HomeMy WebLinkAboutBuilding Permit Application i
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a� 115 Permit Number: 5d-1 d y3
RECEI�'TD JUL 9 2015
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Building Permit Application
Planning cnd Development Semites
Building cr-d Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL.34982
Phone:(772)462-1553 Fax:(772)462-1578 ft'tmef`tt4 Residential
PERMIT APPLICATION FOR:
PRt)POSEC ,l ROVEt1t W(WCATIQ I„
r n�.
Address: 28d-q Nes*
Legal Description: R A S -Zl
PropertyTaxlD#: �c}-Z�}-']per-�,Irjn--Dr,�^2 Lot No.
Site Plan Name: leg hJQS± Way Block No. LPZ
Pr�jeti'ttaTtre:
Setbacks FTvnt Beek: Rtg}rt-5ide`:` L-eft-57de:
I:TAILED I��fiCRfPTION=t3F"W-WORK-IM v
m eso., .. ,, nr: _. e
, e Marg and
Ca Yn Q10A liter� (Uy 5-\Isiem
CONSTRUCI`rQN
IM016N: "k
Additional
itiona woricto lie performed under this permit-check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters /Windows/Doors
Electric _Plumbing _Sprinklers _Generator -/ Roof
Total Sq.Ft of Construction: 'LCA �f 2C Sq.Ft.of First Floor:_ f�L-�c
Cost of Construction: Z,7; C)0 Utilities: —Sewer _Septic Building Height:�l
1f)CyNER/LESSEE ``' CC1tVTRACTC1yR*
Name ' Name:
Address:
Company:
p y:
City: �,f,ztrT� sAa tP —�---State: Address:
Zip Code:3tfgSj 2 Fax: NJ It City: P+ R
• Q>G,ce
—State:-EL
Phone No.110-9V,,, 3D(ol Zip Code: 3 -iFax:
E-Mail: Phone No. -112-2�?J
Fill in fee simple Title Halder on next page(If different E-Mail:
from the Owner listed above) State or County License; Q�
If value of construction Is 2500 o more,a RECORDED Notice of Commencement Is requireUV WTI
.
Notary Public-Michigan
Berrien County
Scanned by CamScanner My Commission Expire ul 29;2017
Acting in the County of'UTridn
i
1
SUPPLEMENTAIr1CON�`TR1JC-'f ON Ll"" t'l tf INFQRMATI�}N: °x �a q
DESIGNER/ENGINEER: Not
Applicable-MORTGAGE COMPANY: Not A abs
Name: Name:
Address: Address:
City: �. State: City: State:
Zip / Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: N icable BONDING COMPANY: Not plakatste
Name: Name:
Address: Address:
City: City:
Phone: Zi 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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in wnflict 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 Commencemen y resul 1 your p nl tm for
improvements to your property.A Notice of Commencement must record lPtd p on the j6bsite
before the first inspection.If you intend to obtain financing,cons with 1e br ttorn before
commencing work or reWding your Notice of Commencement/
w3
` gh lure o Agent/lessee, Sire of Contractor f License der
STATE O -� STATE OF FLORIDA
COUNTY OF COUNTY OF S+ Lucie
The forgoing instrum rit was acknowledged before me The forgoing instrument was acknowledged before me
this day of T0 20E by this Z�day of Jk(V _ 20!x, by
(Up �hri s�ph�x- Ca li n5
( e f person acknowi in } (Name of person acknowledging)
C,(wyt t_ CUAI
(Signal r ' Notary Public-State d4lerida} (Signature of Notary Public-State of Florida}
Personally Known OR Produ ed identification Personally Known i� OR Produced identification
Type of Identification Produced Lt Type of ide '
.t CONNIE CHILDS
Commission No. CNRISTOP cn T"MPSON mmissio (gyp A �`t+
otary P is-Michigan MISSIOtlaissas7
Berrien County i .® @ti4Qr EXPIRES August 31,2017
My mmiss on Expires Jul 29, 2017 ia®ri eats,olsa Fi tidallotaryServicex m
REVIEWS INTActiniWMI(I{unty ifSiipFRVtSrtgLANS VEGETATION SEATURTLE MANGROVE
CO VIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.772014
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