: r1�cL ''�1 s1
City: 17-f Pie"y .t...
State:�L Address:(���7 SL;• `.� ,
Zip Code: ��1 Fax: City; f”�G- State:
Phone No. ��� �rR✓�✓' l` Zip Code: Fax: G,;7
E-Mail: Phone Noj )
Fill in fee simple Title Holder on next page(if different E-Mail i1) (=%i11eP.d ie,-R +ti`'i'Gl�ii%�} <� �
from the Owner listed above) State or County License-V?t'.,. `-i �, g
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. ��
To: Page 4 of 5 2015-07-20 18:52:31 (GMT) 17726733383 From: Maritza Ramirez-Carpenter
C Yyy1 L 'yW, 5��.l+
`,u.. d.t r S>.9-�Uts•E,..x �',�. i ., _ •.Fr v,k.4 ;� :r..
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER; ____Not Applicable BONDING COMPANY: Not Applicable
I Name: Name:
1 Address: Address:
City: City:
I Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: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 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 pern•►it applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,wails,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. Notice of Commencement must be recorded and pos d on the jobsite
before the first' spection. If y intend to obtain financing, consult Jhlender or an orney before
comme in rk r recordi our Notice of Commencement.
A e, �M:�yv
Signature of Owner/Age t/Lessee/Contractor Si nature of Contractor cense Holder
f STATE OF FLORIDA _-.. STATE OF FLORIDA
# cvuNTv of COUNTYOF
54,
I The forgoing instrument was acknowledged�efore me The forgoing instrument was acknowledged before me
this day of t 20 .S by this .Z%day of J ku)1, 20l.-�by
;± MICHAEL GERHART :yt"' MICHAEL
'My COMMISSION ' ``.'.:5u34 'Y:f�dY C(AWISSION#r�FZit
(Name of person acknowle &...,i ,:�:., r�wul»Nwu•s,�Ke;�• Name of person ackno j g. , � aurdwa sr.7�u
I (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known _OR Produced Identification Personally Known V OR Produced identification
Type of identification Type of Identification
Produced Produced
i Commission No. (Seal) commission No. (Seal)
r
#i REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
1 COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED I I
DATE
COMPLETED
ev.